2024-05-15T18:04:38-05:00 2023-06-30 135565207 KPMG LLP 210 PARK AVENUE SUITE 2650 OKLAHOMA CITY OK 73102 990 2022-07-01 731369586 INTEGRIS HOSPICE INC INTE 4059496026 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 MIKE WEED CFO 4059496026 2024-05-15 1 MIKE WEED XXX-XX-XXXX 0 ZELJKO POPOVIC P01795951 4052396411 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z SEE SCHEDULE O MIKE WEED 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 6434206 0 X WWW.INTEGRISOK.COM X 1990 OK ENHANCE THE QUALITY AND DIGNITY OF LIFE FOR TERMINALLY ILL PERSONS AND THEIR FAMILIES. 16 14 56 14 0 0 318600 140250 6081160 5823959 158214 469997 0 0 6557974 6434206 0 0 0 0 4013402 4391203 0 0 0 2148804 2240546 6162206 6631749 395768 -197543 11623135 11406550 731025 724432 10892110 10682118 X ENHANCE THE QUALITY AND DIGNITY OF LIFE FOR TERMINALLY ILL PERSONS AND THEIR FAMILIES. 0 0 5943801 5823959 SEE SCHEDULE O FOR DETAIL. 5943801 1 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 56 1 0 0 0 0 0 0 0 0 0 0 0 0 X 16 14 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 OK X DONNA WALLACE 4059512744 3001 QUAIL SPRINGS PARKWAY OKLAHOMA CITY OK 73134 CHRISTOPHER TURNER DIRECTOR 1.00 1.00 X 0 29930 0 DAVID THOMPSON DIRECTOR 1.00 1.00 X 0 23000 0 FRANK MERRICK DIRECTOR 1.00 1.00 X 0 23430 0 GEORGIANNE SNOWDEN MD DIRECTOR 1.00 1.00 X 0 23575 0 JIM COUCH DIRECTOR 1.00 1.00 X 0 23430 0 JOEY SAGER DIRECTOR 1.00 1.00 X 0 22330 0 KARLA MARSHALL DIRECTOR 1.00 1.00 X 0 22750 0 LINDA VYTLACIL PHD DIRECTOR 1.00 1.00 X 0 22150 0 MARK WERNER DIRECTOR & CHAIRMAN 1.00 1.00 X X 0 21730 0 MARSHALL SNIPES DIRECTOR - PART YEAR 1.00 1.00 X 0 0 0 NEAL HOGAN PHD DIRECTOR & VICE CHAIRMAN 1.00 1.00 X X 0 23250 0 NICO GOMEZ DIRECTOR 1.00 1.00 X 0 23680 0 PETER DELANEY DIRECTOR 1.00 1.00 X 0 23080 0 SAM COMBS DIRECTOR 1.00 1.00 X 0 23430 0 SHERRI LANCE DIRECTOR 1.00 1.00 X 0 22500 0 TIMOTHY PEHRSON DIRECTOR, OFFICER 1.00 39.00 X X 0 2539008 286936 BRENT HUBBARD DIRECTOR 1.00 39.00 X 0 648949 93267 DOUGLAS M SMITH PART YEAR CFO OF IH 1.00 39.00 X 0 907662 130539 MICHAEL WEED PART YEAR CFO OF IH 1.00 39.00 X 0 394260 60017 TERRY GONSOULIN ADMINISTRATIVE DIRECTOR 1.00 39.00 X 162821 0 18112 LEROY SOUTHMAYD PHYSICIAN 40.00 0.00 X 121105 0 7247 LYDIA A WELCH MGR. NURSING 40.00 0.00 X 127613 0 12556 SARAH R MINOR PHYSICIAN 1.00 39.00 X 210556 0 11670 CHRISTINE BRIDGES PHYSICIAN 40.00 0.00 X 116977 0 7516 JUDY PRATER REGISTERED NURSE 40.00 0.00 X 119262 0 5496 858334 4818144 633356 6 0 1 0 0 140250 140250 PATIENT REVENUE 621990 5823959 5823959 5823959 171898 171898 298099 0 298099 298099 298099 6434206 5823959 0 469997 180933 180933 3376112 3376112 59789 59789 514668 514668 259701 259701 687948 687948 89 89 674327 674327 175854 175854 102105 102105 93669 93669 177445 177445 23544 23544 PURCHASED SERVICES 241565 241565 CONTRACT LABOR 39177 39177 DUES & MEMBERSHIPS 17044 17044 LICENSES/PERMITS ETC. 4872 4872 2907 2907 6631749 5943801 687948 0 943496 1877527 1605186 706554 1388850 1016247 4184657 1681408 2679557 2503249 2091753 2091753 2914293 3211220 11623135 11406550 642942 408853 88083 315579 731025 724432 X 8800357 8590365 2091753 2091753 10892110 10682118 11623135 11406550 -197543 -12449 0 X 0 1 X 1 1 1 X 164973 522564 286400 318600 140250 1432787 5668148 6270884 5890638 6081160 5823959 29734789 5833121 6793448 6177038 6399760 5964209 31167576 0 0 0 31167576 92324 65988 46909 111323 171898 488442 92324 65988 46909 111323 171898 488442 2177 2177 5925445 6859436 6226124 6511083 6136107 31658195 0.98450 0.98480 0.01540 0.01510 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 428892 428892 2581078 598205 1982873 3393 3393 0 1039463 949075 90388 131830 130734 1096 2503249 INVESTMENT IN INTEGRIS HEALTH FOUNDATION, INC. - SFAS 136 2091753 F 2091753 LONG TERM INVESTMENTS HELD FOR TRADING 2901171 RIGHT-OF-USE ASSET 310049 3211220 ST LEASE LIABILITY ASC 842 209321 CURRENT PORTION OF OPERATING LEASE RIGHT OF USE OBLIGATION 106258 315579 0 1 0 0 0 0 0 1 0 TIMOTHY PEHRSON DIRECTOR, OFFICER 0 1230472 0 1003444 0 305092 0 280336 0 6600 0 2825944 0 286003 DOUGLAS M SMITH PART YEAR CFO OF IH 0 613208 0 149498 0 144956 0 123939 0 6600 0 1038201 0 131709 BRENT HUBBARD DIRECTOR 0 470133 0 150000 0 28816 0 89609 0 3658 0 742216 0 0 MICHAEL WEED PART YEAR CFO OF IH 0 311224 0 72029 0 11007 0 53417 0 6600 0 454277 0 0 SARAH R MINOR PHYSICIAN 162914 0 47550 0 92 0 11418 0 252 0 222226 0 0 0 TERRY GONSOULIN ADMINISTRATIVE DIRECTOR 119653 0 41259 0 1909 0 13081 0 5031 0 180933 0 0 0 PART I, LINE 3 INTEGRIS HOSPICE, INC. (HOSPICE) IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS). AS PART OF THIS SYSTEM, HOSPICE RELIES UPON INTEGRIS TO ESTABLISH THE COMPENSATION FOR ITS TOP MANAGEMENT OFFICIALS. INTEGRIS UTILIZES A COMPENSATION SURVEY OR STUDY 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 INDIVIDUALS LISTED IN PART VII OF FORM 990 PARTICIPATED IN THIS PLAN BUT DID NOT RECEIVE A PAYMENT DURING THE YEAR. MICHAEL WEED BRENT HUBBARD THE FOLLOWING INDIVIDUALS RECEIVED A PAYMENT DURING THE YEAR: TIMOTHY PEHRSON $ 286,003 DOUGLAS 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 HAS ESTABLISHED A FINANCIAL INCENTIVE PLAN THAT ENCOURAGES THE EXECUTIVE OFFICER'S PARTICIPATION IN THE SIGNIFICANT IMPROVEMENTS OF THE QUALITY AND FINANCIAL OPERATIONS OF THE ORGANIZATION. THE QUALITY COMPONENT IS DEFINED AS IMPROVEMENT IN PATIENT SAFETY, PATIENT SATISFACTION AND REDUCTION OF EMPLOYEE TURNOVER. THE FINANCIAL COMPONENT CONSISTS OF ACHIEVEMENT IN NET OPERATING INCOME THRESHOLD TO BE ACHIEVED TO ACTIVATE THE PLAN. A PREDETERMINED THRESHOLD IS CREATED WITHIN ALL ASPECTS OF THE PLAN BEFORE FINANCIAL ACHIEVEMENT IS PAYABLE. ALL PLANS ARE WRITTEN ACCORDING TO EXECUTIVE LEVEL AND ADOPTED BY INTEGRIS HEALTH BOARD RESOLUTION EACH PLAN YEAR AND PAYABLE AFTER INDEPENDENT AUDIT RESULTS ARE DETERMINED. IN THE SECOND PLAN, CERTAIN EMPLOYED PHYSICIANS ARE ELIGIBLE TO RECEIVE INCENTIVE COMPENSATION PURSUANT TO THEIR WRITTEN EMPLOYMENT AGREEMENTS. ALL INCENTIVE COMPENSATION IS SUBJECT TO A CAP AND DOES NOT EXCEED 50% OF THE PHYSICIAN'S TOTAL COMPENSATION. THERE ARE A VARIETY OF METHODS USED TO CALCULATE INCENTIVE COMPENSATION BASED ON THE PHYSICIAN'S PERSONAL PRODUCTION, RANGING FROM (I) A SPECIFIED PERCENTAGE OF NET INCOME LESS EXPENSES; (II) A SPECIFIED PERCENTAGE OF TOTAL COLLECTIONS LESS EXPENSES; (III) A SPECIFIED PERCENTAGE OF BASE SALARY BASED COMPLIANCE WITH CERTAIN QUALITY, PATIENT SATISFACTION, PRODUCTION AND FINANCIAL INDICATORS; (IV) A SPECIFIED PERCENTAGE OF BASE SALARY BASED ON COMPLIANCE WITH QUALITY, GUIDING VALUES, PATIENT SATISFACTION AND PRODUCTION CRITERIA; (V) A SPECIFIED PERCENTAGE OF FEE-BASED COLLECTIONS AND CAPITATION COLLECTIONS, IF APPLICABLE, IN EXCESS OF QUARTERLY SALARY; (VI) QUARTERLY BONUSES MEASURED BY RVUS THAT EXCEED A SPECIFIED TARGET PER QUARTER; AND (VII) PRO RATA SHARE OF ANNUAL INCENTIVE POOLS BASED UPON PRODUCTION, COMPLIANCE WITH CLINICAL GUIDELINES, QUALITY AND PATIENT SATISFACTION CRITERIA. FORM 990, BOX C: DOING BUSINESS AS INTEGRIS HOSPICE OF GRADY COUNTY INTEGRIS HOSPICE HOUSE FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS: INTEGRIS HOSPICE SERVICES INCLUDE HOSPICE OF OKLAHOMA COUNTY, INC. (HOC) AND INTEGRIS HOSPICE HOUSE, INC., A TWELVE BED INPATIENT HOSPICE FACILITY, PROVIDING A TEAM-ORIENTED APPROACH TO MEDICAL CARE, EXPERT PAIN MANAGEMENT, AND EMOTIONAL, SPIRITUAL, AND BEREAVEMENT SUPPORT EXPRESSLY TAILORED TO THE PATIENT AND FAMILY'S NEEDS AND WISHES. IN FISCAL YEAR 2022, INTEGRIS HOSPICE AND THE INTEGRIS HOSPICE HOUSE SERVED 1,370 PATIENTS IN HOSPICE CARE AND SERVED OVER 2,445 INDIVIDUALS PROVIDING BEREAVEMENT CARE AND GRIEF SUPPORT COUNSELING. THE HOSPICE VOLUNTEER PROGRAM PROVIDED 1,007.8 HOURS OF SUPPORTIVE CARE DURING THE YEAR. CURRENTLY, THE INTEGRIS HOSPICE PROGRAM REMAINS A PARTNER AGENCY OF THE UNITED WAY OF CENTRAL OKLAHOMA. PROVIDING GRIEF SUPPORT FOR ANYONE IN THE COMMUNTIY AND HOSPICE CARE FOR THOSE WITHOUT FINANCIAL ASSISTANCE. FOUNDED IN 1990 BY PHYSICIANS OF THE OKLAHOMA COUNTY MEDICAL SOCIETY, INTEGRIS HOSPICE, INC. IS CERTIFIED BY MEDICARE, ACCREDITED BY THE JOINT COMMISSION AND LICENSED IN OKLAHOMA. AN INTEGRIS HEALTH PROGRAM SINCE 1996, INTEGRIS HOSPICE IS A MEMBER OF THE OKLAHOMA HOSPICE AND PALLIATIVE CARE ASSOCIATION, AS WELL AS THE NATIONAL HOSPICE AND PALLIATIVE CARE ORGANIZATION. INTEGRIS HOSPICE HOUSE IS ALSO CERTIFIED BY MEDICARE AND ACCREDITED BY THE JOINT COMMISSION. PARTNERING WITH MEDICAL UNIVERSITIES IN THE METROPOLITAN AREA, THE INTEGRIS HOSPICE PROGRAM PROVIDES HOSPICE TRAINING TO STUDENT NURSES AND PHYSICIAN FELLOWSHIP TRAINING. PART V: LINE 1A AND 2A PART V: 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. PART V: 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 EMPOYEES REPORTED ON PART V, LINE 2A REPRESENTS THE NUMBER OF FULL TIME EMPLOYEES, AS DETERMINED BY FTE HOURS WORKED, FOR THE FILING ORGANIZATION DURING THE 2021 TAX YEAR. FORM 990, PART VI, SECTION A, LINE 1A THE HOSPITAL ADVISORY BOARD FULFILLS THE NECESSARY GOVERNANCE AUTHORITY FOR MEDICAL STAFF MEMBERSHIP AND QUALITY OF CARE OVERSIGHT AS REQUIRED BY THE CENTER FOR MEDICARE AND MEDICAID SERVICES CONDITIONS OF PARTICIPATION. FORM 990, PART VI, SECTION A, LINE 2 THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (SYSTEM). THE FOLLOWING OFFICERS AND DIRECTORS OF THE FILING ORGANIZATION HAVE A BUSINESS RELATIONSHIP WITH ONE ANOTHER BY VIRTUE OF THEIR POSITIONS AS OFFICERS, DIRECTORS, OR EMPLOYEES OF RELATED ENTITIES WITHIN THE SYSTEM: DOUGLAS M. SMITH TIMOTHY PEHRSON MIKE WEED FORM 990, PART VI, SECTION A, LINE 6 INTEGRIS HEALTH, INC. IS THE SOLE MEMBER OF INTEGRIS HOSPICE, INC. FORM 990, PART VI, SECTION A, LINE 7A INTEGRIS HEALTH, INC. IS THE SOLE MEMBER OF INTEGRIS HOSPICE, INC. AND AS SUCH IT HAS THE POWER (1) TO CONFIRM OR DENY THE ELECTION OF EACH MEMBER OF THE BOARD OF DIRECTORS, (2) TO APPROVE OR DISAPPROVE ANY ACTION TAKEN BY THE BOARD OF DIRECTORS AMENDING, ALTERING, CHANGING OR REPEALING THE CERTIFICATE OF INCORPORATION OR BYLAWS, (3) TO VOTE ON ALL MATTERS WHERE THE AUTHORIZATION OR APPROVAL OF THE SOLE MEMBER IS REQUIRED BY THE CERTIFICATE OF INCORPORATION, THE BYLAWS OR STATE LAW AND, (4) TO APPROVE CERTAIN SIGNIFICANT DECISIONS OF THE BOARD OF DIRECTORS, INCLUDING BUT NOT LIMITED TO THE ADOPTION OF BUDGETS, AUTHORIZATION OF SIGNIFICANT CAPITAL EXPENDITURES, DISPOSITION OF ASSETS, AND CHANGE OF THE ORGANIZATION'S PURPOSE. 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 ALL SYSTEM EMPOYEES RECEIVE TRAINING DURING NEW EMPLOYEE ORIENTATION AND INSTRUCTED TO REPORT ANY POSSIBLE CONFLICTS, 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 B, LINE 15A THE FILING ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY INTEGRIS HEALTH, INC. (INTEGRIS OR SYSTEM). THE MEDICAL DIRECTOR'S COMPENSATION IS REVIEWED BY THE INTEGRIS DEPARTMENT OF HUMAN RESOURCES. INDEPENDENT SALARY SURVEY SOURCES FROM THIRD PARTY PROVIDERS ARE USED TO DETERMINE LOCAL AND REGIONAL FAIR MARKET COMPETITIVENESS. ADJUSTMENTS IN SALARIES BASED ON INDIVIDUAL PERFORMANCE STANDARDS OR ANY MARKET EQUITY ADJUSTMENTS ARE APPROVED BY THE RESPECTIVE VICE PRESIDENT OR MANAGING DIRECTOR. FORM 990, PART VI, SECTION B, LINE 15B - INTEGRIS HOSPICE, INC. DOES NOT HAVE ANY INDIVIDUALS THAT FALL WITHIN THE CATEGORIES OF OTHER OFFICERS OR KEY EMPLOYEES. AS SUCH, A PROCESS FOR DETERMINING THE COMPENSATION FOR THESE INDIVIDUALS HAS NOT BEEN DETERMINED. 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. SECTION 1.263(A)-1(F) DE MINIMIS SAFE HARBOR ELECTION INTEGRIS HOSPICE, INC. HEREBY MAKES THE DE MINIMIS SAFE HARBOR ELECTION UNDER SECTION 1.263(A)-1(F) OF THE TREASURY REGULATIONS, EFFECTIVE FOR THE TAX YEAR ENDING JUNE 30, 2022. TAXPAYER HAS AN APPLICABLE FINANCIAL STATEMENT FOR THE YEAR OF THE ELECTION. THIS ELECTION PERMITS THE TAXPAYER TO DEDUCT FOR TAX PURPOSES ANY ITEM DEDUCTED UNDER ITS BOOK POLICY THAT DOES NOT EXCEED $5,000 PER INVOICE (OR PER ITEM, AS SUBSTANTIATED BY THE INVOICE) OR ITEMS HAVING AN ECONOMIC USEFUL LIFE OF TWELVE MONTHS OR LESS AS DESCRIBED IN SECTION 1.263(A)-1(F)(1)(I). TAXPAYER NAME: INTEGRIS HOSPICE, INC. ADDRESS: 3001 QUAIL SPRINGS PARKWAY, OKLAHOMA CITY, OK 73134 TAXPAYER IDENTIFICATION NUMBER: 73-1369586 SECTION 1.263(A)-3(N) ELECTION - BOOK CONFORMITY ELECTION INTEGRIS HOSPICE, INC. IS MAKING THE ELECTION UNDER TREAS. REG. 1.263(A)-3(N) TO CAPITALIZE THOSE REPAIR AND MAINTENANCE COSTS THAT IT TREATS AS CAPITAL EXPENDITURES ON ITS BOOKS AND RECORDS FOR THE TAX YEAR ENDED JUNE 30, 2022. TAXPAYER NAME: INTEGRIS HOSPICE, INC. ADDRESS: 3001 QUAIL SPRINGS PARKWAY, OKLAHOMA CITY, OK 73134 TAXPAYER IDENTIFICATION NUMBER: 73-1369586 INTEGRIS AMBULATORY CARE CORPORATION 3001 QUAIL SPRINGS PKWY OKLAHOMA CITY OK 73134 731192765 HEALTH CARE OK 501(C)(3) LINE 3 IH 0 INTEGRIS HEALTH INC 3001 QUAIL SPRINGS PKWY OKLAHOMA CITY OK 73134 731192764 HEALTH CARE OK 501(C)(3) LINE 12A, I N/A 0 INTEGRIS BAPTIST MEDICAL CENTER INC 3001 QUAIL SPRINGS PKWY OKLAHOMA CITY OK 73134 731034824 HEALTH CARE OK 501(C)(3) LINE 3 IH 0 INTEGRIS RURAL HEALTH INC 3001 QUAIL SPRINGS PKWY OKLAHOMA CITY OK 73134 731444504 HEALTH CARE OK 501(C)(3) LINE 3 IH 0 INTEGRIS SOUTHWEST MEDICAL CENTER INC 3001 QUAIL SPRINGS PKWY OKLAHOMA CITY OK 73134 731089149 HEALTH CARE OK 501(C)(3) LINE 3 IH 0 INTEGRIS HEALTH FOUNDATION INC 3001 QUAIL SPRINGS PKWY OKLAHOMA CITY OK 73134 731047338 FUNDRAISING OK 501(C)(3) LINE 7 IH 0 WESTERN VILLAGE ACADEMY INC 3001 QUAIL SPRINGS PKWY OKLAHOMA CITY OK 73134 731588764 SCHOOL OK 501(C)(3) LINE 2 IACC 0 INTEGRIS HEALTH EDMOND INC 3001 QUAIL SPRINGS PKWY OKLAHOMA CITY OK 73134 451027361 HEALTH CARE OK 501(C)(3) LINE 3 IH 0 INTEGRIS MENTAL HEALTH INC 3001 QUAIL SPRINGS PKWY OKLAHOMA CITY OK 73134 730738716 HEALTH CARE OK 501(C)(3) LINE 3 IH 0 INTEGRIS HEALTH ALLSET URGENT CARE LLC 3001 QUAIL SPRINGS PKWY OKLAHOMA CITY OK 73134 923075963 HEALTH CARE OK 501(C)(3) LINE 3 IH 0 BMPA LTD 3001 QUAIL SPRINGS PKWY OKLAHOMA CITY OK 73134 731228665 MED.OFFICE BLDG. OK N/A N/A 0 0 QC-III 3001 QUAIL SPRINGS PKWY 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 WOMEN'S HOSPITAL LLC 3001 QUAIL SPRINGS PKWY 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 PKWY OKLAHOMA CITY OK 73134 731076179 RETAIL PHARMACY OK N/A C 0 THE STANLEY F HUPFELD CHARITABLE REMAIN TRUST 3001 QUAIL SPRINGS PKWY OKLAHOMA CITY OK 73134 266238051 FINANCIAL OK N/A T 0 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 PKWY OKLAHOMA CITY OK 73134 731477468 DORMANT OK N/A C 0 ONE CARE INC 3001 QUAIL SPRINGS PKWY OKLAHOMA CITY OK 73134 DORMANT OK N/A C 0 VADOVATIONS INC 3001 QUAIL SPRINGS PKWY OKLAHOMA CITY OK 73134 270821922 HEALTH CARE OK N/A C 0 INTEGRIS HEALTH PARTNERS LLC 3001 QUAIL SPRINGS PKWY OKLAHOMA CITY OK 73134 453482852 HEALTH CARE OK N/A C 0 INTEGRIS CARDIOVASCULAR PHYSICIANS LLC 3001 QUAIL SPRINGS PKWY OKLAHOMA CITY OK 73134 452867352 HEALTH CARE OK N/A C 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 1 1 0 0