COVENANT ACO INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: COVENANT ACO INC (EIN 61-1573313)
Tax period: 2016-07-01 to 2017-06-30
Filed: 2018-05-14
IRS object ID: 201811349349302906
Schema version: 2016v3.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule D
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-05-14T10:16:28-05:00	ReturnTs
Tax Period End	2017-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	ERNST & YOUNG US LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	18101 VON KARMAN AVE STE 1700	AddressLine1Txt
City	IRVINE	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	92612	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	611573313	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	COVENANT ACO INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% DYANA KERR	InCareOfNm
Business Name Control	COVE	BusinessNameControlTxt
Phone	8067250711	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3615 19TH STREET	AddressLine1Txt
City	LUBBOCK	CityNm
State Abbreviation	TX	StateAbbreviationCd
ZIP	794101203	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DYANA KERR	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	8067250711	PhoneNum
Signature	2018-05-14	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	KARA ADAMS	PreparerPersonNm
PTIN	P00023315	PTIN
Phone	9497942300	PhoneNum

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	JOHN GRIGSON	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3615 19TH STREET	AddressLine1Txt
City	LUBBOCK	CityNm
State Abbreviation	TX	StateAbbreviationCd
ZIP	794101203	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$186,882	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.COVENANTHEALTHPARTNERS.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2007	FormationYr
Legal Domicile State	TX	LegalDomicileStateCd
Activity Or Mission	TO IMPROVE THE HEALTH OF THE POPULATIONS WE ARE CONTRACTED TO SERVE. FOR FURTHER INFORMATION, SEE SCHEDULE O.	ActivityOrMissionDesc
Voting Members Governing Body	18	VotingMembersGoverningBodyCnt
Voting Members Independent	6	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	0	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
PY Contributions Grants	$0	PYContributionsGrantsAmt
CY Contributions Grants	$0	CYContributionsGrantsAmt
PY Program Service Revenue	$1,176,939	PYProgramServiceRevenueAmt
CY Program Service Revenue	$182,218	CYProgramServiceRevenueAmt
PY Investment Income	$3,034	PYInvestmentIncomeAmt
CY Investment Income	$4,664	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$1,179,973	PYTotalRevenueAmt
CY Total Revenue	$186,882	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$0	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$0	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$1,751,628	PYOtherExpensesAmt
CY Other Expenses	$483,548	CYOtherExpensesAmt
PY Total Expenses	$1,751,628	PYTotalExpensesAmt
CY Total Expenses	$483,548	CYTotalExpensesAmt
PY Revenues Less Expenses	-$571,655	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$296,666	CYRevenuesLessExpensesAmt
Total Assets BOY	$3,512,691	TotalAssetsBOYAmt
Total Assets EOY	$3,061,327	TotalAssetsEOYAmt
Total Liabilities BOY	$1,366,019	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,211,321	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$2,146,672	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$1,850,006	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	SEE SCHEDULE O	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$477,943	ExpenseAmt
Revenue	$182,218	RevenueAmt
Desc	SEE SCHEDULE O	Desc
Total Program Service Expenses	$477,943	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	false	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	false	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	false	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	false	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	false	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	false	OperateHospitalInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	0	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	18	GoverningBodyVotingMembersCnt
Independent Voting Member	6	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	DYANA KERR	PersonNm
Phone	8067251011	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3615 19TH STREET	AddressLine1Txt
City	LUBBOCK	CityNm
State Abbreviation	TX	StateAbbreviationCd
ZIP	79410	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd
DAVID BLANN MD
BOARD MEMBER	2.0	48.0	Yes (X)	$0	$776,353	$19,967
DAVID E MANGOLD MD
BOARD MEMBER	2.0	2.0	Yes (X)	$0	$0	$0
DAVID GRAY DO
BOARD MEMBER	2.0	48.0	Yes (X)	$0	$224,103	$15,459
FREDERICK HENSAL MD
BOARD MEMBER	2.0	48.0	Yes (X)	$0	$1,551,065	$28,249
JUAN FITZ MD
BOARD MEMBER	2.0	48.0	Yes (X)	$0	$596,280	$26,353
KELLY KENSING MD
BOARD MEMBER	2.0	2.0	Yes (X)	$0	$0	$0
NILESH PATEL MD
BOARD MEMBER	2.0	48.0	Yes (X)	$0	$601,949	$31,784
SRINIVAS KADIYALA MD
BOARD MEMBER	2.0	48.0	Yes (X)	$0	$426,332	$27,234
SUSAN DEVINE MD
BOARD MEMBER	2.0	2.0	Yes (X)	$0	$0	$0
ANGELA FERGUSON MD
BOARD MEMBER	2.0	48.0	Yes (X)	$0	$229,684	$16,109
AMANDA BACKLUND MD
BOARD MEMBER	2.0	48.0	Yes (X)	$0	$304,234	$8,525
LAKHU ROHRA MD
BOARD MEMBER	2.0	2.0	Yes (X)	$0	$0	$0
SHAILI FELTON MD
BOARD MEMBER	2.0	48.0	Yes (X)	$0	$227,900	$11,728
WILLIAM B SNODGRASS MD
BOARD MEMBER	2.0	48.0	Yes (X)	$0	$201,056	$23,427
RICHARD HENDERSON MD
BOARD MEMBER	2.0	48.0	Yes (X)	$0	$526,498	$30,165
CYNTHIA BROWN MD
BOARD MEMBER/SECRETARY (PT YR)	2.0	2.0	Yes (X)	$0	$0	$0	Yes (X)
IBRAHIM SHALABY MD
BOARD MEMBER (PART YEAR)	2.0	48.0	Yes (X)	$0	$773,903	$35,845
BRIAN BRUENING MD
BOARD MEMBER (PART YEAR)	2.0	2.0	Yes (X)	$0	$0	$0
BRIAN NICHOLSON MD
BOARD MEMBER/CHAIRMAN	2.0	48.0	Yes (X)	$0	$557,604	$20,557	Yes (X)
CHRISTOPHER ROSE MD
BOARD MEMBER/VICE CHAIR	2.0	2.0	Yes (X)	$0	$0	$0	Yes (X)
COLEY DUNCAN MD
BOARD MEMBER	2.0	2.0	Yes (X)	$0	$0	$0
JOHN GRIGSON
CEO	12.0	38.0		$0	$661,926	$29,359	Yes (X)
MICHAEL ROBERTSON MD
CMO	2.0	48.0		$0	$465,774	$28,331	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$0	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$8,124,661	TotReportableCompRltdOrgAmt
Total Other Compensation	$353,092	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt
Fundraising	$0	FundraisingAmt
Noncash Contributions	$0	NoncashContributionsAmt
Total Contributions	$0	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	PHYSICIAN SERVICE REVENUE	Desc
Business	622110	BusinessCd
Total Revenue Column	$182,218	TotalRevenueColumnAmt
Related Or Exempt Func Income	$182,218	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$182,218	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,664	TotalRevenueColumnAmt
Exclusion	$4,664	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$0	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$186,882	TotalRevenueColumnAmt
Related Or Exempt Func Income	$182,218	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$4,664	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Fundraising	$0	FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$477,943	TotalAmt
Program Services	$477,943	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,605	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$5,605	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$483,548	TotalAmt
Program Services	$477,943	ProgramServicesAmt
Management And General	$5,605	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Joint Costs TotalJointCostsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$1,314,848	BOYAmt
EOY	$1,264,313	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$0	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$0	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$2,197,843	BOYAmt
EOY	$1,797,014	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,512,691	BOYAmt
EOY	$3,061,327	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$13	BOYAmt
EOY	$27,534	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$1,366,006	BOYAmt
EOY	$1,183,787	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,366,019	BOYAmt
EOY	$1,211,321	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,146,672	BOYAmt
EOY	$1,850,006	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$2,146,672	BOYAmt
EOY	$1,850,006	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$3,512,691	BOYAmt
EOY	$3,061,327	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$296,666	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$0	NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts	$0	DonatedServicesAndUseFcltsAmt
Investment Expense	$0	InvestmentExpenseAmt
Prior Period Adjustments	$0	PriorPeriodAdjustmentsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	false	FSAuditedInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Supporting Organization509a3	Yes (X)	SupportingOrganization509a3Ind
Supporting Org Type1	Yes (X)	SupportingOrgType1Ind
IRS Written Determination	Yes (X)	IRSWrittenDeterminationInd
Supported Organizations	1	SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	COVENANT HEALTH SYSTEM	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
EIN	752765566	EIN
Organization Type	3	OrganizationTypeCd
Governing Document Listed	Yes (true)	GoverningDocumentListedInd
Support	$0	SupportAmt
Other Support	$0	OtherSupportAmt

Field	Value	IRS element (for citing)
Supported Organizations Total	1	SupportedOrganizationsTotalCnt
Support Sum	$0	SupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

Field	Value	IRS element (for citing)
Listed By Name Governing Doc	Yes (true)	ListedByNameGoverningDocInd
Suprt Org No IRS Determination	false	SuprtOrgNoIRSDeterminationInd
Supported Org Section C456	false	SupportedOrgSectionC456Ind
Supported Org Not Organized US	false	SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org	false	OrganizationChangeSuprtOrgInd
Support Non Supported Org	false	SupportNonSupportedOrgInd
Payment Substantial Contribtr	false	PaymentSubstantialContribtrInd
Loan Disqualified Person	false	LoanDisqualifiedPersonInd
Controlled Disqualified Prsn	false	ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int	false	DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int	false	DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules	false	ExcessBusinessHoldingsRulesInd
Contribution Controller	false	ContributionControllerInd
Contribution Family	false	ContributionFamilyInd
Contribution35 Controlled	false	Contribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

Field	Value	IRS element (for citing)
Power Appoint Majority Dir Trst	Yes (true)	PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt Org	false	OperateBenefitNonSuprtOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE A, PART VI	FormAndLineReferenceDesc
Explanation	RELATIONSHIP WITH COVENANT HEALTH SYSTEM COVENANT ACO, INC. A TEXAS NONPROFIT CORPORATION ("COVENANT ACO"), IS A PHYSICIAN-GOVERNED ENTITY ORGANIZED TO PARTICIPATE AS AN ACCOUNTABLE CARE ORGANIZATION ("ACO") IN THE MEDICARE SHARED SAVINGS PROGRAM ("MSSP"), WHERE GROUPS OF DOCTORS AND OTHER HEALTH CARE PROVIDERS VOLUNTARILY WORK TOGETHER WITH MEDICARE TO GIVE HIGH QUALITY SERVICE TO MEDICARE FEE-FOR-SERVICE BENEFICIARIES. COVENANT ACO AIMS TO IMPROVE PATIENT OUTCOMES AND ENRICH THE HEALTHCARE EXPERIENCE BY PROVIDING BETTER CARE FOR INDIVIDUALS AND LOWERING HEALTHCARE EXPENSES.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp
CY Minus3 Yr Endwmt Fund		CYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt Fund		CYMinus4YrEndwmtFundGrp
Land		LandGrp
Buildings		BuildingsGrp
Leasehold Improvements		LeaseholdImprovementsGrp
Equipment		EquipmentGrp
Other Land Buildings		OtherLandBuildingsGrp

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDesc	Book ValueBookValueAmt
DUE FROM COV HEALTH PARTNERS	$1,796,672
DUE FROM COV HEALTH SYSTEM	$342

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$1,797,014	TotalBookValueOtherAssetsAmt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DAVID BLANN MD
BOARD MEMBER	$0	$523,819	$0	$245,713	$0	$6,821	$0	$10,000	$0	$9,967	$0	$796,320	$0	$0
DAVID GRAY DO
BOARD MEMBER	$0	$174,829	$0	$29,801	$0	$19,473	$0	$0	$0	$15,459	$0	$239,562	$0	$0
FREDERICK HENSAL MD
BOARD MEMBER	$0	$469,297	$0	$116,275	$0	$965,493	$0	$10,000	$0	$18,249	$0	$1,579,314	$0	$956,785
JUAN FITZ MD
BOARD MEMBER	$0	$567,827	$0	$19,085	$0	$9,368	$0	$10,000	$0	$16,353	$0	$622,633	$0	$0
NILESH PATEL MD
BOARD MEMBER	$0	$319,264	$0	$272,486	$0	$10,199	$0	$10,000	$0	$21,784	$0	$633,733	$0	$0
SRINIVAS KADIYALA MD
BOARD MEMBER	$0	$327,279	$0	$92,142	$0	$6,911	$0	$8,000	$0	$19,234	$0	$453,566	$0	$0
ANGELA FERGUSON MD
BOARD MEMBER	$0	$181,842	$0	$43,747	$0	$4,095	$0	$8,000	$0	$8,109	$0	$245,793	$0	$0
AMANDA BACKLUND MD
BOARD MEMBER	$0	$190,421	$0	$109,341	$0	$4,472	$0	$8,000	$0	$525	$0	$312,759	$0	$0
SHAILI FELTON MD
BOARD MEMBER	$0	$171,801	$0	$52,201	$0	$3,898	$0	$8,000	$0	$3,728	$0	$239,628	$0	$0
WILLIAM B SNODGRASS MD
BOARD MEMBER	$0	$174,593	$0	$21,882	$0	$4,581	$0	$8,000	$0	$15,427	$0	$224,483	$0	$0
RICHARD HENDERSON MD
BOARD MEMBER	$0	$281,352	$0	$239,032	$0	$6,114	$0	$10,000	$0	$20,165	$0	$556,663	$0	$0
IBRAHIM SHALABY MD
BOARD MEMBER (PART YEAR)	$0	$588,612	$0	$176,886	$0	$8,405	$0	$10,000	$0	$25,845	$0	$809,748	$0	$0
BRIAN NICHOLSON MD
BOARD MEMBER/CHAIRMAN	$0	$399,621	$0	$151,261	$0	$6,722	$0	$0	$0	$20,557	$0	$578,161	$0	$0
JOHN GRIGSON
CEO	$0	$432,609	$0	$172,905	$0	$56,412	$0	$13,250	$0	$16,109	$0	$691,285	$0	$0
MICHAEL ROBERTSON MD
CMO	$0	$317,765	$0	$115,235	$0	$32,774	$0	$10,439	$0	$17,892	$0	$494,105	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE J, PART I, LINE 3

THE ORGANIZATIONS CHIEF EXECUTIVE OFFICER, JOHN GRIGSON, IS PAID BY ITS CORPORATE MEMBER, COVENANT HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O FORM 990, PART VI, LINES 15A AND 15B FOR THE PROCESS THAT IS COMPLETED BY COVENANT HEALTH SYSTEM.

SCHEDULE J, PART I, LINE 4B

COVENANT ACO ADOPTED THE COVENANT MEDICAL GROUP DEFERRED COMPENSATION PLAN, IN ORDER TO PROVIDE SUPPLEMENTAL RETIREMENT INCOME BENEFITS FOR HIGHLY COMPENSATED PHYSICIAN EMPLOYEES THROUGH DEFERRAL OF SALARY, AND THROUGH COMPANY MATCHING CONTRIBUTIONS. THE BASIC DESIGN OF THE PLAN WAS AS FOLLOWS: MONIES WERE DEFERRED EITHER THROUGH EMPLOYER CONTRIBUTIONS, EMPLOYEE ELECTIVE PRE-TAX DEFERRAL OR BOTH INTO AN INDIVIDUAL ACCOUNT. THE PARTICIPANT WAS ALLOWED TO DIRECT INVESTMENT OF THE MONIES IN THE ACCOUNT AND THE RESULTING BALANCE UPON PAYOUT WAS THE PARTICIPANT'S PLAN BENEFIT. MATCHING CONTRIBUTIONS FOR PLAN YEARS BEGINNING ON AND AFTER JANUARY 1, 2002 WERE DISCONTINUED. THE FOLLOWING INDIVIDUAL RECEIVED 457(F) PAYMENTS DURING THE YEAR: FREDERICK HENSAL, M.D. - $956,785. CERTAIN EXECUTIVES PARTICIPATE IN A NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN PROVIDED BY A RELATED ENTITY. THE AMOUNTS SHOWN IN COLUMN F OF PART II REFLECT CURRENT YEAR PAYOUTS FROM THESE PLANS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART I, LINE 1 AND PART III, LINE 1	ORGANIZATION'S MOST SIGNIFICANT ACTIVITIES COVENANT ACO, INC. A TEXAS NONPROFIT CORPORATION ("COVENANT ACO"), IS A PHYSICIAN-GOVERNED ENTITY ORGANIZED TO PARTICIPATE AS AN ACCOUNTABLE CARE ORGANIZATION ("ACO") IN THE MEDICARE SHARED SAVINGS PROGRAM ("MSSP"), WHERE GROUPS OF DOCTORS AND OTHER HEALTH CARE PROVIDERS VOLUNTARILY WORK TOGETHER WITH MEDICARE TO GIVE HIGH QUALITY SERVICE TO MEDICARE FEE-FOR-SERVICE BENEFICIARIES. COVENANT ACO AIMS TO IMPROVE PATIENT OUTCOMES AND ENRICH THE HEALTHCARE EXPERIENCE BY PROVIDING BETTER CARE FOR INDIVIDUALS AND LOWERING HEALTHCARE EXPENSES.
FORM 990, PART III, LINE 4A	PROGRAM SERVICE ACCOMPLISHMENTS COVENANT ACO, INC. A TEXAS NONPROFIT CORPORATION ("COVENANT ACO"), IS A PHYSICIAN-GOVERNED ENTITY ORGANIZED TO PARTICIPATE AS AN ACCOUNTABLE CARE ORGANIZATION ("ACO") IN THE MEDICARE SHARED SAVINGS PROGRAM ("MSSP"), WHERE GROUPS OF DOCTORS AND OTHER HEALTH CARE PROVIDERS VOLUNTARILY WORK TOGETHER WITH MEDICARE TO GIVE HIGH QUALITY SERVICE TO MEDICARE FEE-FOR-SERVICE BENEFICIARIES. COVENANT ACO AIMS TO IMPROVE PATIENT OUTCOMES AND ENRICH THE HEALTHCARE EXPERIENCE BY PROVIDING BETTER CARE FOR INDIVIDUALS AND LOWERING HEALTHCARE EXPENSES. AFFILIATIONS ON JULY 1, 2016, PROVIDENCE HEALTH SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT, THE PURPOSE OF WHICH WAS TO BETTER SERVE BOTH ORGANIZATIONS COMMUNITIES, MAINTAIN STRONG TRADITIONS OF CATHOLIC HEALTHCARE, AND PROVIDE GREATER AFFORDABILITY AND ACCESS TO HEALTHCARE SERVICES. AS PART OF THE BUSINESS COMBINATION, PHS AND SJHS ALIGNED UNDER A SINGLE PARENT CORPORATION, PROVIDENCE ST. JOSEPH HEALTH, WITH A CONSOLIDATED BOARD OF DIRECTORS AND COSPONSORSHIP FROM THE PUBLIC JURIDIC PERSONS PROVIDENCE MINISTRIES AND ST. JOSEPH HEALTH MINISTRY.
FORM 990 PART IV, LINE 11F AND 12B & PART XII, LINE 2B	COVENANT ACO, INC. WAS INCLUDED IN CONSOLIDATED, INDEPENDENT AUDITED FINANCIAL STATEMENTS FOR PROVIDENCE ST. JOSEPH HEALTH FOR THE PERIOD ENDED DECEMBER 31, 2017. AS SUCH, AUDITED FINANCIAL STATEMENTS WERE NOT PREPARED FOR THE TAX YEAR ENDED JUNE 30, 2017. THE REPORTING ORGANIZATION WILL CHANGE ITS TAX YEAR END TO DECEMBER 31 FOR 2017. FORM 990, PART V, LINE 1A ST. JOSEPH HEALTH SYSTEM (SJHS) PAYS ALL VENDORS FOR SJH ENTITIES UNDER SJH AP SHARED SERVICES. THEREFORE, SJHS ISSUES FORM 1099-MISC UNDER ITS TAX ID. SJHS 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 ACO.
FORM 990, PART VI, LINE 7A	DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS THE CORPORATE MEMBER, COVENANT HEALTH SYSTEM, APPROVES THE ELECTION OF THE COVENANT ACO BOARD.
FORM 990, PART VI, LINE 7B	DESCR CLASSES OF PERSONS, DECISIONS REQ APPR & TYPE OF VOTING RIGHTS THE FOLLOWING ACTIONS ARE RESERVED TO COVENANT HEALTH SYSTEM AND SHALL NOT REQUIRE ANY PRIOR ACTION OR APPROVAL BY THE BOARD OF DIRECTORS OR THE INDIVIDUAL MEMBERS: (I) THE ADOPTION, AMENDMENT OR INTERPRETATION OF ANY STATEMENT OF MISSION, PHILOSOPHY, ROLE, OR PURPOSE OF THE CORPORATION; (II) ANY ALTERATION, AMENDMENT OR REPEAL OF BYLAWS OR ADOPTION OF NEW BYLAWS; (III) ANY AMENDMENT TO, OR RESTATEMENT OF, THE CORPORATION'S CERTIFICATE OF FORMATION; (IV) THE APPOINTMENT OR REMOVAL OF CORPORATE OFFICERS OF THE CORPORATION; (V) THE ACQUISITION, SALE, LEASE (WHETHER AS LESSOR OR LESSEE), MORTGAGE, PLEDGE, HYPOTHECATION, TRANSFER, OR OTHER ENCUMBRANCE OR ALIENATION OF PROPERTY OF THE CORPORATION; (VI) THE SALE, LEASE, MORTGAGE, OR OTHER TRANSFER OR ENCUMBRANCE OF THE REAL PROPERTY OF THE CORPORATION; (VII) ANY MERGER, ACQUISITION, CONSOLIDATION, REORGANIZATION OR DISSOLUTION OF THE CORPORATION; (VIII) BORROWING OR LENDING OF MONEY OR THE CREATION OF INDEBTEDNESS THROUGH THE GUARANTY OF ANOTHER'S DEBT OR SIMILAR ACTION; (IX) GIVING, SEEKING, OR ACCEPTING GRANTS OR DONATIONS THAT WOULD OBLIGATE THE CORPORATION TO EXPEND FUNDS AND/OR ASSUME RESPONSIBILITIES OUTSIDE THOSE CONTEMPLATED BY ITS STATED CHARITABLE PURPOSES; (X) SETTLEMENT OF CLAIMS OR LITIGATION; (XI) THE ESTABLISHMENT OR CHANGE OF THE CORPORATION'S FISCAL YEAR; (XII) CREATION, OWNERSHIP, OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION; AND (XIII) ANY DETERMINATIONS WITH RESPECT TO INDEMNIFICATION OF DIRECTOR AND OFFICERS OF THE CORPORATION BYLAWS.
FORM 990, PART VI, LINE 11B	PROCESS USED BY MANAGEMENT AND/OR GOVERNING BODY TO REVIEW 990 THE FORM 990 WAS PREPARED BY THE FINANCE DEPARTMENT BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION AS APPLICABLE. THE FORM 990 WAS THEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. A COPY OF THE FORM 990 FILING WAS DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD FOR THE APRIL 2018 MEETING. DURING THE FINANCE COMMITTEE MEETING, MANAGEMENT PRESENTED AND DISCUSSED CERTAIN DISCLOSURES AND INFORMATION INCLUDED IN THE FORM 990. THE FINANCE COMMITTEE CHAIR THEN PROVIDES A SUMMARY AT THE FULL BOARD MEETING.
FORM 990, PART VI, LINE 12C	DESCR OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST OFFICERS, TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE THE EXISTENCE AND NATURE OF ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICTS OF INTEREST HE/SHE MAY HAVE THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT IN CONNECTION WITH THAT INDIVIDUAL SATISFYING THEIR FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES SHALL BE MADE PROMPTLY ANY TIME AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST ARISES AND BEFORE THE CONSUMMATION OF ANY CONTRACT, TRANSACTION OR ARRANGEMENT THAT IS THE SUBJECT OF THE POTENTIAL CONFLICT OF INTEREST. WITH GUIDANCE FROM THE ST. JOSEPH HEALTH SYSTEM CHIEF COMPLIANCE OFFICER (CCO), THE CHIEF EXECUTIVE AND/OR THE GOVERNING BOARD CHAIRPERSON, AS APPROPRIATE, CONSIDERS THE MATTER INITIALLY. IF THE MATTER CANNOT BE RESOLVED AT THAT LEVEL, THE MATTER IS ESCALATED TO THE CCO. THE CCO, IN CONSULTATION WITH THE ST. JOSEPH HEALTH SYSTEM GENERAL COUNSEL, REVIEWS THE MATTER AND PRESENTS RECOMMENDATIONS TO THE GOVERNING BOARD AND/OR BOARD COMMITTEE, AS APPROPRIATE, FOR DISCUSSION AND VOTE. THE INDIVIDUAL WHOSE POTENTIAL CONFLICT IS BEING REVIEWED MAY BE REQUESTED TO BE PRESENT DURING ANY MEETING IN WHICH THE BOARD OR BOARD COMMITTEE CONDUCTS ITS EVALUATION BUT SHALL BE EXCUSED FOR ANY DISCUSSION OR VOTE. ONCE ALL NECESSARY INFORMATION HAS BEEN OBTAINED, THE COMMITTEE CONDUCTS ITS EVALUATION AND FORWARDS ITS FINDINGS AND RECOMMENDATIONS TO THE SJHS CHIEF COMPLIANCE OFFICER. IF THE COMMITTEE DETERMINES AN UNRESOLVED CONFLICT OF INTEREST EXISTS, THE COMMITTEE WILL EVALUATE AND RECOMMEND CONFLICT MITIGATION STRATEGIES. THE SJHS CHIEF COMPLIANCE OFFICER, IN CONSULTATION WITH SJHS GENERAL COUNSEL, WILL REVIEW THE COMMITTEE FINDINGS, RECOMMENDATIONS, AND MITIGATION STRATEGIES, AND PRESENT RECOMMENDATIONS TO THE BOARD FOR DISCUSSION AND VOTE.
FORM 990, PART VI, LINES 15A & 15B	PROCESS USED TO DETERMINE COMPENSATION It is St. Joseph Health System's intention to make financial information accessible and transparent. Although the filing of Form 990 provides insight into how St. Joseph Health System 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. St. Joseph Health System has a single fiduciary Board, with responsibility for financial oversight associated with fulfillment of the St. Joseph Health System Mission, developing system policies, protecting the assets entrusted to the organization and overseeing the strategic and operational affairs of St. Joseph Health System's legal entities. St. Joseph Health System also maintains a network of community ministry boards with responsibility for quality of care oversight, community relations, advocacy and community needs assessments. St. Joseph Health System 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 and approved by the full Board of Directors, none of whom is a St. Joseph Health System employee. 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. St. Joseph Health System 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 St. Joseph Health System. Additionally, St. Joseph Health Systems labor market continues to spread across health care and into general industry. Because of this, St. Joseph Health System also takes into consideration general industry for-profit market data, where applicable. Base salaries for St. Joseph Health System 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 St. Joseph Health System operating commitments and strategic objectives. The Board of Directors conducts a thorough 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 LAST REVIEW WAS PERFORMED BY ST. JOSEPH HEALTH SYSTEM IN SEPTEMBER 2016.
FORM 990, PART VI, LINE 19	AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN SMTS TO GEN PUBLIC THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE SJHS COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE SJHS INTERNET SITE.
FORM 990 PART IX LINE 11G	DESCRIPTION:PURCHASED SERVICES TOTAL FEES:477943

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (110 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
COVENANT HEALTH NETWORK INC
3345 MICHELSON DRIVE STE 100	IRVINE	CA	92612	461259908	HEALTHCARE	CA	501(C)(3)	12,III	SJHS	Yes (true)
COVENANT HEALTH SYSTEM
3615 19TH STREET	LUBBOCK	TX	79410	752765566	HEALTHCARE	TX	501(C)(3)	3	SJHS	Yes (true)
COVENANT HEALTH SYSTEM FOUNDATION
3623 22ND PLACE	LUBBOCK	TX	79410	752897026	HEALTHCARE	TX	501(C)(3)	7	CHS	Yes (true)
COVENANT MEDICAL GROUP
3420 22ND PLACE	LUBBOCK	TX	79410	752743883	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes (true)
COVENANT HEALTH PARTNERS
3615 19TH STREET	LUBBOCK	TX	79410	463516417	HEALTHCARE	TX	501(C)(3)	12,I	CHS	Yes (true)
HMTS INC
1 HOAG DRIVE	NEWPORT BEACH	CA	92658	453583707	HEALTHCARE	CA	501(C)(3)	12,I	HMHP	Yes (true)
HOAG CHARITY SPORTS
330 PLACENTIA AVE	NEWPORT BEACH	CA	92663	452982422	SUPPORT	CA	501(C)(3)	7	HHF	Yes (true)
HOAG HOSPITAL FOUNDATION
330 PLACENTIA AVE	NEWPORT BEACH	CA	92663	953222343	FUNDRAISING	CA	501(C)(3)	7	HMHP	Yes (true)
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
1 HOAG ROAD BOX 6100	NEWPORT BEACH	CA	92663	951643327	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes (true)
HOSPICE OF LUBBOCK
3702 21ST STREET	LUBBOCK	TX	79410	752133781	HEALTHCARE	TX	501(C)(3)	10	CHS	Yes (true)
LUBBOCK METHODIST HOSPITAL FOUNDATION
3615 19TH STREET	LUBBOCK	TX	79410	752220963	HEALTHCARE	TX	501(C)(3)	7	CHS	Yes (true)
METHODIST CHILDREN'S HOSPITAL
3610 21ST STREET	LUBBOCK	TX	79410	752428911	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes (true)
METHODIST HOSPITAL LEVELLAND
1900 COLLEGE AVENUE	LEVELLAND	TX	79336	752246348	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes (true)
METHODIST HOSPITAL PLAINVIEW
2601 DIMMITT ROAD	PLAINVIEW	TX	79072	752426010	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes (true)
MISSION HOSPITAL REGIONAL MEDICAL CTR
27700 MEDICAL CENTER ROAD	MISSION VIEJO	CA	92691	951643360	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes (true)
QUEEN OF THE VALLEY MEDICAL CENTER
1000 TRANCAS STREET	NAPA	CA	94558	941243669	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes (true)
REDWOOD MEMORIAL FOUNDATION
3300 RENNER DRIVE	FORTUNA	CA	95540	942779313	HEALTHCARE	CA	501(C)(3)	7	RMH	Yes (true)
REDWOOD MEMORIAL HOSPITAL
3300 RENNER DRIVE	FORTUNA	CA	95540	941384665	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes (true)
SANTA ROSA MEMORIAL HOSPITAL
1165 MONTGOMERY DRIVE	SANTA ROSA	CA	95405	941231005	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes (true)
SRM ALLIANCE HOSPITAL SERVICES (PVH)
400 NORTH MCDOWELL BLVD	PETALUMA	CA	94954	680395200	HEALTHCARE	CA	501(C)(3)	3	SRMH	Yes (true)
ST JOSEPH HEALTH SYSTEM
3345 MICHELSON DRIVE	IRVINE	CA	92612	953589356	HEALTHCARE	CA	501(C)(3)	12,I	PSJH	false
ST JOSEPH HEALTH SYSTEM FOUNDATION
3345 MICHELSON DRIVE STE 100	IRVINE	CA	92612	330143024	HEALTHCARE	CA	501(C)(3)	7	SJHS	Yes (true)
ST JOSEPH HOME CARE NETWORK
1111 SONOMA STE 308	SANTA ROSA	CA	95405	680331084	HEALTHCARE	CA	501(C)(3)	10	SJHS	Yes (true)
ST JOSEPH HOSPITAL OF EUREKA
2700 DOLBEER STREET	EUREKA	CA	95501	941156596	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes (true)
ST JOSEPH HOSPITAL OF ORANGE
1100 WEST STEWART DRIVE	ORANGE	CA	92868	951643359	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes (true)
ST JOSEPH HERITAGE HEALTHCARE
200 WEST CENTER ST PROMENADE	ANAHEIM	CA	92805	330185031	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes (true)
ST JUDE HOSPITAL INC
101 EAST VALENCIA MESA DRIVE	FULLERTON	CA	92635	951643324	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes (true)
ST MARY MEDICAL CENTER
18300 HIGHWAY 18	APPLE VALLEY	CA	92307	951914489	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes (true)
ST MARY OF THE PLAINS HOSPITAL FDN
4000 24TH STREET	LUBBOCK	TX	79410	751653181	HEALTHCARE	TX	501(C)(3)	7	CHS	Yes (true)
ST JOSEPH HEALTH NOR CAL LLC
3345 MICHELSON DRIVE STE 100	IRVINE	CA	92612	814791043	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes (true)
SISTERS OF ST JOSEPH OF ORANGE
480 S BATAVIA	ORANGE	CA	92868	951643383	RELIGIOUS ORG	CA	501(C)(3)	1	NA	false
ST JOSEPH HEALTH MINISTRY
3345 MICHELSON DRIVE STE 100	IRVINE	CA	92612	271666576	RELIGIOUS ORG	CA	501(C)(3)	1	SSJO	false
E WA & MT UNEMPLOYMENT COMP INSR TRUST
1801 LIND AVENUE SW 9016	RENTON	WA	980579016	911082119	UNEMPLOYMENT	WA	501(C)(3)	12,I	PHS WA	Yes (true)
EVERETT TRANSITIONAL CARE SERVICES
PO BOX 5128	EVERETT	WA	982065128	943264605	TRANS. CARE	WA	501(C)(3)	10	NA	false
FACEY MEDICAL FOUNDATION
15451 SAN FERNANDO MISSION BLVD 2	MISSION HILLS	CA	91345	954322584	SUPPORT	CA	501(C)(3)	7	PHS SOCAL	Yes (true)
GAMELIN WASHINGTON ASSOCIATION
1423 FIRST AVENUE	SEATTLE	WA	98101	201910170	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
GLOBAL TO LOCAL HEALTH INITIATIVE
2800 SOUTH 192ND ST 104	SEATAC	WA	98188	273133200	HEALTHCARE	WA	501(C)(3)	7	SHS	Yes (true)
INLAND NORTHWEST HEALTH SERVICES
601 W 1ST AVENUE	SPOKANE	WA	99201	911307555	HEALTHCARE	WA	501(C)(3)	3	PHS WA	Yes (true)
INSTITUTE FOR MENTAL HEALTH & WELLNESS
1801 LIND AVENUE SW 9016	RENTON	WA	98057	814260130	HEALTHCARE	WA	501(C)(3)	7	PHS SJHS	Yes (true)
INSTITUTE FOR SYSTEMS BIOLOGY
401 TERRY AVE N	SEATTLE	WA	98109	912003593	HEALTHCARE	WA	501(C)(3)	7	WHC	Yes (true)
JOHN WAYNE CANCER INSTITUTE
2200 SANTA MONICA BLVD	SANTA MONICA	CA	90404	954291515	HEALTHCARE	CA	501(C)(3)	4	PSJHC	Yes (true)
KADLEC AUXILIARY INC
888 SWIFT BLVD	RICHLAND	WA	99352	916033089	SUPPORT	WA	501(C)(3)	12,III	KRMC	Yes (true)
KADLEC FOUNDATION
888 SWIFT BLVD	RICHLAND	WA	99352	237005501	SUPPORT	WA	501(C)(3)	12,I	KRMC	Yes (true)
KADLEC NEUROLOGICAL RESOURCE CENTER
1268 LEE BLVD	RICHLAND	WA	99352	911266345	HEALTHCARE	WA	501(C)(3)	10	WHC	Yes (true)
KADLEC REGIONAL MEDICAL CENTER
888 SWIFT BLVD	RICHLAND	WA	99352	910655392	HEALTHCARE	WA	501(C)(3)	3	WHC	Yes (true)
LITTLE COMPANY OF MARY ANCILLARY SVCS CO
4101 TORRANCE BLVD	TORRANCE	CA	90503	330844408	IMAGING SVCS	CA	501(C)(3)	10	PHS SOCAL	Yes (true)
LUNDBERG ASSOCIATIONPROVIDENCE HOUSE
5921 E BURNSIDE	PORTLAND	OR	97215	911562797	SUPPORT	OR	501(C)(3)	7	PHS OR	Yes (true)
MARSHA RIVKIN CENTER FOR OVARIAN CANCER
747 BROADWAY	SEATTLE	WA	98122	912054035	RESEARCH	WA	501(C)(3)	7	SHS	Yes (true)
PACMED CLINICS
1200 12TH AVENUE S	SEATTLE	WA	98144	562290878	HEALTHCARE	WA	501(C)(3)	10	WHC	Yes (true)
PH&S FOUNDATIONSFVSA & SCVSA
501 S BUENA VISTA STREET	BURBANK	CA	91505	953544877	HEALTHCARE	CA	501(C)(3)	7	PHS SOCAL	Yes (true)
PROVIDENCE ALASKA FOUNDATION
3300 PROVIDENCE DR TOWER 2	ANCHORAGE	AK	99508	920093565	HEALTHCARE	AK	501(C)(3)	12,I	PHS WA	Yes (true)
PROVIDENCE BENEDICTINE NURSING CTR FNDN
540 SOUTH MAIN STREET	MT ANGEL	OR	973629532	911940286	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE BLANCHET ASSOCIATION
1700 PROVIDENCE PL	CENTRALIA	WA	98531	911789266	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE CHILD CENTER FOUNDATION
830 NE 47TH	PORTLAND	OR	97213	930800140	SUPPORT	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE COMMUNITY HEALTH FOUNDATION
1111 CRATER LAKE AVE	MEDFORD	OR	97504	930692907	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE DETHMAN HOUSE
1205 MONTELLO AVE	HOOD RIVER	OR	97031	473385506	SUPPORT	WA	501(C)(3)	7	NA	false
PROVIDENCE FOUNDATION
1801 LIND AVENUE SW 9016	RENTON	WA	980579016	943078543	HEALTHCARE	WA	501(C)(3)	12,I	PHS WA	Yes (true)
PROVIDENCE GAMELIN HOUSE ASSOCIATION
4515 MLK JR WAY S STE 200	SEATTLE	WA	98108	311744654	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE HEALTH & SERVICES
1801 LIND AVENUE SW 9016	RENTON	WA	980579016	911549796	HEALTHCARE	WA	501(C)(3)	12,II	PSJH	false
PROVIDENCE HEALTH & SERVICES - MONTANA
500 W BROADWAY PO BOX 4587	MISSOULA	MT	598064587	810231793	HEALTHCARE	MT	501(C)(3)	3	PHS WA	Yes (true)
PROVIDENCE HEALTH & SERVICES - OREGON
1801 LIND AVENUE SW 9016	RENTON	WA	980579016	510216587	HEALTHCARE	OR	501(C)(3)	3	PHS	Yes (true)
PROVIDENCE HEALTH & SERVICES - WA
1801 LIND AVENUE SW 9016	RENTON	WA	980579016	510216586	HEALTHCARE	WA	501(C)(3)	3	PHS	Yes (true)
PROVIDENCE HEALTH & SERVICES - WEST WA
1801 LIND AVENUE SW 9016	RENTON	WA	980579016	911303277	HEALTHCARE	WA	501(C)(3)	3	PMWHC	Yes (true)
PROVIDENCE HEALTH ASSURANCE
4400 NE HALSEY BLDG 2	PORTLAND	OR	97213	550828701	MEDICAID	OR	501(C)(4)	N/A	PHP	Yes (true)
PROVIDENCE HEALTH CARE FNDN - E WA
101 W 8TH AVENUE	SPOKANE	WA	99204	320014330	HEALTHCARE	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE HEALTH CARE FNDN (CENTRALIA)
914 S SCHEUBER ROAD	CENTRALIA	WA	98531	911433382	HEALTHCARE	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE HEALTH PLAN
4400 NE HALSEY BLDG 2	PORTLAND	OR	97213	930863097	HEALTHCARE	OR	501(C)(4)	N/A	PPP	Yes (true)
PROVIDENCE HEALTH SYSTEM - SO CAL
1801 LIND AVENUE SW 9016	RENTON	WA	980579016	510216589	HEALTHCARE	CA	501(C)(3)	3	PHS	Yes (true)
PROVIDENCE HOOD RIVER MEM HOSP FDN
811 13TH ST	HOOD RIVER	OR	97031	930921990	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE HOSPICE AND HOME CARE FNDN
2731 WETMORE AVENUE STE 500	EVERETT	WA	98201	272552749	HEALTHCARE	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE HOSPICE OF SEATTLE FOUNDATION
425 PONTIUS AVENUE NORTH 300	SEATTLE	WA	980195452	912077378	HEALTHCARE	WA	501(C)(3)	12,I	PHS WA	Yes (true)
PROVIDENCE LITTLE COMPANY OF MARY FNDN
4101 TORRANCE BLVD	TORRANCE	CA	90503	510224944	HEALTHCARE	CA	501(C)(3)	7	PHS SOCAL	Yes (true)
PROVIDENCE MARIANWOOD FOUNDATION
3725 PROVIDENCE POINT DRIVE SE	ISSAQUAH	WA	980297219	931554288	HEALTHCARE	WA	501(C)(3)	12,I	PHS WA	Yes (true)
PROVIDENCE MEDICAL INSTITUTE
4101 TORRANCE BLVD	TORRANCE	CA	90503	330283773	HEALTHCARE	CA	501(C)(3)	12,I	PHS SOCAL	Yes (true)
PROVIDENCE MILWAUKIE FOUNDATION
10150 SE 32ND	MILWAUKIE	OR	97222	943079515	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE MOUNT ST VINCENT FOUNDATION
4831 35TH AVENUE SW	SEATTLE	WA	981262799	911188119	HEALTHCARE	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE NEWBERG HEALTH FOUNDATION
1001 PROVIDENCE DRIVE	NEWBERG	OR	97132	930889144	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE PETER CLAVER ASSOCIATION
7101 38TH AVENUE SOUTH	SEATTLE	WA	98118	311629656	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE PLAN PARTNERS
4400 NE HALSEY BLDG 2	PORTLAND	OR	97213	911861964	HEALTHCARE	WA	501(C)(4)	N/A	PHS OR	Yes (true)
PROVIDENCE PORTLAND MEDICAL FOUNDATION
4805 NE GLISAN STREET	PORTLAND	OR	972132967	931231494	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE ROSSI ASSOCIATION
1700 PROVIDENCE PLACE	CENTRALIA	WA	98531	311584166	SUPPORT	WA	501(C)(3)	10	PHS WA	Yes (true)
PROVIDENCE SAINT JOHN'S HEALTH CENTER
2121 SANTA MONICA BLVD	SANTA MONICA	CA	90404	951684082	HEALTHCARE	CA	501(C)(3)	3	PHS SOCAL	Yes (true)
PROVIDENCE SAINT JOHN'S MEDICAL FNDN
20555 EARL ST	TORRANCE	CA	90503	814542216	HEALTHCARE	CA	501(C)(3)	Pending	PHS SOCAL	Yes (true)
PROVIDENCE SEASIDE HOSPITAL FOUNDATION
725 S WAHANNA RD	SEASIDE	OR	97138	930927320	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE ST ELIZABETH HOUSE ASSOC
3201 SW GRAHAM ST	SEATTLE	WA	98126	912171539	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE ST FRANCIS ASSOCIATION
3415 12TH AVENUE NE	OLYMPIA	WA	98506	943244854	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE ST JOSEPH HEALTH
1801 LIND AVENUE SW 9016	RENTON	WA	98057	811244422	HEALTHCARE	WA	501(C)(3)	12,III	NA	false
PROVIDENCE ST JOSEPH MEDICAL CENTER
PO BOX 1010	POLSON	MT	598601010	810463482	HEALTHCARE	MT	501(C)(3)	3	PHS WA	Yes (true)
PROVIDENCE ST MARY FOUNDATION
401 W POPLAR STREET	WALLA WALLA	WA	99362	452841492	HEALTHCARE	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE ST PETER FOUNDATION
413 LILLY ROAD NE	OLYMPIA	WA	985065166	911097056	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE ST VINCENT MEDICAL FNDN
9205 SW BARNES ROAD	PORTLAND	OR	97225	930575982	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE TRINITYCARE HOSPICE
5315 TORRANCE BLVD STE B1	TORRANCE	CA	90503	953264139	HEALTHCARE	CA	501(C)(3)	10	PHS SOCAL	Yes (true)
PROVIDENCE TRINITYCARE HOSPICE FNDN
5315 TORRANCE BLVD STE B1	TORRANCE	CA	90503	330261016	HEALTHCARE	CA	501(C)(3)	7	PTCH	Yes (true)
PROVIDENCE WILLAMETTE FALLS MEDICAL FNDN
1500 DIVISION STREET	OREGON CITY	OR	97045	931003750	HEALTHCARE	OR	501(C)(3)	12, I	PHS OR	Yes (true)
SAINT JOHN'S HOSPITALHEALTH CENTER FNDN
2121 SANTA MONICA BLVD	SANTA MONICA	CA	90404	956100079	SUPPORT	CA	501(C)(3)	7	PSJHC	Yes (true)
SEATTLE SCIENCE FOUNDATION
550 17TH AVENUE	SEATTLE	WA	98122	611502822	PHYSN COLLAB	WA	501(C)(3)	7	WHC	Yes (true)
SISTERS OF PROVIDENCE OF MONTANA CORP
1801 LIND AVENUE SW 9016	RENTON	WA	980579016	262612415	SHELL CORP	MT	501(C)(3)	1	PHS WA
ST LUKE ASSOCIATION
350 WASHINGTON AVE SE	CHEHALIS	WA	98352	943176618	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
ST PATRICK HOSPITAL FOUNDATION
500 WEST BROADWAY PO BOX 4587	MISSOULA	MT	598064587	237056976	HEALTHCARE	MT	501(C)(3)	7	PHS WA	Yes (true)
ST THOMAS CHILD AND FAMILY CENTER
1710 BENEFIS COURT	GREAT FALLS	MT	59405	810233495	EDUCATION	MT	501(C)(3)	10	PHS WA	Yes (true)
SWEDISH EDMONDS
21601 76TH AVENUE	EDMONDS	WA	98026	272305304	HEALTHCARE	WA	501(C)(3)	3	WHC	Yes (true)
SWEDISH HEALTH SERVICES
747 BROADWAY	SEATTLE	WA	98122	910433740	HEALTHCARE	WA	501(C)(3)	3	WHC	Yes (true)
SWEDISH MEDICAL CENTER FOUNDATION
747 BROADWAY	SEATTLE	WA	98122	910983214	HEALTHCARE	WA	501(C)(3)	7	SHS	Yes (true)
SWEDISH MJM HOLDINGS
747 BROADWAY	SEATTLE	WA	98122	273139262	HOLDING CO	WA	501(C)(3)	12,I	SHS	Yes (true)
THE GAMELIN ASSOCIATION
312 NORTH FOURTH STREET	YAKIMA	WA	98901	911180824	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
THE GAMELIN CALIFORNIA ASSOCIATION
540 23RD STREET	OAKLAND	CA	94612	911293869	SUPPORT	CA	501(C)(3)	10	PHS SOCAL	Yes (true)
THE GAMELIN OREGON ASSOCIATION
5520 NE GLISAN	PORTLAND	OR	97213	911214491	SUPPORT	OR	501(C)(3)	10	PHS OR	Yes (true)
UNIVERSITY OF GREAT FALLS
1301 20TH STREET SOUTH	GREAT FALLS	MT	59405	810231777	EDUCATION	MT	501(C)(3)	2	PHS	Yes (true)
WESTERN HEALTHCONNECT
747 BROADWAY	SEATTLE	WA	98122	454171900	SHELL CORP	WA	501(C)(3)	12,II	PHS W WA	Yes (true)
PROVIDENCE MINISTRIES
1801 LIND AVENUE SW 9016	RENTON	WA	98057		RELIGIOUS ORG	WA	501(C)(3)	1	NA	false

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (58 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt
ADVANCED SURGERY INSTITUTE LLC
1739 4TH STREET	SANTA ROSA	CA	95404	262299255	HEALTHCARE	CA	NA	N/A
COVENANT LONG-TERM CARE LP
4000 24TH STREET	LUBBOCK	TX	79410	205033419	HEALTHCARE	TX	NA	N/A
HERITAGE INVESTMENT GROUP I LLC
500 S MAIN STREET STE 1000	ORANGE	CA	92868	271000061	INVESTMENTS	CA	NA	N/A
HOAG ORTHOPEDIC INSTITUTE
1 HOAG DRIVE BOX 6100	NEWPORT BEACH	CA	92658	611588294	HEALTHCARE	CA	NA	N/A
METHODIST DIAGNOSTIC IMAGING
4005 24TH STREET	LUBBOVK	TX	79410	752343261	HEALTHCARE	TX	NA	N/A
NEWPORT IMAGING CENTER
360 SN MIGUEL	NEWPORT BEACH	CA	92660	330191776	HEALTHCARE	CA	NA	N/A
SHA LLC
12940 NORTH HIGHWAY 183	AUSTIN	TX	78750	752569094	HEALTHCARE	TX	NA	N/A
ST JOSEPH PHYSICIAN VENTURES I LLC
1100 WEST STEWART DRIVE	ORANGE	CA	92868	454521884	REAL ESTATE	CA	NA	N/A
NORTH BAY ENDOSCOPY CENTER
1383 N MCDOWELL BLVD SUITE 110	PETALUMA	CA	94954	611559876	HEALTHCARE	CA	NA	N/A
SOUTHERN CALIFORNIA SURGERY CENTER LLC
18321 VENTURA BLVD STE 740	TARZANA	CA	91356	330939000	HEALTHCARE	CA	NA	N/A
COASTAL ASC HOLDINGS LLC
ONE HOAG DRIVE BOX 6100	NEWPORT BEACH	CA	92664	810986844	HEALTHCARE	CA	NA	N/A
ST JOSEPHSATELLITE DIALYSIS CENTERS
300 SANTANA ROW SUITE 300	SAN JOSE	CA	95128	814657391	HEALTHCARE	CA	NA	N/A
ALPHA MEDICAL LABORATORY LLC
611 N PERRY	SPOKANE	WA	99202	912017347	OUTPATIENT LAB	ID	NA	N/A
BROADWAY IMAGING LLC
500 W BROADWAY	MISSOULA	MT	59802	522405971	MEDICAL IMAGING	MT	NA	N/A
CALIFORNIA LABORATORY ASSOCIATES LLC
501 BUENA VISTA	BURBANK	CA	91505	273888692	OUTPATIENT LAB	CA	NA	N/A
CENTER FOR SPECIALTY SURGERY LLC
11782 SW BARNES RD	PORTLAND	OR	97225	263638838	AMBULATORY SURG	OR	NA	N/A
CLACKAMAS RADIATION ONCOLOGY CENTER LLC
4400 NE HALSEY ST BLDG II 495	PORTLAND	OR	97213	260381897	RADIATION ONCOL	OR	NA	N/A
CTR FOR MED IMAGING-BRIDGEPORT LLC
4400 NE HALSEY 495	PORTLAND	OR	97213	260796953	IMAGING DIAG.	OR	NA	N/A
CTR FOR MED IMAGING-TANASBOURNE LLC
4400 NE HALSEY 495	PORTLAND	OR	97213	200477972	IMAGING DIAG.	OR	NA	N/A
GREATER VALLEY MEDICAL BUILDING LP
501 S BUENA VISTA ST	BURBANK	CA	91505	954570858	REAL ESTATE - MOB	CA	NA	N/A
MINOR & JAMES MEDICAL PLLC
515 MINOR AVENUE 200	SEATTLE	WA	98104	911340223	PHYSICIAN CLINIC	WA	NA	N/A
MOUNTAINSTAR CLINICAL LABORATORIES LLC
611 N PERRY	SPOKANE	WA	99202	261345983	OUTPATIENT LAB	MT	NA	N/A
OREGON ADVANCED IMAGING LLC
881 OHARE PARKWAY	MEDFORD	OR	97504	450471748	MEDICAL IMAGING	OR	NA	N/A
OREGON OUTPATIENT SURGERY CENTER
7300 SW CHILDS RD	TIGARD	OR	97224	223883387	AMBULATORY SURG	OR	NA	N/A
PACLAB LLC
611 N PERRY SPOKANE	SPOKANE	WA	99202	911743952	OUTPATIENT LAB	WA	NA	N/A
PATHOLOGY ASSOCIATES MEDICAL LABORATORIE
611 N PERRY SPOKANE	SPOKANE	WA	99202	270943279	OUTPATIENT LAB	WA	NA	N/A
PETCT IMAGING AT SWEDISH CANCER INSTITU
1221 MADISON STREET	SEATTLE	WA	98104	203132044	MEDICAL IMAGING	WA	NA	N/A
PORTLAND MEDICAL IMAGING LLC
4400 NE HALSEY	PORTLAND	OR	97213	201054971	IMAGING DIAGNOSTI	OR	NA	N/A
PROV RADIATION ONCOLOGY DEVELOP ASSN
4400 NE HALSEY	PORTLAND	OR	97213	260682491	REAL ESTATE - MOB	OR	NA	N/A
PROVIDENCE IMAGING CENTER
3340 PROVIDENCE DRIVE	ANCHORAGE	AK	99508	920118807	MEDICAL IMAGING	AK	NA	N/A
PROVIDENCE PARTNERS FOR HEALTH LLC
501 S BUENA VISTA ST	BURBANK	CA	91505	454041798	CLIN QUALITY/INT	CA	NA	N/A
PROVIDENCE SURGERY CENTER LLC
902 N ORANGE ST	MISSOULA	MT	59802	841401625	AMBULATORY SURG	MT	NA	N/A
PROVIDENCESILVERTON REHAB LLC
4400 NE HALSEY 425	PORTLAND	OR	97213	481287267	REHAB SERVICES	OR	NA	N/A
PROVIDENCEUSP SANTA CLARITA GP LLC
11550 INDIAN HILLS ROAD	MISSION HILLS	CA	91345	202829660	AMBULATORY SURG	CA	NA	N/A
PROVIDENCEUSP SURGERY CTRS LLC
11550 INDIAN HILLS ROAD	MISSION HILLS	CA	91345	200905938	AMBULATORY SURG	CA	NA	N/A
SOUTHERN IDAHO REGIONAL LABORATORY LLC
611 N PERRY SPOKANE	SPOKANE	WA	99202	820511819	OUTPATIENT LAB	ID	NA	N/A
THE MADISON SPOKANE INN LLC
15 WEST ROCKWOOD BLVD	SPOKANE	WA	99204	841606484	HOTEL SERVICES	WA	NA	N/A
TRI-CITIES LABORATORY LLC
611 N PERRY	SPOKANE	WA	99202	911773986	OUTPATIENT LAB	WA	NA	N/A
HCSA PROPERTIES LLC
1600 M STREET NW	AUBURN	WA	98001	460620892	REAL ESTATE RENT	WA	NA	N/A
PHS INVESTMENT TRUST HEDGE FUND PORTFOLI
1801 Lind Avenue SW No 9016	Renton	WA	98057	472293255	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST BANK LOANS PORTFOLI
1801 Lind Avenue SW No 9016	Renton	WA	98057	472357735	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRANSITION PORTFOLIO
1801 Lind Avenue SW No 9016	Renton	WA	98057	472279711	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST RISK PARITY PORTFOL
1801 Lind Avenue SW No 9016	Renton	WA	98057	472336377	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST LONG TREASURIES POR
1801 Lind Avenue SW No 9016	Renton	WA	98057	472385238	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST MLP PORTFOLIO
1801 Lind Avenue SW No 9016	Renton	WA	98057	472367538	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST RELATIVE VALUE PORT
1801 Lind Avenue SW No 9016	Renton	WA	98057	472314743	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST TIPS PORTFOLIO
1801 Lind Avenue SW No 9016	Renton	WA	98057	472402609	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST PUBLIC EQUITY PORTF
1801 Lind Avenue SW No 9016	Renton	WA	98057	472283974	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST LDI PORTFOLIO
1801 Lind Avenue SW No 9016	Renton	WA	98057	472392060	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST PUBLIC DEBT PORTFOL
1801 Lind Avenue SW No 9016	Renton	WA	98057	472353569	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST TACTICAL TRADING PO
1801 Lind Avenue SW No 9016	Renton	WA	98057	472327491	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST COMMODITIES PORTFOL
1801 Lind Avenue SW No 9016	Renton	WA	98057	472269004	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST 2015 PRIVATE ASSETS
1801 Lind Avenue SW No 9016	Renton	WA	98057	473393740	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST SHORT TERM INVESTME
1801 Lind Avenue SW No 9016	Renton	WA	98057	812701056	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST 2016 PRIVATE ASSETS
1801 Lind Avenue SW No 9016	Renton	WA	98057	811532735	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST 2016 PRIVATE REAL E
1801 Lind Avenue SW No 9016	Renton	WA	98057	812960145	INVESTMENTS	WA	NA	N/A
LSC REAL PROPERTY LLC
2301 QUAKER AVENUE	LUBBOCK	TX	79410	474646059	REAL ESTATE	TX	NA	N/A
CALIFORNIA SPECIALTY SURGERY CENTER LP
26371 CROWN VALLEY PARKWAY	MISSION VIEJO	CA	92691	330939003	HEALTHCARE	CA	NA	N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (23 entries)

Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd	Foreign PostalForeignAddress/ForeignPostalCd	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Legal Domicile StateLegalDomicileStateCd
AMERICAN UNITY GROUP LTD
90 PITTS BAY ROAD	PEMBROKE	BD	HM08	CAPTIVE INSURANCE	BD	NA	C-CORP
COASTAL MANAGEMENT SERVICES ORGANIZATION
				HEALTHCARE		NA	C-CORP	1 HOAG DRIVE BOX 6100	NEWPORT BEACH	CA	92658	330676831	CA
DATU HEALTH INC AND SUBSIDIARIES
				IT SVCS		NA	C-CORP	16150 MAIN CIRCLE DR SUITE 250	CHESTERFIELD	MO	63017	463070062	DE
HOAG MANAGEMENT SERVICES INC
				HEALTHCARE		NA	C-CORP	1 HOAG DRIVE BOX 6100	NEWPORT BEACH	CA	92658	330731587	CA
LUBBOCK METHODIST HOSP PRACTICE MGMT
				INACTIVE		NA	C-CORP	2107 OXFORD STREET STE 300	LUBBOCK	TX	79410	752578995	TX
LUBBOCK METHODIST HOSPITAL SVCS
				HEALTHCARE		NA	C-CORP	PO BOX 1201	LUBBOCK	TX	79410	752118585	TX
MISSION VIEJO MEDICAL VENTURES
				HEALTHCARE		NA	C-CORP	27800 MEDICAL CENTER RD	MISSION VIEJO	CA	92691	330212905	CA
ST JOSEPH HEALTH
				HOLDING COMPANY		NA	C-CORP	3345 MICHELSON DRIVE SUITE 100	IRVINE	CA	92612	462340232	CA
ST JOSEPH HEALTH SOURCE INC
				HEALTHCARE		NA	C-CORP	3345 MICHELSON DRIVE SUITE 100	IRVINE	CA	92612	461900168	CA
ST JOSEPH PROF SVCS ENTERPRSES INC
				HEALTHCARE		NA	C-CORP	3345 MICHELSON DRIVE SUITE 100	IRVINE	CA	92612	330155323	CA
OPHIE HEALTHCARE SERVICES INC
				HEALTHCARE		NA	C-CORP	3345 MICHELSON DRIVE SUITE 100	IRVINE	CA	92612	271002825	CA
PROVIDENCE HEALTH VENTURES INC
				INVESTMENT		NA	C-CORP	4101 TORRANCE BLVD	TORRANCE	CA	90503	330122216	CA
CARON HEALTH CORPORATION
				MED PHYS SVCS		NA	C-CORP	510 W FRONT ST	MISSOULA	MT	59802	810486082	MT
PROVIDENCE HEALTH CARE VENTURES INC
				CLIN/MED LAB		NA	C-CORP	101 W 8TH AVE TAF C-9	SPOKANE	WA	99204	900155714	WA
PROVIDENCE PHYSICIAN SERVICES CO
				CLIN/MED LAB		NA	C-CORP	101 W 8TH AVE TAF C-9	SPOKANE	WA	99204	911216033	WA
YAKIMA MEDICAL ARTS INC
				RENT REAL ESTATE		NA	C-CORP	611 N PERRY 100	SPOKANE	WA	99202	910787963	WA
BOURGET HEALTH SERVICES INC
				CLIN/MED LAB		NA	C-CORP	PO BOX 2687	SPOKANE	WA	99220	911354431	WA
1221 MADISON STREET OWNERS ASSOC
				OWNERS' ASSOC.		NA	C-CORP	747 BROADWAY	SEATTLE	WA	98122	201954319	WA
WESTERN HEALTHCONNECT VENTURES INC
				INVESTMENTS		NA	C-CORP	1801 LIND AVE SW 9016	RENTON	WA	98057	800953654	WA
PHN HOLDINGS
				STRAT PLAN SVCS		NA	C-CORP	20555 EARL STREET	TORRANCE	CA	90503	461814184	CA
PROVIDENCE HEALTH NETWORK
				PREPAID HEALTH		NA	C-CORP	20555 EARL STREET	TORRANCE	CA	90503	800886966	CA
PIONEER INNOVATIONS INC
				HEALTH INNOVATNS		NA	C-CORP	800 5TH AVE 10TH FLOOR	SEATTLE	WA	98104	364818191	WA
VINSERRA INC
				INVESTMENTS		NA	C-CORP	1328 22ND STREET	SANTA MONICA	CA	90403	953943315	CA

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	false	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE R, PART III	FormAndLineReferenceDesc
Explanation	IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP ADVANCED SURGERY INSTITUTE, LLC EIN: 26-2299255 ADDRESS: 1739 4TH STREET, SANTA ROSA, CA 95404 COVENANT LONG-TERM CARE, LP EIN: 20-5033419 ADDRESS: 4000 24TH STREET, LUBBOCK, TX 79410 HERITAGE INVESTMENT GROUP I, LLC EIN: 27-1000061 ADDRESS: 500 S. MAIN STREET, STE 1000, ORANGE, CA 92868 HOAG ORTHOPEDIC INSTITUTE EIN: 61-1588294 ADDRESS: 1 HOAG DRIVE, BOX 6100, NEWPORT BEACH, CA 92658 METHODIST DIAGNOSTIC IMAGING EIN: 75-2343261 ADDRESS: 4005 24TH STREET, LUBBOCK, TX 79410 NEWPORT IMAGING CENTER EIN: 33-0191776 ADDRESS: 360 SAN MIGUEL, NEWPORT BEACH, CA 92660 SHA, LLC EIN: 75-2569094 ADDRESS: 12940 NORTH HIGHWAY 183, AUSTIN, TX 78750 ST. JOSEPH PHYSICIAN VENTURES I, LLC EIN: 45-4521884 ADDRESS: 1100 WEST STEWART DRIVE, ORANGE, CA 92868 NORTH BAY ENDOSCOPY CENTER, LLC EIN: 61-1559876 ADDRESS: 1383 N. MCDOWELL BLVD, STE 110, PETALUMA, CA 94954 SOUTHERN CALIFORNIA SURGERY CENTER, LLC EIN: 33-0939000 ADDRESS: 18321 VENTURA BLVD, STE 740, TARZANA, CA 91356 COASTAL ASC HOLDINGS LLC EIN: 81-0986844 ADDRESS: 1 HOAG DRIVE, BOX 6100, NEWPORT BEACH, CA 92664 ST. JOSEPH/SATELLITE DIALYSIS CENTERS, LLC EIN: 81-4657391 ADDRESS: 300 SANTANA ROW, STE 300, SAN JOSE, CA 95128 ALPHA MEDICAL LABORATORY, LLC EIN: 91-2017347 ADDRESS: 611 N. PERRY, SPOKANE, WA 99202 BROADWAY IMAGING, LLC EIN: 52-2405971 ADDRESS: 500 W. BROADWAY, MISSOULA, MT 59802 CALIFORNIA LABORATORY ASSOCIATES, LLC EIN: 27-3888692 ADDRESS: 501 BUENA VISTA, BURBANK, CA 91505 CENTER FOR SPECIALTY SURGERY, LLC EIN: 26-3638838 ADDRESS: 11782 SW BARNES ROAD, PORTLAND, OR 97225 CLACKAMAS RADIATION ONCOLOGY CENTER, LLC EIN: 26-0381897 ADDRESS: 4400 NE HALSEY ST., BLDG. II #495, PORTLAND, OR 97213 CENTER FOR MEDICAL IMAGING-BRIDGEPORT, LLC EIN: 26-0796953 ADDRESS: 4400 NE HALSEY #495, PORTLAND, OR 97213 CENTER FOR MEDICAL IMAGING-TANASBOURNE, LLC EIN: 20-0477972 ADDRESS: 4400 NE HALSEY #495, PORTLAND, OR 97213 GREATER VALLEY MEDICAL BUILDING, LP EIN: 95-4570858 ADDRESS: 501 S. BUENA VISTA STREET, BURBANK, CA 91505 MINOR & JAMES MEDICAL, PLLC EIN: 91-1340223 ADDRESS: 515 MINOR AVENUE #200, SEATTLE, WA 98104 MOUNTAINSTAR CLINICAL LABORATORIES, LLC EIN: 26-1345983 ADDRESS: 611 N. PERRY, SPOKANE, WA 99202 OREGON ADVANCED IMAGING, LLC EIN: 45-0471748 ADDRESS: 881 O'HARE PARKWAY, MEDFORD, OR 97504 OREGON OUTPATIENT SURGERY CENTER EIN: 22-3883387 ADDRESS: 7300 SW CHILDS ROAD, TIGARD, OR 97224 PACLAB, LLC EIN: 91-1743952 ADDRESS: 611 N. PERRY, SPOKANE, WA 99202 PATHOLOGY ASSOCIATES MEDICAL LABORATORIES, LLC EIN: 27-0943279 ADDRESS: 611 N. PERRY, SPOKANE, WA 99202 PET/CT IMAGING AT SWEDISH CANCER INSTITUTE, LLC EIN: 20-3132044 ADDRESS: 1221 MADISON STREET, SEATTLE, WA 98104 PORTLAND MEDICAL IMAGING, LLC EIN: 20-1054971 ADDRESS: 4400 NE HALSEY #495, PORTLAND, OR 97213 PROVIDENCE RADIATION ONCOLOGY DEVELOPMENT ASSOCIATION, LLC EIN: 26-0682491 ADDRESS: 4400 NE HALSEY #495, PORTLAND, OR 97213 PROVIDENCE IMAGING CENTER EIN: 92-0118807 ADDRESS: 3340 PROVIDENCE DRIVE, ANCHORAGE, AK 99508 PROVIDENCE PARTNERS FOR HEALTH, LLC EIN: 45-4041798 ADDRESS: 501 S. BUENA VISTA STREET, BURBANK, CA 91505 PROVIDENCE SURGERY CENTER, LLC EIN: 84-1401625 ADDRESS: 902 N. ORANGE STREET, MISSOULA, MT 59802 PROVIDENCE/SILVERTON REHAB, LLC EIN: 48-1287267 ADDRESS: 4400 NE HALSEY #425, PORTLAND, OR 97213 PROVIDENCE/USP SANTA CLARITA GP LLC EIN: 20-2829660 ADDRESS: 11550 INDIAN HILLS ROAD #160, MISSION HILLS, CA 91345 PROVIDENCE/USP SURGERY CENTERS., LLC EIN: 20-0905938 ADDRESS: 11550 INDIAN HILLS ROAD #160, MISSION HILLS, CA 91345 SOUTHERN IDAHO REGIONAL LABORATORY, LLC EIN: 82-0511819 ADDRESS: 611 N. PERRY, SPOKANE, WA 99202 THE MADISON SPOKANE INN, LLC EIN: 84-1606484 ADDRESS: 15 WEST ROCKWOOD BLVD, SPOKANE, WA 99204 TRI-CITIES LABORATORY, LLC EIN: 91-1773986 ADDRESS: 611 N. PERRY, SPOKANE, WA 99202 HCSA PROPERTIES LLC EIN: 46-0620892 ADDRESS: 1600 M STREET NW, AUBURN, WA 98001 PHS INVESTMENT TRUST HEDGE FUND PORTFOLIO EIN: 47-2293255 ADDRESS: 1801 LIND AVENUE SW, #9016, RENTON, WA 98057 PHS INVESTMENT TRUST BANK LOANS PORTFOLIO EIN: 47-2357735 ADDRESS: 1801 LIND AVENUE SW, #9016, RENTON, WA 98057 PHS INVESTMENT TRANSITION PORTFOLIO EIN: 47-2279711 ADDRESS: 1801 LIND AVENUE SW, #9016, RENTON, WA 98057 PHS INVESTMENT TRUST RISK PARITY PORTFOLIO EIN: 47-2336377 ADDRESS: 1801 LIND AVENUE SW, #9016, RENTON, WA 98057 PHS INVESTMENT TRUST LONG TREASURIES PORTFOLIO EIN: 47-2385238 ADDRESS: 1801 LIND AVENUE SW, #9016, RENTON, WA 98057 PHS INVESTMENT TRUST MLP PORTFOLIO EIN: 47-2367538 ADDRESS: 1801 LIND AVENUE SW, #9016, RENTON, WA 98057 PHS INVESTMENT TRUST RELATIVE VALUE PORTFOLIO EIN: 47-2314743 ADDRESS: 1801 LIND AVENUE SW, #9016, RENTON, WA 98057 PHS INVESTMENT TRUST TIPS PORTFOLIO EIN: 47-2402609 ADDRESS: 1801 LIND AVENUE SW, #9016, RENTON, WA 98057 PHS INVESTMENT TRUST PUBLIC EQUITY PORTFOLIO EIN: 47-2283974 ADDRESS: 1801 LIND AVENUE SW, #9016, RENTON, WA 98057 PHS INVESTMENT TRUST LDI PORTFOLIO EIN: 47-2392060 ADDRESS: 1801 LIND AVENUE SW, #9016, RENTON, WA 98057 PHS INVESTMENT TRUST PUBLIC DEBT PORTFOLIO EIN: 47-2353569 ADDRESS: 1801 LIND AVENUE SW, #9016, RENTON, WA 98057 PHS INVESTMENT TRUST TACTICAL TRADING PORTFOLIO EIN: 47-2327491 ADDRESS: 1801 LIND AVENUE SW, #9016, RENTON, WA 98057 PHS INVESTMENT TRUST COMMODITIES PORTFOLIO EIN: 47-2269004 ADDRESS: 1801 LIND AVENUE SW, #9016, RENTON, WA 98057 PHS INVESTMENT TRUST 2015 PRIVATE ASSETS PORTFOLIO EIN: 47-3393740 ADDRESS: 1801 LIND AVENUE SW, #9016, RENTON, WA 98057 PHS INVESTMENT TRUST SHORT TERM INVESTMENT PORTFOLIO EIN: 81-2701056 ADDRESS: 1801 LIND AVENUE SW, #9016, RENTON, WA 98057 PHS INVESTMENT TRUST 2016 PRIVATE ASSETS PORTFOLIO EIN: 81-1532735 ADDRESS: 1801 LIND AVENUE SW, #9016, RENTON, WA 98057 PHS INVESTMENT TRUST 2016 PRIVATE REAL ESTATE PORTFOLIO EIN: 81-2960145 ADDRESS: 1801 LIND AVENUE SW, #9016, RENTON, WA 98057 LSC REAL PROPERTY, LLC EIN: 47-4646059 ADDRESS: 2301 QUAKER AVE, LUBBOCK, TX 79410 CALIFORNIA SPECIALTY SURGERY CENTER, LP EIN: 33-0939003 ADDRESS: 26371 CROWN VALLEY PARKWAY, MISSION VIEJO, CA 92691	ExplanationTxt