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.”

“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.”

“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. 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; evaluations; debt limits; strategic & financial plans; assets; and system policies & procedures. These areas are subject to certain levels of approval by Ascension Health per the system authority matrix.”

“St. John Broken Arrow, Inc. (SJBA) is an affiliate of 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 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. 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.”

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

“Compensation of independent contractors is paid by and reported on 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.”

“Dietary/Food Nutrition - Total Revenue: 184157, Related or Exempt Function Revenue: 0, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 184157; Enviromental Services - Total Revenue: 56696, Related or Exempt Function Revenue: 0, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 56696; Medical Services - Total Revenue: 33827, Related or Exempt Function Revenue: 0, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 33827; Telecommunications - Total Revenue: 7967, Related or Exempt Function Revenue: 0, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 7967; Misc - Total Revenue: 0, Related or Exempt Function Revenue: 0, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: ;”

“Owasso medical facility, inc. ("st. John owasso"), st. John health system foundation, inc. ("st. John foundation"), st. John building corporation ("sjbc"), st. John broken arrow, inc. ("st. John broken arrow"), and jane phillips nowata hospital, inc. ("jp nowata"). St. John, these subsidiaries, and all other subsidiaries under st. John's direct or indirect control or ownership are referred to herein as "the st. John system". The st. John system supports the purpose and activities of ascension health and both st. John's and ascension health's powers must be exercised in accordance with the teachings, traditions and canon law of the roman catholic church and the ethical and religious directives for catholic health facilities promulgated by the national conference of catholic bishops of the united states catholic conference. Mission and values: as a catholic healthcare organization, st. John carries on the mission of its sponsors, through ascension health, of continuing the healing ministry of jesus christ. It aspires to provide health care that works, health care that is safe, and health care that leaves no one behind, with a promise to our patients and the communities we serve of providing medical excellence and compassionate care. It operates in conformance with "the ethical and religious directives for catholic health facilities." faithful to the sponsorship mission, philosophy and values, st. John's mission is to provide healthcare and related ministries for the people served, especially the sick, the poor and the powerless. The board of directors, management and employees of st. John are guided in their day-to-day actions and interactions with those who serve and who are served by the values of service to the poor, wisdom, reverence, creativity, dedication and integrity. St. John and the hospital collaborate with other individuals and institutions in the various communities served to ascertain community needs and provide a broad range of services along the healthcare continuum to help meet those needs. Programs and services include preventive, diagnostic, therapeutic and rehabilitative programs, including an emphasis on health promotion and disease prevention. St. John also advocates for public policies which advance a healthy and just society. St. John works with local, state and national leaders and organizations to bring about a healthcare delivery system that provides dignified access to and affordable, high quality healthcare for all persons. Community needs assessment: each owned hospital in the st. John system has completed a community health needs assessment and implementation strategy. These have been posted to each hospital's website and also the health system website. St. John continues to look for ways to meet unmet community needs in a sustainable and collaborative way with other organizations to build healthier communities. The st. John system serves a diverse representation of health disparities in one of the lowest ranked states in the united states for health status (46th in 2014). Within the state of oklahoma, counties served rank from 17th out of 77 to 63rd out of 77.”

“Using the chna completed in 2013, the st john system developed, adopted, and worked on executing a 2014-2016 implementation strategy to address the community health needs identified in the community-wide community health needs assessment. Many of these are done in collaboration with individuals representing interests of the community and/or in support of community based programs. In total for this fiscal year ending june 2015, the st. John system participated in over 100 community events. St. John broken arrow individually sponsored or participated in 31 events. Each year a budget is established for this purpose and is exceeded through identification of additional community requests. Upon completion of the assessment with input from local public health officials and other leaders, st john broken arrow identified and has continued to collaboratively work toward addressing the following priority needs as a hospital within a larger health system and through supporting the needs identified for a community-wide plan: 1. Diet, inactivity, and obesity - active participaton by several associates in the community wide coalition, "pathways to health," which supports the tulsa health department (thd) and community partners of thd; during 2015, pathways to health community foundation set obesity prevention as its primary focus. - the st. John system supports health promotion walks including: american cancer society's relay for life, american heart and american stroke associations' heart walk, susan g. Komen - race for a cure, and march of dimes walk. - st. John food and nutrition services color code healthy menu items. - the st. John system began participation in ascension health's "smart health" wellness program initiatives - first focusing on our own associates and subsequently taking lessons learned to the broader community. This was a multi-year initiative that began in fy 2014. - the community is currently undergoing an updated community health needs assessment with support from the county health department to determine if positive changes have been realized. - st. John broken arrow actively engages with the local school district in supporting various events. 2. Mental health, substance abuse, tobacco use - as a healthcare provider of emergency and acute hospital and related services, the hospital sees the direct and often devastating effects of alcohol and drug abuse, as well as tobacco use, on a daily basis. Many, if not most, of the patients who present to the system in acute crisis from alcohol and abuse - whether from injury or overdose (or both) - also have underlying acute or chronic mental health conditions and needs. The health system is exploring how virtual technology might be used to support hospitals in providing better access to patients for mental health services. - process outcomes are measured for mental health and tobacco use screening through both the comprehensive primary care program and the medicare shared savings program in which st. John hospitals and employed st. John physicians participate. Since these programs were in their early stages, we did not have outcomes reported by the end of the fiscal year. Through these programs, we are now able to track the volume of patients who receive counseling and referrals.”

“- each hospital maintains ongoing patient education related to smoking; materials are provided to patients and referrals are made to the state of oklahoma tobacco help line. - patients identified at st. John broken arrow are referred to a hospital outpatient department at st. John medical center, inc. Where drug and alcohol counseling is provided. Patients from any of our hospitals and clinics may be referred to this service which has a convenient, accessible location. Referrals are also made to area agencies. - the community is currently undergoing an updated community health needs assessment with support from the county health department to determine if positive changes have been realized. 3. Chronic disease management - st. John broken arrow participates as an accountable care organization (aco) participant in the medicare shared savings program which, establishes several quality and process outcome measures that pertain to chronic disease management such as diabetes, hypertension, coronary artery disease, and copd. - employed physicians of the health system also participate in comprehensive primary care which focuses on a medical home model in care for high risk patients with chronic conditions. - the community is currently undergoing an updated community health needs assessment with support from the county health department to determine if positive changes have been realized. 4. Access to services access to services in oklahoma is a significant challenge due to the limited availability of primary care physicians. The community is currently undergoing an updated community health needs assessment with support from the county health department and the st. John system to determine if positive changes have been realized related to the following implementation initiatives and to refine priority needs identified in the 2013 assessments: - safety net and emergency services (described below) - direct care for the poor and vulnerable (described below) - medical access program (described below) - medical education (described below) needs not being addressed: st. John broken arrow and the st. John system addressed all of the priority needs recommended by the community-wide community health needs assessment. However, "obesity" was grouped with "poor diet and inactivity," and "tobacco use" was grouped with "alcohol/drug use" and renamed "mental health, substance abuse, tobacco use."”

“Governance: the administrative powers of st. John broken arrow, inc. Are vested in its board of directors, which controls and manages the properties, affairs and funds of the hospital, subject to reservation of certain powers by st. John. The board meets regularly and it works in concert with, and when appropriate, under the direction of the st. John health system, inc. Board. The board reviews and approves the community health needs assessment and recommended implementation initiatives. Community benefit: in measuring and reporting quantifiable community benefit, st. John follows guidelines promulgated by the catholic health association of the united states and endorsed by other organizations. Uncompensated care and other elements of community benefit are measured at the unreimbursed estimated cost of services or resources provided. Safety net and emergency services (subpart a of access to services): the st. John system serves as an important safety net provider of a broad continuum of health care services to the citizens of northeastern oklahoma and the surrounding region. Each of its six main hospitals operates a full-service, 24-hour, 365-day emergency room providing both urgent and emergency care to all individuals, regardless of their ability to pay. St. John broken arrow, inc., a level iv emergency care center, provides much needed services for residents of broken arrow, oklahoma and the surrounding areas. The hospital is an integral part of the mission of service and the continuum of medical care provided by st. John. Patients seen in the st. John system for the fiscal year ended june 30, 2015: total discharges (excluding normal newborns) - 38,586 total observation days - 15,413 combined discharges and observation days - 53,999 total patient days (excl. Normal newborn and observations) - 179,945 births - 3,279 emergency room visits - 166,705 selected outpatient visits (excl. Er & one day surgeries) - 342,529 inpatient surgical cases - 11,659 outpatient surgical cases - 17,248 physician office patient visits - 448,349 urgent care clinic patient visits - 61,970 combined physician office and urgent care visits - 510,319 total laboratory procedures (incl. Hospital & reference labs) - 8,171,752”

“Direct care for the poor and vulnerable (subpart b of access to services): the st. John system considers care for the poor to be an essential part of its mission of service to the community. The total cost of care for the poor includes the cost of charity care, the unreimbursed cost of services to medicaid beneficiaries (together referred to as "uncompensated care for the poor") and the cost of special programs or other activities specifically targeted to increase access to care or provide other services to the poor. "care for the poor" includes the estimated cost of care classified as charity care plus the estimated excess of the cost of services provided to medicaid beneficiaries over the payments received from medicaid. "care for the poor" does not include the cost of services classified and written off as bad debts or the excess of the cost of services provided to medicare beneficiaries over the payments received from medicare. Charity and uncompensated care: the st. John system's hospitals, senior-care and other facilities provide services without regard to a patient's ability to pay. In fy15, the st. John system hospitals provided a discount of at least 30% of billed charges to all uninsured patients. Uninsured patients also could qualify for an additional 15% prompt pay discount. In addition to these automatic discounts, patients can apply for financial assistance up to and including free care. The determination of the patient's qualification for financial assistance is based on an objective determination of the patient's financial resources and ability to pay. In general, all uninsured patients with household incomes of less than 300% of the federal poverty guidelines qualify for free or substantially discounted care. Other entities in the st. John system also provide charity care based on individual determinations of need. Management for st. John believes that all of its billing and collection policies and procedures comply with irs guidelines and directives. Other community benefit and outreach activities: the st. John system and st. John broken arrow provide other forms of community benefit in the form of free, or reduced-charge educational seminars for the general public on wide ranging topics from prenatal care to chronic disease management. St. John broken arrow participates in community-wide health screening events, blood donation drives, and a number of other outreach activities to improve the health status of the residents of northeastern oklahoma and the surrounding area. Ongoing community input: in addition to the many organizations with which st. John health system, inc. Engages in the community, the medicare shared savings program has sought community feedback by including two patients who are medicare beneficiaries on the accountable care organization's board and maintains a seat designated for a health department representative on one of the primary committees. Also, in october 2014, st. John health system, inc. Supported the formation of the pathways to health community foundation, a non-profit created to support fundraising and grant submissions for the pathways to health community coalition partners, with the goal of improving the health status of residents in the region. St. John health system, inc. Hosted the monthly board meetings through the remainder of the fiscal year.”

“Access to health insurance coverage: between september 2014 and february 2015, st. John engaged a total of 772 individuals in discussions about the health insurance marketplace and referred them to enrollment assistance. - of those 772 individuals, 643 were engaged in discussions about the enrollment process during one of our health ministry's 24 onsite or community outreach events held between september 2014 and february 2015. These consumers were also informed about st. John health system, inc.'s financial assistance program. - the remaining 129 consumers who were seeking information about the marketplace spoke to our health ministry's contracted certified application counselors with midland group over the phone about the enrollment process. If the caller did not schedule an enrollment assistance appointment, they were either inquiring about what plans st. John health system, inc. Takes, whether they qualified for a tax credit, or asked about general information, but did not want to set up an appointment at that time. - st. John's contracted certified application counselors, through midland group, assisted 40 consumers with navigation activities during the enrollment period. - st. John produced and distributed educational signage, fliers, and cards to 119 locations within the health system (including: specialty clinics - st. John clinic, some nursing floors at the medical center, patient admissions and financial counseling at all hospitals, inpatient and outpatient specialty departments at all hospitals, hospital emergency departments, and main lobby and high traffic areas within all hospitals). These materials also informed consumers about st. John health system, inc.'s financial assistance program. Other program service accomplishments: as previously discussed, the st. John system is organized and operated to provide medical excellence and compassionate care to the citizens of northeastern oklahoma, with a special preference for the poor and disadvantaged. Summary: the st. John system's role as one of the significant safety-net health care providers for the region continues to grow in prominence. St. John reinvests 100% of any profits derived into new and expanded services to the community. The st. John system is very proud of its history of service to the community and views its responsibility to continue to provide medical services to everyone, especially the poor and disadvantaged, very seriously. As the st. John system continues to face growing financial challenges, it becomes increasingly difficult to sustain our mission of service. Nevertheless, we believe that the quantifiable community benefit, as well as the many other areas of service provided by the st. John system and the hospital, continue a sound record of stewardship and a significant contribution to the well-being of both the collective communities and the individuals within those communities we serve. The hospital is an important part of st. John health system, inc.”

“The activity of St. John Broken Arrow, Inc. (SJBA) is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of SJBA is completed. Therefore, the attached audited financial statements are of Ascension Health Alliance, which include the activity of SJBA.”

“The salaries reflected on form 990 were all reported on form 941, employer's quarterly federal tax return of st. John medical center, inc. (sjmc). These salaries were reimbursed to sjmc by the filing organization and were included in the number of employees on sjmc's calendar year 2014 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 2014.”

“Medical Services` - Total Expense: 4515418, Program Service Expense: 4228414, Management and General Expenses: 287004, Fundraising Expenses: 0; Lab - Total Expense: 1307955, Program Service Expense: 1307955, Management and General Expenses: 0, Fundraising Expenses: 0; Contract Services - Total Expense: 1174215, Program Service Expense: 1086082, Management and General Expenses: 88133, Fundraising Expenses: 0; Professional Services - Total Expense: 311483, Program Service Expense: 277912, Management and General Expenses: 33571, Fundraising Expenses: 0; Purchased Services - Total Expense: 1269079, Program Service Expense: 1267561, Management and General Expenses: 1518, Fundraising Expenses: 0; Other - Total Expense: 192905, Program Service Expense: 300, Management and General Expenses: 192605, Fundraising Expenses: 0;”

“Transfers to affiliates - 2128;”