2017-05-12T15:13:19-05:00 2016-06-30 ERNST & YOUNG US LLP 18101 VON KARMAN AVE STE 1700 IRVINE CA 92612 990 2015-07-01 611573313 COVENANT ACO INC % DYANA KERR COVE 8067250711 3615 19TH STREET LUBBOCK TX 794101203 JOHN GRIGSON CEO 8067250711 2017-05-12 true INAS RAOUF P01254678 9497942300 2015 2021-01-29 14:40:06Z JOHN GRIGSON 3615 19TH STREET LUBBOCK TX 794101203 1179973 false X WWW.COVENANTHEALTHPARTNERS.ORG X 2007 TX TO IMPROVE THE HEALTH OF THE POPULATIONS WE ARE CONTRACTED TO SERVE. FOR FURTHER INFORMATION, SEE SCHEDULE O. 20 8 0 0 0 0 0 0 1176939 -19 3034 0 0 -19 1179973 0 0 0 0 0 0 0 0 0 737025 1751628 737025 1751628 -737044 -571655 2718327 3512691 0 1366019 2718327 2146672 X SEE SCHEDULE O false false 1751628 1176939 SEE SCHEDULE O 1751628 true false false false false false false false false false false false false true false true false true false false false false false false false false false false false true false false false false false false false false false false false false false true true true false false true X 0 0 true 0 true false false false false false false false false false false X 20 8 false false false false true true true true true false false true true true true true true false false false X DYANA KERR 8067251011 3615 19TH STREET LUBBOCK TX 79410 BRIAN NICHOLSON MD BOARD MEMBER/CHAIRMAN 2.0 48.0 X X 0 507085 19599 CHRISTOPHER ROSE MD BOARD MEMBER/VICE CHAIR 2.0 2.0 X X 0 0 0 COLEY DUNCAN MD BOARD MEMBER 2.0 2.0 X 0 0 0 CYNTHIA BROWN MD BOARD MEMBER/SECRETARY 2.0 2.0 X X 0 0 0 DAVID BLANN MD BOARD MEMBER 2.0 48.0 X 0 744526 19621 DAVID E MANGOLD MD BOARD MEMBER 2.0 2.0 X 0 0 0 DAVID GRAY DO BOARD MEMBER 2.0 48.0 X 0 220584 16449 FREDERICK HENSAL MD BOARD MEMBER 2.0 48.0 X 0 626781 25023 IBRAHIM SHALABY MD BOARD MEMBER 2.0 48.0 X 0 811119 32353 JUAN FITZ MD BOARD MEMBER 2.0 48.0 X 0 537502 20653 KELLY KENSING MD BOARD MEMBER 2.0 2.0 X 0 0 0 NILESH PATEL MD BOARD MEMBER 2.0 48.0 X 0 592205 31545 SRINIVAS KADIYALA MD BOARD MEMBER 2.0 48.0 X 0 405900 26336 SUSAN DEVINE MD BOARD MEMBER 2.0 2.0 X 0 0 0 ANGELA FERGUSON MD BOARD MEMBER 2.0 48.0 X 0 221128 14652 AMANDA BACKLUND MD BOARD MEMBER 2.0 48.0 X 0 367776 13145 BILL ATKINSON MD BOARD MEMBER 2.0 48.0 X 0 780618 25311 BRIAN BRUENING MD BOARD MEMBER 5.0 5.0 X 0 0 0 LAKHU ROHRA MD BOARD MEMBER 2.0 2.0 X 0 0 0 SHAILI FELTON MD BOARD MEMBER 2.0 48.0 X 0 221615 8321 JOHN GRIGSON CEO 12.0 38.0 X 0 679504 29376 BRUCE LANE VP OF FINANCE (PART YEAR) 2.0 48.0 X 0 331318 26025 MICHAEL ROBERTSON MD CMO 2.0 48.0 X 0 487934 25918 0 7535595 334327 0 false true false 0 0 0 0 PHYSICIAN SERVICE REVENUE 622110 1176939 1176939 0 0 1176939 3034 3034 0 0 0 0 0 0 0 0 0 0 1179973 1176939 0 3034 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1751628 1751628 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1751628 1751628 0 0 0 0 0 -241370 1314848 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2959697 2197843 2718327 3512691 0 13 0 0 0 1366006 0 0 0 0 0 0 0 0 0 0 0 0 0 1366019 X 2718327 2146672 0 0 0 0 2718327 2146672 2718327 3512691 -571655 0 0 0 0 0 X false true X true false X X X 1 COVENANT HEALTH SYSTEM 752765566 3 true 0 0 1 0 0 true false false false false false false false false false false false false false false true false SCHEDULE A, PART VI 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. DUE FROM COV HEALTH PARTNERS 2197843 2197843 0 0 X SCHEDULE D, PART X, LINE 2 ASC 740 (FIN 48) FOOTNOTE ACCOUNTING STANDARDS CODIFICATION (ASC 740), INCOME TAXES, CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING A MINIMUM RECOGNITION THRESHOLD THAT A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. ASC 740 ALSO PROVIDES GUIDANCE ON DERECOGNITION, MEASUREMENT, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE, AND TRANSITION. THE GUIDANCE IS APPLICABLE TO PASS-THROUGH ENTITIES AND TAX-EXEMPT ORGANIZATIONS. NO SIGNIFICANT TAX LIABILITY FOR TAX BENEFITS, INTEREST OR PENALTIES WAS ACCRUED AT JUNE 30, 2016 OR 2015. false true false false false false false false false BRIAN NICHOLSON MD BOARD MEMBER/CHAIRMAN 0 384952 0 114971 0 7162 0 0 0 19599 0 526684 0 0 DAVID BLANN MD BOARD MEMBER 0 573930 0 170596 0 0 0 10000 0 9621 0 764147 0 0 DAVID GRAY DO BOARD MEMBER 0 201560 0 17574 0 1450 0 0 0 16449 0 237033 0 0 FREDERICK HENSAL MD BOARD MEMBER 0 463781 0 162840 0 160 0 10000 0 15023 0 651804 0 0 IBRAHIM SHALABY MD BOARD MEMBER 0 588380 0 214219 0 8520 0 10000 0 22353 0 843472 0 0 JUAN FITZ MD BOARD MEMBER 0 491020 0 23594 0 22888 0 10000 0 10653 0 558155 0 0 NILESH PATEL MD BOARD MEMBER 0 331954 0 255697 0 4554 0 10000 0 21545 0 623750 0 0 SRINIVAS KADIYALA MD BOARD MEMBER 0 321576 0 76787 0 7537 0 8000 0 18336 0 432236 0 0 ANGELA FERGUSON MD BOARD MEMBER 0 185548 0 29215 0 6365 0 8000 0 6652 0 235780 0 0 AMANDA BACKLUND MD BOARD MEMBER 0 192605 0 175058 0 113 0 8000 0 5145 0 380921 0 0 BILL ATKINSON MD BOARD MEMBER 0 694274 0 55632 0 30712 0 10000 0 15311 0 805929 0 0 SHAILI FELTON MD BOARD MEMBER 0 177403 0 41400 0 2812 0 8000 0 321 0 229936 0 0 JOHN GRIGSON CEO 0 448362 0 170769 0 60373 0 13249 0 16127 0 708880 0 0 BRUCE LANE VP OF FINANCE (PART YEAR) 0 222309 0 84365 0 24644 0 2445 0 23580 0 357343 0 0 MICHAEL ROBERTSON MD CMO 0 324762 0 131582 0 31590 0 8632 0 17286 0 513852 0 0 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. NO INDIVIDUALS RECEIVED 457(F) PAYMENTS DURING THE YEAR. 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. 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 2017 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 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. EXECUTIVE COMPENSATION IS APPROVED BY THE COVENANT HEALTH SYSTEM CONFLICTS AND COMPENSATION COMMITTEE, WHICH IS COMPRISED OF INDEPENDENT PERSONS. THE COMMITTEE REVIEWS COMPARABILITY DATA PREPARED FOR AND COMPILED BY THE ST.JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE, A COMMITTEE OF THE ST. JOSEPH HEALTH SYSTEM BOARD OF TRUSTEES COMPRISED OF INDEPENDENT MEMBERS. THE ST.JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE ACTS IN ACCORDANCE WITH A COMMITTEE CHARTER APPROVED BY THE ST. JOSEPH HEALTH SYSTEM BOARD OF TRUSTEES AND AN EXECUTIVE COMPENSATION PHILOSOPHY. THE CHARTER DIRECTS THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE TO ADMINISTER THE EXECUTIVE COMPENSATION PROGRAM AND TO APPROVE PROGRAM CHANGES, AS NECESSARY, TO ENSURE ALIGNMENT WITH THE STATED PHILOSOPHY AND ENSURE CONTINUED COMPLIANCE WITH FEDERAL AND STATE REGULATIONS ON BEHALF OF THE ST. JOSEPH HEALTH SYSTEM BOARD OF TRUSTEES. OVERALL, THE PHILOSOPHY IS INTENDED TO REWARD A BROAD SPECTRUM OF HIGH ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE EXPECTATIONS, AS WELL AS RETENTION OF KEY MANAGEMENT TALENT. THE EXECUTIVE COMPENSATION PHILOSOPHY DEFINES THE MARKET FOR ADMINISTERING COMPENSATION AS A COMPARABLE SET OF FOR PROFIT AND NOT-FOR-PROFIT HEALTH CARE DELIVERY SYSTEMS. ST. JOSEPH HEALTH SYSTEM PROVIDES COMPENSATION TO ITS EXECUTIVES IN THE FORM OF BASE SALARY, AN ANNUAL INCENTIVE PROGRAM, AND BENEFITS. TO ENSURE COMPENSATION PHILOSOPHY ADHERENCE AND GENERAL FAIR MARKET VALUE COMPENSATION, THE COMMITTEE REGULARLY REVIEWS INFORMATION FROM MULTIPLE SOURCES OF MARKET DATA AND ENGAGES LEGAL COUNSEL AND CONSULTING SUPPORT, AS NEEDED. THEY USE THIS INFORMATION TO SUPPORT ONGOING EFFECTIVENESS AND ADMINISTRATION OF THE PROGRAM. THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE MEETS AT LEAST 3 TIMES A YEAR AND TAKES ACTION IN EXECUTIVE SESSION. THESE ACTIONS ARE DOCUMENTED IN DETAILED MINUTES AND APPROVED IN SUBSEQUENT MEETINGS. A FULL COMPENSATION REVIEW IS CONDUCTED ON A BIENNIAL BASIS AND THE LAST REVIEW WAS PERFORMED IN JUNE 2016. DURING THE YEAR, THE COVENANT HEALTH SYSTEM CONFLICTS AND COMPENSATION COMMITTEE REVIEWED AND APPROVED ANY CHANGES IN COMPENSATION FOR KEY EXECUTIVES PREDICATED ON THE ANALYSIS AND RECOMMENDATION BY AN INDEPENDENT THIRD PARTY CONSULTING FIRM WITH EXPERTISE IN HEALTHCARE EXECUTIVE COMPENSATION. IN ADDITION, ANNUAL INCENTIVE AWARDS ARE REVIEWED AND APPROVED PRIOR TO PAYMENT CONSISTENT WITH THE MOST RECENT COMPENSATION BIENNIAL REVIEW AND IN ACCORDANCE WITH THE PLAN DOCUMENT. THESE ACTIONS ARE DOCUMENTED IN DETAILED MINUTES WHICH ARE SUBSEQUENTLY APPROVED AT THE COMMITTEE MEETING. 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:MEMBER INCENTIVE FEES TOTAL FEES:1176939 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:574689 COVENANT HEALTH NETWORK INC 3345 MICHELSON DRIVE STE 100 IRVINE CA 92612 461259908 HEALTHCARE CA 501(C)(3) 11,III SJHS true COVENANT HEALTH SYSTEM 3615 19TH STREET LUBBOCK TX 79410 752765566 HEALTHCARE TX 501(C)(3) 3 SJHS true COVENANT HEALTH SYSTEM FOUNDATION 3623 22ND PLACE LUBBOCK TX 79410 752897026 HEALTHCARE TX 501(C)(3) 7 CHS true COVENANT MEDICAL GROUP 3420 22ND PLACE LUBBOCK TX 79410 752743883 HEALTHCARE TX 501(C)(3) 3 CHS true COVENANT HEALTH PARTNERS 3615 19TH STREET LUBBOCK TX 79410 463516417 HEALTHCARE TX 501(C)(3) 11,I CHS true HMTS INC 1 HOAG DRIVE NEWPORT BEACH CA 92663 453583707 HEALTHCARE CA 501(C)(3) 11,I HMHP true HOAG CHARITY SPORTS 330 PLACENTIA AVE NEWPORT BEACH CA 92663 452982422 SUPPORT CA 501(C)(3) 7 HHF true HOAG HOSPITAL FOUNDATION 330 PLACENTIA AVE NEWPORT BEACH CA 92663 953222343 FUNDRAISING CA 501(C)(3) 7 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330731587 HEALTHCARE CA NA C-CORP LUBBOCK METHODIST HOSP PRACTICE MGMT 2107 OXFORD STREET STE 300 LUBBOCK TX 79410 752578995 INACTIVE TX NA C-CORP LUBBOCK METHODIST HOSPITAL SVCS PO BOX 1201 LUBBOCK TX 79410 752118585 HEALTHCARE TX NA C-CORP MISSION VIEJO MEDICAL VENTURES 27800 MEDICAL CENTER RD 354 MISSION VIEJO CA 92691 330212905 HEALTHCARE CA NA C-CORP ST JOSEPH HEALTH 3345 MICHELSON DRIVE SUITE 100 IRVINE CA 92612 462340232 HOLDING COMPANY CA NA C-CORP ST JOSEPH HEALTH SOURCE INC 3345 MICHELSON DRIVE SUITE 100 IRVINE CA 92612 461900168 HEALTHCARE CA NA C-CORP ST JOSEPH PROF SVCS ENTERPRISES INC 3345 MICHELSON DRIVE SUITE 100 IRVINE CA 92612 330155323 HEALTHCARE CA NA C-CORP false false false false false false false false false false false false false false false false false false false SCHEDULE R, PART III IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP 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. 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