2024-05-15T18:06:07-05:00 2023-06-30 135565207 KPMG LLP 1225 17TH STREET SUITE 800 DENVER CO 80202 990 2022-07-01 731047338 INTEGRIS HEALTH FOUNDATION INC INTE 4059512744 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 MIKE WEED CFO 4059512744 2023-05-14 1 MIKE WEED XXX-XX-XXXX 0 KIMBERLY J MAC NAMEE P02479140 3033827400 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z SEE SCHEDULE O MICHAEL L WEED 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 6908349 0 X WWW.INTEGRISOK.COM X 1978 OK THE FOUNDATION PROMOTES THE PHILANTHROPIC SUPPORT AND MISSION OF INTEGRIS HEALTH, INC. TO IMPROVE THE HEALTH AND WELFARE OF THE PEOPLE AND THE COMMUNITIES WE SERVE. 17 11 20 15 1277545 176933 1685034 4143436 0 0 2820088 1861036 529532 423014 5034654 6427486 3480183 3936606 0 0 1179491 1344183 0 0 3671504 1528548 2471245 6188222 7752034 -1153568 -1324548 66140871 65479902 8032679 5157516 58108192 60322386 X INTEGRIS HEALTH FOUNDATION, INC. PROMOTES THE PHILANTHROPIC SUPPORT AND MISSION OF INTEGRIS HEALTH, INC. TO PROMOTE THE HEALTH AND WELFARE OF THE PEOPLE AND THE COMMUNITIES WE SERVE. 0 0 3936606 3936606 SEE SCHEDULE O. 3936606 1 1 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 X 0 0 20 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 17 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 OK X DONNA WALLACE 4059512744 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 HARRISON LEVY CHAIRMAN 1.00 0.00 X X 0 0 0 RYAN DETORO DIRECTOR 1.00 0.00 X 0 0 0 CHARLES WALLACE DIRECTOR 1.00 0.00 X 0 0 0 AMALIA MIRANDA-SILVERSTEIN DIRECTOR 1.00 0.00 X 0 0 0 SISSY HOLLOWAY DIRECTOR 1.00 0.00 X 0 0 0 JOEL CHAMPLIN DIRECTOR 1.00 0.00 X 0 0 0 SHERYL COLTON DIRECTOR 1.00 0.00 X 0 0 0 STEVE YOUNG DIRECTOR 1.00 0.00 X 0 0 0 JEFF SPARLING MD DIRECTOR 1.00 39.00 X 0 929828 10644 MICHAEL LEVINE DIRECTOR 1.00 0.00 X 0 0 0 AMANDA VANLANDINGHAM DIRECTOR 1.00 39.00 X 0 260501 19445 DOUGLAS HORSTMANSHOF MD DIRECTOR 1.00 39.00 X 0 720152 28694 SKIP LEONARD VP FOUNDATION 40.00 0.00 X 445196 0 19856 TIMOTHY PEHRSON DIRECTOR & PRESIDENT/CEO 0.00 40.00 X X 0 2539008 286936 SUSAN BREWER DIRECTOR 10.00 0.00 X 0 0 0 SUSAN MORITZ SECRETARY 1.00 0.00 X X 0 0 0 DENA O'LEARY DIRECTOR 1.00 39.00 X 0 502135 22764 MICHAEL WEED PART YEAR CFO 1.00 39.00 X 0 394260 60017 DOUGLAS M SMITH PART YEAR CFO 1.00 39.00 X 0 907662 130539 445196 6253546 578895 3 0 1 0 BLACKBAUD INC 65 FAIRCHILD STREET CHARLESTON SC 29492 SOFTWARE SERVICES 382313 ACCORDANT PHILANTHROPHY LLC 105 TEAL NEST COURT PONTE VEDRA BEACH FL 320821544 CONSULTING SERVICES 235400 OKLAHOMA CITY CONVENTION CENTER 100 MICK CORNETT DRIVE OKLAHOMA CITY OK 73109 EVENT SERVICES 130843 CAUSE AND SOLUTION INC 1277 KELLY JOHNSON COLORADO SPRINGS CO 80920 PROF. FUND RAISING SVCS 123500 BESPOKE MEDIA LLC 3000 SW 138TH STREET OKLAHOMA CITY OK 73170 EVENT PLANNING SERVICES 100048 5 220525 510076 3412835 138290 4143436 1861036 1277545 583491 903877 220525 480863 423014 423014 6427486 0 1277545 1006505 3936606 3936606 465052 465052 649296 649296 16834 16834 145134 145134 67867 67867 143924 143924 374118 374118 235 235 931372 931372 12086 12086 2235 2235 913 913 28156 28156 PURCHASED SERVICES 210995 210995 DONOR CULTIVATION 38246 38246 SPECIAL FUNCTIONS 18731 18731 CONTRACT LABOR 15246 15246 694988 694988 7752034 3936606 143924 3671504 200 0 9379894 13916277 5104151 3892967 276868 482531 467686 15758 14845 51637841 47375918 3027 3027 66140871 65479902 7922362 5048315 110317 109201 8032679 5157516 X 12063829 9815423 46044363 50506963 58108192 60322386 66140871 65479902 -1324548 3538742 0 X 0 1 X 1 0 X 8370781 3815090 3960944 1628833 3922911 21698559 8370781 3815090 3960944 1628833 3922911 21698559 3523716 18174843 2346930 1950904 2073820 2351309 583491 9306454 0 0 0 0 1277545 1277545 5628 8218 529532 423014 966392 33248950 0.54660 0.56140 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2018 AMOUNT: $ 5,628. 2021 AMOUNT: $ 413. FUNDRAISING - 2018 AMOUNT: $ 0. 2019 AMOUNT: $ 8,218. 2020 AMOUNT: $ 0. 2021 AMOUNT: $ 529,119. 2022 AMOUNT: $ 423,014. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 9659026 969758 728703 1579257 9778230 9977728 98850 -1142268 711888 12828 9659026 8467562 330179 1621881 -443575 1681 9977728 7931049 531912 99711 89993 5117 8467562 7291402 478963 160684 7931049 0.88890 0.11110 0.00000 0 0 11130 11130 33204 33204 0 431603 430142 1461 6594 4340 2254 14845 BOARD DESIGNATED INVESTMENTS 47603218 F RESTRICTED FUND INVESTMENTS 121651 F OTHER INVESTMENTS -348951 F 47375918 PART IV, LINE 2B: GIFT ANNUITIES AND CHARITABLE REMAINDER TRUSTS CONSIST OF CONTRIBUTED AMOUNTS SUBJECT TO OBLIGATIONS TO MAKE PERIODIC PAYMENTS TO BENEFICIARIES OVER A SPECIFIED PERIOD. THE LIABILITIES SHOWN ARE RECORDED AT THE ACTUARIAL PRESENT VALUES OF THE AGGREGATE LIABILITY BASED ON THE SPECIFIED PERIOD. A DISCOUNT RATE WAS USED TO DETERMINE THE PRESENT VALUE OF THE LIABILITIES. PART V, LINE 4: THE MAJORITY OF THE ENDOWMENT FUNDS ARE RESTRICTED FOR USE IN FUNDING THE INTEGRIS HEALTH SYSTEM'S CENTERS FOR EXCELLENCE. SPECIALIZED CENTERS OF EXCELLENCE HAVE BEEN DEVELOPED THROUGH VARIOUS INTEGRIS ENTITIES TO PROVIDE THE HIGHEST STANDARD OF CARE FOR OUR COMMUNITIES. CENTERS OF EXCELLENCE INCLUDE THE PAUL SILVERSTEIN BURN CENTER, INTEGRIS HEART HOSPITAL, NAZIH ZUHDI TRANSPLANT INSTITUTE, TROY & DOLLIE SMITH CANCER CENTER, WOMEN'S CENTER, HENRY G. BENNETT JR. FERTILITY INSTITUTE, SLEEP DISORDERS CENTER OF OKLAHOMA, THE HOUGH EAR INSTITUTE, THE CENTRAL OKLAHOMA CANCER CENTER, SOUTHWEST BREAST HEALTH AND IMAGING CENTER, INTEGRIS JIM THORPE REHABILITATION NETWORK, INTEGRIS NEUROMUSCULAR CENTER, SLEEP DISORDERS CENTER OF OKLAHOMA AND THE JAMES R. DANIEL STROKE CENTER OF OKLAHOMA. GALA 775262 104250 671012 774 144619 126954 46662 40343 IHF GOLF TOURNAMENT 233210 106000 127210 14074 31669 7990 1025 16580 2 115930 10275 105655 1938 5018 34972 2063 6182 1124402 220525 903877 16786 181306 169916 49750 63105 480863 423014 1 INTEGRIS BAPTIST MEDICAL CENTER INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 731034824 501(C)(3) 1939136 363851 FMV MEDICAL EQUIPMENT & RENOVATIONS TO FUND OPERATIONS INTEGRIS AMBULATORY CARE CORPORATION 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 731192765 501(C)(3) 47648 0 TO FUND OPERATIONS INTEGRIS SOUTH OKLAHOMA CITY HOSPITAL CORP 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 731089149 501(C)(3) 389522 110000 FMV RENOVATIONS TO FUND OPERATIONS INTEGRIS HEALTH INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 731192764 501(C)(3) 262647 177531 FMV MEDICAL EQUIPMENT & RENOVATIONS TO FUND OPERATIONS INTEGRIS HEALTH EDMOND INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 451027361 501(C)(3) 8698 25841 FMV MEDICAL EQUIPMENT & RENOVATIONS TO FUND OPERATIONS INTEGRIS RURAL HEALTH INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 731444504 501(C)(3) 484543 127189 FMV MEDICAL EQUIPMENT & RENOVATIONS TO FUND OPERATIONS 6 0 PART I, LINE 2: INTEGRIS HEALTH FOUNDATION, INC. (IH FDN OR FOUNDATION) WAS ESTABLISHED TO SUPPORT, THROUGH FUNDRAISING AND GRANT MAKING ACTIVITIES, THE NOT-FOR-PROFIT CHARITABLE AFFILIATES OF INTEGRIS HEALTH, INC. (AFFILIATE OR AFFILIATES OF INTEGRIS HEALTH SYSTEM), INCLUDING BUT NOT LIMITED TO INTEGRIS BAPTIST MEDICAL CENTER, INC. THE PROCESS FOR PROVIDING GRANTS TO AFFILIATES OF INTEGRIS HEALTH SYSTEM BEGINS WITH A REQUEST FOR FUNDING FROM THE AFFILIATE TO THE IH FDN. A DEPARTMENT DIRECTOR OF THE AFFILIATE MAKES AN INITIAL REQUEST TO THE ADMINISTRATIVE DIRECTOR OR VICE PRESIDENT OF THE AFFILIATE. THE ADMINISTRATIVE DIRECTOR OR VICE PRESIDENT VALIDATES THE DEPARTMENT'S NEED FOR THE FUNDS AND APPROVES THE REQUEST. THIS APPROVAL INDICATES THAT THE REQUESTED FUNDS ARE IN KEEPING WITH THE AFFILIATE'S OVERALL CHARITABLE GOALS. ONCE VALIDATED, THE REQUEST IS SENT TO THE DIRECTOR OF OPERATIONS OFFICE TO VERIFY THE FUNDS ARE AVAILABLE. IH FDN'S DIRECTOR OF OPERATIONS THEN REVIEWS THE REQUEST TO CONFIRM THE REQUESTED USE OF FUNDS ARE IN KEEPING WITH THE FOUNDATION'S CHARITABLE PURPOSES AND WITH THE INTENT OF DONORS TO THE FOUNDATION. ASSUMING THIS IS THE CASE, THE FOUNDATION'S DIRECTOR OF OPERATIONS APPROVES THE REQUEST. FUNDS REQUESTED BY THE AFFILIATES GENERALLY FALL INTO TWO CATEGORIES: CAPITAL AND NON-CAPITAL. THE REQUEST FOR FUNDS FORM MEMORIALIZES THE MOVEMENT OF FUNDS FROM THE FOUNDATION TO THE AFFILIATE FOR REIMBURSEMENT OF ITEMS PURCHASED. 0 1 0 0 0 0 0 1 0 TIMOTHY PEHRSON DIRECTOR & PRESIDENT/CEO 0 1230472 0 1003444 0 305092 0 280336 0 6600 0 2825944 0 286003 DOUGLAS M SMITH PART YEAR CFO 0 613208 0 149498 0 144956 0 123939 0 6600 0 1038201 0 131709 JEFF SPARLING MD DIRECTOR 0 426757 0 492927 0 10144 0 7625 0 3019 0 940472 0 0 DOUGLAS HORSTMANSHOF MD DIRECTOR 0 703303 0 0 0 16849 0 22125 0 6569 0 748846 0 0 DENA O'LEARY DIRECTOR 0 352539 0 146220 0 3376 0 16232 0 6532 0 524899 0 0 SKIP LEONARD VP FOUNDATION 314781 0 48668 0 81747 0 11046 0 8810 0 465052 0 0 0 MICHAEL WEED PART YEAR CFO 0 311224 0 72029 0 11007 0 53417 0 6600 0 454277 0 0 AMANDA VANLANDINGHAM DIRECTOR 0 186609 0 72600 0 1292 0 16850 0 2595 0 279946 0 0 PART I, LINE 3 INTEGRIS HEALTH FOUNDATION, INC. (IHF) IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS). AS PART OF THIS SYSTEM, IHF RELIES UPON INTEGRIS TO ESTABLISH THE COMPENSATION FOR ITS TOP MANAGEMENT OFFICIALS. INTEGRIS UTILIZES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THIS COMPENSATION. PART I, LINE 4B THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS). INTEGRIS PROVIDES TO CERTAIN EXECUTIVES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THE PURPOSE OF THE PLAN IS TO SUPPLEMENT THE SPONSOR-PROVIDED RETIREMENT BENEFITS TO BE PAID TO SENIOR EXECUTIVES PURSUANT TO THE DEFINED BENEFIT PENSION PLAN, THE TAX DEFERRED ANNUITY PLAN AND OTHER QUALIFIED OR NON QUALIFIED RETIREMENT PLANS WHICH ARE MAINTAINED BY THE SPONSOR. THE PLAN PROVIDES AN OPPORTUNITY TO EARN SUPPLEMENTAL INCENTIVE INCOME BY PROVIDING ANNUAL CONTRIBUTIONS TO THE ACCOUNT SO LONG AS THE EXECUTIVE REMAINS EMPLOYED BY THE SPONSOR TO RETIREMENT AGE OF 65. THE FOLLOWING INDIVIDUAL LISTED IN PART VII OF FORM 990 PARTICIPATED IN THIS PLAN BUT DID NOT RECEIVE A PAYMENT DURING THE YEAR. MICHAEL WEED THE FOLLOWING INDIVIDUALS LISTED IN PART VII OF FORM 990 PARTICIPATED IN THIS PLAN AND RECEIVED RECEIVED PAYMENTS IN THE CURRENT REPORTING YEAR: TIMOTHY PEHRSON - $286,003 DOUGLAS M. SMITH - $131,709 PART I, LINE 7 THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS). INTEGRIS HEALTH HAS ESTABLISHED A FINANCIAL INCENTIVE PLAN THAT ENCOURAGES THE EXECUTIVE OFFICER'S PARTICIPATION IN THE SIGNIFICANT IMPROVEMENTS OF THE QUALITY AND FINANCIAL OPERATIONS OF THE ORGANIZATION. THE QUALITY COMPONENT IS DEFINED AS IMPROVEMENT IN PATIENT SAFETY, PATIENT SATISFACTION AND REDUCTION OF EMPLOYEE TURNOVER. THE FINANCIAL COMPONENT CONSISTS OF ACHIEVEMENT IN NET OPERATING INCOME THRESHOLD TO BE ACHIEVED TO ACTIVATE THE PLAN. A PREDETERMINED THRESHOLD IS CREATED WITHIN ALL ASPECTS OF THE PLAN BEFORE FINANCIAL ACHIEVEMENT IS PAYABLE. ALL PLANS ARE WRITTEN ACCORDING TO EXECUTIVE LEVEL AND ADOPTED BY INTEGRIS HEALTH BOARD RESOLUTION EACH PLAN YEAR AND PAYABLE AFTER INDEPENDENT AUDIT RESULTS ARE DETERMINED. X 2 60604 FMV X GIK CONTRIB. 56 35475 FMV X MISC. ITEMS 2 34596 FMV X EQUIPMENT 1 7615 FMV 0 1 0 PART I, COLUMN (B): PART I, COL(B) REPORTS THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, BOX C: DOING BUSINESS AS INTEGRIS FOUNDATION PART III, LINE 4A: STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS INTEGRIS HEALTH FOUNDATION, INC. WAS ESTABLISHED TO FACILITATE FINANCIAL SUPPORT FOR THE ORGANIZATION BY CONNECTING DONORS TO THEIR INTEGRIS PASSIONS AS THEY RELATE TO THE MYRIAD OF PROGRAMS AND SERVICES OF INTEGRIS HEALTH, INC. AND ITS CHARITABLE AFFILIATES. THE INTEGRIS HEALTH FOUNDATION ACCOMPLISHED THE FOLLOWING FOR FY23: THE TWELFTH ANNUAL INTEGRIS YOU&I EMPLOYEE GIVING CAMPAIGN EXPERIENCED MUCH SUCCESS AS WE WELCOMED THE GIFTS OF 2,770 INTEGRIS EMPLOYEES AND PHYSICIANS. THIS GENEROSITY WAS MET BY THE MATCHING GIFTS FROM INTEGRIS VOLUNTEER AUXILIARIES ACROSS THE STATE FOR A TOTAL EXCEEDING $759,439 RAISED FOR VARIOUS CARE CENTERS THROUGHOUT THE SYSTEM. AT THE INTEGRIS HEALTH GALA, THE INTEGRIS HEALTH FOUNDATION RAISED MORE THAN $775,687 FROM THE EVENT WHICH BENEFITED HEART HEALTH ACROSS OKLAHOMA. THE INTEGRIS HEALTH GOLF CLASSIC BROKE RECORDS, RAISING MORE THAN $230,000 TO BENEFIT THE INTEGRIS HEALTH CANCER INSTITUTE, AND THE INAUGURAL PICKLEBALL TOURNAMENT RAISED MORE THAN $16,000 FOR ARCADIA TRAILS CENTER FOR ADDICTION RECOVERY. OTHER NOTABLE PROJECTS IN FY23 INCLUDE ALMOST $18,000 FOR MEALS GIVEN TO CANCER PATIENTS UNDERGOING THEIR FIRST TREATMENT, MORE THAN $398,471 IN PATIENT ASSISTANCE SPENT FOR ADDICTION RECOVERY, MORE THAN $3200 FOR CAR SEATS FOR FAMILIES WHO CANNOT AFFORD THEM AND MORE THAN $111,000 IN SCHOLARSHIPS FOR TRANSPLANT PATIENTS, TO NAME JUST A FEW. THE INTEGRIS HEALTH FOUNDATION HAD 4,224 DONORS IN FY23 AND INVESTED ALMOST $5.4 MILLION BACK TO OUR HOSPITALS, IMPACTING PATIENT CARE AND ADVANCING OUR MISSION TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. PART V: LINE 1A AND 2A LINE 1A - INTEGRIS HEALTH, INC., AS THE PARENT ENTITY OF THE INTEGRIS HEALTH SYSTEM, PAYS ALL VENDORS FOR SERVICES PROVIDED TO ALL ENTITIES WITHIN THE SYSTEM. ACCORDINGLY, COMPENSATION PAID TO INDEPENDENT CONTRACTORS IS REPORTED ON THE FORM 1096, ANNUAL SUMMARY AND TRANSMITTAL OF U.S. INFORMATION RETURNS OF INTEGRIS HEALTH, INC., EIN 73-1192764. EXPENSES ARE ALLOCATED TO AND REIMBURSED BY INDIVIDUAL ENTITIES WITHIN THE SYSTEM, AND REPORTED ON THEIR RESPECTIVE FORMS 990, PART VII, SECTION B AND PART IX, AS APPROPRIATE. LINE 2A - THE SALARIES REFLECTED ON FORM 990, PART IX, LINE 7, WERE ALL REPORTED ON THE FORM 941 EMPLOYER'S QUARTERLY FEDERAL TAX RETURN, OF INTEGRIS HEALTH, INC., EIN 73-1192764. THESE SALARIES WERE REIMBURSED TO INTEGRIS HEALTH, INC. AND WERE INCLUDED IN THE NUMBER OF EMPLOYEES ON INTEGRIS HEALTH, INC.'S FORM W-3. THE NUMBER OF EMPLOYEES REPORTED ON PART V, LINE 2A REPRESENTS THE, NUMBER OF FULL TIME EMPLOYEES, AS DETERMINED BY FTE HOURS WORKED, FOR THE FILING ORGANIZATION DURING THE 2022 TAX YEAR. FORM 990, PART VI, SECTION A, LINE 6 INTEGRIS HEALTH, INC. IS THE SOLE MEMBER OF INTEGRIS HEALTH FOUNDATION, INC. FORM 990, PART VI, SECTION A, LINE 7A INTEGRIS HEALTH, INC. IS THE SOLE MEMBER OF INTEGRIS HEALTH FOUNDATION, INC. AS SUCH IT HAS THE POWER (1) TO SELECT AND REMOVE ALL OFFICERS, AGENTS AND EMPLOYEES OF THE CORPORATION, PRESCRIBE SUCH POWERS AND DUTIES FOR THEM AS MAY BE CONSISTENT WITH LAW, WITH THE AMENDED AND RESTATED CERTIFICATE OF INCORPORATION OR THE BYLAWS, (2) TO CONDUCT, MANAGE AND CONTROL THE AFFAIRS AND BUSINESS OF THE CORPORATION, AND TO MAKE SUCH RULES AND REGULATIONS THEREFORE CONSISTENT WITH LAW, OR WITH THE AMENDED AND RESTATED CERTIFICATE OF INCORPORATION OR THE BYLAWS, AS THEY MAY DEEM BEST, SUBJECT TO THE APPROVAL OF THE SOLE MEMBER, (3) TO FIX AND LOCATE FROM TIME TO TIME ONE OR MORE SUBSIDIARY OFFICES OF THE CORPORATION WITHIN OR WITHOUT THE STATE OF OKLAHOMA; AND TO ADOPT, MAKE AND USE A CORPORATE SEAL, AND TO ALTER THE FORM OF SUCH SEAL FROM TIME TO TIME, AS IN THEIR JUDGEMENT THEY MAY DEEM BEST, PROVIDED SUCH SEAL AT ALL TIMES COMPLY WITH THE PROVISIONS OF LAW, THE CERTIFICATE OF INCORPORATION AND THESE BYLAWS. FORM 990, PART VI, SECTION A, LINE 7B PLEASE SEE THE NARRATIVE FOR FORM 990, PART VI, SECTION A, LINE 7A. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (SYSTEM). THE SYSTEM HAS A SINGLE AUDIT COMPLIANCE COMMITTEE WHICH OVERSEES THE CONSOLIDATED FINANCIAL STATEMENT AUDIT AS WELL AS THE FILING OF FEDERAL AND STATE TAX FORMS. THE SYSTEM ENGAGES A PAID PREPARER EXPERIENCED IN THE PREPARATION OF FORM 990 TO PREPARE THE FORM. A DRAFT FORM 990 IS PROVIDED TO THE SYSTEM VICE PRESIDENT OF FINANCE FOR REVIEW. A FINAL FORM 990 IS GIVEN TO THE SYSTEM CHIEF FINANCIAL OFFICER FOR REVIEW, APPROVAL, AND SIGNATURE. THE FINAL FORM 990 IS MADE AVAILABLE TO THE ORGANIZATION'S BOARD OF DIRECTORS, AS WELL AS TO THE SYSTEM'S AUDIT/COMPLIANCE COMMITTEE, FOR REVIEW PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS OR SYSTEM). CONFLICT OF INTEREST IS ADDRESSED IN THE INTEGRIS CODE OF CONDUCT. ALL SYSTEM EMPLOYEES RECEIVE TRAINING DURING NEW EMPLOYEE ORIENTATION AND ARE INSTRUCTED TO REPORT ANY POSSIBLE CONFLICTS OR TO REFER ANY CONFLICT OF INTEREST QUESTIONS TO THE SYSTEM'S COMPLIANCE OFFICER, OR THROUGH THE ANONYMOUS INTEGRITY LINE. ALL NEW MANAGERS RECEIVE ADDITIONAL TRAINING ON CONFLICT OF INTEREST POLICIES DURING LEADERSHIP TRAINING. LEGAL SERVICES REVIEWS ALL CONTRACTS FOR CONFLICTS OF INTEREST. INTERNAL AUDIT CONDUCTS AUDITS FOR POSSIBLE CONFLICTS OF INTEREST BASED ON THEIR ANNUAL RISK ASSESSMENT. CORPORATE COMPLIANCE INCLUDES ASSESSMENTS FOR CONFLICTS OF INTEREST IN ITS ANNUAL WORK PLAN AND CONDUCTS SPECIALIZED TRAINING FOR HIGH RISK AREAS. THE GOVERNANCE COMMITTEE, A COMMITTEE OF THE INTEGRIS HEALTH BOARD COMPRISED OF INDEPENDENT BOARD MEMBERS, REVIEWS AND APPROVES ANY AND ALL PROPOSED BUSINESS TRANSACTIONS BETWEEN ANY ENTITY OF INTEGRIS AND A DISQUALIFIED PERSON. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICTS OF INTEREST POLICY AVAILABLE TO THE PUBLIC. HOWEVER, THE FINANCIAL STATEMENTS OF THE ORGANIZATION ARE INCLUDED IN THE CONSOLIDATED FINANCIALS FOR INTEGRIS HEALTH, INC., A RELATED CORPORATION. THESE CONSOLIDATED FINANCIALS ARE DISCLOSED FOR BOND COMPLIANCE PURPOSES USING DIGITAL ASSURANCE CERTIFICATION. INTEGRIS AMBULATORY CARE CORPORATION 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 731192765 HEALTH CARE OK 501(C)(3) LINE 3 IH 0 INTEGRIS HOSPICE INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 731369586 HEALTH CARE OK 501(C)(3) LINE 10 IH 0 INTEGRIS BAPTIST MEDICAL CENTER INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 731034824 HEALTH CARE OK 501(C)(3) LINE 3 IH 0 INTEGRIS RURAL HEALTH INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 731444504 HEALTH CARE OK 501(C)(3) LINE 3 IH 0 INTEGRIS SOUTHWEST MEDICAL CENTER INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 731089149 HEALTH CARE OK 501(C)(3) LINE 3 IH 0 WESTERN VILLAGE ACADEMY INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 731588764 SCHOOL OK 501(C)(3) LINE 2 IACC 0 INTEGRIS HEALTH INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 731192764 HEALTH CARE OK 501(C)(3) LINE 3 N/A 0 INTEGRIS HEALTH EDMOND INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 451027361 HEALTH CARE OK 501(C)(3) LINE 3 IH 0 INTEGRIS MENTAL HEALTH INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 730738716 HEALTH CARE OK 501(C)(3) LINE 3 IH 0 INTEGRIS HEALTH ALLSET URGENT CARE LLC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 923075963 HEALTH CARE OK 501(C)(3) LINE 3 IACC 0 BMPA LTD 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 731228665 MEDICAL OFFICE BUILDING OK N/A N/A 0 0 QC-III 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 208723857 MEDICAL OK N/A N/A 0 0 DIAGNOSTIC LAB 500 PLAZA DR TAX DEPT FL 8 SECAUCUS NJ 07094 731560760 CLINICAL LAB NJ N/A N/A 0 0 LAKESIDE HOSPITAL 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 731493662 MEDICAL OK N/A N/A 0 0 INTEGRISUSP HEALTH 14201 DALLAS PARKWAY DALLAS TX 75254 352632292 MEDICAL SERVICES TX N/A N/A 0 0 INTEGRIS EMERGENCY HOSPITAL 8686 NEW TRAILS DRIVE THE WOODLANDS TX 77381 901215089 HEALTH CARE TX N/A N/A 0 0 INTEGRIS DDSI ENDOSCOPY CENTERS LLC 3366 NORTHWEST EXPRESSWAY STE 400 OKLAHOMA CITY OK 73112 854253589 HEALTH CARE OK N/A N/A 0 0 INTEGRIS PROHEALTH INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 731046179 RETIAL PHARMACY OK N/A C 0 THE STANLEY F HUPFELD CHARITABLE REMAINDER TRUST 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 266238051 FINANCIAL OK N/A T 59903 1.00000 1 QUALITY ALLIANCE ASSURANCE CO PO BOX 10027 GRAND CAYMAN CJ KYI-1001 981060671 INSURANCE CJ N/A C 0 BAPTIST HEALTH SYSTEM INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 731477468 DORMANT OK N/A C 0 ONE CARE INC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 DORMANT OK N/A C 0 VADOVATIONS 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 270821922 HEALTH CARE OK N/A C 0 INTEGRIS HEALTH PARTNERS LLC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 453482852 HEALTH CARE OK N/A C 0 INTEGRIS CARDIOVASCULAR PHYSICIANS LLC 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 462867352 HEALTH CARE OK N/A C 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0