TY 2023 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) KENNETH P DEFURIO...................................................................... PRESIDENT & CEO	20.00 ................. 40.00	X	X	1,082,276	0	23,946
(2) PAUL BACHARACH...................................................................... CHAIR	4.00 ................. 5.00	X	X	0	0	0
(3) TIMOTHY MORGUS...................................................................... VICE CHAIR	4.00 ................. 5.00	X	X	0	0	0
(4) PATRICK HAMPSON...................................................................... SECRETARY	2.00 ................. 5.00	X	X	0	0	0
(5) JEFFREY CURRY...................................................................... TREASURER	4.00 ................. 5.00	X	X	0	0	0
(6) ANIE PERARD MD...................................................................... TRUSTEE/PHYSICIAN	3.00 ................. 50.00	X		0	360,954	20,625
(7) JOHN REEFER MD...................................................................... TRUSTEE/PHYSICIAN	40.00 ................. 5.00	X		247,100	0	0
(8) LARRY RICHERT...................................................................... TRUSTEE	1.00 ................. 5.00	X		0	0	0
(9) JAMES ADISEY MD...................................................................... TRUSTEE/PHYSICIAN	3.00 ................. 50.00	X		0	590,481	27,986
(10) TERESA PETRICK...................................................................... TRUSTEE	1.00 ................. 5.00	X		0	0	0
(11) JOHN SPHON...................................................................... TRUSTEE/FORMER PRESIDENT & CEO OF EXCELA HEALTH	1.00 ................. 59.00	X		0	435,322	27,599
(12) DEBRA THOMPSON PHD RN...................................................................... TRUSTEE	1.00 ................. 5.00	X		0	0	0
(13) DAVID ROTTINGHAUS...................................................................... PHYSICIAN & PROVIDER NETWORK PRESIDENT	40.00 ................. 20.00		X	633,696	0	26,064
(14) NORMAN K BEALS...................................................................... CHIEF WELLNESS OFFICER	40.00 ................. 20.00		X	292,583	0	22,198
(15) MICHAEL FIORINA DO...................................................................... ASSISTANT CHIEF MEDICAL OFFICER	60.00 .................		X	439,813	0	26,419
(16) KAREN ALLEN...................................................................... PRESIDENT, BUTLER MEMORIAL & CLARION HOSPITALS	40.00 ................. 20.00		X	503,584	0	26,572
(17) THOMAS GENEVRO...................................................................... CHIEF HUMAN RESOURCES OFFICER	40.00 ................. 20.00		X	374,593	0	26,592

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(18) KATHY SELVAGGI........................................................................ CHIEF COMMUNITY HEALTH OFFICER	60.00 .......................	X			287,794	0	22,929
(19) ROGER LUTZ........................................................................ CHIEF INFORMATION OFFICER	60.00 .......................	X			378,451	0	26,332
(20) HILARY HARLAN........................................................................ CHIEF COMPLIANCE OFFICER	45.00 .......................15.00	X			187,498	0	17,054
(21) THOMAS S ALBANESI JR CPA........................................................................ CHIEF FINANCIAL OFFICER	20.00 .......................40.00	X			0	503,655	33,620
(22) CAROL J FOX MD........................................................................ CHIEF MEDICAL OFFICER	20.00 .......................40.00	X			0	511,325	22,697
(23) RANDY TEWKSBURY........................................................................ EXEC DIRECTOR OF REVENUE CYCLE	45.00 .......................15.00		X		216,371	0	18,682
(24) MELINDA HILDEBRANDT........................................................................ CNO	40.00 .......................		X		211,143	0	10,267
(25) MATTHEW SCHNUR........................................................................ PHARMACIST	40.00 .......................		X		201,150	0	23,952
(26) DAVID DILLON........................................................................ CHIEF INTEGRATION OFFICER	40.00 .......................		X		379,388	0	21,007
(27) PAMELA HEPP ESQ........................................................................ GENERAL COUNSEL	40.00 .......................		X		489,925	0	788
(28) STEVEN DAVIS........................................................................ FORMER PRESIDENT CLARION HEALTH	0.00 .......................			X	493,486	0	20,909
(29) ERIC HUSS........................................................................ FORMER CHIEF FINANCIAL OFFICER	0.00 .......................			X	478,650	0	7,307

(A) Name and business address	(B) Description of services	(C) Compensation
ABBOTT LABORATORIES INC 22400 NETWORK PLACE CHICAGO,IL606731224	PHARMACEUTICAL SERVICES	3,369,902
BECKMAN COULTER INC DEPT CH 10164 PALATINE,IL600550164	DIAGNOSTIC SERVICES	2,513,136
OMNICELL CAPITAL PO BOX 35145/LB 271128 SEATTLE,WA981245145	PHARMACY MANAGEMENT	2,037,954
BUTLER ANESTHESIA ASSOCIATES PC PO BOX 645587 PITTSBURGH,PA152645253	ANESTHESIOLOGY	1,822,906
ZIMMER BIOMET 14235 COLLECTIONS CENTER DRIVE CHICAGO,IL60693	PHARMACY MANAGEMENT	1,538,339
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 61

- 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

2023

Open to Public
Inspection

Name of the organization

BUTLER HEALTHCARE PROVIDERS

Employer identification number

25-0965274

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) 2023

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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. 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—2022. 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—2023. 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—2022. 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) 2023

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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. 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—2022. 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) 2023

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) 2023

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) 2023

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) 2023

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 2023 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-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, 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 2023. 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 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

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) 2023

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

2023

Name of the organization

BUTLER HEALTHCARE PROVIDERS

Employer identification number

25-0965274

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) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization BUTLER HEALTHCARE PROVIDERS

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) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization BUTLER HEALTHCARE PROVIDERS		Employer identification number 25-0965274

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) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization BUTLER HEALTHCARE PROVIDERS			Employer identification number 25-0965274
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) (2023)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

right arrow

Complete if the organization is described below. 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

2022

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

BUTLER HEALTHCARE PROVIDERS

Employer identification number

25-0965274

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... right arrow

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... right arrow

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ right arrow

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... right arrow

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990) 2022

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check right arrow

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check right arrow

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2022

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

49,413

Total. Add lines 1c through 1i ....................................................................................................

49,413

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	A PORTION OF THE ANNUAL DUES PAID TO THE HOSPITAL ASSOCIATION OF PENNSYLVANIA AND THE AMERICAN HOSPITAL ASSOCIATION ARE USED FOR LOBBYING.

Schedule C (Form 990) 2022

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.
right arrow

Attach to Form 990.
right arrow

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

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

BUTLER HEALTHCARE PROVIDERS

Employer identification number

25-0965274

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 July 25, 2006, 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 right arrow

Number of states where property subject to conservation easement is located right arrow

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
right arrow

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

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 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

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

Cat. No. 52283D

Schedule D (Form 990) 2022

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 ....	467,911	454,304	453,377	452,697	447,823
b	Contributions ...
c	Net investment earnings, gains, and losses	17,992	13,607	927	680	4,874
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	485,903	467,911	454,304	453,377	452,697

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

Board designated or quasi-endowment right arrow

Permanent endowment right arrow

100.000 %

Term endowment right arrow

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)

Yes

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

Yes

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 .....	2,744,128		2,744,128
b	Buildings ....	113,125,050	68,012,502	45,112,548
c	Leasehold improvements	8,632,130	7,118,012	1,514,118
d	Equipment ....	274,794,804	214,851,331	59,943,473
e	Other .....	15,992,975	9,403,022	6,589,953
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				115,904,220

Schedule D (Form 990) 2022

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)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

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)INVESTMENTS IN AFFILIATES	20,585,211	C
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)	20,585,211

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)OTHER ASSETS				7,307,644
(2)DUE FROM THIRD PARTY				4,430,960
(3)DUE FROM AFFILIATES				54,841,553
(4)RIGHT OF USE ASSET - OPERATING				2,029,669
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				68,609,826

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
DUE TO AFFILIATES	30,152,302
ACCRUED INTEREST PAYABLE	2,404,109
OPERATING LEASE LIABILITES	2,897,381
457(B) PLAN LIABILITIES	1,817,769
SERP PLAN LIABILITIES	3,192,874




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	40,464,435
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) 2022

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 V, LINE 4:	INVESTMENT EARNINGS WILL BE USED TO SUPPORT BUTLER HEALTHCARE PROVIDERS OR OTHER RELATED ORGANIZATIONS PER THEIR RESTRICTIVE PURPOSE (E.G. TECHNOLOGY AND CHARITY CARE) OR IF NO RESTRICTIVE PURPOSE, AT THE DISCRETION OF THE BOARD TO SUPPORT ITS MISSION.
PART X, LINE 2:	MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.

Schedule D (Form 990) 2022

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 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

BUTLER HEALTHCARE PROVIDERS

Employer identification number

25-0965274

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? . . . . . .

Yes

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

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

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

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) . . .	494,353		494,353	0.170 %
b	Medicaid (from Worksheet 3, column a) . . . . .	32,097,968	17,247,997	14,849,971	5.180 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	381,430	398,127	0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	32,973,751	17,646,124	15,344,324	5.350 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	97,903		97,903	0.030 %
f	Health professions education (from Worksheet 5) . . .	250,236		250,236	0.090 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	121,842		121,842	0.040 %
j	Total. Other Benefits . .	469,981		469,981	0.160 %
k	Total. Add lines 7d and 7j .	33,443,732	17,646,124	15,814,305	5.510 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

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.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
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

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. ......

9,808,572

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).....

30,227,011

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

30,514,653

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

-287,642

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %
11 BUTLER PHYSICIANS REALTY LLC	LEASES MEDICAL OFFICE SPACE	16.670 %	11.110 %
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2023

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	BUTLER MEMORIAL HOSPITAL 1 HOSPITAL WAY BUTLER,PA160014670 WWW.BUTLERHEALTHSYSTEM.ORG	X	X	X

Schedule H (Form 990) 2023

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)

	BUTLER MEMORIAL HOSPITAL
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 22

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

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): INDEPENDENCE.HEALTH/ABOUT-US/COMMUNITY-WELLNESS

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 22

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

Yes

If "Yes" (list url): INDEPENDENCE.HEALTH/ABOUT-US/COMMUNITY-WELLNESS

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) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	BUTLER MEMORIAL HOSPITAL
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 200.000000000000%
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):

INDEPENDENCE.HEALTH/PATIENTS-VISITORS/FINANCIAL-SERVICES

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

INDEPENDENCE.HEALTH/PATIENTS-VISITORS/FINANCIAL-SERVICES

A plain language summary of the FAP was widely available on a website (list url):
INDEPENDENCE.HEALTH/PATIENTS-VISITORS/FINANCIAL-SERVICES

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) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	BUTLER MEMORIAL HOSPITAL
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) 2023

Page 7

Part VFacility Information (continued)

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

	BUTLER MEMORIAL HOSPITAL
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) 2023

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
BUTLER MEMORIAL HOSPITAL	PART V, SECTION B, LINE 5: THERE IS NOT A COUNTY HEALTH DEPARTMENT IN BUTLER COUNTY OR ITS PRIMARY SERVICE AREA. CURRENTLY, PENNSYLVANIA HAS SEVEN COUNTY HEALTH DEPARTMENTS (ALLEGHENY, BUCKS, CHESTER, DELAWARE, ERIE, MONTGOMERY, AND PHILADELPHIA) AND FOUR MUNICIPAL HEALTH DEPARTMENTS (ALLENTOWN, BETHLEHEM, WILKES-BARRE, AND YORK). SEVERAL PUBLIC HEALTH PROFESSIONALS WERE CONSULTED IN THE PROCESS OF THIS COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDING ALLISON ROTH, MHA CANDIDATE (MASTERS IN HEALTH ADMINISTRATION) FROM THE UNIVERSITY OF PITTSBURGH GRADUATE SCHOOL OF PUBLIC HEALTH. SHE WAS A MAJOR CONTRIBUTOR IN DATA COLLECTION AND ANALYSIS.IN JUNE OF 2021, REPRESENTATIVES FROM MANY ORGANIZATIONS WITHIN THE BUTLER COMMUNITY CAME TOGETHER VIA ZOOM (DUE TO COVID RESTRICTIONS) TO DISCUSS THE STRENGTHS AND NEEDS OF THE COMMUNITY. INPUT WAS GATHERED FROM A WIDE RANGE OF INDIVIDUALS AND ORGANIZATIONS THAT REPRESENT THE BROAD INTERESTS OF THE BUTLER REGION; THIS WAS COMPLETED THROUGH A VARIETY OF METHODS INCLUDING INDIVIDUAL ZOOM MEETINGS, GROUP ZOOM MEETINGS, SURVEY MONKEY QUESTIONNAIRES AND PHONE CONVERSATIONS.MULTIPLE MEETINGS WERE HELD TO IDENTIFY THE TOP HEALTH PRIORITIES WITHIN THE PRIMARY SERVICE AREA OF BUTLER COUNTY. BUTLER MEMORIAL HOSPITAL (BMH) COLLECTED HEALTH DATA FROM COUNTY HEALTH RANKINGS, CENTERS FOR DISEASE CONTROL AND PREVENTION, WORLD LIFE EXPECTANCY, PAYS, AND US CENSUS. 529 COMMUNITY MEMBERS COMPLETED ELECTRONIC AND PAPER SURVEYS TO PROVIDE ADDITIONAL DATA AND 36 COMMUNITY STAKEHOLDER SURVEYS WERE ALSO COMPLETED.PARTICIPATING ORGANIZATIONS:- ALLIANCE FOR NON-PROFIT RESOURCES (ANR) - FOOD INSECURE INDIVIDUALS- BUTLER AREA SCHOOL DISTRICT- BUTLER COUNTY CHILDREN'S CENTER- CHILDREN AND LOW-INCOME FAMILIES- BUTLER COUNTY COMMUNITY COLLEGE- BUTLER COUNTY HUMAN SERVICES- AGING, DRUG AND ALCOHOL, CHILDREN & YOUTH, FAIR HOUSING- BUTLER COUNTY PARKS AND RECREATION- BUTLER MEMORIAL HOSPITAL-CARE MANAGEMENT- BUTLER TRANSPORTATION AUTHORITY- CATHOLIC CHARITIES OF BUTLER COUNTY- PEOPLE LIVING IN SHELTERS, HOMELESS OR AT RISK OF BEING HOMELESS, EXPECTANT AND NEW MOTHERS- CENTER FOR COMMUNITY RESOURCES (CCR) - HOMELESS, CHILDREN AND ADULTS WITH MENTAL ILLNESS (INCLUDING SUBSTANCE USE), INTELLECTUAL AND DEVELOPMENTAL DISABILITIES, VETERANS, HIV + INDIVIDUALS- COMMUNITY CARE CONNECTIONS- INFANTS, CHILDREN AND ADULTS WHO HAVE DEVELOPMENTAL DELAYS OR DISABILITIES- COMMUNITY OPTIONS INC.- INDIVIDUALS WITH DISABILITIES- MARS AREA SCHOOL DISTRICT- MEALS ON WHEELS OF BUTLER COUNTY- HOMEBOUND INDIVIDUALS- MONITEAU SCHOOL DISTRICT- NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) -INDIVIDUALS WITH SEVERE MENTAL ILLNESS AND THEIR FAMILIES- VETERANS SERVICES- VETERANS- AC VALLEY SCHOOL DISTRICT- ARC OF BUTLER COUNTY - INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTALFOCUS GROUPS MET VIA ZOOM AND DISCUSSED THE DATA COLLECTED FROM ALL THE SOURCES ABOVE. INDIVIDUALS WERE ASKED TO DESCRIBE THE OVERALL HEALTH OF THE REGION. EACH ORGANIZATION WAS ASKED TO IDENTIFY THE TOP THREE HEALTH PRIORITIES FOR THE AREA. THESE ANSWERS WERE ALSO COMPARED AMONGST THE GROUP. THE MAIN THEMES THAT AROSE OUT OF THE FOCUS GROUPS WERE MENTAL/BEHAVIORAL HEALTH, FOOD INSECURITY AND THE ONGOING NEED FOR HEALTH AND NUTRITION EDUCATION AND SUBSTANCE ABUSE AND ADDICTION. OTHER TOP PRIORITY ISSUES IDENTIFIED WERE ACCESS TO CARE, TRANSPORTATION, COVID-19, DIABETES, OBESITY, AND CHILDCARE.
BUTLER MEMORIAL HOSPITAL	PART V, SECTION B, LINE 11: FUTURE STRATEGIES TO IMPROVE MENTAL HEALTH ISSUES- IMPLEMENT A SYSTEM TO COMMUNICATE TO PARENTS AND STUDENTS OF SCHOOL AND COMMUNITY EVENTS TO INCREASE PARTICIPATION IN EXTRACURRICULAR ACTIVITIES.- DEVELOP SOCIAL NETWORKS FOR CHILDREN TO CONNECT WITH EACH OTHER TO HELP CREATE MEANINGFUL RELATIONSHIPS FOR THOSE WHO DO NOT HAVE THE SOCIAL SKILLS TO DO IT ON THEIR OWN.- DEVELOP BETTER REFERRAL PROCESSES TO ACCESS MENTAL HEALTH SPECIALISTS. WAIT LISTS CAN BE LONG AND IT IS DIFFICULT FOR PEOPLE TO RECEIVE PROPER CARE IN A TIMELY FASHION.- THE BUTLER AREA SCHOOL DISTRICT IS IN THE PROCESS OF HIRING BEHAVIORAL MODIFICATION SPECIALISTS TO HELP CHILDREN DEVELOP AND IMPROVE SOCIAL THEIR SOCIAL SKILLS AND INTERACTIONS.FUTURE STRATEGIES TO IMPROVE SUBSTANCE ABUSE ISSUES- PROVIDE EDUCATION TO PARENTS ON THE SIGNS AND SYMPTOMS OF SUBSTANCE ABUSE. SCHOOLS EDUCATE STUDENTS BUT PARENTS NEED EDUCATION AS WELL.- PROVIDE EASIER ACCESS AND AVAILABILITY TO RECOVERY PROGRAMS. WE NEED TO ADDRESS BARRIERS SUCH AS LACK OF TRANSPORTATION AND ONGOING MENTAL HEALTH ISSUES THAT PREVENT PEOPLE FROM SEEKING HELP.- CONTINUE ONGOING ENGAGEMENT AND COLLABORATION WITH LAW ENFORCEMENT TO HELP INDIVIDUALS OBTAIN THE BASICS LIKE EMPLOYMENT AND A DRIVER'S LICENSE FOR THOSE WHO HAVE A HISTORY OF INCARCERATION.FUTURE STRATEGIES TO IMPROVE HEALTH EDUCATION AND CHRONIC ILLNESS- ENGAGE BUTLER COUNTY FARMS WITH FOOD INSECURE RESIDENTS. THIS PILOT STUDY OF 15 FAMILIES REQUIRED FAMILIES TO BE AT THE 200% FEDERAL POVERTY LINE. THE GOAL OF THIS PROGRAM WAS TO PROVIDE NUTRITION EDUCATION AND HEALTHY MEALS TO FOOD-INSECURE FAMILIES ON A LIMITED BUDGET. A BARRIER IDENTIFIED BY THIS PROGRAM WAS THAT QUALIFIED FAMILIES DID NOT WANT TO IDENTIFY THEMSELVES AS NEEDING ASSISTANCE.- INSTITUTE MORE FARMERS MARKETS IN THE COMMUNITY TO INCREASE ACCESS TO FRESH FRUITS AND VEGETABLES AND PROVIDING HEALTHY RECIPES.

Schedule H (Form 990) 2023

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?2
Name and address		Type of Facility (describe)
1	1 - BUTLER HEALTHCARE PROVIDERS PSYCH 1 HOSPITAL WAY BUTLER,PA16001	PSYCHIATRIC AND CHEMICAL DEPENDENCY
2	2 - BUTLER HEALTHCARE PROVIDERS OP PSYCH 216 NORTH WASHINGTON STREET BUTLER,PA16001	OUTPATIENT BEHAVIORAL HEALTH CLINIC
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2023

Page 10

Part VI

Supplemental Information

Provide the following information.

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

Form and Line Reference	Explanation
PART I, LINE 7:	THE COSTING METHODOLOGY IS BASED ON THE RATIO OF COST TO CHARGES FROM BUTLER MEMORIAL HOSPITAL'S ACCOUNTING SYSTEM.
PART I, LN 7 COL(F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), WAS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $9,808,572.
PART III, LINE 4:	THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTABLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTABLE ACCOUNTS.
PART III, LINE 8:	THE COSTING METHODOLOGY IS BASED ON THE RATIO OF COST TO CHARGES FROM BUTLER MEMORIAL HOSPITAL'S ACCOUNTING SYSTEM.
PART III, LINE 9B:	AS PART OF OUR COMMITMENT TO THE HEALTH CARE NEEDS OF OUR COMMUNITY BHM HAS A PROGRAM DESIGNED TO PROVIDE FINANCIAL ASSISTANCE THAT MAY COVER ALL OR PART OF PATIENT CARE. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS DETERMINED THROUGH AN APPLICATION PROCESS. BMH FOLLOWS THE FEDERAL POVERTY GUIDELINES WHEN DETERMINING THE PATIENT ELIGIBILITY. ONCE THE APPLICATION IS APPROVED, IT WILL BE IN EFFECT FOR SIX MONTHS BEFORE AND AFTER THE APPROVAL DATE. BMH WILL REVIEW ALL ACCOUNTS PRIOR TO PLACEMENT WITH A COLLECTION AGENCY TO SEE IF THE PATIENT IS ELIGIBLE UNDER OUR PRESUMPTIVE CHARITY CARE PROCESS. IF THERE IS NO APPLICATION ON FILE, BHM WILL USE ONE OR MORE OF THE FOLLOWING CRITERIA TO MAKE A DETERMINATION BASED ON: PATIENTS WHO QUALIFY FOR SECTION 8 HOUSING, NO ESTATE, FOOD STAMP ELIGIBILITY, PATIENT IS HOMELESS OR RECEIVED CARE FROM A HOMELESS CLINIC, OR A LETTER FROM FAMILY OR FRIENDS OF A PATIENT THAT PROVIDE INFORMATION ESTABLISHING THE PATIENT'S INABILITY TO PAY.
PART VI, LINE 2:	WHILE BMH HAS ALWAYS CONSIDERED THE NEEDS OF THE REGION IT SERVES, IT HAS FORMALLY BEEN CONDUCTING COMMUNITY HEALTH ASSESSMENTS FOR OVER 20 YEARS. THESE ASSESSMENTS HAVE ALLOWED THE ORGANIZATION TO APPROPRIATELY ALLOCATE RESOURCES AND DEVELOP SERVICES THAT BEST SUIT THE NEEDS OF BUTLER COUNTY AND SURROUNDING REGIONS. DURING THE CHNA PROCESS IN ATTEMPT TO REACH AS MANY PEOPLE AND DISTINCT POPULATIONS AS POSSIBLE, BMH DISTRIBUTED THE SURVEY USING VARIOUS METHODS. CENSUS DATA SHOWED THAT ONLY 78.5% OF HOUSEHOLDS IN BUTLER CITY (16001) HAD BROADBAND INTERNET, SO PAPER SURVEYS WERE CIRCULATED IN ADDITION TO AN ONLINE VERSION. DUE TO COVID RESTRICTIONS, STAKEHOLDERS AT THE INITIAL ZOOM MEETING WERE GIVEN THE ONLINE SURVEY LINK TO TAKE BACK AND DISTRIBUTE TO THEIR RESPECTIVE POPULATIONS. THEY WERE ALSO ENCOURAGED TO PROMOTE THE ONLINE VERSION OF THE SURVEY AMONGST THEIR ORGANIZATION. THE BUTLER COUNTY COLLABORATIVE FOR FAMILIES (BCF) ALSO DISTRIBUTED THE LINK TO THE ONLINE SURVEY THROUGH THEIR EMAIL LIST. THE BCF IS A MULTI-AGENCY NETWORK THAT COLLABORATES TO PROVIDE SERVICES FOR INDIVIDUALS AND FAMILIES IN BUTLER COUNTY. THE ELECTRONIC VERSION WAS ALSO DISTRIBUTED TO PRIMARY CARE OFFICES IN THE SERVICE AREA.THE EMPLOYEE SURVEY PROMPTED EMPLOYEES WHO LIVE IN BUTLER COUNTY TO TAKE THE GENERAL COMMUNITY SURVEY UPON COMPLETION OF THE EMPLOYEE SPECIFIC QUESTIONNAIRE. BUTLER MEMORIAL HOSPITAL COLLECTED A TOTAL 565 SURVEYS COMPLETED (EITHER ONLINE OR ON PAPER) BY COMMUNITY MEMBERS AND STAKEHOLDERS. THE SURVEY ASKED SEVERAL QUESTIONS REGARDING THE INDIVIDUAL'S HEALTH STATUS AND OTHER FACTORS LINKED TO HEALTH, LIKE DEMOGRAPHICS AND PROXIMITY TO STORES WITH FRESH FRUITS AND VEGETABLES. A SUMMARY OF THE RESULTS FOUND THROUGH THE COMMUNITY SURVEY ARE SHOWN IN OUR RESPONSE FOR VI, LINE 4.
PART VI, LINE 3:	SUPPORTING THOSE IN NEED: BMH CHARITY CARE AND COMMUNITY BENEFIT - BMH PROVIDES FREE CARE TO THOSE PATIENTS WHO HAVE AN OBLIGATION AFTER INSURANCE PAYMENTS, IF ANY. THE AMOUNT OF FREE CARE IS DETERMINED BASED ON THE PATIENT'S INCOME AND FAMILY SIZE. FREE CARE IS PROVIDED TO THOSE WITH INCOMES UP TO 300% OF THE FEDERAL POVERTY GUIDELINE.TO INFORM PATIENTS OF THIS PROGRAM, SIGNS ARE POSTED IN ALL THE REGISTRATION AREAS NOTIFYING THE PUBLIC OF THE AVAILABILITY OF OUR FREE CARE PROGRAM. MORE INFORMATION IS AVAILABLE IN THE PATIENT HANDBOOK AND ON THE SYSTEM WEBSITE WWW.BUTLERHEALTHSYSTEM.ORG UNDER PATIENT & VISITORS TAB THEN SELECT FINANCIAL SERVICES. AT THE TIME OF REGISTRATION, ANY PATIENT IS UNINSURED IS GIVEN A PATIENT NOTICE OF FINANCIAL AID NOTICE. THE NOTICE INSTRUCTS THE PATIENT TO CALL THE PATIENT FINANCIAL ASSISTANCE DEPARTMENT. THE CHARITY CARE APPLICATION IS ALSO ON THE BACK OF OUR PATIENT STATEMENTS.
PART VI, LINE 4:	THE PRIMARY SERVICE AREA FOR BMH WAS IDENTIFIED AS BUTLER COUNTY, PENNSYLVANIA. A MAJORITY OF PATIENTS AND VISITS ORIGINATE FROM BUTLER CITY (16001 ZIP CODE). AS SUCH BHS HAS PLACED SEVERAL SERVICE LOCATIONS WITHIN THIS AREA TO MEET THE DEMAND OF THE PRIMARY LOCATION. THE INDIVIDUALS THAT COME FROM SURROUNDING COUNTIES TO RECEIVE MORE ADVANCED SERVICES INCLUDE: ARMSTRONG, WESTMORELAND, CLARION, BEAVER, LAWRENCE, MERCER, VENANGO, AND ALLEGHENY. FOR THE PURPOSE OF SECONDARY DATA COLLECTION, CLARION COUNTY WAS DETERMINED TO BE THE COMMUNITY SERVED. APPROXIMATELY 80% OF THE HOSPITAL'S RESIDENTS RESIDE WITHIN THE COUNTY.BELOW IS A TABLE SUMMARIZING THE COUNTY POPULATION DATA COMPARED TO DATA SPECIFIC TO THE STATE OF PENNSYLVANIA BUTLER COUNTY PENNSYLVANIA2021 POPULATION ESTIMATE 194,273 12,964,056POPULATION PERCENT CHANGE:APRIL 2020-JULY 2021 .3% -0.3%MEDIAN AGE (2019) 43.3 YEARS 40.8 YEARSPERCENT UNDER 18 19.7% 20.6%PERCENT 65 YEARS AND OLDER 19.4% 18.7%RACE AND ORIGINWHITE ALONE, NOT HISPANIC ORLATINO, PERCENT 95.8% 81.6%BLACK OR AFRICAN AMERICAN,PERCENT 1.4% 12%AMERICAN INDIAN & ALASKANNATIVE ALONE, PERCENT 0.2% 0.4%ASIAN ALONE, PERCENT 1.5% 3.8%HISPANIC OR LATINO, PERCENT 1.6% 7.8%TWO OR MORE RACES, PERCENT 1.2% 2.1%VETERANS (2016-2020) 12,838 731,411EDUCATIONHIGH SCHOOL GRADUATE OR HIGHER 95.4% 91.0%BACHELOR'S DEGREE OR HIGHER 37.5% 32.3%MEDIAN HOUSEHOLD INCOME $72,642 $63,627PER CAPITAL INCOME IN PAST12 MONTHS $39,906 $35,518PERSONS IN POVERTY, PERCENT 7.4% 10.9%PERCENT WITH A DISABILITY UNDERAGE 65, 2016-2020 8.5% 9.8%PERSONS WITHOUT HEALTHINSURANCE UNDER AGE 65, PERCENT 4.8% 7.0%TABLE: BUTLER COUNTY DEMOGRAPHICS(HTTPS://WWW.CENSUS.GOV/QUICKFACTS/FACT/TABLE/PA,BUTLERCOUNTYPENNSYLVANIA/BZA210219)WITHIN THE COUNTY, THERE IS SIGNIFICANT VARIABILITY AMONGST MANY OF THE SOCIAL AND ECONOMIC DETERMINANTS OF HEALTH DEPENDING ON THE LOCATION IN THE COUNTY BECAUSE OF THE LARGE GEOGRAPHIC AREA BUTLER COUNTY ENCOMPASSES.RECURRING THEME AMONG COMMUNITY STAKEHOLDERS WAS THE ACCESS AND RESOURCES IN THE SOUTHERN PART OF THE COUNTY DIFFERS WITHIN THE COUNTY FROM THE CENTRAL AND NORTHERN AREAS. BECAUSE OF THESE DIFFERENCES, IT SHOULD BE REMEMBERED THAT COUNTY LEVEL DATA ON HEALTH RELATED ISSUES MIGHT BE TILTED TOWARDS THE AFFLUENCE OF THE SOUTH.THE TABLE BELOW SHOWS A SELECT NUMBER OF DISPARITIES THAT EXIST WITHIN THE PRIMARY SERVICE AREA OF BMH. THESE AREAS INCLUDE: ADAMS TOWNSHIP, CRANBERRY TOWNSHIP, BUTLER CITY, AND CENTER TOWNSHIP. BUTLER CITY IS THE IMMEDIATE AREA SURROUNDING BMH, AND CENTER TOWNSHIP IS IN NORTHERN BUTLER COUNTY. ADAMS CRANBERRY BUTLER CENTER TOWNSHIP TOWNSHIP CITY TOWNSHIP (16046) (16066) (16001) (16061)HIGH SCHOOL GRADUATEOR HIGHER, PERCENT 98.8% 97.3% 91.0% 96.8%BACHELOR'S DEGREEOR HIGHER 66.2% 62.0% 22.7% 36.1%MEDIAN HOUSEHOLDINCOME, 2016-2020 $124,982 $108,160 $32,746 $76,100PER CAPITA INCOMEPAST 12 MONTHS, 2016-2020 $69,935 $53,744 $22,127 $42,109PERSONS IN POVERTY,PERCENT 3.6% 3.1% 24.2% 4.1%PERCENT WITH A DISABILITY,UNDER AGE 65, 2016-2020 3.8% 4.7% 20.4% 10.8%PERSONS WITHOUT HEALTHINSURANCE 8% 2.2% 6.1% 2.6%HOUSEHOLDS WITH BROADBANDINTERNET SUBSCRIPTION,2016-2020 93.3% 94.9% 78.5% 85.3%(HTTPS://WWW.CENSUS.GOV/QUICKFACTS/FACT/TABLE/ADAMSTOWNSHIPBUTLERCOUNTYPENNSYLVANIA, CRANBERRYTOWNSHIPBUTLERCOUNTYPENNSYLVANIA,BUTLERCITYPENNSYLVANIA,CENTERTOWNSHIPBUTLERCOUNTYPENNSYLVANIA/BZA210219)LOOKING AT DATA AT THE COUNTY LEVEL, THERE IS A SIGNIFICANT PORTION OF OUR SERVICE POPULATION BEING UNDER-REPRESENTED. THERE ARE DRAMATIC DIFFERENCES IN FACTORS LIKE INCOME, EDUCATION, AND DISABILITY ACROSS THE COUNTY CREATING A DIFFERENT PICTURE OF HEALTH AND THE HEALTH NEEDS OF DEFINED SUBPOPULATIONS WITHIN THE COUNTY.
PART VI, LINE 5:	BUTLER HEALTHCARE PROVIDERS, AN AFFILIATE OF INDEPENDENCE HEALTH SYSTEM, EXISTS TO PROVIDE A TRUSTED DELIVERY OF CARE WHICH MAKES A POSITIVE IMPACT ON THE LIVES OF EVERY INDIVIDUAL WE TOUCH. EVERY LIFE MEANS THAT INDEPENDENCE HEALTH SYSTEM DOES NOT DISCRIMINATE FOR RACE, RELIGION, GENDER, COLOR, OR CREED AND ACCEPTS ALL PATIENTS FOR ANY SERVICES, REGARDLESS OF THE ABILITY TO PAY FOR THOSE SERVICES. INDEPENDENCE HEALTH SYSTEM STRIVES TO PROVIDE ITS COMMUNITIES WITH STATE OF THE ART EQUIPMENT AND FACILITIES. THIS CAN ONLY BE ACCOMPLISHED BY INVESTING ANY EXCESS IN REVENUES OVER EXPENSES INDEPENDENCE HEALTH SYSTEM MAY HAVE IN SECURE INVESTMENTS TO PROVIDE FOR FUTURE TECHNOLOGY, TREATMENTS OF CARE, AND MAINTAIN AGING FACILITIES. INDEPENDENCE HEALTH SYSTEM ENCOURAGES PATIENTS TO TELL IT WHAT IT IS DOING RIGHT AND WRONG THROUGH PATIENT SATISFACTION SURVEYS AND INDEPENDENCE HEALTH SYSTEM REACTS TO THOSE SURVEYS. INDEPENDENCE HEALTH SYSTEM STRIVES TO PROVIDE ITS PATIENTS WITH GREATER ACCESS TO CARE THROUGH OFF SITE CLINICS AND DIAGNOSTIC SERVICE CENTERS. INDEPENDENCE HEALTH SYSTEM ASSISTS ITS MEDICAL STAFF IN RECRUITING TOP OF THE CLASS DOCTORS TO PROVIDE SERVICES TO ITS COMMUNITY WHERE THERE IS A NEED AND A SHORTAGE OF PHYSICIANS. INDEPENDENCE HEALTH SYSTEM ALSO RECRUITS SPECIALTY PHYSICIANS THAT WOULD HELP TO OFFSET THE BURDEN OF CALL COVERAGE AND FOR SUCCESSION PLANNING, WHICH IS ESSENTIAL FOR THE CONTINUUM OF CARE.
PART VI, LINE 6:	BUTLER HEALTHCARE PROVIDERS IS PART OF INDEPENDENCE HEALTH SYSTEM. INDEPENDENCE HEALTH SYSTEM (IHS) COMPRISES BUTLER MEMORIAL, CLARION, FRICK, LATROBE, AND WESTMORELAND HOSPITALS. WITH A TOTAL BED COMPLEMENT OF 925, THE SYSTEM HAS MORE THAN 1,000 PHYSICIANS AND ADVANCED PRACTICE PROVIDERS AND 7,300 EMPLOYEES. IHS IS NOW THE THIRD LARGEST HEALTHCARE SYSTEM IN WESTERN PENNSYLVANIA, SERVING A POPULATION BASE OF 750,000 IN A FOOTPRINT SPANNING MORE THAN 10 COUNTIES.

Schedule H (Form 990) 2023

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
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

BUTLER HEALTHCARE PROVIDERS

Employer identification number

25-0965274

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

Yes

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) 2023

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)
1KENNETH P DEFURIO PRESIDENT & CEO	(i) (ii)	1,078,797 ------------- 0	0 ------------- 0	3,479 ------------- 0	4,950 ------------- 0	18,996 ------------- 0	1,106,222 ------------- 0	0 ------------- 0
2DAVID ROTTINGHAUS PHYSICIAN & PROVIDER NETWORK PRESIDE	(i) (ii)	632,325 ------------- 0	0 ------------- 0	1,371 ------------- 0	4,950 ------------- 0	21,114 ------------- 0	659,760 ------------- 0	0 ------------- 0
3JAMES ADISEY MD TRUSTEE/PHYSICIAN	(i) (ii)	0 ------------- 422,008	0 ------------- 31,074	0 ------------- 137,399	0 ------------- 13,200	0 ------------- 14,786	0 ------------- 618,467	0 ------------- 0
4THOMAS S ALBANESI JR CPA CHIEF FINANCIAL OFFICER	(i) (ii)	0 ------------- 496,255	0 ------------- 0	0 ------------- 7,400	0 ------------- 18,086	0 ------------- 15,534	0 ------------- 537,275	0 ------------- 0
5CAROL J FOX MD CHIEF MEDICAL OFFICER	(i) (ii)	0 ------------- 503,855	0 ------------- 0	0 ------------- 7,470	0 ------------- 21,258	0 ------------- 1,439	0 ------------- 534,022	0 ------------- 0
6KAREN ALLEN PRESIDENT, BUTLER MEMORIAL & CLARION	(i) (ii)	500,020 ------------- 0	0 ------------- 0	3,564 ------------- 0	4,950 ------------- 0	21,622 ------------- 0	530,156 ------------- 0	0 ------------- 0
7STEVEN DAVIS FORMER PRESIDENT CLARION HEALTH	(i) (ii)	122,040 ------------- 0	0 ------------- 0	371,446 ------------- 0	0 ------------- 0	20,909 ------------- 0	514,395 ------------- 0	0 ------------- 0
8PAMELA HEPP ESQ GENERAL COUNSEL	(i) (ii)	487,603 ------------- 0	2,322 ------------- 0	0 ------------- 0	0 ------------- 0	788 ------------- 0	490,713 ------------- 0	0 ------------- 0
9ERIC HUSS FORMER CHIEF FINANCIAL OFFICER	(i) (ii)	82,903 ------------- 0	0 ------------- 0	395,747 ------------- 0	0 ------------- 0	7,307 ------------- 0	485,957 ------------- 0	0 ------------- 0
10MICHAEL FIORINA DO ASSISTANT CHIEF MEDICAL OFFICER	(i) (ii)	439,813 ------------- 0	0 ------------- 0	0 ------------- 0	4,950 ------------- 0	21,469 ------------- 0	466,232 ------------- 0	0 ------------- 0
11JOHN SPHON TRUSTEE/FORMER PRESIDENT & CEO OF EX	(i) (ii)	0 ------------- 187,174	0 ------------- 0	0 ------------- 248,148	0 ------------- 23,413	0 ------------- 4,186	0 ------------- 462,921	0 ------------- 0
12ROGER LUTZ CHIEF INFORMATION OFFICER	(i) (ii)	311,239 ------------- 0	0 ------------- 0	67,212 ------------- 0	4,950 ------------- 0	21,382 ------------- 0	404,783 ------------- 0	0 ------------- 0
13THOMAS GENEVRO CHIEF HUMAN RESOURCES OFFICER	(i) (ii)	373,660 ------------- 0	0 ------------- 0	933 ------------- 0	4,950 ------------- 0	21,642 ------------- 0	401,185 ------------- 0	0 ------------- 0
14DAVID DILLON CHIEF INTEGRATION OFFICER	(i) (ii)	379,388 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	21,007 ------------- 0	400,395 ------------- 0	0 ------------- 0
15ANIE PERARD MD TRUSTEE/PHYSICIAN	(i) (ii)	0 ------------- 326,938	0 ------------- 0	0 ------------- 34,016	0 ------------- 0	0 ------------- 20,625	0 ------------- 381,579	0 ------------- 0
16NORMAN K BEALS CHIEF WELLNESS OFFICER	(i) (ii)	292,583 ------------- 0	0 ------------- 0	0 ------------- 0	3,640 ------------- 0	18,558 ------------- 0	314,781 ------------- 0	0 ------------- 0
17KATHY SELVAGGI CHIEF COMMUNITY HEALTH OFFICER	(i) (ii)	287,794 ------------- 0	0 ------------- 0	0 ------------- 0	4,158 ------------- 0	18,771 ------------- 0	310,723 ------------- 0	0 ------------- 0
18JOHN REEFER MD TRUSTEE/PHYSICIAN	(i) (ii)	0 ------------- 0	0 ------------- 0	247,100 ------------- 0	0 ------------- 0	0 ------------- 0	247,100 ------------- 0	0 ------------- 0
19RANDY TEWKSBURY EXEC DIRECTOR OF REVENUE CYCLE	(i) (ii)	212,441 ------------- 0	0 ------------- 0	3,930 ------------- 0	0 ------------- 0	18,682 ------------- 0	235,053 ------------- 0	0 ------------- 0
20MATTHEW SCHNUR PHARMACIST	(i) (ii)	200,983 ------------- 0	0 ------------- 0	167 ------------- 0	3,131 ------------- 0	20,821 ------------- 0	225,102 ------------- 0	0 ------------- 0
21MELINDA HILDEBRANDT CNO	(i) (ii)	210,137 ------------- 0	650 ------------- 0	356 ------------- 0	3,192 ------------- 0	7,075 ------------- 0	221,410 ------------- 0	0 ------------- 0
22HILARY HARLAN CHIEF COMPLIANCE OFFICER	(i) (ii)	148,208 ------------- 0	0 ------------- 0	39,290 ------------- 0	300 ------------- 0	16,754 ------------- 0	204,552 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2023

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, LINES 4A-B

4(B) THE ORGANIZATION UTILIZES A SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM (SERP) TO RECRUIT AND RETAIN LEADERSHIP TALENT. VESTING PERIODS ARE 5 AND 10 YEARS, FOR ALL EXECUTIVES, WITH THE EXCEPTION OF THE PRESIDENT/CEO, AT AGE 65. THE THIRD VESTING PERIOD FOR THE PRESIDENT/CEO IS AGE 60. ELIGIBLE EXECUTIVES RECEIVE DISTRIBUTIONS UPON REACHING THE VESTING PERIODS. ALL CONTRIBUTIONS TO THE SERP HAVE BEEN REPORTED PREVIOUSLY AND ARE REPORTED ANNUALLY. THE ANNUAL ACCRUAL AMOUNTS FOR CALENDAR YEAR 2023 WERE: KENNETH P DEFURIO, $351,888; DAVID ROTTINGHAUS, $35,024; KAREN ALLEN, $37,859; THOMAS GENEVRO, $37,700; ROGER LUTZ, $33,227; MICHAEL FIORINA, DO, $24,991; KATHY SELVAGGI, $20,407. DURING CALENDAR YEAR 2023, ERIC HUSS RECEIVED A SERP PAYOUT OF $73,063 AND STEVEN DAVIS RECEIVED A SERP PAYOUT OF $73,201. DURING CALENDAR YEAR 2023, ERIC HUSS RECEIVED SEVERANCE IN THE AMOUNT OF $322,683 AND STEVEN DAVIS RECEIVED SEVERANCE IN THE AMOUNT OF $232,440.

PART I, LINE 7

EMPLOYEES ARE ELIGIBLE AND RECEIVED BONUS COMPENSATION. BONUSES ARE NOT GUARANTEED AND ARE AWARDED BASED ON BOARD APPROVED METRICS WHICH INCLUDE QUALITY, SERVICES, AND STRATEGIC FINANCIAL PERFORMANCE.

Schedule J (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

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

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
BUTLER HEALTHCARE PROVIDERS

Employer identification number
25-0965274

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	BUTLER COUNTY HOSPITAL AUTHORITY	25-1458912	123592DR5	03-18-2015	100,481,533	SEE PART VI		X		X		X
B	BUTLER COUNTY HOSPITAL AUTHORITY	25-1458912		03-18-2015	41,000,000	SEE PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	19,780,000		12,570,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	100,481,533		41,000,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	1,107,924
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............
11 Other spent proceeds .............
12 Other unspent proceeds .............
13 Year of substantial completion .............	2015		2015
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........	X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X
16 Has the final allocation of proceeds been made? ..........	X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2023

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X
b Exception to rebate? ........		X	X
c No rebate due? .........	X			X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X	X

Schedule K (Form 990) 2023

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
PART I, BOND A, COLUMN F	ADVANCED REFUNDING OF SERIES 2009B BONDS ISSUED 4/30/2009, CURRENT REFUNDING OF REISSUED SERIES 2009A BONDS ISSUED 6/29/2010.
PART I, BOND B, COLUMN F	CURRENT REFUNDING OF REMAINING PORTION OF THE REISSUED SERIES 2009A BONDS ISSUED 6/29/2010.
PART IV, LINE 1	MAJORITY OF PROCEEDS OF 2015 ISSUE DEPOSITED TO AN ADVANCE REFUNDING ESCROW STRUCTURED TO HAVE A YIELD LESS THAN THAT OF THE BONDS.

Schedule K (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
Attach to Form 990 or Form 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

BUTLER HEALTHCARE PROVIDERS

Employer identification number

25-0965274

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... $

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ $

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No




Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990) 2023

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) ALISON ANNETT	FAMILY MEMBER OF KENNETH DEFURIO, PRESIDENT & CEO	59,342	EMPLOYEE		No
(2) JOSHUA LUTZ	FAMILY MEMBER OF ROGER LUTZ, CIO	40,349	EMPLOYEE		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990) 2023

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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

BUTLER HEALTHCARE PROVIDERS

Employer identification number

25-0965274

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 6	PER THE BY-LAWS OF THE ORGANIZATION, THE ORGANIZATION SHALL HAVE ONE CORPORATE MEMBER, BUTLER HEALTH SYSTEM, INC. THERE SHALL BE NO OTHER MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7A	BUTLER HEALTH SYSTEM, INC., THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, APPOINTS THE MEMBERS OF THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 7B	AS PER THE BY-LAWS OF THE ORGANIZATION, THE SUBJECT MATTERS OF THE POWERS RESERVED TO THE MEMBER ARE AS FOLLOWS: A. THE NUMBER OF TRUSTEES THAT WILL COMPRISE THE BOARD. B. THE ELECTION OF TRUSTEES. C. THE REMOVAL OF ANY TRUSTEE FOR CAUSE FROM THE CORPORATION'S BOARD OF TRUSTEES AND APPROVAL OF THE REPLACEMENT OF ANY SUCH REMOVED TRUSTEE FOR THE UNEXPIRED PORTION OF THE TERM. D. THE ELECTION, RE-ELECTION, APPOINTMENT AND REAPPOINTMENT OF ALL OFFICERS OF THE BOARD. E. THE AMENDMENT, REVISION, OR RESTATEMENT OF THE CORPORATION'S ARTICLES OF INCORPORATION AND/OR BY-LAWS. F. THE ADOPTION OR CHANGE IN THE MISSION, PURPOSE, PHILOSOPHY OR OBJECTIVES OF THE CORPORATION. G. THE CHANGE IN THE GENERAL STRUCTURE OF THE CORPORATION AS A VOLUNTARY, NONPROFIT CORPORATION. H. THE DISSOLUTION, DIVISION, CONVERSION OR LIQUIDATION OF THE CORPORATION, THE CONSOLIDATION OR MERGER OF THE CORPORATION WITH ANOTHER CORPORATION OR ENTITY, OR THE ACQUISITION OF SUBSTANTIALLY ALL OF THE ASSETS OF ANOTHER CORPORATION OR ENTITY, SUBJECT TO THE PROVISION OF THE ARTICLES OF INCORPORATION. I. THE CORPORATION'S BORROWING OF MONEY, ISSUANCE OF INDEBTEDNESS AND/OR INCURRENCE OF GUARANTEES, WHETHER IN A SINGLE TRANSACTION OR A SERIES OF RELATED TRANSACTIONS, WHETHER OR NOT SUCH BORROWINGS OR GUARANTEES ARE TO BE SECURED BY A MORTGAGE, PLEDGE OR OTHER LIEN ON THE CORPORATION'S CURRENT OR FUTURE REAL PROPERTY, PERSONAL PROPERTY OR ENDOWMENT FUNDS. J. APPROVAL OF THE ANNUAL CAPITAL AND OPERATING BUDGETS OF THE CORPORATION AND ANY AMENDMENTS THERETO. K. APPROVAL OF ANY CHARITABLE DONATION BY THE CORPORATION, OTHER THAN TO THE MEMBER OR ANY NONPROFIT ENTITY IN WHICH THE MEMBER IS A SOLE MEMBER, IN AN AMOUNT EXCEEDING $15,000 PER DONEE OR IN AN AMOUNT EXCEEDING $150,000 IN THE AGGREGATE DURING ANY ONE FISCAL YEAR. L. APPROVAL OF ANY TRANSFER OTHER THAN CHARITABLE DONATIONS OF THE CORPORATION'S ASSETS UNLESS SPECIFICALLY AUTHORIZED IN THE CORPORATION'S APPROVED BUDGETS. M. APPROVAL OF CHANGE OF MEMBERSHIP OR VOTING RIGHTS OF THE MEMBER. N. APPROVAL OF THE STRATEGIC PLANS AND/OR INVESTMENT POLICIES OF THE CORPORATION AND ANY SUBSIDIARY OF THE CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11B	THE ORGANIZATION HAS A CPA FIRM PREPARE ITS FORM 990. THE RETURN IS COMPLETED IN DRAFT FORM AND REVIEWED BY MANAGEMENT OF THE ORGANIZATION. THE FORM 990 IS THEN PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW BEFORE IT IS FILED.
FORM 990, PART VI, SECTION B, LINE 12C	A WEB-BASED SOFTWARE PROGRAM IS USED TO ADMINISTER A CONFLICT OF INTEREST DISCLOSURE FORM AND QUESTIONNAIRE ANNUALLY TO ALL BOARD TRUSTEES, KEY EMPLOYEES AND CERTAIN OTHER DIRECTORS, MANAGERS AND CONTRACTED PHYSICIANS. COMPLIANCE IN COMPLETING THE FORM IS REQUIRED AT 100% FOR OFFICERS, TRUSTEES AND KEY EMPLOYEES. THE DISCLOSURES ARE REVIEWED BY THE COMPLIANCE OFFICER, CHIEF LEGAL OFFICER AND CERTAIN BOARD COMMITTEES. ADDITIONALLY, THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY THAT IS SHARED WITH EMPLOYEES, MEDICAL STAFF AND BUSINESS PARTNERS THROUGH ONE OR MORE OF THE FOLLOWING METHODS: POSTING ON THE ORGANIZATION'S INTRANET WEBSITE, ON THE ORGANIZATION'S PUBLIC WORLD WIDE WEBSITE, IN ITS POLICY MANUAL AND IN ITS CORPORATE CODE. REPORTS AND SUBSEQUENT FINDINGS OF NON-COMPLIANCE RESULT IN DISCIPLINARY ACTION THROUGH HUMAN RESOURCES, THE OFFICE OF MEDICAL AFFAIRS, OR THROUGH COMPANY SANCTIONS TOWARDS BUSINESS PARTNERS.
FORM 990, PART VI, SECTION B, LINE 15	THE BOARD OF TRUSTEES RECOGNIZES THE GREAT CHALLENGES AND DIFFICULTIES THAT HEALTHCARE EXECUTIVES FACE, PARTICULARLY IN THE CURRENT ERA OF NATIONAL AND STATE HEALTHCARE REFORM. IN ADDITION, THE PITTSBURGH REGIONAL MARKET IS HIGHLY COMPETITIVE AND CHANGING RAPIDLY. THE BOARD COMPETES FOR AND SEEKS EXECUTIVE TALENT ON A NATIONAL BASIS. IT ENGAGES EXPERT COMPENSATION CONSULTANTS, UTILIZING NATIONAL COMPARATIVE DATA TO GUIDE THE DETERMINATION OF COMPETITIVE, APPROPRIATE LEVELS OF COMPENSATION. THE EXECUTIVE COMPENSATION PROCESS IS OVERSEEN BY THE EXECUTIVE/COMPENSATION COMMITTEE OF THE IHS BOARD OF TRUSTEES. THE COMMITTEE IS COMPOSED ENTIRELY OF "DISINTERESTED" MEMBERS WITH NO CONFLICTS OF INTEREST. THE TOTAL COMPENSATION PROGRAM FOR EXECUTIVES CONSISTS OF CASH COMPENSATION AND BENEFITS. FACTORS TAKEN INTO CONSIDERATION IN DETERMINING COMPENSATION FOR EXECUTIVES INCLUDE: MARKET DEMAND AND COMPETITION FOR SIMILAR POSITIONS, EXPERIENCE AND TENURE, AND ACTUAL PERFORMANCE AND EFFECTIVENESS. BASED ON THESE AND OTHER PERTINENT CRITERIA, IHS TARGETS TOTAL COMPENSATION TO FALL WITHIN A RANGE OF THE 25TH TO 75TH PERCENTILE OF THE MARKET. IHS EXECUTIVE COMPENSATION GENERALLY WILL NOT EXCEED THE 75TH PERCENTILE OF THE MARKET. EXCEPTIONS TO THIS MAY BE SUBJECT TO REVIEW AND RECOMMENDATION BY THE COMPENSATION COMMITTEE, WHICH IN TURN IS SUBJECT TO REVIEW AND APPROVAL BY THE BOARD OF TRUSTEES. EXCEPTION MUST BE SUPPORTED BY ORGANIZATIONAL AND/OR INDIVIDUAL PERFORMANCE, OR A RETENTION/RECRUITMENT CIRCUMSTANCE THAT WARRANTS SUCH COMPENSATION. THE COMPENSATION COMMITTEE CONSISTS EXCLUSIVELY OF INDEPENDENT INDIVIDUALS WITH NO REAL OR PERCEIVED CONFLICTS OF INTEREST IN RECOMMENDING EXECUTIVE COMPENSATION GUIDELINES AND LEVELS. WHILE BENEFITS ARE ACCOUNTED FOR IN SCHEDULE J, ACTUAL "TAKE HOME" PAY TO THE EXECUTIVE TYPICALLY CONSISTS ONLY OF BASE SALARY, AND INCENTIVE AWARD EARNED, IF EARNED. APPLICABLE TAXES OR OTHER WITHHOLDINGS ARE DEDUCTED. ANNUAL INCREASES IN BASE PAY, IF ANY, ARE BASED ON COMPETITIVE MARKET TRENDS FROM THE COMPARISON GROUP. SUPPLEMENTAL RETIREMENT BENEFITS ARE USED AS A VEHICLE FOR EXECUTIVE RECRUITMENT AND RETENTION WITH APPROPRIATE VESTING PERIODS. THE BOARD OF TRUSTEES REVIEWS AND APPROVES EXECUTIVE COMPENSATION IN ITS ENTIRETY, INCLUDING THE USE OF "TALLY SHEETS", WHICH DISCLOSE 100% EXECUTIVE COMPENSATION. THE BOARD OF TRUSTEES ENGAGES EXTERNAL COMPENSATION AND LEGAL EXPERTISE TO ASSURE REASONABLENESS OF EXECUTIVE COMPENSATION LEVELS.
FORM 990, PART VI, SECTION C, LINE 18	THE ORGANIZATION MAKES ITS FORM 990, FORM 990-T, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19	AT THIS TIME, THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS AND CONFLICTS OF INTEREST POLICY AVAILABLE TO THE GENERAL PUBLIC.
FORM 990, PART IX, LINE 11G	PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 3,584,017. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,584,017. OUTSIDE MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 532,081. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 532,081. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 19,736,334. MANAGEMENT AND GENERAL EXPENSES 2,501,789. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,238,123. OTHER FEES: PROGRAM SERVICE EXPENSES 3,673,402. MANAGEMENT AND GENERAL EXPENSES 465,642. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,139,044.
FORM 990, PART XI, LINE 9:	PENSION OBLIGATION ADJUSTMENT 978,092. OTHER. NET ADJUSTMENTS -1,065,241. DISTRIBUTIONS RECEIVED AND OTHER 138,302. NET ASSETS RELEASED FROM RESTRICTION -89,745. TRANSFER TO AFFILIATES -29,000,000.

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

Cat. No. 51056K

Schedule O (Form 990) 2023

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.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

BUTLER HEALTHCARE PROVIDERS

Employer identification number

25-0965274

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) BHS DERMATOLOGY ASSOCIATES 1 HOSPITAL WAY BUTLER,PA16001 80-0929620	DERMATOLOGY	PA			BHP
(2) BUTLER IMAGING & INTERVENTIONAL ASSOC 1 HOSPITAL WAY BUTLER,PA16001 26-4263364	RADIOLOGY	PA			BHP
(3) BHS NALLATHAMBI MEDICAL ASSOCIATES PLLC 1 HOSPITAL WAY BUTLER,PA16001 26-4746949	PRIMARY CARE	PA			BHP
(4) BUTLER HEALTH SYSTEM PROVIDER HOSPITAL 1 HOSPITAL WAY BUTLER,PA16001 47-4212217	PHYS HOSP ORG	PA	5,981,565	7,855,640	BHP
(5) BHS SENECA MEDICAL CENTER LLC 1 HOSPITAL WAY BUTLER,PA16001 46-4444529	PRIMARY CARE	PA			BHP

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)LATROBE AREA HOSPITAL 121 W SECOND AVENUE LATROBE,PA15650 25-0965414	HEALTH CARE	PA	501(C)(3)	LINE 3	EXCELA HEALTH		No
(2)WESTMORELAND REGIONAL HOSPITAL 532 WEST PITTSBURGH STREET GREENSBURG,PA15601 25-0965612	HEALTH CARE	PA	501(C)(3)	LINE 3	EXCELA HEALTH		No
(3)LATROBE AREA HOSPITAL CHARITABLE FOUNDATION ONE MELLON WAY LATROBE,PA15650 25-1750654	FUNDRAISING	PA	501(C)(3)	LINE 12A, I	LATROBE AREA HOSPITAL		No
(4)WESTMORELANDFRICK HOSPITAL FOUNDATION 532 WEST PITTSBURGH STREET GREENSBURG,PA15601 25-1309084	FUNDRAISING	PA	501(C)(3)	LINE 12A, I	EXCELA HEALTH		No
(5)FRICK HOSPITAL 508 SOUTH CHURCH STREET MOUNT PLEASANT,PA15650 25-0965375	HEALTH CARE	PA	501(C)(3)	LINE 3	EXCELA HEALTH		No
(6)EXCELA HEALTH HOME CARE AND HOSPICE 532 WEST PITTSBURGH STREET GREENSBURG,PA15601 20-3474707	HEALTH CARE	PA	501(C)(3)	LINE 10	EXCELA HEALTH		No
(7)EXCELA HEALTH 532 WEST PITTSBURGH STREET GREENSBURG,PA15601 25-1471089	HEALTH CARE	PA	501(C)(3)	LINE 12C, III-FI	INDEPENDENCE HEALTH SYSTEM		No
(8)CAREGIVERS OF SOUTHWESTERN PA 532 WEST PITTSBURGH STREET GREENSBURG,PA15601 25-1570733	HEALTH CARE	PA	501(C)(3)	LINE 10	EXCELA HEALTH		No
(9)MOUNTAIN VIEW CANCER ASSOCIATES INC 200 VILLAGE DRIVE GREENSBURG,PA15601 03-0480551	HEALTH CARE	PA	501(C)(3)	LINE 3	EXCELA HEALTH		No
(10)BUTLER HEALTH SYSTEM ONE HOSPITAL WAY BUTLER,PA16001 25-1441855	HC DELIV SYST	PA	501(C)(3)	LINE 10	INDEPENDENCE HEALTH SYSTEM		No
(11)BUTLER MEDICAL PROVIDERS ONE HOSPITAL WAY BUTLER,PA16001 25-1441961	PHYSICIAN PRACTICE	PA	501(C)(3)	LINE 3	BUTLER HEALTH SYSTEM		No
(12)NIXSAR CORPORATION ONE HOSPITAL WAY BUTLER,PA16001 25-1441960	REAL ESTATE	PA	501(C)(3)	LINE 12B, II	BUTLER HEALTH SYSTEM		No
(13)BUTLER HEALTH SYSTEM FOUNDATION ONE HOSPITAL WAY BUTLER,PA16001 26-1543883	FUNDRAISING	PA	501(C)(3)	LINE 12A, I	BUTLER HEALTH SYSTEM		No
(14)CLARION HOSPITAL ONE HOSPITAL WAY CLARION,PA16214 25-1010039	HOSPITAL	PA	501(C)(3)	LINE 3	BUTLER HEALTH SYSTEM		No
(15)CLARION HOSPITAL SELF INS TRUST FUND ONE HOSPITAL WAY CLARION,PA16217 25-0766602	SELF INSURANCE	PA	501(C)(3)	LINE 12A, I	CLARION HOSPITAL		No
(16)BUTLER MEMORIAL HOSPITAL AUXILIARY ONE HOSPITAL WAY BUTLER,PA16001 25-1457575	AUXILIARY	PA	501(C)(3)	LINE 10	BUTLER HEALTH SYSTEM		No
(17)INDEPENDENCE HEALTH SYSTEM ONE HOSPITAL WAY BUTLER,PA16001 92-1340805	HEALTH CARE	PA	501(C)(3)	LINE 12B, II	N/A		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2023

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) BUTLER AMBULATORY SURGERY CENTER LLC 102 TECHNOLOGY DRIVE BUTLER,PA16001 06-1728190	AMBULATORY SURG.	PA	N/A					No			No
(2) BHS FASTERCARE ONE HOSPITAL WAY BUTLER,PA16001 27-1961562	URGENT CARE	PA	BUTLER HEALTHCARE PROVIDERS	RELATED	-69,568	618,698		No			No	53.400 %
(3) BHS FASTER CARE LABORATORY ONE HOSPITAL WAY BUTLER,PA16001 80-0628384	LAB. SERVICES	PA	BUTLER HEALTHCARE PROVIDERS	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) EXCELA HEALTH PHYSICIAN PRACTICES 532 WEST PITTSBURGH STREET GREENSBURG,PA15601 25-1744392	HEALTH CARE	PA	N/A	C					No
(2) EXCELA HEALTH HOLDING COMPANY 532 WEST PITTSBURGH STREET GREENSBURG,PA15601 25-1826537	HEALTH CARE	PA	N/A	C					No
(3) EXCELA HEALTH VENTURES LLC 532 WEST PITTSBURGH STREET GREENSBURG,PA15601 46-1290845	REAL ESTATE	PA	N/A	C					No
(4) EXCELA RECIPROCAL RRG & SUBSIDIARY 100 BANK STREET SUITE 610 BURLINGTON,VT05401 46-4602850	INSURANCE	VT	N/A	C					No
(5) EXCELA PHYSICIAN HOSPITAL ORGANIZATION LLC 532 WEST PITTSBURGH STREET GREENSBURG,PA15601 82-0639487	HEALTH CARE	PA	N/A	C					No
(6) EXCELA HEALTH DIVERSIFIED SERVICES LLC 532 WEST PITTSBURGH STREET GREENSBURG,PA15601 87-1455824	HEALTH CARE	PA	N/A	C					No
(7) PCA OF BUTLER PC 480 EAST JEFFERSON STREET BUTLER,PA16001 25-1351445	PHY. OFFICE	PA	N/A	C					No
(8) CLARION DEVELOPMENT CORPORATION ONE HOSPITAL DRIVE CLARION,PA16214 25-1516298	PHARMACY	PA	N/A	C					No

Schedule R (Form 990) 2023

Page 3

Part V

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

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

Yes

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

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

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

Yes

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

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

Yes

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

Yes

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

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

Schedule R (Form 990) 2023

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) 2023

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) 2023

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: BUTLER HEALTHCARE PROVIDERS, AN AFFILIATE OF INDEPENDENCE HEALTH SYSTEM, WILL BE RECOGNIZED AS THE PREMIER PROVIDER OF HIGH QUALITY, VALUE-DRIVEN AFFORDABLE INTEGRATED CARE IN THE REGION. WE WILL ACHIEVE THIS THROUGH UNWAVERING COMMITMENT TO INDIVIDUAL AND ORGANIZATIONAL EXCELLENCE AND TECHNOLOGICAL INNOVATION.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	12
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	7
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	2,325
6	Total number of volunteers (estimate if necessary) .............	6	7
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	5,747,318
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	374,008

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	4,430,657	1,242,479
9	Program service revenue (Part VIII, line 2g) .........	309,204,848	310,140,580
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-8,379,961	5,816,131
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	6,478,379	7,382,995
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	311,733,923	324,582,185
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	47,496,307	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)	151,063,456	128,686,575
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)....	163,248,828	167,958,084
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	361,808,591	296,644,659
19	Revenue less expenses. Subtract line 18 from line 12.......	-50,074,668	27,937,526
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	374,329,270	383,733,665
21	Total liabilities (Part X, line 26).............	195,733,113	205,284,746
22	Net assets or fund balances. Subtract line 21 from line 20.....	178,596,157	178,448,919

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 271,973,513 including grants of $ ) (Revenue $ 310,140,580 )
	BUTLER HEALTHCARE PROVIDERS D/B/A BUTLER MEMORIAL HOSPITAL (BMH) IS AN INDEPENDENT, COMMUNITY-BASED HOSPITAL THAT HAS SERVED BUTLER COUNTY, PA, AND THE SURROUNDING AREA FOR OVER 100 YEARS. BMH EMPLOYS APPROXIMATELY 1,600 PEOPLE. BMH HAS GROWN INTO A REGIONAL REFERRAL CENTER. IT IS THE LARGEST HOSPITAL FACILITY BETWEEN PITTSBURGH AND ERIE. IT IS COMPRISED OF 296 ACUTE CARE BEDS. BMH SERVES APPROXIMATELY 10,500 ACUTE CARE PATIENTS (ADMISSIONS) AND OVER 440,000 OUTPATIENT REGISTRATIONS EACH YEAR. BMH MAINTAINS A DEEP COMMITMENT TO ITS COMMUNITY, AS IS DEMONSTRATED THROUGH ITS BROAD SERVICES OFFERING, INCLUDING ALL LEVELS OF GENERAL MEDICAL AND SURGICAL CARE, EMERGENCY SERVICES, OBSTETRICS AND GYNECOLOGY SERVICES, A ROBUST BEHAVIORAL HEALTH SERVICE, DRUG AND ALCOHOL TREATMENT, FAMILY SERVICES, PREVENTATIVE & WELLNESS PROGRAMS AND TERTIARY CARDIOVASCULAR CARE. IT ALSO HAS A NETWORK OF APPROXIMATELY 60 CONVENIENT, LOW COST OUTPATIENT SITES THAT ARE LOCATED IN COMMUNITIES THROUGH BUTLER COUNTY AND THE SURROUNDING AREA. A DESCRIPTION OF THE TOP THREE SERVICE LINES FOLLOW.BUTLER MEMORIAL HOSPITAL (BMH) MEDICAL IMAGING SERVICES PROVIDES THE COMMUNITIES WE SERVE WITH EASY ACCESS TO THE LATEST MEDICAL IMAGING TECHNOLOGIES. BUTLER MEMORIAL HOSPITAL IMAGING SERVICES INCLUDE COMPUTERIZED TOMOGRAPHY (CT), MEDICAL RESONANCE IMAGING (MRI), PET/CT, AND DIGITAL MAMMOGRAPHY. ADDITIONAL IMAGING SERVICE INCLUDE ULTRASOUND (SONOGRAPHY), NUCLEAR MEDICINE, BONE DENSITY TESTING, X-RAYS AND FLUOROSCOPIC STUDIES. BMH'S IMAGING STUDIES ARE INTERPRETED BY ON-SITE BOARD-CERTIFIED RADIOLOGISTS TRAINED IN THE FOLLOWING SUBSPECIALTIES: INTERVENTIONAL RADIOLOGY, WOMEN'S IMAGING, MUSCULOSKELETAL IMAGING, BODY IMAGING, NEURORADIOLOGY AND ADVANCED VEIN CARE. BMH PROVIDED MEDICAL IMAGING SERVICES TO OVER 114,000 PATIENTS.CARDIOLOGY SERVICES AT BUTLER MEMORIAL HOSPITAL PROVIDES ROUTINE CARDIAC CARE, INTERVENTIONAL CARDIOLOGY, ELECTROPHYSIOLOGY, OPEN HEART SURGERY AND CARDIAC REHABILITATION. OTHER SERVICE AREAS INCLUDE A DEVICE MANAGEMENT CLINIC, VALVE CLINIC, HEART FAILURE CLINIC AND CHEST PAIN CENTER WITH PCI ACCREDITATION.BUTLER MEMORIAL HOSPITAL LABORATORY HAS STATE-OF-THE ART INSTRUMENTATION COMPLEMENTED BY PROFESSIONAL EXPERTISE IN MICROBIOLOGY, PATHOLOGY, CHEMISTRY, HEMATOLOGY AND CYTOLOGY. OUR LABORATORY PROVIDES BLOOD WORK AND TESTING THROUGHOUT OUR SERVICE AREA, FOR PATIENTS, PHYSICIAN OFFICES AND LONG-TERM CARE FACILITIES AND IS ACCREDITED BY THE COLLEGE OF AMERICAN PATHOLOGISTS (CAP) AND LICENSED BY THE CLINICAL LABORATORY IMPROVEMENT ACT (CLIA). LABORATORY SERVICES VARY BY LOCATION AND COVER ALL OF THE FOLLOWING AREAS: SURGICAL PATHOLOGY, MOLECULAR DIAGNOSTICS, DERMATOPATHOLOGY, CYTOPATHOLOGY, HEMATOPATHOLOGY AND TRANSFUSION MEDICINE. BUTLER MEMORIAL HOSPITAL PROVIDE LABORATORY SERVICE TO OVER 300,000 PATIENTS.

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 expenses271,973,513

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	6,897,501	2,401,737	453,545

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	1,152,734

f	All other contributions, gifts, grants, and similar amounts not included above		1f	89,745

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

h Total. Add lines 1a-1f.......		1,242,479

		Business Code
2a	NET PATEINT SERVICE REVENUE	621500	298,745,802	298,745,802
b	OTHER OPERATING REVENUE	621500	11,394,778	11,394,778
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		310,140,580

3 Investment income (including dividends, interest, and othersimilar amounts) ......			1,641,328			1,641,328
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	330,391
b	Less: rental expenses	6b	0
c	Rental income or (loss)	6c	330,391
d	Net rental income or (loss).......			330,391			330,391
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a	4,158,410	16,393
b	Less: cost or other basis and sales expenses	7b	0	0
c	Gain or (loss)	7c	4,158,410	16,393
d	Net gain or (loss).........			4,174,803			4,174,803
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
11a	PHARAMCY		456110	3,587,416		3,587,416
b	NON PATIENT LAB		541380	1,481,468		1,481,468
c	CAFETERIA		900099	1,305,286			1,305,286
d	All other revenue ....			678,434		678,434
e	Total. Add lines 11a–11d ......			7,052,604
12	Total revenue. See instructions.....			324,582,185	310,140,580	5,747,318	7,451,808

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 ...........
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........	94,613,642	83,969,607	10,644,035
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	6,361,964	5,646,243	715,721
9	Other employee benefits .......	19,494,270	17,301,165	2,193,105
10	Payroll taxes ...........	8,216,699	7,292,320	924,379
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	866,271		866,271
c	Accounting ...........	344,297		344,297
d	Lobbying ...........	49,413	43,854	5,559
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)	30,493,265	27,525,834	2,967,431
12	Advertising and promotion ....	444,031	394,078	49,953
13	Office expenses .......	1,821,126	1,616,249	204,877
14	Information technology ......	4,428,849	3,930,603	498,246
15	Royalties ..
16	Occupancy ...........	5,318,261	4,719,957	598,304
17	Travel ............	108,637	96,415	12,222
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	510,525	453,091	57,434
20	Interest ...........	5,756,322	5,108,736	647,586
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	17,579,171	15,601,514	1,977,657
23	Insurance ...	4,159,350	3,691,423	467,927
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	64,510,876	64,510,876
b	EQUIPMENT RENTAL & MAIN	11,136,218	9,883,393	1,252,825
c	BAD DEBT EXPENSE	9,808,572	9,808,572
d	MA MODERNIZATION ASSESS	6,679,020	6,679,020
e	All other expenses	3,943,880	3,700,563	243,317
25	Total functional expenses. Add lines 1 through 24e	296,644,659	271,973,513	24,671,146	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 ........			2,699	1	1,953
2	Savings and temporary cash investments .........			31,618,264	2	26,885,710
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			24,421,470	4	39,380,912
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 ...........				7
8	Inventories for sale or use ............			3,527,259	8	3,188,524
9	Prepaid expenses and deferred charges ......			25,668,770	9	16,045,154
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	415,289,087
b	Less: accumulated depreciation	10b	299,384,867	125,079,082	10c	115,904,220
11	Investments—publicly traded securities .			101,476,882	11	93,132,155
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..			23,563,219	13	20,585,211
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			38,971,625	15	68,609,826
16	Total assets. Add lines 1 through 15 (must equal line 33)...			374,329,270	16	383,733,665

17	Accounts payable and accrued expenses .....	35,273,148	17	46,954,287
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	103,610,000	20	103,149,530
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 ..	19,248,516	23	14,716,494
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	37,601,449	25	40,464,435
26	Total liabilities. Add lines 17 through 25..	195,733,113	26	205,284,746

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	175,518,083	27	175,247,577
28	Net assets with donor restrictions ...........	3,078,074	28	3,201,342
	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 ...........	178,596,157	32	178,448,919
33	Total liabilities and net assets/fund balances ........	374,329,270	33	383,733,665