The Guthrie Clinic

Schedule O Supplemental Information Disclosures

“Form 990 Part III Line 1 The Guthrie Clinic is a nonprofit Health Care organization that serves to coordinate the activities of Guthrie Medical Group P.C.(GMG) and the affiliates within Guthrie Healthcare System (GHS: see Form 990, Schedule R, for a listing of affiliates of GHS, including Robert Packer Hospital (RPH)). Through the activities of the GMG, GHS, RPH and its other affiliates (collectively referred to as "Guthrie"), The Guthrie Clinic provides charitable community-based healthcare services and programs to improve the health and well-being of the people and communities served by its facilities and providers. Prior to 2/1/14, The Guthrie Clinic was called Guthrie Health. Form 990 Part IV Line 12b The organization's financial statements were audited on a consolidated basis with The Guthrie Clinic and Affiliates. Form 990 Part VI line 4 In November 2013, the Board approved a restructure plan to merge Guthrie Healthcare System into Guthrie Health, with Guthrie Health, renamed The Guthrie Clinic, the survivor. As a result of the merger, The Guthrie Clinic became a non-member corporation governed by a self-perpetuating board of directors. Form 990 Part VI Line 6 The Guthrie Clinic is a non-member corporation governed by a self-perpetuating board of directors. Form 990 Part VI Section A Line 7a The Guthrie Clinic Board of Directors are appointed by existing members of the Board. Form 990 Part VI Section B Line 11a & 11b The Form 990 of the organization is provided to the Board of Directors for review and is also reviewed by the organization's finance personnel and an independent accounting firm prior to filing with the IRS. Form 990 Part VI Section B Line 12c The Conflict of Interest Disclosure Policy sets forth that all persons, including employees, agents and Board/Committee members, particularly those involved in decision-making for The Guthrie Clinic (TGC), act in an appropriate manner and will not participate in any actions that might create a personal or professional conflict of interest and/or not be in the best interest of TGC. All Members of any TGC Board/Committee and TGC senior management must make full disclosure of any possible conflict of interest through the use of the Conflict of Interest Disclosure Form and refrain from voting or participating in decision-making involving any possible conflict of interest. The form is distributed to all Board/Committee members, and employees (when applicable) annually by the TGC Administration office. TGC Board/Committee members or employees must complete the Conflict of Interest Disclosure Form. This form should be completed when there is any situation where a possible conflict of interest exists, and/or on an annual basis and/or at the time of appointment or election of new Board/Committee members. If the form is not completed within 13 months of the last signing, the TGC Board Chairman will be advised. Any individual having a conflict of interest or possible conflict of interest on any matter should excuse themselves from the portion of the meeting or meetings where the matter is discussed and not vote or use his or her personal influence on the matter. The minutes of the meeting or meetings should reflect the disclosure, the abstention from voting, and any action taken to determine whether a conflict of interest existed. Form 990 Part VI Section B Line 15a and 15b Executive compensation is generally established within a written employment agreement. Compensation is determined based on market studies, presented to The Guthrie Clinic Compensation Committee, and subsequently approved by the Board of Directors. Form 990 Part VI Section C Line 18 The organization's Form 1023, 990, and 990-T are available for public inspection upon request. Form 990 Part VI Section C Line 19 The organization does not make its governing documents and conflict of interest policy available to the public. Form 990 Part XI Line 9 Equity Transfer to/from Affiliates (11,551,099), Pension Adjustment”