St John Broken Arrow Inc

“Many of the persons listed on Part VII have a "business relationship" with each other by virtue of employment by St. John Health System, Inc. related entities.”

“St. John Broken Arrow, Inc. has a single corporate member, St. John Health System, Inc.”

“St. John Broken Arrow, Inc. has a single corporate member, St. John Health System, Inc., who has the ability to elect members to the governing body of St. John Broken Arrow, Inc.”

“All decisions that have a material impact to St. John Broken Arrow, Inc.'s financial information or corporation as a whole are subject to approval by its sole corporate member, St. John Health System, Inc. Ascension Health, the sole corporate member of St. John Health System, Inc., has designated a system authority matrix which assigns authority for key decisions that are necessary in the operation of the System. Specific areas that are identified in the authority matrix are: new organizations & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic & financial plans; assets; system policies & procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix.”

“St. John Broken Arrow, Inc. (SJBA) is an affiliate of the St. John Health System, Inc. (SJHS). SJHS has hired a third party preparer experienced in the preparation of Form 990 to assist in the preparation of the return. The Executive Vice President/Chief Financial Officer and Controller of SJHS will work closely with the paid preparer in gathering the information for the return and will perform the initial detailed review of the return. The return will then be reviewed by the SJHS Audit Committee (as delegated by the Board of the filing organization). A copy of the return will be provided to all voting board members of the filing organization prior to filing.”

“At every fiscal year end, St. John Health System, Inc. (SJHS) distributes a copy of the current Conflict of Interest Policy and Procedure Bulletin, together with an explanation and questionnaire to the members of the Board of Directors, administrative officers and key employees of SJHS, its subsidiaries and affiliates, including St. John Broken Arrow, Inc. The board members, administrative officers and key employees of SJHS, its subsidiaries and affiliates must complete the questionnaire and return it to the designated SJHS official within two weeks of receipt. Completed questionnaires are reviewed and summarized by the Vice President, Corporate Compliance and Integrity, or his/her designee. That individual then presents the questionnaire results to the heads of each hospital for further provision to the various boards' Audit and Compliance Committees. The Audit and Compliance Committees, as appropriate, submit a confidential report to their Board Chairman summarizing the questionnaire results. The Board Chairman, as appropriate, may review with the Executive Committee the responses to the questionnaire results. Members of a committee with governing board delegated powers annually sign a statement which affirms such person has received a copy of the Conflict of Interest Policy, has read and understands the Policy, has agreed to comply with the Policy, and understands that the Organization is charitable and, in order to maintain its federal tax exemption, it must engage primarily in activities which accomplish its tax-exempt purpose.”

“Compensation for all executives in St. John Health System, Inc. (SJHS), of which St. John Broken Arrow, Inc. is a part, is analyzed by an independent health care consulting firm. The analysis includes a fair market value assessment and establishment of a range for each position based on research of comparable health care systems of similar size. The report and recommended compensation levels for each executive management position is reviewed and approved by the Executive Compensation Committee of the SJHS Board of Directors.”

“The Organization will provide any documents open to public inspection upon request.”

“Independent Contractor Reporting: Compensation of independent contractors is paid by and reported on the Form 1096, Annual Summary and Transmittal of U.S. Information Returns, of St. John Medical Center, Inc. EIN 73-0579286. Expenses are allocated to and reimbursed by the filing organization to St. John Medical Center, Inc. As such, the organization has not reported independent contractors paid on Form 990, Part VII, Section B.”

“Statements Regarding Other IRS Filings and Tax Compliance The salaries reflected on Form 990 were all reported on the Form 941 Employer's Quarterly Federal Tax Return of St. John Medical Center, Inc. These salaries were reimbursed to SJMC by the filing organization and were included in the number of employees on SJMC's calendar year 2013 Form W-3. The number of employees reported on Part V, Line 2a of Form 990 by the filing organization represents the number of employees providing services to the filing organization during calendar year 2013.”

“Purchased Services-Consulting Services, Contracted Services: Program service expenses 1,047,385. Management and general expenses 102,875. Fundraising expenses 0. Total expenses 1,150,260. Medical Services: Program service expenses 2,152,382. Management and general expenses 490,810. Fundraising expenses 0. Total expenses 2,643,192. Laundry Services: Program service expenses 155,211. Management and general expenses 250. Fundraising expenses 0. Total expenses 155,461. Lab: Program service expenses 1,522,395. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,522,395.”

“Transfers to Affiliates -1,691,774.”