2020-11-13T17:48:35-06:00 2019-12-31 346565596 ERNST & YOUNG US LLP 560 MISSION STREET SUITE 1600 SAN FRANCISCO CA 94105 990 2019-01-01 752765566 COVENANT HEALTH SYSTEM COVE 8067250000 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 JOHN A GRIGSON CFO 8067250000 2020-11-13 1 EVA NITTA P01286320 4158948000 2019 2022-09-23 18:48:47Z X COVENANT HEALTH RICHARD PARKS 3615 19TH STREET LUBBOCK TX 794101203 89452397 0 X WWW.COVENANTHEALTH.ORG X 1998 TX SEE SCHEDULE O.AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 18 14 739 85 0 0 7068430 4350923 687735842 84205475 1345255 895999 0 0 696149527 89452397 5356435 100250 0 0 214581900 34418511 0 0 2201941 466486741 50868065 686425076 85386826 9724451 4065571 716587857 143533032 254415449 192136243 462172408 -48603211 X AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 0 1 51337208 100250 84205475 SEE SCHEDULE OPROVIDENCEON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT TO FORM PROVIDENCE ST. JOSEPH HEALTH (PROVIDENCE). BY COMING TOGETHER, PROVIDENCE SEEKS TO BETTER SERVE ITS COMMUNITIES THROUGH GREATER PATIENT AFFORDABILITY, OUTSTANDING CLINICAL CARE, IMPROVEMENTS TO THE PATIENT EXPERIENCE AND INTRODUCTION OF NEW SERVICES WHERE THEY ARE NEEDED MOST. TOGETHER, OUR CAREGIVERS SERVE IN 51 HOSPITALS, 1,085 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON.THE FOUNDERS OF BOTH ORGANIZATIONS WERE COURAGEOUS WOMEN AHEAD OF THEIR TIME. THE SISTERS OF PROVIDENCE AND THE SISTERS OF ST. JOSEPH OF ORANGE BROUGHT HEALTH CARE AND OTHER SOCIAL SERVICES TO THE AMERICAN WEST WHEN IT WAS STILL A RUGGED, UNTAMED FRONTIER. NOW, AS WE FACE A DIFFERENT LANDSCAPE A CHANGING HEALTH CARE ENVIRONMENT WE DRAW UPON THEIR PIONEERING AND COMPASSIONATE SPIRIT TO PLAN FOR THE NEXT CENTURY OF HEALTH CARE.PROVIDENCE HEALTH & SERVICESIN 1856, MOTHER JOSEPH AND FOUR SISTERS OF PROVIDENCE ESTABLISHED HOSPITALS, SCHOOLS AND ORPHANAGES ACROSS THE NORTHWEST. OVER THE YEARS, OTHER CATHOLIC SISTERS TRANSFERRED SPONSORSHIP OF THEIR MINISTRIES TO PROVIDENCE, INCLUDING THE LITTLE COMPANY OF MARY, DOMINICANS AND CHARITY OF LEAVENWORTH. RECENTLY, SWEDISH HEALTH SERVICES, KADLEC REGIONAL MEDICAL CENTER AND PACIFIC MEDICAL CENTERS HAVE JOINED PROVIDENCE AS SECULAR PARTNERS WITH A COMMON COMMITMENT TO SERVING ALL MEMBERS OF THE COMMUNITY. ST. JOSEPH HEALTH SYSTEMIN 1912, A SMALL GROUP OF SISTERS OF ST. JOSEPH LANDED ON THE RUGGED SHORES OF EUREKA, CALIFORNIA TO PROVIDE EDUCATION AND HEALTH CARE. THEY LATER ESTABLISHED ROOTS IN ORANGE, CALIFORNIA, AND EXPANDED TO SERVE SOUTHERN CALIFORNIA, NORTHERN CALIFORNIA AND TEXAS. THE HEALTH SYSTEM ESTABLISHED MANY KEY PARTNERSHIPS, INCLUDING A MERGER BETWEEN LUBBOCK METHODIST HOSPITAL SYSTEM AND ST. MARY HOSPITAL TO FORM COVENANT HEALTH IN LUBBOCK, TEXAS. RECENTLY, AN AFFILIATION WAS ESTABLISHED WITH HOAG HEALTH TO INCREASE ACCESS TO SERVICES IN ORANGE COUNTY, CALIFORNIA. REALIZING OUR MISSION COVENANT HEALTH SYSTEM (COVENANT HEALTH) PROVIDES KEY COMMUNITY BENEFIT STRATEGY SUPPORT TO SEVEN LOCAL HOSPITALS ON COMMUNITY BENEFIT PLANNING, COMMUNITY HEALTH NEEDS ASSESSMENTS, AND INTERNAL AND EXTERNAL REPORTING. THIS WORK IS ACCOMPLISHED WITH VARIOUS KEY SYSTEM OFFICE DEPARTMENTSINCLUDING ADVOCACY, COMMUNITY OUTREACH, LEGAL AND STRATEGIC SERVICES.COVENANT HEALTH OVERSEES THE TEXAS/EASTERN NEW MEXICO REGION OF PROVIDENCE, ONE OF THE LARGEST TAX-EXEMPT HEALTH SYSTEMS IN THE U.S.. COVENANT HEALTH IS THE LARGEST AND MOST CLINICALLY INTEGRATED HEALTH NETWORK SERVING THE WEST TEXAS/EASTERN NEW MEXICO REGION. COVENANT'S CHRISTIAN MINISTRY OF HEALING SERVES A SIXTY-TWO COUNTY SERVICE AREA COVERING MORE THAN 30,000 SQUARE MILES AND 1.2 MILLION PEOPLE. OUR MISSION OF HEALING INCLUDES SEVEN HOSPITALS, MORE THAN 1,100 LICENSED BEDS, 5,000 CAREGIVERS, 350 OWNED OR ALIGNED PROVIDERS, AND MORE THAN 600 ADMITTING PHYSICIANS. COVENANT HEALTH DELIVERS ANNUALLY AN AVERAGE DAILY CENSUS OF MORE THAN 400 AT ITS HOSPITALS, MORE THAN 28,000 PATIENT DISCHARGES, AND MORE THAN 87,000 EMERGENCY ROOM VISITS. COVENANT IS THE MOST AWARDED HEALTH PROVIDER IN THE REGION BASED ON ANNUAL QUALITY AND SAFETY AWARDS FROM HEALTHGRADES AND US NEWS. MORE THAN A HEALTH SYSTEM, COVENANT HEALTH IS THE LARGEST PRIVATE EMPLOYER IN LUBBOCK AND THE SOUTH PLAINS PROVIDING MORE THAN $1.1 BILLION IN ANNUAL ECONOMIC IMPACT TO THE COMMUNITIES IT SERVES AND IS CONSISTENTLY RATED AS ONE OF THE BEST PLACES TO WORK IN LUBBOCK. COVENANT IS COMMITTED TO OFFERING ACCESSIBLE, AFFORDABLE CARE TO LUBBOCK'S SURROUNDING AREAS WITH HOSPITALS AND SERVICES OFFERED BY COVENANT HOSPITAL LEVELLAND AND COVENANT HOSPITAL PLAINVIEW, AND COVENANT MEDICAL GROUP, A LARGE EMPLOYED PHYSICIAN GROUP COMPRISED OF APPROXIMATELY 200 PRIMARY CARE AND SPECIALIST PHYSICIANS ACROSS WEST TEXAS AND EASTERN NEW MEXICO.PROGRAM SERVICE ACCOMPLISHMENTSMENTAL/BEHAVIORAL HEALTH - COVENANT COMMUNITY OUTREACH COUNSELING CENTER PROVIDES COUNSELING SERVICES TO UNDERSERVED AND LOW-INCOME PERSONS IN OUR COMMUNITY OFFERING INDIVIDUAL, COUPLES AND FAMILY THERAPY TO PEOPLE OF ALL AGES. A PARTNERSHIP WAS FORMED WITH TEXAS TECH UNIVERSITY'S CENTER FOR ADOLESCENT RESILIENCY TO IMPLEMENT AND CO-FUND A PROGRAM WITHIN LUBBOCK INDEPENDENT SCHOOL DISTRICT TO PROVIDE FREE COUNSELING SERVICES AND IN-SCHOOL ADVOCATES FOR IDENTIFIED AT-RISK MIDDLE AND HIGH SCHOOL STUDENTS. A FREE MENTAL HEALTH FIRST AID COURSE WAS HOSTED BY COVENANT HEALTH FOR LOCAL SCHOOL POLICE OFFICERS. ADDITIONALLY, A COUNSELOR WAS ASSIGNED TO THE COVENANT LEVELLAND TO PROVIDE FREE COMMUNITY COUNSELING SERVICES WITH AN EMPHASIS ON SUICIDE PREVENTION. DIABETES WELLNESS AND PREVENTION COVENANT HEALTH OFFERS A FREE DIABETIC AND PREVENTION EDUCATION PROGRAM TO THE COMMUNITY. THIS INCLUDES A FULL TIME REGISTERED DIETITIAN AND CERTIFIED DIABETES EDUCATOR WHO IS DEDICATED TO DIABETES EDUCATION/PREVENTION AND GENERAL HEALTH /NUTRITION EDUCATION FOR ALL AGES. WE ALSO PARTNER WITH COVENANT MEDICAL GROUP WHICH PROVIDES A FULL-TIME REGISTERED NURSE AND A SECOND CERTIFIED DIABETES EDUCATOR WHO ALSO PROVIDE FREE EDUCATION. EDUCATION AND INTERVENTION PROGRAMMING WAS OFFERED MONTHLY AT CATHOLIC CHARITIES, LUBBOCK CHILDREN'S CLINIC AND AT THE COVENANT DIABETES EDUCATION CLINIC. THE HEALTH EDUCATION TEAM ALSO PARTICIPATED LOCAL IN HEALTH SCREENINGS AND HEALTH FAIRS THROUGH THE YEAR. COVENANT HEALTH ALSO FUNDED GO NOODLE PLUS BRINGING PROGRAMING TO 83 SCHOOLS, 1,892 TEACHERS AND 34,500 STUDENTS IN LUBBOCK, HALE AND HOCKLEY COUNTIES IN WEST TEXAS. ADDITIONALLY, COVENANT HEALTH PROVIDES SUBSTANTIAL FUNDING TO COMMUNITY PARTNER AGENCIES THROUGH THE WELLNESS AND PRVENTION GRANT PROGRAM ANNUALLY.DENTAL HEALTH - COMMUNITY OUTREACH DENTAL CLINIC SERVES LOW-INCOME FAMILIES OFFERING COMPREHENSIVE DENTAL CARE TO PATIENTS AGED 5 AND UP AND INCLUDES MOBILE DENTAL UNIT THAT SERVES PATIENTS IN A 75-MILE RADIUS OF LUBBOCK. COVENANT DENTAL PROVIDED DENTAL SEALANTS AND ORAL HEALTH SCREENINGS TO THIRD GRADERS IN THREE AREA SCHOOL DISTRICTS INCLUDING LEVELLAND, SUNDOWN AND LUBBOCK. 107 STUDENTS WERE SCREENED AND 105 SEALANT TREATMENTS WERE COMPLETED. THE DENTAL TEAM PARTICIPATED IN MULTIPLE HEALTH EDUCATION EVENTS AND EDUCATED OVER 500 CHILDREN ON ORAL HYGIENE. COVENANT HEALTH ALSO PROVIDED FUNDING TO THE SOUTH PLAINS COMMUNITY ACTION ASSOCIATION TO PROVIDE DENTAL SERVICES FOR LOW-INCOME CHILDREN IN THEIR HEAD START PROGRAM.EFFECTIVE FEBRUARY 1, 2018, COVENANT HEALTH ACQUIRED GRACE HEALTH SYSTEM TO CREATE THE MOST CLINICALLY INTEGRATED HEALTH NETWORK IN LUBBOCK, WEST TEXAS AND EASTERN NEW MEXICO. TOGETHER, COVENANT HEALTH SYSTEM IS ABLE TO DELIVER MORE EFFECTIVE CARE TO ITS COMMUNITY BY PROVIDING GREATER ACCESS TO SERVICES, PHYSICIANS AND INNOVATION IN THE DELIVERY OF HEALTH CARE.GRACE HEALTH SYSTEM INCLUDES GRACE CLINIC AND GRACE MEDICAL CENTER. GRACE HEALTH SYSTEM IS AN INNOVATIVE HEALTHCARE PROVIDER DEDICATED TO CLINICAL EXCELLENCE, DELIVERING AN ENJOYABLE PATIENT EXPERIENCE AND PROVIDING BEST VALUE. GRACE IS COMMITTED TO DELIVERING THE POSITIVE EFFECTS OF PREVENTIVE MEDICINE AND BELIEVES IN THE IMPORTANCE OF A STRONG PATIENT/DOCTOR RELATIONSHIP. GRACE WAS BUILT ON THE MISSION OF DELIVERING THE KIND OF CARE EACH OF US WANTS FOR OUR OWN FAMILY.FOR MORE INFORMATION ABOUT COVENANT MEDICAL CENTER, PLEASE VISIT HTTPS://WWW.COVENANTHEALTH.ORG/FOR MORE INFORMATION ABOUT GRACE MEDICAL CENTER, PLEASE VISIT HTTPS://GRACEHEALTHSYSTEM.COM/FOR MORE INFORMATION ABOUT PROVIDENCE ST. JOSEPH HEALTH, PLEASE VISIT HTTPS://WWW.PSJHEALTH.ORG/ FOR MORE INFORMATION ABOUT ST. JOSEPH HEALTH, PLEASE VISIT WWW.STJHS.ORG. 51337208 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 X 0 0 1 739 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 18 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 1 0 1 1 0 X DYANA KERR 8067255234 2107 OXFORD AVE LUBBOCK TX 79410 RICHARD PARKS REG CE - WEST TX/EASTERN NM 24.00 28.00 X X 0 1263188 247209 CRAIG RHYNE MD FORMER REG CHIEF MEDICAL OFFICER 50.00 0.00 X 871132 0 206595 JOHN GRIGSON REGIONAL CHIEF FINANCIAL OFFICER 12.00 38.00 X 718138 0 91266 WALTER CATHEY CHIEF EXECUTIVE, COVENANT 20.00 40.00 X 53894 612750 121311 KERRY HENDERSHOT MD BOARD MEMBER/COMMITTEE V CHAIR 2.00 48.00 X 0 645989 34091 BRIAN NICHOLSON MD BOARD MEMBER 2.00 48.00 X 0 623439 35465 PAUL ARRINGTON REG VP - STRATEGIC SVCS - SW (PT YR) 50.00 0.00 X 602483 0 39856 BRIAN SCHROEDER MD CMO, CMC 0.00 50.00 X 598091 0 43984 KAREN BAGGERLY FORMER VP CHIEF NURSING EXEC 0.00 50.00 X 41863 450928 69920 JAMES KELLY SECRETARY/CHIEF GOVERNANCE OFFICER 20.00 30.00 X 0 466782 91121 ROBERT SALEM MD EXEC MEDICAL DIRECTOR 50.00 2.00 X 503236 0 51051 STEVEN BECK CHIEF ADMIN OFFICER-LB 50.00 0.00 X 444181 0 53516 CHRISTINE SHAVER FORMER VP CHIEF HR - COVHS 50.00 0.00 X 0 359788 67374 ROBERT TURNER VP MISSION INTEGRATION 24.00 26.00 X 274656 89113 44106 KELLY MCDANIEL EXEC DIR, SUPPORT SERVICES 50.00 0.00 X 351679 0 44930 DYANA KERR FORMER CFO, SERVICE AREA COV 40.00 10.00 X 319531 0 39513 DAVID GRAY DO BOARD MEMBER/CHIEF OF STAFF CCH 2.00 48.00 X 0 265855 30461 SHARON PRATHER FORMER CHIEF GOVERNANCE OFFICER 19.00 31.00 X 133478 0 3650 BRIAN BRUENING MD BOARD MEMBER/BOARD VICE CHAIR 4.00 4.00 X X 0 0 0 JIM GILBREATH BOARD MEMBER/BOARD CHAIR 5.00 5.00 X X 0 0 0 EDDIE MCBRIDE BOARD MEMBER/COMMITTEE V CHAIR 4.00 4.00 X 0 0 0 JESSIE MENDOZA BOARD MEMBER/COMMITTEE V CHAIR 2.00 2.00 X 0 0 0 KAREN WORLEY BOARD MEMBER/COMMITTEE V CHAIR 4.00 4.00 X 0 0 0 MIKE CUNNINGHAM BOARD MEMBER/COMMITTEE V CHAIR 4.00 4.00 X 0 0 0 VAL COCHRAN BOARD MEMBER/COMMITTEE V CHAIR 4.00 4.00 X 0 0 0 SISTER CHRISTINE RAY CSJ BOARD MEMBER/ COMMITTEE CHAIR 4.00 46.00 X 0 0 0 ROBERT KING MD BOARD MBR/CHIEF OF STAFF CMC 4.00 46.00 X 0 0 0 DAVID BAYOUTH BOARD MEMBER/COMMITTEE CHAIR 2.00 2.00 X 0 0 0 JIM BRUNJES BOARD MEMBER (PART YEAR) 2.00 48.00 X 0 0 0 KIM TURNER BOARD MEMBER (PART YEAR) 2.00 48.00 X 0 0 0 CHRISTY MCCLENDON BOARD MEMBER 4.00 4.00 X 0 0 0 KEITH MANN BOARD MEMBER 5.00 5.00 X 0 0 0 SISTER MARIAN SCHUBERT BOARD MEMBER 2.00 48.00 X 0 0 0 TRAVIS FUNK BOARD MEMBER 2.00 0.00 X 0 0 0 4912362 4777832 1315419 44 1 1 0 FORGE LABORATORIES LLC 2804 N LOOP 289 LUBBOCK TX 79415 RESEARCH AND DEVELOPMENT 1050903 Q-CENTRIX LLC DEPT CH 19901 PALATINE IL 60055 DATA MANAGEMENT 488307 DISCOVERY HEALTHCARE CONSULTING GROUP 2950 50TH STREET LUBBOCK TX 79413 CONSULTING SERVICES 240093 MKJM PARTNERS PO BOX 1581 LITTLE ELM TX 75068 BUSINESS MANAGEMENT 236394 3WON LLC PO BOX 5584 NAPERVILLE IL 60567 DATA MANAGEMENT 229447 49 4350923 4350923 NET PATIENT REVENUE 622110 80439422 80439422 COVENANT SPECIALTY HOS 622110 1409716 1409716 MOB RENTAL REVENUE 531120 1336843 1336843 BILLING/MANAGEMENT FEE 541611 274482 274482 745012 745012 84205475 -23053 -23053 616676 302376 0 0 616676 302376 919052 919052 89452397 84205475 0 895999 X 100250 100250 1176905 1176905 1620077 1620077 27754725 17163484 10591241 1467287 873750 593537 256010 10318 245692 2143507 1274276 869231 8356483 8354593 1890 2747985 2747985 746 746 583 583 14615150 5697463 8917687 797990 7988 790002 2776989 2668835 107247 907 7845676 7643367 202309 988516 603669 385655 -808 65044 16359 46687 1998 408555 315582 92973 MEDICAL SUPPLIES 5013728 4789820 222680 1228 OTHER DIRECT EXPENSES 4163617 47308 1918026 2198283 SYSTEM COST ALLOCATION 2779676 1756897 1022779 DUES & SUBSCRIPTION 307327 13249 293745 333 85386826 51337208 31847677 2201941 42108107 40707793 11490191 523244 67580247 19439692 9250120 0 2038240 449649 111732551 50452582 408772723 61279969 46168365 0 3363590 0 106925 0 22500000 0 103209349 21132685 716587857 143533032 50237067 8597754 204178382 183538489 254415449 192136243 X 462172408 -48603211 462172408 -48603211 716587857 143533032 X 4065571 818 -514842008 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 27663623 27663623 78930517 49494517 29436000 32619 9499 23120 3705148 948566 2756582 1400644 1400644 61279969 OTHER ASSETS 21132685 21132685 DUE TO AFFILIATES 163205417 OTHER LIABILITIES 20333072 183538489 1 1 X 1 X 175.000000000000 1 X 1 1 0 1 1 47634 0 47634 0.00060 44425 60725 0 0.00000 0 0 92059 60725 47634 0.00060 0 0 0 0 0 0 0 0 0 0 92059 60725 47634 0.00060 0 14289484 14988529 -699045 X 1 1 1 METHODIST DIAGNOSTIC HEALTHCARE 0.60000 0.40000 2 COVENANT LONG-TERM CARE LP HEALTHCARE 0.85220 0.14780 3 COVENANT HIGH PLAINS SURGERY CENTER LLC HEALTHCARE 0.31070 0.68930 4 COVENANT REHABILITATION HOSPITAL OF LUBBOCK HEALTHCARE 0.49000 0.51000 1 1 COVENANT SPECIALTY HOSPITAL 3815 20TH ST LUBBOCK TX 79410 WWW.COVENANTHEALTH.ORG 008462 X X COVENANT SPECIALTY HOSPITAL 1 0 0 1 X X X X X X X X X 19 1 1 0 1 X SEE SCHEDULE H, PART V, SECTION C X 1 19 1 SEE SCHEDULE H, PART V, SECTION C 0 1 X 175.000000000000 300.000000000000 X X X X X 1 1 X X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 SCHEDULE H, PART V, SECTION B, LINE 3E THE SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED THROUGH THE CHNA PROCESS AND ARE LISTED IN RANK ORDER (PRIORITIZED). SCHEDULE H, PART V, SECTION B, LINES 4 AND 8 THE FILING ORGANIZATION COMPLETED A CHNA PRIOR TO ITS JUNE 30, 2017 YEAR END. DURING 2017, THE FILING ORGANIZATION CHANGED ITS TAX YEAR END FROM JUNE 30 TO DECEMBER 31 IN 2017. AS A RESULT OF THIS CHANGE, A SHORT PERIOD TAX RETURN WAS FILED FOR THE PERIOD JULY 1, 2017 TO DECEMBER 31, 2017. THE FILING ORGANIZATION ADOPTED A CHNA FOR TAX YEAR 2019 AND WHILE ALL OF THE STEPS WERE COMPLETED PRIOR TO THE FILING OF THIS RETURN, THEY WERE NOT COMPLETED BY DECEMBER 31, 2019. THE COMPLETION OF THE CHNA AFTER DECEMBER 31, 2019 IS NOT AN IRC 501(R) FAILURE PURSUANT TO SECTION 1.501(R)-2(B) OF THE REGULATIONS BECAUSE IT WAS MINOR, INADVERTENT AND DUE TO REASONABLE CAUSE, AND HAS BEEN CORRECTED. IT WAS MINOR BECAUSE IT WAS A SINGLE TIMING ERROR BY A FILING ORGANIZATION OTHERWISE COMPLIANT WITH SECTION 501(R). IT WAS INADVERTENT AND DUE TO REASONABLE CAUSE BECAUSE THE SAME ERROR HAS NOT BEEN MADE PREVIOUSLY AND THE FILING ORGANIZATION HAS AN ESTABLISHED PROCESS FOR COMPLETING CHNAS. THE FILING ORGANIZATION IS AFFILIATED WITH A LARGE HEALTH SYSTEM WHERE THE COMPLETION OF THE CHNA IS COORDINATED ON A SYSTEM-WIDE LEVEL BY A TEAM DEDICATED TO COMMUNITY HEALTH IMPROVEMENT. IT HAS BEEN CORRECTED THROUGH THE COMPLETION OF THE CHNA PRIOR TO FILING THE 2019 FORM 990 AND BY MAKING THE RESULTS OF THE 2019 CHNA WIDELY AVAILABLE. SCHEDULE H, PART V, SECTION B, LINE 5 INPUT FROM COMMUNITY REPRESENTATIVESTHE PROCESS OF COLLECTING QUALITATIVE COMMUNITY INPUT TOOK THREE MAIN FORMS: COMMUNITY RESIDENT FOCUS GROUPS, A NONPROFIT AND GOVERNMENT STAKEHOLDER FOCUS GROUP, AND A COMMUNITY FORUM. EACH GROUP WAS DESIGNED TO CAPTURE THE COLLECTED KNOWLEDGE AND OPINIONS OF PEOPLE WHO LIVE AND WORK IN THE COMMUNITIES SERVED BY COVENANT HEALTH. WE DEVELOPED A PROTOCOL (NOTED IN CHNA APPENDIX 3B, POSTED ON THE COVENANT WEBSITE) FOR EACH GROUP TO ENSURE CONSISTENCY ACROSS INDIVIDUAL FOCUS GROUPS, ALTHOUGH THE FACILITATORS HAD SOME DISCRETION ON ASKING FOLLOW-UP QUESTIONS OR PROBES AS THEY SAW FIT. INVITATION AND RECRUITMENT PROCEDURES VARIED FOR EACH TYPE OF GROUP. CHNA APPENDIX 3, AVAILABLE ONLINE, ON COVENANT HEALTH WEBSITE, INCLUDES A FULL REPORT OF THE COMMUNITY INPUT PROCESS AND FINDINGS ALONG WITH DESCRIPTIONS OF THE PARTICIPANTS.RESIDENT FOCUS GROUPS:FOR COMMUNITY RESIDENT GROUPS, COMMUNITY BENEFIT STAFF, IN COLLABORATION WITH THEIR COMMITTEES AND THE SYSTEM OFFICE, IDENTIFIED GEOGRAPHIC AREAS WHERE DATA SUGGESTED THERE WERE SIGNIFICANT HEALTH, PHYSICAL ENVIRONMENT, AND SOCIOECONOMIC CONCERNS. THIS PROCESS ALSO IDENTIFIED THE LANGUAGE NEEDS OF THE COMMUNITY, WHICH DETERMINED THE LANGUAGE IN WHICH EACH FOCUS GROUP WAS CONDUCTED. COMMUNITY BENEFIT STAFF THEN PARTNERED WITH COMMUNITY-BASED ORGANIZATIONS THAT SERVE THOSE AREAS TO RECRUIT FOR AND HOST THE FOCUS GROUPS. THE COMMUNITY-BASED ORGANIZATION DEVELOPED AN INVITATION LIST USING THEIR CONTACTS AND KNOWLEDGE OF THE AREA, AND PARTICIPANTS WERE PROMISED A SMALL INCENTIVE FOR THEIR TIME.DESCRIPTION OF MEDICALLY UNDERSERVED, LOW INCOME AND/OR MINORITY POPULATIONS REPRESENTED IN COMMUNITY INPUT PROCESS:TWO CONSULTANTS STAFFED EACH FOCUS GROUP, SERVING AS FACILITATORS AND NOTE TAKERS. THESE CONSULTANTS WERE NOT DIRECTLY AFFILIATED WITH THE MINISTRY TO ENSURE CANDOR FROM THE PARTICIPANTS.THE DEMOGRAPHICS OF THE RESIDENT FOCUS GROUPS ARE AS FOLLOWS:FEMALE - 81%MALE - 19%RACE/ETHNICITY:HISPANIC/LATINO - 69%NON-LATINO WHITE - 15%BLACK/AFRICAN-AMERICAN - 12%NATIVE AMERICAN 4%CHRONIC CONDITIONS:PERSON WITH CHRONIC CONDITIONS OR A LEADER OR REPRESENTATIVE OF INDIVIDUALS WITH CHRONIC CONDITIONS - 58%INCOME:TOTAL HOUSEHOLD INCOME BEFORE TAXES LESS THAN $20,000 - 68%.NONPROFIT & GOVERNMENT STAKEHOLDER FOCUS GROUP:FOR THE NONPROFIT AND GOVERNMENT STAKEHOLDER FOCUS GROUP, COMMUNITY BENEFIT STAFF DEVELOPED A LIST OF LEADERS FROM ORGANIZATIONS THAT SERVE DIVERSE CONSTITUENCIES WITHIN THE HOSPITAL'S SERVICE AREA. MINISTRY STAFF SOUGHT TO INVITE ORGANIZATIONS WITH WHICH THEY HAD EXISTING RELATIONSHIPS, BUT ALSO USED THE FOCUS GROUP AS AN OPPORTUNITY TO BUILD NEW RELATIONSHIPS WITH STAKEHOLDERS. PARTICIPANTS WERE NOT GIVEN A MONETARY INCENTIVE FOR ATTENDANCE. AS WITH THE RESIDENT FOCUS GROUPS, THIS GROUP WAS FACILITATED BY OUTSIDE CONSULTANTS WITHOUT A DIRECT LINK TO ST. JOSEPH HEALTH.RESIDENT COMMUNITY FORUM:RECRUITMENT FOR THE COMMUNITY RESIDENT FORUM WAS MUCH BROADER TO ENCOURAGE AS MANY PEOPLE AS POSSIBLE TO ATTEND THE SESSION. COMMUNITY BENEFIT STAFF PUBLICIZED THE EVENT THROUGH FLYERS AND EMAILS USING THEIR EXISTING OUTREACH NETWORKS, AND ALSO ASKED THEIR PARTNER ORGANIZATIONS TO INVITE AND RECRUIT PARTICIPANTS. NO FORMAL INVITATION LIST WAS USED FOR THE FORUMS AND ANYONE WHO WISHED TO ATTEND WAS WELCOMED. THE FORUM WAS CONDUCTED BY AN OUTSIDE CONSULTANT IN ENGLISH, WITH SIMULTANEOUS SPANISH LANGUAGE TRANSLATION FOR ANYONE WHO REQUESTED IT.WHILE THE FOCUS GROUPS FOLLOWED A SIMILAR PROTOCOL TO EACH OTHER IN WHICH FIVE TO SIX QUESTIONS WERE ASKED OF THE GROUP, THE FORUM FOLLOWED A DIFFERENT PROCESS. THE LEAD FACILITATOR SHARED THE HEALTH NEEDS THAT HAD EMERGED FROM THE CHNA PROCESS SO FAR AND ASKED THE PARTICIPANTS TO COMMENT ON THEM AND ADD ANY OTHER CONCERNS. ONCE THE DISCUSSION WAS COMPLETE, THE PARTICIPANTS ENGAGED IN A CUMULATIVE VOTING PROCESS USING DOTS TO INDICATE THEIR GREATEST CONCERNS. THROUGH THIS PROCESS, THE FORUM SERVED AS SOMETHING OF A "CAPSTONE" TO THE COMMUNITY INPUT PROCESS. SCHEDULE H, PART V, SECTION B, LINE 6 CHNA HOSPITAL FACILITIESTHE NEEDS ASSESSMENT WAS CONDUCTED AS A COLLABORATIVE EFFORT BETWEEN THE FOLLOWING COVENANT HEALTH ENTITIES: COVENANT HEALTH MEDICAL CENTER, COVENANT HEALTH CHILDREN'S, COVENANT HEALTH PLAINVIEW, COVENANT HEALTH LEVELLAND AND COVENANT SPECIALTY HOSPITAL (JOINT VENTURE).THESE FACILITIES ARE REFERRED TO COLLECTIVELY AS COVENANT HEALTH AND ALL SERVE THE SAME GEOGRAPHIC SERVICE AREA OF WEST TEXAS AND EASTERN NEW MEXICO. SCHEDULE H, PART V, SECTION B, LINE 7A THE CHNA FOR COVENANT HEALTH SYSTEM CAN BE FOUND ON ITS WEBSITE ATHTTPS://WWW.COVENANTHEALTH.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/ SCHEDULE H, PART V, SECTION B, LINE 10A HTTPS://WWW.COVENANTHEALTH.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/ SCHEDULE H, PART V, SECTION B, LINE 11 COVENANT HEALTH IS WORKING BOTH INTERNALLY AND WITH COMMUNITY PARTNERS TO ADDRESS SIGNIFICANT HEALTH NEEDS IDENTIFIED BY THE COMMUNITY HEALTH NEEDS ASSESSMENT. COVENANT HEALTH'S COMMUNITY BENEFIT PLAN/IMPLEMENTATION STRATEGY REPORT FOCUSES ON THREE AREAS, MENTAL/BEHAVIORAL HEALTH, DIABETES PREVENTION AND INTERVENTION, AND DENTAL HEALTH.BELOW IS A HIGH-LEVEL SUMMARY OF THE CB PLAN/IMPLEMENTATION STRATEGY REPORT:MENTAL/BEHAVIORAL HEALTH - WORK WITH COMMUNITY PARTNERS TO EXPAND AND INVESTIGATE CREATIVE SOLUTIONS ACCESS TO CARE, TO CREATE COMMUNITY RESILIENCE, REDUCE DEPRESSION AND ANXIETY, AND EXPAND SUBSTANCE ABUSE (INCLUDING ALCOHOL) PREVENTION/INTERVENTION INITIATIVES THROUGH EITHERDIRECT PROGRAMMING OR FINANCIAL SUPPORT OF PARTNER AGENCIES. IN FY19 ADDITIONAL ONSITE COUNSELING SERVICES WERE ADDED AT THE LEGACY HOME FOR WOMEN; WORKED WITH THE YWCA TO ESTABLISH COUNSELING SERVICES ONSITE FOR CHILDREN AND FAMILIES; OFFERED FREE MENTAL HEALTH FIRST AID TRAINING TO THE COMMUNITY; FUNDED AND SUPPORTED COMMUNITY ADVOCACY PROGRAM FOR LUBBOCK ISD STUDENTS AT RISK.DIABETES PREVENTION AND INTERVENTION - EXPAND CURRENT OUTREACH TO INCLUDE MORE INNOVATIVE APPROACHES TO PREVENTION WITH EMPHASIS ON EARLY INTERVENTIONS WITH CHILDREN AND FAMILIES, COLLABORATE WITH INTERNAL AND EXTERNAL PARTNERS TO IMPLEMENT EVIDENCE BASED PRACTICES, AND INCREASE ACCESS TO MEDICATION. INCLUDING FOCUS ON PREVENTIVE LIFESTYLE ISSUES SUCH AS OBESITY REDUCTION, UNHEALTHY LIFESTYLES, FOOD CHOICES AND EXERCISE. EXPANDED AND/OR ADDED SERVICES TO THE DREAM CENTER, LEGACY HOME FOR WOMEN, CATHOLIC CHARITIES, THE LUBBOCK CHILDRENS HEALTH CLINIC; FUNDED GO NOODLE PLUS FOR ALL SCHOOLS WITHIN LUBBOCK, PLAINVIEW AND LEVELLAND SERVICES AREA; ADDED GO NOODLE PLUS TO LEA COUNTY.DENTAL HEALTH - ENHANCE CURRENT OUTREACH PRACTICES TO INCLUDE MORE EARLY INTERVENTION WITH CHILDREN AND NEW PARENTS, INCREASE SCHOOL PARTNERSHIPS AND EXPLORE WAYS TO CONTINUE TO IMPROVE ACCESS TO SERVICES. COMPLETED DENTAL SEALANT CLINICS AT LOW INCOME SCHOOLS IN THE REGION; PARTICIPATED IN ELEMENTARY SCHOOL HEALTH FAIRS IN LUBBOCK AND IN THE SURROUNDING REGION; ADDED FIXED SITE DENTAL CLINIC IN PLAINVIEW; TREATED LOW-INCOME AND UNINSURED CHILDREN IN FIXED SITE LUBBOCK DENTAL OUTREACH CLINIC.NEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAMTHE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MINISTRY CHNA ARE NOT ADDRESSED THROUGH DIRECT ONGOING HOSPITAL PROGRAMMING HOWEVER ARE ADDRESSED BY COVENANT HEALTH COMMUNITY PARTNERSHIPS:RESOURCE AWARENESS, POVERTY, TEEN PREGNANCY AND CRIME AND FOOD INSECURITYCOVENANT HEALTH PARTNERS WITH AND PROVIDES FUNDING TO SEVERAL ORGANIZATIONS THAT PROVIDE SERVICES IN THESE AREAS, INCLUDING BUT NOT LIMITED TO CATHOLIC CHARITIES, LOCAL FQHC'S, THE SOUTH PLAINS FOOD BANK, YWCA, WOMEN'S PROTECTIVE SERVICES, MEALS ON WHEELS, AND FAMILY GUIDANCE AND OUTREACH CENTER. WE ALSO HAVE BEGUN HOSTING AN ANNUAL CHILD ABUSE PREVENTION SUMMIT AND HAVE AN INTERNAL FOOD PANTRY FOR PATIENT'S FAMILIES IN NEED.WE ARE COMMITTED TO CONTINUE OUR MISSION THROUGH COMMUNITY BENEFIT PROGRAM AND BY FUNDING OTHER LOCAL NON-PROFITS THROUGH OUR WELLNESS AND PREVENTION GRANTS FUNDED THROUGH OUR CARE FOR THE POOR DOLLARS AND MANAGED BY COVENANT HEALTH COMMUNITY OUTREACH. IN ADDITION, WE COLLABORATE WITH LOCAL ORGANIZATION(S) AND LOCAL FEDERALLY QUALIFIEDHEALTH CLINICS THAT ADDRESS AFOREMENTIONED COMMUNITY NEEDS TO COORDINATE CARE.FOR MORE INFORMATION ON THE KEY STRATEGIES FOR ADDRESSING THIS HEALTH NEEDS GO TO THE COVENANT HEALTH CB PLAN LOCATED AVAILABLE ONLINE ATHTTPS://WWW.COVENANTHEALTH.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/ SCHEDULE H, PART V, SECTION B, LINE 13H THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT ARE INITIALLY CLASSIFIED AS BAD DEBT. PART V, SECTION B, LINE 16A HTTPS://WWW.COVENANTHEALTH.ORG/DOCUMENTS/PATIENT-FINANCIAL-ASSISTANCE/FINANCIAL-ASSISTANCE-POLICY-SJH-TX.ENGLISH_7.20.PDF PART V, SECTION B, LINE 16B HTTPS://WWW.COVENANTHEALTH.ORG/DOCUMENTS/PATIENT-FINANCIAL-ASSISTANCE/FINANCIAL-ASSISTANCE-APPLICATION-SJH-TX.ENGLISH.PDF PART V, SECTION B, LINE 16C HTTPS://WWW.COVENANTHEALTH.ORG/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-AND-PAYMENTS/PATIENT-FINANCIAL-ASSISTANCE/ SCHEDULE H, PART V, SECTION B, LINE 16J THE ORGANIZATION ADHERES TO STATE REGULATIONS IN PUBLICIZING ITS FINANCIAL ASSISTANCE POLICY. THESE REGULATIONS INCLUDE THE POSTING OF THE FULL POLICY ON THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) WEBSITE. IN ADDITION, POLICY NOTICES ARE POSTED IN CONSPICUOUS AREAS SUCH AS EMERGENCY DEPARTMENTS, BILLING OFFICES, ADMISSIONS OFFICES AND OTHER OUTPATIENT SETTINGS. INDIVIDUAL NOTICES OF FINANCIAL ASSISTANCE ARE INCLUDED WITH BILLINGS TO PATIENTS WHO HAVE NOT PROVIDED PROOF OF THIRD-PARTY COVERAGE ALONG WITH CONTACT INFORMATION IN THE EVENT OF ADDITIONAL INQUIRIES. NOTICES OF FINANCIAL ASSISTANCE ARE ALSO PROVIDED UPON REQUEST. WRITTEN NOTICES ARE PROVIDED IN ALL LANGUAGES SPOKEN BY 5% OR MORE OF THE HOSPITAL'S SERVICE AREA. 1 1 - COVENANT HIGH PLAINS SURGERY CTR LLC 10000 MEMORIAL DR STE 540 HOUSTON TX 77024 SURGERY CENTER PART I, LINE 3C: IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, FPG IS A KEY FACTOR. THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS. PART I, LINE 6A: COVENANT HEALTH PREPARES AN ANNUAL REPORT AS A SYSTEM WHICH INCLUDES COVENANT MEDICAL CENTER, COVENANT CHILDREN'S HOSPITAL AND COVENANT SPECIALTY HOSPITAL (JOINT VENTURE), AND IT IS PUBLICLY AVAILABLE AT HTTPS://WWW.COVENANTHEALTH.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/ PART I, LINE 7: THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM. THE ORGANIZATION'S COST ACCOUNTING SYSTEM ADDRESSED ALL PATIENT SEGMENTS. PART I, LINE 7G: NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED. PART III, LINE 2: THE ORGANIZATION ANALYZES ITS HISTORICAL EXPERIENCE AND TRENDS TO ESTIMATE THE APPROPRIATE BAD DEBT EXPENSE. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED PRIOR TO CALCULATING BAD DEBT EXPENSE. PART III, LINE 3: THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USED AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT WERE INITIALLY CLASSIFIED AS BAD DEBT. COLLECTION ACTIONS WERE NOT PURSUED ON THESE ACCOUNTS ONCE THEY WERE RECLASSIFIED BECAUSE RECLASSIFIED ACCOUNTS RECEIVED A 100 PERCENT WRITE-OFF OF THE BALANCE DUE. AFTER THE RECLASSIFICATION THERE WAS NO REMAINING AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY. PART III, LINE 4: FOOTNOTE FROM THE PROVIDENCE ST. JOSEPH HEALTH COMBINED FINANCIALSTATEMENTS FOR THE YEAR ENDED 12/31/2019:AS A RESULT OF ADOPTING ASU 2014-09 , THE HEALTH SYSTEM CONTINUED TO MAINTAIN AN ALLOWANCE FOR BAD DEBTS RELATED TO PERFORMANCE OBLIGATIONS SATISFIED PRIOR TO JANUARY 1, 2018. THESE ACCOUNTS HAVE ALL BEEN FULLY RESOLVED, THEREFORE THE ALLOWANCE FOR BAD DEBTS HAS DECLINED TO $0 AS OF DECEMBER 31, 2019.THE HEALTH SYSTEM PROVIDED FOR AN ALLOWANCE AGAINST PATIENT ACCOUNTS RECEIVABLE FOR AMOUNTS THAT COULD BECOME UNCOLLECTIBLE. THE HEALTH SYSTEM ESTIMATED THIS ALLOWANCE BASED ON THE AGING OF ACCOUNTS RECEIVABLE, HISTORICAL COLLECTION EXPERIENCE BY PAYOR, AND OTHER RELEVANT FACTORS. THERE ARE VARIOUS FACTORS THAT CAN IMPACT THE COLLECTION TRENDS, SUCH AS CHANGES IN THE ECONOMY, WHICH IN TURN HAVE AN IMPACT ON UNEMPLOYMENT RATES AND THE NUMBER OF UNINSURED AND UNDERINSURED PATIENTS, THE INCREASED BURDEN OF COPAYMENTS TO BE MADE BY PATIENTS WITH INSURANCE COVERAGE AND BUSINESS PRACTICES RELATED TO COLLECTION EFFORTS. THESE FACTORS CONTINUOUSLY CHANGE AND CAN HAVE AN IMPACT ON COLLECTION TRENDS AND THE ESTIMATION PROCESS USED BY THE HEALTH SYSTEM. THE HEALTH SYSTEM RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICES ON THE BASIS OF PAST EXPERIENCE, WHICH HAS HISTORICALLY INDICATED THAT MANY PATIENTS ARE UNRESPONSIVE OR ARE OTHERWISE UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. PART III, LINE 8: THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT. PART III, LINE 9B: COVENANT HEALTH SYSTEM PATIENT ACCOUNTS WERE NOT FORWARDED TO COLLECTION STATUS WHEN THE PATIENT MADE A GOOD FAITH EFFORT TO RESOLVE OUTSTANDING ACCOUNT BALANCES. SUCH EFFORTS INCLUDE APPLYING FOR FINANCIAL ASSISTANCE, NEGOTIATING A PAYMENT PLAN, OR APPLYING FOR MEDICAID COVERAGE. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMED AN EVALUATION TO IDENTIFY IF THE ACCOUNT QUALIFIED FOR FINANCIAL ASSISTANCE. ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR FREE CARE WERE WRITTEN OFF AND COLLECTION EFFORTS WERE NOT PURSUED. THE ORGANIZATION'S COLLECTION POLICY ALSO APPLIED TO ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR DISCOUNTED CARE. PART VI, LINE 2: NEEDS ASSESSMENTCOVENANT HEALTH AS PART OF ITS STRATEGIC PLANNING PROCESS DEVELOPS A FIVE-YEAR STRATEGIC PLAN WHICH ESTABLISHES A VISION FOR THE ORGANIZATION WHILE SETTING A GUIDE FOR THE ANNUAL STRATEGIC PLAN. AS PART OF THE PLANNING PROCESS, WE ANALYZE EXTERNAL MARKET INFORMATION (INCLUDING BUT NOT LIMITED TO POPULATION ESTIMATES, DEMOGRAPHIC AND SOCIOECONOMIC INFORMATION, REGIONAL USE RATES AND MARKET UTILIZATION TREND ANALYSES) AND INTERNAL INFORMATION (INCLUDING BUT NOT LIMITED TO INPATIENT, OUTPATIENT/SAME DAY, AND EMERGENCY VISIT DATA BY PATIENT ORIGIN, BY AGECOHORTS, BY RACE AND ETHNICITY AND INCOME STRATA) TO BETTER UNDERSTAND THE NEEDS OF OUR PATIENTS AND COMMUNITY. THIS WORK IS USED TO DEVELOP SERVICE AND PHYSICIAN/PROVIDER NEED PROJECTIONS TO DETERMINE GAPS IN OUR COMMUNITY. AS A FAITH-BASED PROVIDER THIS INFORMATION ALSO IS USED TO DETERMINE NEEDS FOR THE UNDERSERVED AND VULNERABLE IN OUR COMMUNITY AND REGION. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCETHE ORGANIZATION POSTED NOTICES INFORMING THE PUBLIC OF THE FINANCIAL ASSISTANCE PROGRAM. NOTICES WERE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES WERE ALSO POSTED AT LOCATIONS WHERE A PATIENT COULD PAY THEIR BILL. NOTICES INCLUDED CONTACT INFORMATION ON HOW A PATIENT COULD OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES WERE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT WERE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATED LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS WERE OFFERED AN OPPORTUNITY TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND WERE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY HAVE BEEN ELIGIBLE. PART VI, LINE 4: COMMUNITY INFORMATIONCOVENANT HEALTH'S TOTAL HOSPITAL SERVICE AREA INCLUDES 25 COUNTIES. THE MOST DENSE POPULATION OF THE TSA IS IN LUBBOCK COUNTY, AND APPROXIMATELY 100 PERCENT OF LUBBOCK COUNTY'S POPULATION IS WITHIN THE TSA.THE TOTAL HOSPITAL SERVICE AREA POPULATION IS 750,000 WITH A MEDIAN HOUSEHOLD INCOME OF $45,365. THE TOTAL SERVICE HAS 34.6 PERCENT OF THE POPULATION WITH A HOUSEHOLD INCOME BELOW 200% FPL AND 24.5 PERCENT OF CHILDREN AND 10.8 PERCENT OF OLDER ADULTS LIVE BELOW 100% OF POVERTY LEVEL. WHEN LOOKING AT THE PRIMARY SERVICE AREA, 25.4 PERCENT OF THE POPULATION IS UNDER THE AGE OF 18 AND 13.2 OF THE POPULATION IS OVER THE AGE OF 65.LUBBOCK COUNTY DEMOGRAPHICS INCLUDE:54% WHITE NON-HISPANIC,35% HISPANIC/LATINO,2.4% ASIAN/PACIFIC ISLANDER,7.8% AFRICAN AMERICAN,1% NATIVE AMERICAN.COVENANT HEALTH'S TOTAL SERVICE AREA INCLUDES:43.9% HISPANIC/LATINO,47.8 % WHITE NON-HISPANIC,5% AFRICAN AMERICAN,1.4 % ASIAN/PACIFIC ISLANDER,0.5% NATIVE AMERICAN.THE FOLLOWING ZIP CODE HAVE HIGH LEVELS OF POVERTY79401,79411,79404,79415,79403,79412,79064,79041,79357,79410,79339,79316,79414,79072,79241OTHER HOSPITALS IN THE TSA INCLUDE:COCHRAN MEMORIAL HOSPITALCROSBYTON CLINIC HOSPITALMEDICAL ARTS HOSPITALW.J. MANGOLD MEMORIAL HOSPITALMEMORIAL HOSPITALYOAKUM COUNTY HOSPITALCOVENANT HEALTH - PLAINVIEWCOVENANT HEALTH - LEVELLANDLAMB HEALTHCARE CENTERCOVENANT MEDICAL CENTERCOVENANT CHILDREN'S HOSPITALLUBBOCK HEART HOSPITALGRACE HOSPITALUNIVERSITY MEDICAL CENTERLYNN COUNTY HOSPITAL DISTRICTBROWNFIELD REGIONAL MEDICAL CENTERYOAKUM COUNTY HOSPITALCOGDELL MEMORIAL HOSPITALPLAINS REGIONAL MEDICAL CENTERLEA REGIONAL MEDICAL CENTERNOR-LEA GENERAL HOSPITALHEALTH PROFESSIONS SHORTAGE AREA - MENTAL, DENTAL, OTHERTHE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION DESIGNATES HEALTH PROFESSIONAL SHORTAGE AREAS AS AREAS WITH A SHORTAGE OF PRIMARY MEDICAL CARE, DENTAL CARE, OR MENTAL HEALTH PROVIDERS. THEY ARE DESIGNATED ACCORDING TO GEOGRAPHY (I.E., SERVICE AREA), DEMOGRAPHICS (I.E., LOW-INCOME POPULATION), OR INSTITUTIONS (I.E., COMPREHENSIVE HEALTH CENTERS). COVENANT HEALTH IS LOCATED IN A SHORTAGE AREA, THE MAJORITY OF THE TOTAL SERVICE AREA IS DESIGNATED AS SHORTAGE AREAS.MEDICAL UNDERSERVED AREA/MEDICAL PROFESSIONAL SHORTAGE AREAMEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ARE DEFINED BY THE FEDERAL GOVERNMENT TO INCLUDE AREAS OR POPULATION GROUPS THAT DEMONSTRATE A SHORTAGE OF HEALTHCARE SERVICES. THIS DESIGNATION PROCESS WAS ORIGINALLY ESTABLISHED TO ASSIST THE GOVERNMENT IN ALLOCATING COMMUNITY HEALTH CENTER GRANT FUNDS TO THE AREAS OF GREATEST NEED. MEDICALLY UNDERSERVED AREAS ARE IDENTIFIED BY CALCULATING A COMPOSITE INDEX OF NEED INDICATORS COMPILED AND COMPARED WITH NATIONAL AVERAGES TO DETERMINE AN AREA'S LEVEL OF MEDICAL "UNDER SERVICE." MEDICALLY UNDERSERVED POPULATIONS ARE IDENTIFIED BASED ON DOCUMENTATION OF UNUSUAL LOCAL CONDITIONS THAT RESULT IN ACCESS BARRIERS TO MEDICAL SERVICES. MEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ARE PERMANENTLY SET, AND NO RENEWAL PROCESS IS NECESSARY. THE MAJORITY OF THE COVENANT HEALTH SERVICE AREA, IS LOCATED IN A MEDICALLY UNDERSERVED AREA/MEDICALLY UNDERSERVED POPULATIONS AREA, SIGNIFYING THE IMPORTANCE OF COVENANT MEDICAL CENTER TO THE COMMUNITY IT SERVES.FOR MORE INFORMATION, GO TO THE COVENANT HEALTH'S COMMUNITY BENEFIT REPORT POSTED ATHTTPS://WWW.COVENANTHEALTH.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/ PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHCOVENANT CHILDREN'S PROVIDES VITAL COMMUNITY HEALTH SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTED CARE. COVENANT HEALTH IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE IN ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS:1) A COMMUNITY BENEFIT COMMITTEE THAT HAS COMMUNITY REPRESENTATION AND IS A SUBCOMMITTEE OF THE BOARD OF TRUSTEES2) OPEN MEDICAL STAFF3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS.SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEMON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (LEGACY PHS) AND ST. JOSEPH HEALTH SYSTEM (LEGACY SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT. BY COMING TOGETHER, PROVIDENCE SEEKS TO BETTER SERVE ITS COMMUNITIES THROUGH GREATER PATIENT AFFORDABILITY, OUTSTANDING CLINICAL CARE, IMPROVEMENTS TO THE PATIENT EXPERIENCE AND INTRODUCTION OF NEW SERVICES WHERE THEY ARE NEEDED MOST.TOGETHER, OUR CAREGIVERS SERVE IN 51 HOSPITALS AND OVER 1,085 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. PART VI, LINE 7, REPORTS FILED WITH STATES TX 1 LUBBOCK AREA UNITED WAY 1655 MAIN STREET SUITE 101 LUBBOCK TX 74901 750961812 501(C)(3) 100000 GENERAL SUPPORT 1 SCHEDULE I, PART I, LINE 2 DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS IN THE APPLICATION FOR SUPPORT, A DETAILED EXPLANATION OF THE KIND OF SERVICES PROVIDED TO THE COMMUNITY ALONG WITH SPECIFIC FINANCIAL DATA IS REQUESTED. IF THE APPLICATION FOR SUPPORT IS APPROVED, A LETTER IS SENT INDICATING THE AMOUNT OF THE SUPPORT ALONG WITH A REQUEST FOR DOCUMENTATION OF HOW THE FUNDS WERE USED, ALONG WITH A REPORT OF THE NUMBER OF CHILDREN/FAMILIES SERVED OVER THE YEAR. GRANTS MADE TO AFFILIATED FOUNDATIONS ARE MONITORED ON A MONTHLY BASIS AS THE FINANCIAL STATEMENTS OF THESE ORGANIZATIONS ARE READILY AVAILABLE. OTHER GRANTS ARE MADE THAT COMPLY WITH THE MISSION AND FURTHER THE TAX-EXEMPT PURPOSE OF THE ORGANIZATION. 1 1 0 0 0 0 0 1 0 RICHARD PARKS REG CE - WEST TX/EASTERN NM 0 797406 0 453878 0 11904 0 216500 0 30709 0 1510397 0 0 CRAIG RHYNE MD FORMER REG CHIEF MEDICAL OFFICER 610380 0 241893 0 18859 0 180103 0 26492 0 1077727 0 0 0 JOHN GRIGSON REGIONAL CHIEF FINANCIAL OFFICER 509152 0 197097 0 11889 0 61357 0 29909 0 809404 0 0 0 WALTER CATHEY CHIEF EXECUTIVE, COVENANT 53259 381252 36 227243 599 4255 5429 83857 3739 28286 63062 724893 0 0 KERRY HENDERSHOT MD BOARD MEMBER/COMMITTEE V CHAIR 0 361963 0 275954 0 8072 0 10000 0 24091 0 680080 0 0 BRIAN NICHOLSON MD BOARD MEMBER 0 404394 0 211704 0 7341 0 7333 0 28132 0 658904 0 0 PAUL ARRINGTON REG VP - STRATEGIC SVCS - SW (PT YR) 261509 0 141726 0 199248 0 11200 0 28656 0 642339 0 0 0 BRIAN SCHROEDER MD CMO, CMC 413399 0 176840 0 7852 0 11200 0 32784 0 642075 0 0 0 KAREN BAGGERLY FORMER VP CHIEF NURSING EXEC 40316 304734 35 134804 1512 11390 2381 50846 1934 14759 46178 516533 0 0 JAMES KELLY SECRETARY/CHIEF GOVERNANCE OFFICER 0 327532 0 135680 0 3570 0 65128 0 25993 0 557903 0 0 ROBERT SALEM MD EXEC MEDICAL DIRECTOR 355810 0 140485 0 6941 0 25200 0 25851 0 554287 0 0 0 STEVEN BECK CHIEF ADMIN OFFICER-LB 302354 0 133653 0 8174 0 25200 0 28316 0 497697 0 0 0 CHRISTINE SHAVER FORMER VP CHIEF HR - COVHS 0 232429 0 121785 0 5574 0 45590 0 21784 0 427162 0 0 ROBERT TURNER VP MISSION INTEGRATION 163300 87005 107374 34 3982 2074 7171 3658 22612 10665 304439 103436 0 0 KELLY MCDANIEL EXEC DIR, SUPPORT SERVICES 246834 0 100549 0 4296 0 23464 0 21466 0 396609 0 0 0 DYANA KERR FORMER CFO, SERVICE AREA COV 230799 0 86473 0 2259 0 16622 0 22891 0 359044 0 0 0 DAVID GRAY DO BOARD MEMBER/CHIEF OF STAFF CCH 0 192018 0 37994 0 35843 0 10000 0 20461 0 296316 0 0 SHARON PRATHER FORMER CHIEF GOVERNANCE OFFICER 16703 0 116129 0 646 0 1762 0 1888 0 137128 0 0 0 PART I, LINE 3 DESCRIPTION OF PROCESS TO REVIEW COMPENSATION PAID TO TOP MANAGEMENT OFFICIAL THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/TOP MANAGEMENT OFFICIAL IS PAID BY ITS TAX-EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY PROVIDENCE. PART I, LINES 4A-B THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAYMENTS IN 2019: PAUL ARRINGTON - $175,729 ENTITIES WITHIN THE PROVIDENCE SYSTEM SPONSOR NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS FOR CERTAIN EXECUTIVES. THE PLANS PROVIDE FOR EMPLOYER CONTRIBUTIONS BASED ON A PERCENTAGE OF EXECUTIVE BASE SALARY AND, DEPENDING ON THE PLAN, ARE SUBJECT TO EITHER A THREE YEAR, AGE 59 1/2 OR A FIVE YEAR, AGE 65 VESTING SCHEDULE. UNTIL THE EXECUTIVE PROVIDES THESE SUBSTANTIAL FUTURE SERVICES, THESE SUPPLEMENTAL RETIREMENT CONTRIBUTIONS ARE AT RISK, AND WILL BE FORFEITED IF THE EXECUTIVE LEAVES THE ORGANIZATION BEFORE REACHING HER OR HIS VESTING DATE. THE SUPPLEMENTAL RETIREMENT CONTRIBUTIONS ARE INCLUDED IN COLUMN (C) AS A NONTAXABLE BENEFIT IN THE YEAR THE CONTRIBUTION IS CREDITED TO THE EXECUTIVE'S ACCOUNT, AND ARE INCLUDED AGAIN ON THE FORM 990 IN COLUMN (B)(III) IF AND WHEN THE AMOUNT BECOMES VESTED IN A FUTURE YEAR, AS THE FORM 990 REQUIRES. NO INDIVIDUALS RECEIVED A PAYOUT DURING THE CURRENT YEAR. PART I, LINE 7 NON-FIXED PAYMENTS THE PROVIDENCE EXECUTIVE COMPENSATION COMMITTEE (OF THE BOARD) HAS APPROVED AN EXECUTIVE COMPENSATION PHILOSOPHY THAT CLOSELY TIES AN EXECUTIVE'S COMPENSATION TO PERFORMANCE BOTH THE PERFORMANCE OF THE ORGANIZATION AND THE PERFORMANCE OF THE EXECUTIVE. THERE IS NO GUARANTEE THAT THIS PART OF A LEADER'S COMPENSATION WILL BE PAID IF THE PERFORMANCE OF THE ORGANIZATION OR OF THE INDIVIDUAL DOES NOT MEET THE PERFORMANCE STANDARDS FOR PAYMENT, NO PERFORMANCE-BASED PAYMENT IS MADE. THIS APPROACH IS REFLECTED IN PROVIDENCE'S LEADERSHIP ANNUAL INCENTIVE PLAN, WHICH IS A PERFORMANCE-BASED ANNUAL INCENTIVE PLAN THAT AFFORDS PARTICIPATING EXECUTIVES THE OPPORTUNITY TO EARN "AT RISK" COMPENSATION THROUGH PERFORMANCE AGAINST VERY CHALLENGING GOALS. PAYOUTS WILL BE AWARDED BASED ON GOALS RELATED TO STRATEGIC OBJECTIVES, FISCAL STEWARDSHIP AND QUALITY OF CARE THESE GOALS ARE SET BEFORE THE YEAR BEGINS AND ARE VERY CHALLENGING. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS AND APPROVES EACH YEAR'S PERFORMANCE GOALS TO MAKE SURE THEY ARE SUFFICIENTLY CHALLENGING, AND TO MAKE SURE THE GOALS ARE DESIGNED TO HELP PROVIDENCE MEET ITS MISSION AND STRATEGIC PURPOSES. EACH YEAR THE PSJH BOARD EXECUTIVE COMPENSATION COMMITTEE REVIEWS THE INCENTIVE PERFORMANCE AND MUST CERTIFY THE ACHIEVEMENT OF PERFORMANCE GOALS BEFORE ANY AWARDS ARE PAID OUT. WHEN REVIEWING AND APPROVING TOTAL COMPENSATION FOR EXECUTIVES, THE EXECUTIVE COMPENSATION COMMITTEE INCLUDES INCENTIVE AWARDS, TO MAKE SURE THAT COMPENSATION IS REASONABLE AND WELL-SUPPORTED BY MARKET DATA. THE COMMITTEE CONSISTS ONLY OF DIRECTORS WHO ARE FREE OF CONFLICTS OF INTEREST, AND THE COMMITTEE RELIES ON MARKET SURVEY DATA GATHERED BY AN INDEPENDENT CONSULTANT. THE COMMITTEE CONDUCTS THIS REVIEW AND APPROVAL PROCESS IN A MANNER THAT IS IN ACCORDANCE WITH IRS REQUIREMENTS FOR COMPENSATION OF TAX-EXEMPT ORGANIZATION LEADERS, AND IN ACCORDANCE WITH THE BEST GOVERNANCE PRACTICES IN THE INDUSTRY. FORM 990, PART III, LINE 3 COVENANT HEALTH SYSTEM TRANSFERRED THE OPERATIONS OF ITS ACUTE CARE HOSPITAL, COVENANT MEDICAL CENTER, TO A NEWLY FORMED TAX-EXEMPT SUBSIDIARY, COVENANT MEDICAL CENTER (EIN: 82-2913146). ALL OF THE SERVICES THAT WERE PROVIDED BY THIS ACUTE CARE HOSPITAL WHILE OPERATED BY COVENANT HEALTH SYSTEM ARE STILL PROVIDED TO THE COMMUNITY IN THE SAME MANNER, HOWEVER, THE SERVICES ARE NOW PROVIDED DIRECTLY BY COVENANT MEDICAL CENTER AND HAVE BEEN REPORTED ON ITS FORM 990. FORM 990, PART V, LINE 1A ST. JOSEPH HEALTH SYSTEM PAYS ALL VENDORS FOR COVENANT HEALTH SYSTEM FROM ITS SHARED SERVICES. ST. JOSEPH HEALTH SYSTEM ISSUES FORM 1099-MISC UNDER ITS TAX ID NUMBER AND COMPLIES WITH BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS. FORM 990, PART V, LINE 15 INDIVIDUALS LISTED AS OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION THAT ARE PAID BY A RELATED ORGANIZATION ARE COMMON LAW EMPLOYEES OF THE RELATED ORGANIZATION. IT IS THE INTENTION OF PROVIDENCE AND THE FILING ORGANIZATION TO MAKE INFORMATION ACCESSIBLE AND TRANSPARENT, REPORTING THOSE EMPLOYEES OF A RELATED ORGANIZATION WHO HAVE OFFICER AND KEY EMPLOYEE RESPONSIBILITIES TO THE FILING ORGANIZATION. THE RELATED ORGANIZATION COMMON LAW EMPLOYEES ARE INCLUDED IN THE RELATED ORGANIZATIONS SECTION 4960 TAX ANALYSIS AND REPORTING. FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS ST. JOSEPH HEALTH SYSTEM AND LUBBOCK METHODIST HOSPITAL SYSTEM ARE THE CORPORATE MEMBERS OF COVENANT HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS COVENANT HEALTH SYSTEM HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE COVENANT HEALTH SYSTEM BOARD. ALL TRUSTEE APPOINTMENTS THAT COME FROM THE COVENANT HEALTH SYSTEM BOARD AS NOMINATIONS MUST BE APPROVED BY THE ST. JOSEPH HEALTH SYSTEM, AS THE CORPORATE MEMBER, AND THE ST. JOSEPH HEALTH MINISTRY, AS THE ORGANIZATIONAL SPONSOR. THE ST. JOSEPH HEALTH SYSTEM MEMBER APPROVES 50% OF THE BOARD NOMINATIONS, PLUS THE VOTING CEO. THE LUBBOCK METHODIST HEALTH SYSTEM APPROVES THE OTHER 50% OF BOARD NOMINATIONS. FORM 990, PART VI, SECTION A, LINE 7B CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE ST. JOSEPH HEALTH SYSTEM MEMBER OF FINANCING, BUDGETS, UNBUDGETED EXPENDITURES OF DEFINED AMOUNTS, STRATEGIC PLAN, APPOINTMENT OF AUDITORS, CREATION OR INVESTMENT IN A LEGALLY RECOGNIZED ENTITY, JOINT VENTURES, PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. THE CORPORATE MEMBER, ST. JOSEPH HEALTH SYSTEM MEMBER, RESERVES THE RIGHT TO APPROVE THE PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW FORM 990 THE FORM 990 WAS PREPARED BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION INCLUDING THE FINANCE TEAM, HUMAN RESOURCES, PAYROLL, COMPLIANCE AND THE GENERAL COUNSEL'S OFFICE. THE ORGANIZATION ENGAGED AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE RETURN. THE RETURN HAS BEEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. A FULL COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. THE AUDIT COMMITTEE OF THE PARENT ORGANIZATION IS PROVIDED AN ANNUAL UPDATE ON THE TAX REPORTING PROCESS AND KEY DISCLOSURES. FORM 990, PART VI, SECTION B, LINE 12C PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST PROVIDENCE TAKES THE ISSUE OF CONFLICTS OF INTEREST, AND INDEPENDENT UNCONFLICTED DECISION-MAKING, VERY SERIOUSLY. PROVIDENCE HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY AND INTEREST DISCLOSURE POLICY, AND CAREFULLY AND THOROUGHLY ADMINISTERS THESE POLICIES. BOARD MEMBERS, SPONSORS, SENIOR LEADERS AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST IN ACCORDANCE WITH THE PROVIDENCE CONFLICT OF INTEREST POLICY, AND SO THAT THE INDIVIDUAL SATISFIES HIS OR HER FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES ARE MADE ANNUALLY, AS WELL AS ANY TIME AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ARISES. PROVIDENCE CHIEF LEGAL OFFICER AND/OR THE PROVIDENCE CHIEF RISK OFFICER, REVIEW ALL DISCLOSURES. WHERE APPROPRIATE, THE CEO AND/OR THE BOARD CHAIR WILL REVIEW CONFLICT OF INTEREST SITUATIONS THAT INVOLVE SENIOR LEADERSHIP OR A BOARD MEMBER OTHER THAN THE CHAIR. PROVIDENCE CHIEF LEGAL OFFICER AND/OR CHIEF RISK OFFICER REVIEW MATTERS WHERE CONFLICT IS DIFFICULT OR CANNOT BE READILY RESOLVED AND PRESENT RECOMMENDATIONS TO THE APPROPRIATE BOARD COMMITTEE OR THE CEO, FOR DISCUSSION AND RESOLUTION. WHEN APPROPRIATE, THE INDIVIDUAL WITH THE REAL/POTENTIAL CONFLICT THAT IS BEING REVIEWED MAY PARTICIPATE IN THE DISCUSSION BUT IS EXCUSED FROM THE MEETING, AND FROM ANY FINAL DISCUSSION AND VOTE, WHEN A DECISION IS BEING MADE ON WHETHER A CONFLICT EXISTS, OR WHEN THE ACTION GIVING RISE TO THE CONFLICT OF INTEREST IS DECIDED. WHERE APPROPRIATE, THE CHIEF RISK OFFICER OR CHIEF LEGAL OFFICER WILL PROVIDE PLAN TO MANAGE CONFLICTS AND AVOID PARTICIPATION BY THE CONFLICTED INDIVIDUAL IN THE MATTER GIVING RISE TO THE CONFLICT OF INTEREST. AUDITING AND MONITORING OF THIS PROCESS IS DONE REGULARLY. ALL DOCUMENTATION OF CONFLICT OF INTEREST DISCLOSURES IS RETAINED IN ACCORDANCE WITH ORGANIZATION RETENTION POLICY. FORM 990, PART VI, SECTION B, LINE 15B PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/PRESIDENT/EXECUTIVE DIRECTOR IS PAID BY ITS TAX EXEMPT MEMBER, ST. JOSEPH HEALTH SYSTEM, IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. IT IS PROVIDENCE'S INTENTION TO MAKE FINANCIAL INFORMATION ACCESSIBLE AND TRANSPARENT. ALTHOUGH THE FILING OF FORM 990 PROVIDES INSIGHT INTO HOW PROVIDENCE ACHIEVES ITS MISSION, DELIVERS ITS PROGRAMS AND STEWARDS ITS FINANCES, DECIPHERING THE INFORMATION DIRECTLY FROM FORM 990 CAN BE CHALLENGING. THE FOLLOWING PARAGRAPHS PROVIDE FURTHER INFORMATION ABOUT THE PROCESS WE USE TO DETERMINE COMPENSATION FOR TOP MANAGEMENT, OFFICERS AND KEY EMPLOYEES. PROVIDENCE HAS A SINGLE FIDUCIARY BOARD, WITH RESPONSIBILITY FOR FINANCIAL OVERSIGHT ASSOCIATED WITH FULFILLMENT OF THE PROVIDENCE MISSION, DEVELOPING SYSTEM POLICIES, PROTECTING THE ASSETS ENTRUSTED TO THE ORGANIZATION AND OVERSEEING THE STRATEGIC AND OPERATIONAL AFFAIRS OF PROVIDENCE'S LEGAL ENTITIES. PROVIDENCE ALSO MAINTAINS A NETWORK OF COMMUNITY ENTITY BOARDS WITH RESPONSIBILITY FOR QUALITY OF CARE OVERSIGHT, COMMUNITY RELATIONS, ADVOCACY AND COMMUNITY NEEDS ASSESSMENTS. PROVIDENCE HAS A CONSISTENT COMPENSATION PHILOSOPHY FOR ALL OF ITS SENIOR EXECUTIVES, INCLUDING ALL OFFICERS. SALARIES FOR SENIOR EXECUTIVES ARE REVIEWED AT LEAST ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE, WHICH IS A COMMITTEE OF THE PROVIDENCE BOARD CONSISTING ONLY OF OUTSIDE, INDEPENDENT DIRECTORS. THE COMMITTEE MAKES SURE, AT EACH OF ITS MEETINGS, THAT NO MEMBER OF THE COMMITTEE HAS A CONFLICT OF INTEREST AS TO ANY EXECUTIVE WHOSE COMPENSATION IS REVIEWED BY THE COMMITTEE. THE EXECUTIVE COMPENSATION COMMITTEE RETAINS AN INDEPENDENT CONSULTANT EACH YEAR TO REVIEW SALARIES OF THOSE IN THE MOST SIGNIFICANT LEADERSHIP ROLES IN THE ORGANIZATION. PART OF THE CONSULTANT'S ROLE IS TO REVIEW AN EXTENSIVE ARRAY OF COMPENSATION SURVEYS OF LARGE, NOT-FOR-PROFIT HEALTH CARE SYSTEMS IN THE UNITED STATES. PROVIDENCE IS ONE OF THE LARGER HEALTH SYSTEMS IN THE COUNTRY, AND AS SUCH, THE BOARD BENCHMARKS EXECUTIVE COMPENSATION AGAINST OTHER LARGE, NOT-FOR-PROFIT HEALTH SYSTEMS THAT ARE SUBSTANTIALLY SIMILAR TO PROVIDENCE IN SIZE AND COMPLEXITY (SUCH AS HAVING A SIMILAR AMOUNT OF ANNUAL NET REVENUE). ADDITIONALLY, BECAUSE PROVIDENCE OFTEN LOOKS TO GENERAL INDUSTRY FOR LEADERS IN CERTAIN FUNCTIONAL AREAS, PROVIDENCE ALSO TAKES INTO CONSIDERATION GENERAL INDUSTRY MARKET DATA IN THESE SPECIAL SITUATIONS. BASE SALARIES FOR PROVIDENCE EXECUTIVES ARE GENERALLY TARGETED TO THE "MEDIAN" LEVEL OF THE MARKET DATA (WHERE HALF THE SALARIES IN THE DATA ARE LOWER AND HALF THE SALARIES IN THE DATA ARE HIGHER), AS IDENTIFIED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE EXECUTIVE COMPENSATION COMMITTEE. THE PRESIDENT/CEO UTILIZES THE MARKET INFORMATION PROVIDED BY THE CONSULTANT ALONG WITH FORMAL PERFORMANCE EVALUATIONS, TO DETERMINE SALARY RECOMMENDATIONS FOR OTHER SENIOR EXECUTIVES. THIS PROCESS INCLUDES A RIGOROUS ANALYSIS OF THOSE RECOMMENDATIONS WITH THE EXECUTIVE COMPENSATION COMMITTEE AS A PART OF THE REVIEW AND APPROVAL PROCESS. TOTAL COMPENSATION IS TIED CLOSELY TO PERFORMANCE OF THE ORGANIZATION AND THE INDIVIDUAL. PERFORMANCE INCENTIVES ALLOW EXECUTIVES TO EARN ADDITIONAL COMPENSATION IF THEY HELP LEAD PROVIDENCE IN ACHIEVING SPECIFIC ORGANIZATIONAL GOALS FOR FURTHERING PROVIDENCE'S OPERATING COMMITMENTS AND STRATEGIC OBJECTIVES. THE BOARD OF DIRECTORS CONDUCTS A THOROUGH REVIEW PROCESS TO ENSURE PERFORMANCE INCENTIVES ARE ALIGNED WITH APPROPRIATE MARKET PRACTICES. THE BOARD'S PROCESS FOR SETTING, REVIEWING AND APPROVING EXECUTIVE COMPENSATION FULLY COMPLIES WITH IRS STANDARDS (TO ASSURE THAT ALL COMPENSATION IS CONSIDERED REASONABLE) AND REFLECTS BEST GOVERNANCE PRACTICES IN THE INDUSTRY. THE PROCESS WAS LAST COMPLETED IN 2020. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE PROVIDENCE COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE PROVIDENCE INTERNET SITE. FORM 990, PART IX, LINE 11G AGENCY & CONTRACT LABOR: PROGRAM SERVICE EXPENSES 161,843. MANAGEMENT AND GENERAL EXPENSES 180,445. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 342,288. BILLING & COLLECTIONS: PROGRAM SERVICE EXPENSES 19,559. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,559. GENERAL CONSULTING FEES: PROGRAM SERVICE EXPENSES 1,399,143. MANAGEMENT AND GENERAL EXPENSES 6,892,923. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,292,066. MEDICAL DIRECTOR & MED PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 265,051. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 265,051. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 3,851,867. MANAGEMENT AND GENERAL EXPENSES 1,844,319. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,696,186. FORM 990, PART XI, LINE 9: NET ASSET TRANSFERS BETWEEN RELATED TAX-EXEMPT ORGANIZATIONS -472,348,073. CHANGE IN EQUITY RELATED TO INVESTMENTS -41,084,219. K-1 INCOME FROM JV -1,409,716. 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