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X X X X X true true X X X true X SEE SECTION C X SEE SECTION C X SEE SECTION C X X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT THE 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. SPRING 2017 - 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% SPRING 2017 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 HOSPITALS 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. SPRING 2017 - 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 6A THE 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 CHNA WEBSITE ADDRESS HTTPS://WWW.COVENANTHEALTH.ORG/DOCUMENTS/CHP-CHNA-FY17.PDF SCHEDULE H, PART V, SECTION B, LINE 10A IMPLEMENTATION STRATEGY WEBSITE ADDRESS HTTPS://WWW.COVENANTHEALTH.ORG/DOCUMENTS/COMMUNITY_BENEFITS/CHP-CBPLAN-ISR EPORT-FY18-20.PDF SCHEDULE H, PART V, SECTION B, LINE 11 COVENANT HEALTH IS WORKING BOTH INTERNALLY AND WITH COMMUNITY PARTNERS TO ADDRESS SIGNIFICANT HEALTH NEEDS IDENTIFY BY THE FY17 COMMUNITY HEALTH NEEDS ASSESSMENT. COVENANT HEALTHS FY18-FY20 COMMUNITY BENEFIT PLAN/IMPLEMENTATION STRATEGY REPORT FOCUSES ON THREE AREAS, MENTAL/BEHAVIORAL HEALTH, DIABETES PREVENTION & INTERVENTION AND DENTAL HEALTH. BELOW IS A HIGH-LEVEL SUMMARY OF THE THE FY18-FY20 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 EITHER DIRECT PROGRAMMING OR FINANCIAL SUPPORT OF PARTNER AGENCIES. 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. 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. FOR MORE INFORMATION ON THE KEY STRATEGIES FOR ADDRESSING THIS HEALTH NEEDS GO TO THE COVENANT HEALTH FY18-FY20 CB PLAN LOCATED AVAILABLE ONLINE AT https://www.covenanthealth.org/documents/Community_Benefits/CHP-CBPlan-ISR eport-FY18-20.pdf NEEDS BEYOND THE HOSPITALS SERVICE PROGRAM THE 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 & FOOD INSECURITY COVENANT HEALTH PARTNERS WITH AND PROVIDES FUNDING TO SEVERAL ORGANIZATIONS THAT PROVIDE SERVICES IN THESE AREAS, INCLUDING BUT NOT LIMITED TO CATHOLIC CHARITIES, LOCAL FQHCS, THE SOUTH PLAINS FOOD BANK, YWCA, WOMENS 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 PATIENTS 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 QUALIFIED HEALTH CLINICS THAT ADDRESS AFOREMENTIONED COMMUNITY NEEDS TO COORDINATE CARE. SCHEDULE H, PART V, SECTION B, LINE 13H THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDER-INSURED 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. SCHEDULE H, PART V, SECTION B, LINE 16A THE FAP IS MADE WIDELY AVAILABLE AT: HTTPS://WWW.COVENANTHEALTH.ORG/DOCUMENTS/PATIENT-FINANCIAL-ASSISTANCE/FINA NCIAL-ASSISTANCE-POLICY-SJH-TX.ENGLISH.PDF SCHEDULE H, PART V, SECTION B, LINE 16B THE FAP APPLICATION FORM IS MADE WIDELY AVAILABLE AT: HTTPS://WWW.COVENANTHEALTH.ORG/DOCUMENTS/PATIENT-FINANCIAL-ASSISTANCE/FINA NCIAL-ASSISTANCE-APPLICATION-SJH-TX.ENGLISH.PDF SCHEDULE H, PART V, SECTION B, LINE 16C THE FAP PLAIN LANGUAGE SUMMARY IS MADE WIDELY AVAILABLE AT: HTTPS://WWW.COVENANTHEALTH.ORG/DOCUMENTS/PATIENT-FINANCIAL-ASSISTANCE/FINA NCIAL-ASSISTANCE-BROCHURE-SJH-TEXAS-ENGLISH-.PDF 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. 4 COVENANT HEALTHCARE CENTER PLAINVIEW 2222 W 24TH STREET PLAINVIEW TX 79072 MEDICAL CLINIC COVENANT HEALTHCARE CENTER PLAINVIEW 2502 XENIA PLAINVIEW TX 79072 MEDICAL CLINIC MOTLEY COUNTY CLINIC 1224 MAIN STREET MATADOR TX 79244 MEDICAL CLINIC COVENANT PLAINVIEW MEDICAL 2606 YONKERS PLAINVIEW TX 79072 MEDICAL CLINIC SCHEDULE H, PART I, LINE 3C CRITERIA USED TO DETERMINE ELIGIBILITY FOR PROVIDING FREE CARE 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. SCHEDULE H, PART I, LINE 6A COVENANT HEALTH PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT HTTPS://WWW.COVENANTHEALTH.ORG/DOCUMENTS/CH-CBR-FY17.PDF SCHEDULE H, PART I, LINES 7A-I 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. SCHEDULE H, PART I, LINE 7G NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED. SCHEDULE H, PART III, SECTION A, 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. SCHEDULE H, PART III, SECTION A, 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 WERE GRANTED 100 PERCENT FINANCIAL ASSISTANCE (FREE CARE). AFTER THE RECLASSIFICATION, THERE WAS NO REMAINING AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART III, SECTION A, LINE 4 FINANCIAL STATEMENT FOOTNOTE DESCRIBING BAD DEBT THE HEALTH SYSTEM PROVIDES FOR AN ALLOWANCE AGAINST PATIENT ACCOUNTS RECEIVABLE FOR AMOUNTS THAT COULD BECOME UNCOLLECTIBLE. THE HEALTH SYSTEM ESTIMATES 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. SCHEDULE H, PART III, SECTION B, LINE 8 THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT. SCHEDULE H, PART III, SECTION C, LINE 9B 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 IDENTICY 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. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT COVENANT 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 AGE COHORTS, 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. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE THE 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. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION COVENANT 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 HOUSHOLD 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 13.2 OF THE POPULATION IS OVER THE AGE OF 65. LEVEL. 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 POVERTY 79401,79411,79404,79415,79403,79412,79064,79041,79357,79410,79339,79316, 79414,79072,79241 OTHER HOSPITALS IN THE TSA INCLUDE: COCHRAN MEMORIAL HOSPITAL CROSBYTON CLINIC HOSPITAL MEDICAL ARTS HOSPITAL W.J. MANGOLD MEMORIAL HOSPITAL MEMORIAL HOSPITAL YOAKUM COUNTY HOSPITAL COVENANT HEALTH - LEVELLAND LAMB HEALTHCARE CENTER COVENANT MEDICAL CENTER COVENANT CHILDREN'S HOSPITAL LUBBOCK HEART HOSPITAL GRACE HOSPITAL UNIVERSITY MEDICAL CENTER LYNN COUNTY HOSPITAL DISTRICT BROWNFIELD REGIONAL MEDICAL CENTER YOAKUM COUNTY HOSPITAL COGDELL MEMORIAL HOSPITAL PLAINS REGIONAL MEDICAL CENTER LEA REGIONAL MEDICAL CENTER NOR-LEA GENERAL HOSPITAL HEALTH PROFESSIONS SHORTAGE AREA - MENTAL, DENTAL, OTHER THE 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 AREA MEDICALLY 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 HEALH 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 FY17 COMMUNITY BENEFIT REPORT POSTED AT HTTPS://WWW.COVENANTHEALTH.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH COVENANT HOSPITAL PLAINVIEW PROVIDES VITAL COMMUNITY HEALTH SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERSINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTED CARE. COVENANT HOSPITAL PLAINVIEW 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 TRUSTEES. 2) OPEN MEDICAL STAFF. 3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS. SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM ON 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 ST. JOSEPH HEALTH 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 829 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT TEXAS false true false false false false false true false BOB COPELAND BOARD MEMBER/CEO 211492 0 42801 0 4560 0 8828 0 26315 0 293996 0 0 0 MICHAEL BENJAMIN FARR DO BOARD MEMBER 0 492006 0 293745 0 4473 0 0 0 26130 0 816354 0 0 MARCELINO GODINO PHARMACIST IN CHARGE 150533 0 687 0 6895 0 6653 0 26856 0 191624 0 0 0 LESLIE HACKETT EXECUTIVE DIRECTOR, NURSING 138271 0 20837 0 2877 0 13129 0 26456 0 201570 0 0 0 KEVIN JONES MD BOARD MEMBER 0 494880 0 320340 0 16556 0 8000 0 25654 0 865430 0 0 CASSIE MOGG EXECUTIVE DIRECTOR, FINANCE 106190 0 14896 0 1953 0 6997 0 20919 0 150955 0 0 0 CLAY TAYLOR FORMER CEO 0 196487 0 34515 0 25757 0 13543 0 10538 0 280840 0 0 SCHEDULE J, PART I, LINE 3 ALTHOUGH THE CHIEF EXECUTIVE OFFICER IS PAID BY THE FILING ORGANIZATION, THE PROCESS TO DETERMINE COMPENSATION IS COMPLETED BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A NARRATIVE FOR THE PROCESS USED BY ST. JOSEPH HEALTH SYSTEM. SCHEDULE J, PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN ENTITIES WITHIN THE PSJH 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 OR A FIVE YEAR, AGE 65 VESTING SCHEDULE. CERTAIN EXECUTIVES PARTICIPATE IN A NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN PROVIDED BY A RELATED ENTITY. SCHEDULE J, PART I, LINE 7 A PORTION OF EXECUTIVE SALARIES ARE PLACED AT-RISK AND ARE NOT AWARDED UNLESS SPECIFIC STRATEGIC OBJECTIVE TARGETS ARE MET OR EXCEEDED. THE AT-RISK EXECUTIVE PLAN IS DESIGNED TO MOTIVATE AND REWARD EXECUTIVES FOR TEAM PERFORMANCE THAT SUPPORTS THE STRATEGIC GOALS AND SUCCESSFUL PERFORMANCE OF ST. JOSEPH HEALTH SYSTEM. AT-RISK PAY IS AWARDED TO ASSISTANT VICE PRESIDENTS, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, AND THE CHIEF EXECUTIVE OFFICER BASED ON ACHIEVING OR SURPASSING SPECIFIC GOALS THAT ARE PREDETERMINED BY THE BOARD OF TRUSTEES PRIOR TO THE BEGINNING OF THE FISCAL YEAR. THE GOALS INCLUDE STRATEGIC OBJECTIVES AS WELL AS FISCAL STEWARDSHIP. EACH OF THESE FACTORS IS TAKEN INTO CONSIDERATION WHEN DETERMINING THE PERCENTAGE OF AT-RISK. FORM 990, PART III, LINE 4A PROVIDENCE ST. JOSEPH HEALTH SYSTEM ON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT. BY COMING TOGETHER, PROVIDENCE ST. JOSEPH HEALTH 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, 829 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 & SERVICES IN 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. TODAY, PROVIDENCE SERVES ALASKA, CALIFORNIA, MONTANA, OREGON AND WASHINGTON. ST. JOSEPH HEALTH SYSTEM IN 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. PROGRAM SERVICE ACCOMPLISHMENTS: - MENTAL/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. DURING 2018, 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. IN 2018 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 DURING THE 2017-18 ACADEMIC BRINING PROGRAMING TO 83 SCHOOLS, 1,892 TEACHERS AND 34,500 STUDENTS IN LUBBOCK, HALE AND HOCKLEY COUNTIES IN WEST TEXAS. ADDITIOANLLY COVENANT HEALTH PROVIDES SUBSTANCIAL 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. IN 2018, 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. FOR MORE INFORMATION ABOUT COVENANT PLAINVIEW, PLEASE VISIT HTTPS://WWW.COVENANTHEALTH.ORG/ 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. FORM 990, PART V, LINE 1A ST. JOSEPH HEALTH SYSTEM (SJHS) PAYS ALL VENDORS FOR SJH ENTITIES FROM ITS SHARED SERVICES. SJHS ISSUES FORM 1099-MISC UNDER ITS TAX ID NUMBER AND COMPLIES WITH BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS. FORM 990, PART VI, LINE 6 DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS COVENANT HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER OF COVENANT HOSPITAL PLAINVIEW. FORM 990, PART VI, LINE 7A CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS COVENANT HOSPITAL PLAINVIEW HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBER RESERVES THE RIGHT TO APPOINT TRUSTEES TO THE COVENANT HOSPITAL PLAINVIEW BOARD. ALL TRUSTEE APPOINTMENTS THAT COME FROM THE COVENANT HOSPITAL PLAINVIEW BOARD AS NOMINATIONS MUST BE APPROVED BY THE COVENANT HEALTH SYSTEM (CHS), AS THE CORPORATE MEMBER. FORM 990, PART VI, LINE 7B DESCR CLASSES OF PERSONS, DECISIONS REQ APPR & TYPE OF VOTING RIGHTS THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE COVENANT 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, EXEMPT 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 OF COVENANT HEALTH SYSTEM, ST. JOSEPH HEALTH SYSTEM, 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, LINE 11B DESCR THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 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 COUNSELS 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, LINE 12C PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST BOARD MEMBERS, SPONSORS, SENIOR LEADERS AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANY REAL OR POTENTIAL CONFLICT OF INTEREST IN ACCORDANCE WITH THE PSJH COI POLICY AND IN CONNECTION WITH THAT INDIVIDUAL SATISFYING HIS OR HER FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES ARE MADE ANNUALLY AND/OR IF AT ANY TIME AN ACTUAL, REAL OR POTENTIAL CONFLICT OF INTEREST ARISES. PSJH CHIEF LEGAL OFFICER AND/OR THE PSJH CHIEF RISK OFFICER, REVIEW ALL DISCLOSURES. WHERE APPROPRIATE, THE CEO AND/OR THE BOARD CHAIR CONSIDER MATTERS THAT INVOLVE SENIOR LEADERSHIP OR A BOARD MEMBER. PSJH CHIEF LEGAL OFFICER AND/OR CHIEF RISK OFFICER REVIEW MATTERS WHERE CONFLICT IS DIFFICULT OR CANNOT BE 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 WHEN ACTION IS DECIDED. WHERE APPROPRIATE, THE CHIEF RISK OFFICER OR CHIEF LEGAL OFFICER WILL PROVIDE PLAN TO MANAGE CONFLICTS. AUDITING AND MONITORING OF THIS PROCESS IS DONE PERIODICALLY. ALL DOCUMENTATION OF COI DISCLOSURES IS RETAINED PER ORGANIZATION RETENTION POLICY. FORM 990, PART VI, LINE 15A & 15B PROCESS USED TO DETERMINE COMPENSATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX EXEMPT PARENT, COVENANT HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. IT IS PROVIDENCE ST. JOSEPH HEALTH'S INTENTION TO MAKE FINANCIAL NFORMATION ACCESSIBLE AND TRANSPARENT. ALTHOUGH THE FILING OF FORM 990 PROVIDES INSIGHT INTO HOW PROVIDENCE ST. JOSEPH HEALTH 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 ST. JOSEPH HEALTH HAS A SINGLE FIDUCIARY BOARD, WITH RESPONSIBILITY FOR FINANCIAL OVERSIGHT ASSOCIATED WITH FULFILLMENT OF THE PROVIDENCE ST. JOSEPH HEALTH MISSION, DEVELOPING SYSTEM POLICIES, PROTECTING THE ASSETS ENTRUSTED TO THE ORGANIZATION AND OVERSEEING THE STRATEGIC AND OPERATIONAL AFFAIRS OF PROVIDENCE ST. JOSEPH HEALTH'S LEGAL ENTITIES. PROVIDENCE ST. JOSEPH HEALTH ALSO MAINTAINS A NETWORK OF COMMUNITY ENTITY BOARDS WITH RESPONSIBILITY FOR QUALITY OF CARE OVERSIGHT, COMMUNITY RELATIONS, ADVOCACY AND COMMUNITY NEEDS ASSESSMENTS. PROVIDENCE ST. JOSEPH HEALTH HAS A CONSISTENT COMPENSATION PHILOSOPHY FOR ALL OF ITS OFFICERS, INCLUDING OUR SENIOR EXECUTIVES. SALARIES FOR SENIOR EXECUTIVES ARE REVIEWED BY THE PROVIDENCE ST. JOSEPH HEALTH COMMITTEE. THE BOARD 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 ST. JOSEPH HEALTH 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 WHOSE REVENUE IS SIMILAR TO THAT OF PROVIDENCE ST. JOSEPH HEALTH. ADDITIONALLY, PROVIDENCE ST. JOSEPH HEALTH'S LABOR MARKET CONTINUES TO SPREAD ACROSS HEALTH CARE AND INTO GENERAL INDUSTRY. BECAUSE OF THIS, PROVIDENCE ST. JOSEPH HEALTH ALSO TAKES INTO CONSIDERATION GENERAL INDUSTRY FOR-PROFIT MARKET DATA, WHERE APPLICABLE. BASE SALARIES FOR PROVIDENCE ST. JOSEPH HEALTH EXECUTIVES ARE GENERALLY TARGETED TO THE MEDIAN LEVEL OF THE MARKET, 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. PERFORMANCE INCENTIVES ALLOW EXECUTIVES TO EARN ADDITIONAL COMPENSATION IF THEY ACHIEVE SPECIFIC ORGANIZATIONAL GOALS FOR FURTHERING PROVIDENCE ST. JOSEPH HEALTH 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 EXECUTIVE COMPENSATION FULLY COMPLIES WITH IRS STANDARDS AND MIRRORS BEST PRACTICES. THE PROCESS TO REVIEW COMPENSATION WAS LAST COMPLETED IN MARCH 5, 2019. FORM 990, PART VI, LINE 19 AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO PUBLIC THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE PSJH COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE PSJH INTERNET SITE. FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:8788419 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT LABOR TOTAL FEES:964159 COVENANT ACO 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 611573313 HEALTHCARE TX 501(C)(3) 12, I CHS true COVENANT HEALTH NETWORK INC 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 461259908 HEALTHCARE CA 501(C)(3) 12, III SJHS true COVENANT HEALTH PARTNERS 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 463516417 HEALTHCARE TX 501(C)(3) 12, I CHS true COVENANT HEALTH SYSTEM 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 752765566 HEALTHCARE TX 501(C)(3) 3 SJHS true COVENANT HEALTH SYSTEM FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 752897026 HEALTHCARE TX 501(C)(3) 7 CHS true COVENANT MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 822913146 HEALTHCARE TX 501(C)(3) 3 CHS true COVENANT MEDICAL GROUP 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 752743883 HEALTHCARE TX 501(C)(3) 3 CHS true E WA & MT UNEMPLOYMENT COMP INSR TRUST 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 911082119 UNEMPLOYMENT WA 501(C)(3) 12, I PHS WA true EVERETT TRANSITIONAL CARE SERVICES PO BOX 5128 EVERETT WA 982065128 943264605 TRANS. 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