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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. true true X true X 175. true X true true true false true true 1107146 1107146 0.01540 41936773 40498410 1438363 0.02010 43043919 40498410 2545509 0.03550 5420 5420 0.00010 153007 153007 0.00210 158427 158427 0.00220 43202346 40498410 2703936 0.03770 false 2887474 true true 1 1 METHODIST CHILDREN'S HOSPITAL 4015 22ND PLACE LUBBOCK TX 79410 WWW.COVENANTCHILDRENS.ORG 8638 X X X X X METHODIST CHILDREN'S HOSPITAL false false true X X X X X X X X X 13 true true false true X SEE SCHEDULE H, PART V, SECTION C X true 13 true SEE SCHEDULE H, PART V, SECTION C false true X 175. 300. X X X X X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE SECTION C X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT WAS GATHERED THROUGH FOCUS GROUPS, INTERVIEWS AND AN ON-LINE SURVEY CONDUCTED DURING JANUARY 2014. INPUT WAS GATHERED BASED ON THE HEALTH NEEDS THAT SURFACED IN THE 2012 PRC HEALTH NEEDS ASSESSMENT (FULL PDF REPORT AVAILABLE UPON REQUEST) PREPARED FOR COVENANT HEALTH. THE PRC NEEDS ASSESSMENT ANALYZED BOTH PRIMARY AND SECONDARY DATA FOR COVENANT HEALTH INCLUDING PHONE SURVEYS OF COMMUNITY RESIDENTS. FOCUS GROUPS, INTERVIEWS AND SURVEYS WERE CONDUCTED BY COVENANT HEALTH COMMUNITY OUTREACH STAFF. PERSONS REPRESENTING BROAD INTERESTS OF THE COMMUNITY AND WITH SPECIAL KNOWLEDGE OF PUBLIC HEALTH WERE ASKED TO PARTICIPATE IN ONE OF MORE OF THE DATA GATHERING SESSIONS. INPUT WAS GATHERED FROM GOVERNMENTAL HEALTH AGENCIES, PERSONS REPRESENTING MEDICALLY UNDERSERVED AND LOW INCOME POPULATIONS, AS WELL AS INDIVIDUALS REPRESENTING MINORITY HEALTH NEEDS. REPRESENTATIVES FROM PUBLIC HEALTH OR OTHER DEPARTMENTS OR AGENCIES INCLUDING: TEXAS HEALTH AND HUMAN SERVICES COMMISSION TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER COMMUNITY HEALTH CENTER OF LUBBOCK LUBBOCK CHILDRENS HEALTH CLINIC AMERIGROUP/CHILDRENS MEDICAID STARR CARE MANAGED CARE CATHOLIC CHARITIES SOUTH PLAINS FOOD BANK SUSAN KOMEN FOUNDATION LUNA EAST LUBBOCK NEIGHBORHOODS EAST LUBBOCK PROMISE NEIGHBORHOOD SUPERIOR HEALTH MEDICAID AND CHIP PROGRAMS RONALD MCDONALD CHARITIES THE DREAM CENTER TEXAS TECH UNIVERSITY CENTER FOR ADOLESCENT RESILIENCY VOLUNTEER CENTER OF LUBBOCK SOUTH PLAINS COMMUNITY ACTION THE DIFFERENCE MARKERS FELLOWSHIP MARCH OF DIMES TEXAS TECH SCHOOL OF NURSING WOMENS PROTECTIVE SERVICES LUBBOCK CITY COUNCIL LUBBOCK INDEPENDENT SCHOOL DISTRICT REGION 17 EDUCATION SERVICE CENTER SOUTH PLAINS ASSOCIATION OF GOVERNMENTS YWCA SCHEDULE H, PART V, SECTION B, LINE 6 COVENANT HEALTH'S COMMUNITY HEALTH OUTREACH DEPARTMENT (CHO) CONDUCTS A COMMUNITY NEEDS AND ASSETS ASSESSMENT EVERY THREE YEARS. THIS NEEDS ASSESSMENT IS CONDUCTED AS A SYSTEM WHICH INCLUDES COVENANT MEDICAL CENTER, COVENANT CHILDREN'S HOSPITAL, COVENANT LEVELLAND, COVENANT PLAINVIEW, AND COVENANT LT CARE LP, DBA COVENANT SPECIALTY HOSPITAL (JOINT VENTURE) ALL LOCATED IN LUBBOCK, TX. SCHEDULE H, PART V, SECTION B, LINE 7A THE WEB ADDRESS IS: HTTP://WWW.COVENANTHEALTH.ORG/DOCUMENTS/CHILDREN-S-CHNA-FINAL-2014.PDF SCHEDULE H, PART V, SECTION B, LINE 10A HTTP://WWW.COVENANTHEALTH.ORG/DOCUMENTS/CHILDRENS-HOSPITAL-FY15-17-CB-PLAN -IMPLEMENTATION-FINAL.PDF SCHEDULE H, PART V, SECTION B, LINE 11 BASED ON REVIEW OF PRIORITIZED SIGNIFICANT HEALTH NEEDS AND A THOUGHTFUL PRIORITY SETTING PROCESS, COVENANT HEALTH, INCLUDING COVENANT MEDICAL CENTER, COVENANT CHILDRENS HOSPITAL AND COVENANT SPECIALTY HOSPITAL WILL ADDRESS THE FOLLOWING PRIORITY AREAS AS PART OF ITS FY15-17 CB PLAN: 1. WELLNESS AND PREVENTION FOCUSED PRIMARILY ON ADULT DIABETIC EDUCATION, OBESITY PREVENTION FOR CHILDREN, ADULT CARDIAC HEALTH EDUCATION AND EARLY ORAL HEALTH INTERVENTIONS FOR CHILDREN; A FULL TIME HEALTH EDUCATOR WILL BE DEDICATED TO DIABETES EDUCATION/PREVENTION AND GENERAL HEALTH/NUTRITION EDUCATION FOR ALL AGES; FUNDING FOR CHILDHOOD OBESITY AND WELLNESS PROGRAMS WILL BE PROVIDED TO COMMUNITY AGENCIES; PARTICIPATION IN HEALTH SCREENINGS AND HEALTH FAIRS; FUNDING FOR WELL HEART PRESENTATIONS; ORAL HEALTH EDUCATION PROVIDED ON-SITE AT ELEMENTARY SCHOOLS 2. ORAL HEALTH - COMMUNITY OUTREACH DENTAL CLINIC SERVES LOW-INCOME FAMILIES OFFERING COMPREHENSIVE DENTAL CARE TO PATIENTS AGED 5 AND UP; MOBILE DENTAL UNIT THAT SERVES PATIENTS IN A 75-MILE RADIUS OF LUBBOCK; FREE REGIONAL DENTAL SEALANT CLINICS FOR SCHOOL CHILDREN 3. MENTAL HEALTH - COVENANT COMMUNITY OUTREACH COUNSELING CENTER PROVIDES COUNSELING SERVICES TO UNDERSERVED AND LOW-INCOME PERSONS IN OUR COMMUNITY OFFERING INDIVIDUAL, COUPLES AND FAMILY THERAPY TO PEOPLE OF ALL AGES IN ADDITION TO THE PRECEDING PRIORITY AREAS, THE COVENANT HEALTH PLANS TO PROVIDE OTHER COMMUNITY BENEFIT PROGRAMS RESPONSIVE TO THE HEALTH NEEDS IDENTIFIED IN THE 2014 CHNA. COMMUNITY BENEFIT PROGRAMS LISTED BELOW ONLY INCLUDE ADDITIONAL COMMUNITY SERVICES FOR THE LOW-INCOME AND BROADER COMMUNITY THAT HAVE NOT BEEN PREVIOUSLY COVERED IN THIS CB PLAN/IMPLEMENTATION STRATEGY REPORT. INITIATIVES (COMMUNITY NEEDS BEING ADDRESSED): 1. FOOD INSECURITY SUMMER OF SHARING FOOD DRIVE CONDUCT FOOD DRIVE FOR SOUTH PLAINS FOOD BANK LOW-INCOME 2. CHILD ABUSE ANNUAL CHILD ABUSE SUMMIT HOST AND ORGANIZE AN ANNUAL CHILD ABUSE PREVENTION SUMMIT BROADER COMMUNITY 3. CHILDRENS HEALTH FUNDING LUBBOCK CHILDRENS HEALTH CLINIC PROVIDE FUNDING AND A DIETICIAN FOR LUBBOCK CHILDRENS HEALTH CLINIC LOW INCOME 4. CHILDHOOD OBESITY FUNDING TEXAS TECH UNIVERSITY COVENANT BODY MIND INSTITUTE (CBMI) PROVIDE FUNDING FOR IMPLEMENTING CBMI CURRICULUM IN AREA SCHOOLS BROADER COMMUNITY 5. WOMENS HEALTH/CANCER MOBILE MAMMOGRAPHY SERVICES MOBILE MAMMOGRAPHY SERVICES OFFERING SERVICES TO BOTH UN-INSURED AND INSURED PATIENTS LOW INCOME AND BROADER COMMUNITY 6. CARDIAC WELL HEART MOBILE SERVICES AND FREE BLOOD PRESSURE CHECKS MOBILE WELL HEART UNIT LOW INCOME AND BROADER COMMUNITY 7. ACCESS TO PRESCRIPTIONS FUNDING CATHOLIC CHARITIES PRESCRIPTION ASSISTANCE PROGRAM PRESCRIPTION ASSISTANCE PROGRAM CATHOLIC CHARITIES LOW INCOME 8. ACCESS TO CARE COVENANT PATIENT NAVIGATOR PROGRAM ADULT PATIENT NAVIGATORS LOW INCOME AND BROADER COMMUNITY 9. ASTHMA PEDIATRIC ASTHMA NAVIGATOR PROGRAM PEDIATRIC PATIENT NAVIGATORS LOW INCOME AND BROADER COMMUNITY ALTHOUGH NO HEALTH CARE FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY, WE ARE COMMITTED TO CONTINUE OUR MISSION THROUGH COMMUNITY BENEFIT EFFORTS AND BY FUNDING OTHER NON-PROFITS THROUGH THE COVENANT HEALTH WELLNESS AND PREVENTION GRANTS AND COVENANT HEALTH GRANTS AND CONTRIBUTIONS COMMITTEE. THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MINISTRY CHNA WILL NOT BE DIRECTLY ADDRESSED THROUGH PROGRAMMING OR FUNDING AND AN EXPLANATION IS PROVIDED BELOW: HEALTH NEEDS IDENTIFIED BUT NOT SELECTED AS PRIORITY FOCUS AREAS FOR COVENANT COMMUNITY OUTREACH INCLUDE ADULT DOMESTIC VIOLENCE AND YOUTH SUBSTANCE ABUSE (INCLUDING TOBACCO AND ALCOHOL USE). SEVERAL COMMUNITY PROVIDERS AND NON-PROFIT AGENCIES ARE ADDRESSING THESE NEEDS. COVENANT HEALTH WILL CONTINUE TO PARTNER WITH ORGANIZATIONS ADDRESSING DOMESTIC VIOLENCE SUCH AS FAMILY PROMISE, THE PARENTING COTTAGE AND WOMEN'S PROTECTIVE SERVICES. COVENANT HEALTH WILL ALSO PARTNER WITH ORGANIZATIONS ADDRESSING SUBSTANCE ABUSE SUCH AS TEXAS TECH UNIVERSITY, STARCARE AND MANAGED CARE. IN ADDITION, COVENANT HEALTH WILL COLLABORATE WITH LOCAL ORGANIZATIONS THAT ADDRESS AFOREMENTIONED COMMUNITY NEEDS, TO COORDINATE CARE AND REFERRALS TO ADDRESS THESE UNMET NEEDS. FOR FURTHER INFORMATION, PLEASE SEE THE IMPLEMENTATION STRATEGY REPORT FOUND AT: HTTP://WWW.COVENANTHEALTH.ORG/DOCUMENTS/MEDICAL-CENTER-FY15-17-CB-PLAN-IMP LEMENTATION-FINAL.PDF. SCHEDULE H, PART V, SECTION B, LINE 13H THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT ARE INITIALLY CLASSIFIED AS BAD DEBT. SCHEDULE H, PART V, SECTION B, LINE 16A HTTP://WWW.COVENANTHEALTH.ORG/DOCUMENTS/PATIENT-FINANCIAL-ASSISTANCE/FINAN CIAL-ASSISTANCE-POLICY-ENGLISH_4.20.16.PDF SCHEDULE H, PART V, SECTION B, LINE 16B HTTP://WWW.COVENANTHEALTH.ORG/DOCUMENTS/PATIENT-FINANCIAL-ASSISTANCE/FINAN CIAL-ASSISTANCE-APPLICATION-ENGLISH_2.24.16.PDF SCHEDULE H, PART V, SECTION B, LINE 16C HTTP://WWW.COVENANTHEALTH.ORG/DOCUMENTS/PATIENT-FINANCIAL-ASSISTANCE/COVEN ANT_FABROCHURE_2016.PDF SCHEDULE H, PART V, SECTION B, LINE 16I THE ORGANIZATION POSTS ITS SUMMARIZED FINANCIAL ASSISTANCE NOTICE IN ALL ADMITTING AREAS IN BOTH ENGLISH AND SPANISH AND PROVIDES THE FULL POLICY UPON REQUEST. SUMMARIZED NOTICES OF THE POLICY ARE AVAILABLE ON ITS WEBSITE ALONG WITH CONTACT INFORMATION IN THE EVENT OF ADDITIONAL INQUIRIES. NOTICES OF FINANCIAL ASSISTANCE ARE INCLUDED WITH BILLINGS FOR UNINSURED PATIENTS. BILINGUAL PATIENT ACCOUNT REPRESENTATIVES ARE AVAILABLE TO ADDRESS QUESTIONS AND ASSIST IN THE COMPLETION OF A FINANCIAL ASSISTANCE APPLICATION IN ENGLISH OR SPANISH. SCHEDULE H, PART V, SECTION B, LINE 22D FOR PATIENTS WITH A FAMILY INCOME BETWEEN 176% AND 300% OF FEDERAL POVERTY GUIDELINES (FPG), THE HOSPITAL FACILITY USES MEDICARE RATES WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED. FOR CATASTROPHIC CASES WITH A PATIENT RESPONSIBILITY GREATER THAN $75,000, MEDICARE RATES ARE USED TO DETERMINE THE MAXIMUM AMOUNT THAT CAN BE CHARGED. SCHEDULE H, PART I, LINE 3C IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS. SCHEDULE H, PART I, LINE 6A COVENANT HEALTH PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT AS A SYSTEM WHICH INCLUDES COVENANT MEDICAL CENTER, COVENANT CHILDREN'S HOSPITAL AND COVENANT SPECIALTY HOSPITAL (JOINT VENTURE), AND IT IS PUBLICLY AVAILABLE AT HTTP://WWW.COVENANTHEALTH.ORG/DOCUMENTS/FY16-COMMUNITY-BENEFIT-ANNUAL-REPO RT-FINAL.PDF SCHEDULE H, PART I, LINES 7A-I THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM. THE ORGANIZATION'S COST ACCOUNTING SYSTEM ADDRESSED ALL PATIENT SEGMENTS. SCHEDULE H, PART III, SECTION A, LINE 2 THE ORGANIZATION ANALYZES ITS HISTORICAL EXPERIENCE AND TRENDS TO ESTIMATE THE APPROPRIATE BAD DEBT EXPENSE. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED PRIOR TO CALCULATING BAD DEBT EXPENSE. SCHEDULE H, PART III, SECTION A, LINE 3 THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USED AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT WERE INITIALLY CLASSIFIED AS BAD DEBT. COLLECTION ACTIONS WERE NOT PURSUED ON THESE ACCOUNTS ONCE THEY WERE RECLASSIFIED BECAUSE RECLASSIFIED ACCOUNTS RECEIVED A 100 PERCENT WRITE-OFF OF THE BALANCE DUE. AFTER THE RECLASSIFICATION THERE WAS NO REMAINING AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART III, SECTION A, LINE 4 FINANCIAL STATEMENT FOOTNOTE DESCRIBING BAD DEBT THE ORGANIZATION RECEIVES PAYMENT FOR SERVICES RENDERED TO PATIENTS FROM FEDERAL AND STATE GOVERNMENTS UNDER THE MEDICARE AND MEDICAID PROGRAMS, PRIVATELY SPONSORED MANAGED CARE PROGRAMS FOR WHICH PAYMENT IS MADE BASED ON TERMS DEFINED UNDER FORMAL CONTRACTS, AND OTHER PAYORS. THE ORGANIZATION BELIEVES THERE ARE NO SIGNIFICANT CREDIT RISKS ASSOCIATED WITH RECEIVABLES FROM GOVERNMENT PROGRAMS. RECEIVABLES FROM CONTRACTED PAYORS ARE SUBJECT TO DIFFERING ECONOMIC CONDITIONS AND DO NOT REPRESENT ANY CONCENTRATED RISKS TO THE ORGANIZATION. THE ORGANIZATION REGULARLY ANALYZES ITS HISTORICAL EXPERIENCE AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SCHEDULE H, PART III, SECTION B, LINE 8 THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT. MEDICARE COSTS ARE DETERMINED FROM THE MEDICARE COST REPORT USING CMS STANDARD COSTING METHODS. THIS INCLUDES STEP-DOWN ALLOCATION PROCESSES WHICH ARE APPLIED TO CALCULATE ALLOWABLE MEDICARE COSTS. SCHEDULE H, PART III, SECTION C, LINE 9B COVENANT CHILDREN'S HOSPITAL PATIENT ACCOUNTS WERE NOT FORWARDED TO COLLECTION STATUS WHEN THE PATIENT MADE A GOOD FAITH EFFORT TO RESOLVE OUTSTANDING ACCOUNT BALANCES. SUCH EFFORTS INCLUDE APPLYING FOR FINANCIAL ASSISTANCE, NEGOTIATING A PAYMENT PLAN, OR APPLYING FOR MEDICAID COVERAGE. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMED AN EVALUATION TO IDENTIFY IF THE ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR FREE CARE (100 PERCENT FINANCIAL ASSISTANCE) WERE WRITTEN OFF AND COLLECTION EFFORTS WERE NOT PURSUED. THE ORGANIZATION'S COLLECTIONS POLICY APPLIED TO ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR A PARTIAL DISCOUNT. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT A NEEDS ASSESSMENT IS COMPILED EVERY THREE YEARS WHICH DETAILS OVERARCHING HEALTHCARE CONCERNS FOR TEXAS IN GENERAL AS WELL AS MANY DETAILS AFFECTING THE LUBBOCK COMMUNITY BENEFIT SERVICE AREA IN PARTICULAR. SOME OF THE OTHER SOURCES USED FOR COVENANT'S NEEDS ASSESSMENT INCLUDE: INTERCITY HARDSHIP INDEX (IHI) MAPPING COMPLETED BY ST. JOSEPH HEALTH, THE UNITED WAY COMMUNITY STATUS REPORT, AND THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES DATA. THE PROCESS USED FOR THE PRIORITIZATION OF THE PROGRAMS WAS DETERMINED BY GENERAL CONSENSUS. ALL ASSESSMENTS USED FOR THIS PLAN, PRIMARY AND SECONDARY DATA THAT WAS ANALYZED, INDIVIDUAL MEETINGS WITH GROUPS OF STAKEHOLDERS, AND MEMBERS OF THE COMMUNITY BENEFIT COMMITTEE ALL CONFIRMED THE PROGRAMS WHICH ARE PRIORITIZED FOR THIS PLAN. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE THE ORGANIZATION POSTED NOTICES INFORMING THE PUBLIC OF THE FINANCIAL ASSISTANCE PROGRAM. NOTICES WERE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES WERE ALSO POSTED AT LOCATIONS WHERE A PATIENT COULD PAY THEIR BILL. NOTICES INCLUDED CONTACT INFORMATION ON HOW A PATIENT COULD OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES WERE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT WERE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATED LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS WERE OFFERED AN OPPORTUNITY TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND WERE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY HAVE BEEN ELIGIBLE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION COVENANT HEALTH (INCLUDING COVENANT MEDICAL CENTER AND COVENANT CHILDREN'S HOSPITAL) IS A MEMBER OF THE ST. JOSEPH HEALTH, SPONSORED BY THE ST. JOSEPH HEALTH MINISTRY, AND IS ONE OF THE LARGEST NON-PROFIT HEALTHCARE ORGANIZATIONS IN THE WEST TEXAS/EASTERN NEW MEXICO REGION, SERVING A 62 COUNTY AREA. MANY OF THE COUNTIES IN THE SERVICE AREA ARE CONSIDERED MEDICALLY UNDERSERVED. WE CONSIST OF 1,154 LICENSED BEDS, APPROXIMATELY 4,000 EMPLOYEES, AND OVER 600 ADMITTING PHYSICIANS. COVENANT HEALTH HAS AN AVERAGE DAILY CENSUS OF 409, OVER 28,000 ANNUAL PATIENT DISCHARGES, AND MORE THAN 85,000 ANNUAL EMERGENCY ROOM VISITS. COVENANT HEALTH (INCLUDING COVENANT MEDICAL CENTER AND COVENANT CHILDREN'S HOSPITAL) IS THE ONLY SJH MINISTRY PROVIDING SERVICES TO COMMUNITIES IN TWO STATES. COVENANT HEALTH PROVIDES SERVICES IN NEW MEXICO AND DRAWS PATIENTS FROM NEW MEXICO COMMUNITIES INTO LUBBOCK. THE CIRCUMSTANCES OF THESE COMMUNITY MEMBERS PROFOUNDLY IMPACT THE ORGANIZATION AND THE SERVICES IT PROVIDES. COVENANT HEALTH'S COMMUNITY BENEFIT PRIORITIES ADDRESS DUHN POPULATIONS WITHIN BOTH CORE SERVICE AREAS AND SECONDARY SERVICE AREAS FOR COMMUNITY RESIDENTS WHO ARE FACED WITH MULTIPLE HEALTH PROBLEMS AND HAVE LIMITED ACCESS TO TIMELY, HIGH-QUALITY HEALTH CARE. CORE SERVICE AREAS INCLUDE THE TEXAS COUNTIES OF LUBBOCK, HALE, HOCKLEY, LOCKNEY, IDALOU, LAMESA, LITTLEFIELD, SHALLOWATER, SLATON, RANSOM CANYON, TAHOKA, AND WOLFFORTH. ESPECIALLY WITHIN LUBBOCK, FOUR NEIGHBORHOODS, ARNETT-BENSON, HARWELL,PARKWAY-CHERRY POINT AND DUNBAR-MANHATTAN HEIGHTS, ARE DESIGNATED AS MEDICALLY UNDERSERVED AREAS (MUA'S). SECONDARY SERVICE AREAS INCLUDE PARMER, CASTRO, AND KING COUNTIES IN TEXAS. COMMUNITIES WITH DISPROPORTIONATE UNMET HEALTH NEEDS (DUHN) ARE COMMUNITIES DEFINED BY ZIP CODES AND CENSUS TRACTS WHERE THERE IS A HIGHER PREVALENCE OR SEVERITY FOR A PARTICULAR HEALTH CONCERN THAN THE GENERAL POPULATION WITHIN COVENANT HEALTHS SERVICE AREA. THE TWENTY ZIP CODES (REPRESENTING TEN CITIES) WITHIN THE COVENANT HEALTH PRIMARY COMMUNITY BENEFIT SERVICE AREA ARE CONSIDERED MEDICALLY UNDERSERVED. COVENANT HEALTH COVENANT MEDICAL CENTER, COVENANT CHILDRENS HOSPITAL AND COVENANT SPECIALTY HOSPITAL (JOINT VENTURE) ARE ALL LOCATED IN LUBBOCK, TX. LUBBOCK IS THE COUNTY SEAT OF LUBBOCK COUNTY. THE CITY IS LOCATED IN THE NORTHWESTERN PART OF THE STATE AT THE BASE OF THE PANHANDLE IN A REGION KNOWN AS THE LLANO ESTACADO. LUBBOCK IS HOME TO TEXAS TECH UNIVERSITY, LUBBOCK CHRISTIAN UNIVERSITY AND HAS SATELLITE CAMPUSES OF SOUTH PLAINS JR. COLLEGE AND WAYLAND BAPTIST UNIVERSITY. THE LUBBOCK METROPOLITAN STATISTICAL AREA IS COMPRISED OF LUBBOCK AND CROSBY COUNTIES. LUBBOCK SERVES AS AN ECONOMIC CENTER WITH AN ECONOMY BASED IN AGRICULTURE, HEALTHCARE, EDUCATION, AND MANUFACTURING. FOR A COMPLETE COPY OF COVENANT HEALTH'S, COVENANT MEDICAL CENTERS, COVENANT CHILDRENS HOSPITAL AND COVENANT SPECIALTY HOSPITALS FY14 CHNA VISIT: HTTP://WWW.COVENANTHEALTH.ORG/DOCUMENTS/CHILDREN-S-CHNA-FINAL-2014.PDF. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH REALIZING OUR MISSION COVENANT HEALTH IS AN ACUTE-CARE HOSPITAL LOCATED IN LUBBOCK SERVING THE FOLLOWING REGION WEST TEXAS/EASTERN NEW MEXICO REGION. COVENANT HEALTH PROVIDES VITAL HOSPITAL AND COMMUNITY SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERSINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE (TRADITIONAL CHARITY CARE) AND DISCOUNTED CARE. COVENANT HEALTH IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE OF ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS: 1) A COMMUNITY BENEFIT COMMITTEE THAT IS A SUBCOMMITTEE OF THE BOARD OF TRUSTEES, 2) AN OPEN MEDICAL STAFF AND 3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ARE IN PART FUNDED BY CARE FOR THE POOR DOLLARS. OUR COMMUNITY BENEFIT COMMITTEE, A SUBCOMMITTEE OF CHS BOARD OF TRUSTEES, IS MADE UP OF HOSPITAL LEADERSHIP AND LOCAL COMMUNITY PROFESSIONALS. OUR EXECUTIVE MANAGEMENT TEAM (EMT) IS INVOLVED IN COMMUNITY BENEFIT PLANNING, PRIORITIZATION OF PROGRAMS AND REPORTING THROUGH THE PARTICIPATION OF THE VICE PRESIDENT OF MISSION INTEGRATION, THE CEO, COO, VICE PRESIDENT OF REGIONAL SERVICES/ADVOCACY AND THE BOARD LIAISON AT THE MONTHLY COMMUNITY BENEFIT COMMITTEE MEETINGS. IN ADDITION, THE CHAIR OF THE COMMUNITY BENEFIT COMMITTEE REPORTS MONTHLY AT BOARD OF DIRECTORS MEETINGS, KEEPING THEM INFORMED ABOUT PROGRAM PROGRESS. THE COMMUNITY BENEFIT COMMITTEE CONSISTS OF CH BOARD OF DIRECTORS MEMBERS AND AT-LARGE COMMUNITY MEMBERS. EACH HAS A UNIQUE INSIGHT TO THE COMMUNITIES WE SERVE. THE ROLE OF THE COMMUNITY BENEFIT COMMITTEE OF COVENANT HEALTH IS TO SUPPORT THE BOARD OF DIRECTORS IN PROVIDING OVERSIGHT OF ACHIEVEMENT OF THE HEALTHIEST COMMUNITIES GOALS AND INITIATIVES, COMMUNITY OUTREACH ACTIVITIES, AND ASSURING THE ACCURACY OF INFORMATION INCLUDED IN THE COMMUNITY BENEFIT REPORTS APPROVED BY THE BOARD AND SUBMITTED AS REQUIRED TO STATE AND FEDERAL AGENCIES. THE COMMUNITY BENEFIT COMMITTEE WORKS WITH COVENANTS STRATEGIC PLANNING AND ADVOCACY DEPARTMENTS TO INSURE GOALS ALIGNMENT. THE COMMUNITY BENEFIT COMMITTEE ACHIEVES THIS ROLE THROUGH FULFILLING THE FUNCTIONS AS OUTLINED IN THE COMMITTEE CHARTER. COVENANT HEALTHS FY15-FY17 COMMUNITY BENEFIT PLAN/IMPLEMENTATION STRATEGY REPORT FOCUSES ON WELLNESS AND PREVENTION INCLUDING DIABETES PREVENTION AND MANAGEMENT, CHILDHOOD OBESITY PREVENTION AND HEART HEALTH EDUCATION, ORAL HEALTH FOR ALL AGES AND MENTAL HEALTH OUTREACH, WELLNESS AND PREVENTION FOCUSED PRIMARILY ON ADULT DIABETIC EDUCATION, OBESITY PREVENTION FOR CHILDREN, ADULT CARDIAC HEALTH EDUCATION AND EARLY ORAL HEALTH INTERVENTIONS FOR CHILDREN; A FULL TIME HEALTH EDUCATOR IS DEDICATED TO DIABETES EDUCATION/PREVENTION AND GENERAL HEALTH/NUTRITION EDUCATION FOR ALL AGES; FUNDING FOR CHILDHOOD OBESITY AND WELLNESS PROGRAMS IS PROVIDED TO COMMUNITY AGENCIES; PARTICIPATION IN HEALTH SCREENINGS AND HEALTH FAIRS; FUNDING FOR WELL HEART PRESENTATIONS; ORAL HEALTH EDUCATION PROVIDED ON-SITE AT ELEMENTARY SCHOOLS ORAL HEALTH - COMMUNITY OUTREACH DENTAL CLINIC SERVES LOW-INCOME FAMILIES OFFERING COMPREHENSIVE DENTAL CARE TO PATIENTS AGED 5 AND UP; MOBILE DENTAL UNIT THAT SERVES PATIENTS IN A 75-MILE RADIUS OF LUBBOCK; FREE REGIONAL DENTAL SEALANT CLINICS FOR SCHOOL CHILDREN MENTAL HEALTH - COVENANT COMMUNITY OUTREACH COUNSELING CENTER PROVIDES COUNSELING SERVICES TO UNDERSERVED AND LOW-INCOME PERSONS IN OUR COMMUNITY OFFERING INDIVIDUAL, COUPLES AND FAMILY THERAPY TO PEOPLE OF ALL AGES. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM COVENANT HEALTH IS A HEALING MINISTRY OF ST. JOSEPH HEALTH, AN INTEGRATED HEALTHCARE DELIVERY SYSTEM SPONSORED BY THE ST. JOSEPH HEALTH MINISTRY. ST. JOSEPH HEALTH IS ORGANIZED INTO THREE REGIONS: NORTHERN CALIFORNIA, SOUTHERN CALIFORNIA, AND WEST TEXAS/EASTERN NEW MEXICO. THE SYSTEM INCLUDES 14 ACUTE CARE HOSPITALS, HOME HEALTH AGENCIES, HOSPICE CARE, OUTPATIENT SERVICES, COMMUNITY CLINICS, AND PHYSICIAN ORGANIZATIONS. EACH ASSOCIATED MINISTRY WORKS TO LIVE OUT ITS MISSION TO EXTEND THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE BY CONTINUALLY IMPROVING THE HEALTH AND QUALITY OF LIFE OF THE COMMUNITIES IT SERVES. IN 1986, ST. JOSEPH HEALTH SYSTEM CREATED A PLAN AND BEGAN AN EFFORT TO FURTHER ITS COMMITMENT TO NEIGHBORS IN NEED. WITH A VISION OF REACHING BEYOND THE WALLS OF ITS HEALTHCARE FACILITIES AND TRANSCENDING TRADITIONAL EFFORTS OF PROVIDING FINANCIAL ASSISTANCE FOR THOSE IN NEED OF ACUTE SERVICES, ST. JOSEPH HEALTH SYSTEM CREATED THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND (FORMERLY KNOWN AS THE ST. JOSEPH HEALTH SYSTEM FOUNDATION) TO IMPROVE THE HEALTH OF LOW-INCOME INDIVIDUALS RESIDING IN LOCAL COMMUNITIES. EVERY YEAR, EACH ST. JOSEPH HEALTH HOSPITAL CONTRIBUTES 10% OF THEIR NET INCOME TO THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND TO SUPPORT OUTREACH EFFORTS FOR THE ECONOMICALLY POOR. IN FY16, THE HOSPITAL CONTRIBUTED $3,553,100 TO THE SJH COMMUNITY PARTNERSHIP FUND. THE CONTRIBUTIONS ARE USED TO SUPPORT CARE FOR THE POOR PROGRAMS THAT ARE SELECTED LOCALLY BY EACH HOSPITAL. ST. JOSEPH HEALTH FURTHERMORE RECOGNIZES THAT THE HEALTH OF ANY COMMUINTY DEPENDS ON THE MAINTENANCE AND CREATION OF STRONG STRUCTURES- BOTH PHYSICAL AND SOCIAL - THAT CONTRIBUTE TO THE LONG-TERM WELL-BEING OF PEOPLE. THAT PHILOSOPHY INSPIRED THE INITIATION OF THE ST. JOSEPH HEALTH COMMUNITY INVESTMENT FUND - AN EFFORT TO ENABLE NON PROFIT 501(C)3 ORGANIZATIONS TO ACHIEVE THEIR FULL POTENTIAL AND PLAY A MAJOR ROLE IN THE GROWTH OF THEIR COMMUNITIES. TO LEARN MORE ABOUT ST. JOSEPH HEALTH GO TO STJHS.ORG SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT TEXAS true TEXAS TECH UNIVERSITY PO BOX 41105 LUBBOCK TX 79409 752668014 GOVT 125000 0 HEALTH COMM & CHILD OB PRG GRANT GRANT MARCH OF DIMES FOUNDATION 1275 MAMARONECK AVE WHITE PLAINS NY 10605 131846366 501(c)(3) 20000 0 SUPPORT PROGRAM SRVS SONDRAS SONG PO BOX 64042 LUBBOCK TX 79464 452651615 501(c)(3) 10000 0 SUPPORT PROGRAM SRVS 3 SCHEDULE I, PART I, LINE 2 DESCR OF ORGANIZATION'S PROCEDURES FOR MONITORING DONATIONS MADE TO OTHER ORGANIZATIONS ARE APPROVED BY MANAGEMENT TO ENSURE THEY SUPPORT THE MISSION OF COVENANT CHILDREN'S HOSPITAL. NO ADDITIONAL MONITORING IS DONE. X true true false true false false false false false true false RICHARD PARKS BD MBR/PRES/EVP W. TX & E. NM 0 726692 0 358218 0 77029 0 10600 0 17263 0 1189802 0 0 DARRIN MONTALVO BOARD MEMBER 0 774102 0 692629 0 119544 0 23850 0 34855 0 1644980 0 0 LARRY WARMOTH MD BOARD MEMBER 0 380185 0 0 117483 0 8000 0 19302 0 524970 0 0 MICHAEL O'NEILL MD BOARD MEMBER 0 460066 0 14195 0 59307 0 10000 0 19730 0 563298 0 0 MICHAEL ROBERTSON MD BOARD MEMBER (PART YEAR) 0 324762 0 131582 0 31590 0 8632 0 17286 0 513852 0 0 JOHN GRIGSON SVP CHIEF FINANCIAL OFFICER 0 448362 0 170769 0 60373 0 13249 0 16127 0 708880 0 0 JAMES KELLY SECRETARY 0 241928 0 94163 0 21657 0 7805 0 20290 0 385843 0 0 CHRIS DOUGHERTY CEO CHILDREN'S HOSP (PT YR) 284030 0 125725 0 26851 0 10210 0 21165 0 467981 0 0 0 AMY THOMPSON MD CEO CHILDREN'S HOSPITAL 284550 0 111424 0 26666 0 10600 0 21133 0 454373 0 0 0 LISA MARGUERITE FALLON VP PATIENT CARE SVCS NURSING 155467 0 57368 0 17433 0 14507 0 11746 0 256521 0 0 0 GARTH THOMAS CLINICAL PHARMACIST 162819 0 0 355 0 5567 0 28399 0 197140 0 0 0 STEPHEN GARR CLINICAL PHARMACIST 158072 0 0 792 0 8335 0 18812 0 186011 0 0 0 WESLEY WELLS CLINICAL PHARMACIST 152644 0 1040 0 742 0 11349 0 21748 0 187523 0 0 0 LINDA DURBIN REG NURSE IV 136296 0 1500 0 431 0 12562 0 7622 0 158411 0 0 0 KACI HILL CLINICAL PHARMACIST 132369 0 0 705 0 9521 0 9366 0 151961 0 0 0 TROY THIBODEAUX FORMER OFFICER 0 216717 0 225265 0 553127 0 7909 0 2758 0 1005776 0 0 SCHEDULE J, PART I, 1A ST. JOSEPH HEALTH SYSTEM ALLOWS FOR COMPANION TRAVEL TO CERTAIN PRE-APPROVED, MINISTRY SPONSORED EVENTS. COMPANION TRAVEL IS TREATED AS TAXABLE COMPENSATION IN MOST CASES. IN THE CASE THAT COMPANION TRAVEL IS NOT TAXABLE COMPENSATION, THE INDIVIDUAL IS PROVIDING A SERVICE TO THE HEALTH SYSTEM AS A REPRESENTATIVE WITH KNOWLEDGE OF THE COMMUNITIES AND MINISTRIES WE SERVE. MEMBERS OF THE BOARD AND EXECUTIVE MANAGEMENT TEAM ARE SELECTED TO PARTICIPATE IN AN ANNUAL PILGRIMAGE TO LE PUY, FRANCE, WHERE THE SISTERS' FIRST CONGREGATION WAS FORMED. THE PURPOSE OF THE PILGRIMAGE IS FOR THE ORGANIZATION'S LEADERS TO DEVELOP A DEEPER UNDERSTANDING OF THE ROOTS AND HERITAGE OF THE ORGANIZATION IN ORDER TO CARRY OUT THE MISSION. COMPANION TRAVEL IS CONSIDERED TO BE AN ESSENTIAL PART OF THIS EXPERIENCE AND THE COMPANION ACTS AS A REPRESENTATIVE WITH KNOWLEDGE OF THE COMMUNITIES AND MINISTRIES WE SERVE. THE FOLLOWING OFFICER RECEIVED A BENEFIT FOR COMPANION TRAVEL THAT WAS INTENDED TO BE COMPENSATION: AMY THOMPSON - $4,486 SCHEDULE J, PART I, LINE 3 THE COMPENSATION OF THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS DETERMINED BY ITS CORPORATE MEMBER, COVENANT HEALTH SYSTEM. SEE SCHEDULE O OF FORM 990, PART VI, LINE 15A NARRATIVE FOR THE PROCESS THAT IS COMPLETED BY THE RELATED ORGANIZATION. SCHEDULE J, PART I, LINE 4B BEGINNING IN JULY 2015, NEW EXECUTIVES PARTICIPATE IN A NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THE PLAN PROVIDES FOR EMPLOYER CONTRIBUTIONS BASED ON A PERCENTAGE OF EXECUTIVE BASE SALARY AND ARE SUBJECT TO A FIVE YEAR OR AGE 65 VESTING SCHEDULE. SCHEDULE J, PART I, LINE 7 A PORTION OF EXECUTIVES SALARIES ARE PLACED 'AT-RISKARE NOT AWARDED UNLESS SPECIFIC STRATEGIC OBJECTIVE TARGETS ARE MET OR EXCEEDED. THE AT-RISK EXECUTIVE PLAN IS DESIGNED TO MOTIVATE AND REWARD EXECUTIVES FOR TEAM PERFORMANCE THAT SUPPORTS THE STRATEGIC GOALS AND SUCCESSFUL PERFORMANCE OF ST. JOSEPH HEALTH SYSTEM. AT-RISK PAY IS AWARDED TO ASSISTANT VICE PRESIDENTS, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, AND THE CHIEF EXECUTIVE OFFICER BASED ON ACHIEVING OR SURPASSING SPECIFIC GOALS THAT ARE PREDETERMINED BY THE BOARD OF TRUSTEES PRIOR TO THE BEGINNING OF THE FISCAL YEAR. THE GOALS INCLUDE STRATEGIC OBJECTIVES AS WELL AS FISCAL STEWARDSHIP. EACH OF THESE FACTORS IS TAKEN INTO CONSIDERATION WHEN DETERMINING THE PERCENTAGE OF AT-RISK PAY. FORM 990, PART I, LINE 1 COVENANT CHILDREN'S HOSPITAL IS COMMITTED TO EXTENDING CHRISTIAN MINISTRY BY CARING FOR THE WHOLE PERSON-BODY, MIND AND SPIRIT, AND BY WORKING WITH OTHERS TO IMPROVE HEALTH AND QUALITY OF LIFE IN OUR COMMUNITIES. FORM 990, PART V, LINE 1 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 III, LINE 4A REALIZING OUR MISSION COVENANT CHILDREN'S HOSPITAL HAS BEEN MEETING THE HEALTH AND QUALITY OF LIFE NEEDS OF THE LOCAL COMMUNITY FOR OVER 15 YEARS. SERVING THE COMMUNITIES OF WEST TEXAS AND EASTERN NEW MEXICO, COVENANT HEALTH LUBBOCK INCLUDES COVENANT MEDICAL CENTER, COVENANT CHILDREN'S HOSPITAL, COVENANT SPECIALITY HOSPITAL, AND COVENANT MEDICAL GROUP. COVENANT HEALTH PROVIDES QUALITY CARE IN THE AREAS OF CARDIAC SERVICES, MOBILE MAMMOGRAPHY, MOBILE DENTAL, OUTPATIENT CANCER TREATMENT, PRIMARY CARE, WOMENS HEALTH AND CHILDRENS HEALTH. WITH OVER 4,000 EMPLOYEES COMMITTED TO REALIZING THE MISSION, COVENANT HEALTH IS ONE OF THE LARGEST EMPLOYERS IN THE WEST TEXAS REGION. AS A MEMBER OF THE ST. JOSEPH HEALTH SYSTEM, COVENANT HEALTH IS COMMITTED TO EXTENDING THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE. THIS MISSION HAS GUIDED OUR CATHOLIC HEALTHCARE MINISTRY SINCE THE OPENING OF OUR FIRST HOSPITAL IN EUREKA, CALIFORNIA NEARLY 100 YEARS AGO. THE SISTERS OF ST. JOSEPH OF ORANGE TRACE THEIR ROOTS BACK TO 17TH CENTURY FRANCE AND THE UNIQUE VISION OF A JESUIT PRIEST NAMED JEAN-PIERRE MEDAILLE. HE SOUGHT TO ORGANIZE AN ORDER OF RELIGIOUS WOMEN WHO, RATHER THAN REMAINING SAFELY CLOISTERED IN A CONVENT, VENTURED OUT INTO THE COMMUNITY TO SEEK OUT "THE DEAR NEIGHBORSMINISTER TO THEIR NEEDS. THE CONGREGATION MANAGED TO SURVIVE THE TURBULENCE OF THE FRENCH REVOLUTION AND EVENTUALLY EXPANDED, NOT ONLY THROUGHOUT FRANCE, BUT THROUGHOUT THE WORLD. IN 1912 A SMALL GROUP OF SISTERS OF ST. JOSEPH WENT TO EUREKA, CALIFORNIA, AT THE INVITATION OF THE LOCAL BISHOP, TO ESTABLISH A SCHOOL. A FEW YEARS LATER, THE GREAT INFLUENZA EPIDEMIC OF 1918 CAUSED THE SISTERS TO TEMPORARILY SET ASIDE THEIR EDUCATION EFFORTS TO CARE FOR THE ILL. THEY REALIZED IMMEDIATELY THAT THE SMALL COMMUNITY DESPERATELY NEEDED A HOSPITAL. THROUGH BOLD FAITH, FORESIGHT, AND FLEXIBILITY IN 1920, THE SISTERS OPENED THE 28-BED ST. JOSEPH HOSPITAL OF EUREKA, THE FIRST ST. JOSEPH HEALTH SYSTEM MINISTRY. PATIENT FINANCIAL ASSISTANCE PROGRAM COVENANT HEALTH CHILDREN'S HOSPITAL BELIEVES THAT NO ONE SHOULD DELAY SEEKING NEEDED MEDICAL CARE BECAUSE THEY LACK HEALTH INSURANCE. THAT IS WHY COVENANT HEALTH HAS A PATIENT FINANCIAL ASSISTANCE PROGRAM (FAP) THAT PROVIDES FREE OR DISCOUNTED SERVICES TO ELIGIBLE PATIENTS. IN FY16, COVENANT HEALTH MEDICAL CENTER PROVIDED $1,107,146 IN FREE AND DISCOUNTED CARE. MEDICAID PROGRAM COVENANT HEALTH CHILDREN'S HOSPITAL PROVIDED ACCESS TO UNINSURED AND UNDERINSURED PERSONS BY PARTICIPATING IN THE FEDERAL AND STATE SPONSORED MEDICAID PROGRAM. IN FY16, COVENANT HEALTH MEDICAL CENTER PROVIDED $1,438,363 IN MEDICAID SHORTFALL. COVENANT HEALTH IS AN ACUTE-CARE HOSPITAL LOCATED IN LUBBOCK SERVING THE FOLLOWING REGION WEST TEXAS/EASTERN NEW MEXICO REGION. COVENANT HEALTH PROVIDES VITAL HOSPITAL AND COMMUNITY SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERSINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE (TRADITIONAL CHARITY CARE) AND DISCOUNTED CARE. COVENANT HEALTH IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE OF ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS: 1) A COMMUNITY BENEFIT COMMITTEE THAT IS A SUBCOMMITTEE OF THE BOARD OF TRUSTEES, 2) AN OPEN MEDICAL STAFF AND 3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ARE IN PART FUNDED BY CARE FOR THE POOR DOLLARS. COVENANT HEALTHS FY15-FY17 COMMUNITY BENEFIT PLAN/IMPLEMENTATION STRATEGY REPORT FOCUSES ON WELLNESS AND PREVENTION INCLUDING DIABETES PREVENTION AND MANAGEMENT, CHILDHOOD OBESITY PREVENTION AND HEART HEALTH EDUCATION, ORAL HEALTH FOR ALL AGES AND MENTAL HEALTH OUTREACH. WELLNESS AND PREVENTION FOCUSED PRIMARILY ON ADULT DIABETIC EDUCATION, OBESITY PREVENTION FOR CHILDREN, ADULT CARDIAC HEALTH EDUCATION AND EARLY ORAL HEALTH INTERVENTIONS FOR CHILDREN; A FULL TIME HEALTH EDUCATOR IS DEDICATED TO DIABETES EDUCATION/PREVENTION AND GENERAL HEALTH/NUTRITION EDUCATION FOR ALL AGES; FUNDING FOR CHILDHOOD OBESITY AND WELLNESS PROGRAMS IS PROVIDED TO COMMUNITY AGENCIES; PARTICIPATION IN HEALTH SCREENINGS AND HEALTH FAIRS; FUNDING FOR WELL HEART PRESENTATIONS; ORAL HEALTH EDUCATION PROVIDED ON-SITE AT ELEMENTARY SCHOOLS ORAL HEALTH - COMMUNITY OUTREACH DENTAL CLINIC SERVES LOW-INCOME FAMILIES OFFERING COMPREHENSIVE DENTAL CARE TO PATIENTS AGED 5 AND UP; MOBILE DENTAL UNIT THAT SERVES PATIENTS IN A 75-MILE RADIUS OF LUBBOCK; FREE REGIONAL DENTAL SEALANT CLINICS FOR SCHOOL CHILDREN MENTAL HEALTH - COVENANT COMMUNITY OUTREACH COUNSELING CENTER PROVIDES COUNSELING SERVICES TO UNDERSERVED AND LOW-INCOME PERSONS IN OUR COMMUNITY OFFERING INDIVIDUAL, COUPLES AND FAMILY THERAPY TO PEOPLE OF ALL AGES. FOR MORE INFORMATION ABOUT COVENANT HEALTH, PLEASE VISIT HTTP://WWW.COVENANTHEALTH.ORG/. FOR MORE INFORMATION ABOUT ST. JOSEPH HEALTH, PLEASE VISIT WWW.STJHS.ORG. FORM 990, PART VI, LINE 6 DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS COVENANT HEALTH IS THE SOLE CORPORATE MEMBER OF COVENANT CHILDREN'S HOSPITAL. FORM 990, PART VI, LINE 7A DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS COVENANT CHILDREN'S HOSPITAL HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE COVENANT CHILDREN'S HOSPITAL BOARD. ALL DIRECTOR APPOINTMENTS THAT COME FROM THE COVENANT CHILDREN'S HOSPITAL BOARD AS NOMINATIONS MUST BE APPROVED BY COVENANT HEALTH, AS THE CORPORATE MEMBER, AND THE ST. JOSEPH HEALTH SYSTEM, AS THE TAX EXEMPT PARENT OF COVENANT HEALTH, AND ST. JOSEPH HEALTH MINISTRY, AS THE ORGANIZATIONAL SPONSOR. FORM 990, PART VI, LINE 7B DESCR CLASSES OF PERSONS, DECISIONS REQ APPR & TYPE OF VOTING RIGHTS THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE COVENANT HEALTH MEMBER OF FINANCING, BUDGETS, UNBUDGETED EXPENDITURES OF DEFINED AMOUNTS, STRATEGIC PLAN, APPOINTMENT OF AUDITORS, CREATION OR INVESTMENT IN A LEGALLY RECOGNIZED ENTITY, JOINT VENTURES, PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. FORM 990, PART VI, LINE 11B DESCR THE PROCESS USED BY MANAGEMENT &/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 BOARD FINANCE COMMITTEE CHAIR THEN PROVIDED A SUMMARY AT THE FULL BOARD MEETING. FORM 990, PART VI, LINE 12C DESCRIPTION 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 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 HEATLH 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 CONSULTNG 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 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. THE AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO FORM 990. FORM 990, PART XI, LINE 9 CONTRIBUTED CAPITAL - $111,375 EQUITY TRANSFERS - $(60,778,039) ROUNDING - $(3) ------------ TOTAL $(60,666,667) FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:13333917 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:3134351 COVENANT HEALTH NETWORK INC 3345 MICHELSON DRIVE STE 100 IRVINE CA 92612 461259908 HEALTHCARE CA 501(C)(3) 11,III SJHS true COVENANT ACO 3615 19TH STREET LUBBOCK TX 79410 611573313 HEALTHCARE TX 501(C)(3) 11,I CHS 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) 3 CHS true HOAG CHARITY SPORTS 330 PLACENTIA AVENUE NEWPORT BEACH CA 92663 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ORANGEWOOD AVENUE, STE 200 ORANGE, CA 92868-2012 THE INNOVATION INSTITUTE EIN: 90-0745066 ADDRESS: 1 CENTERPOINTE DRIVE SUITE 200, LA PALMA, CA 90623-1052 NORTH BAY ENDOSCOPY CENTER, LLC EIN: 61-1559876 ADDRESS: 1383 N. MCDOWELL BLVD SUITE 110, PETALUMA, CA 94954 MISSION VIEJO PHYSICIAN PARTNERS I LLC EIN: 47-1559873 ADDRESS: 27700 MEDICAL CENTER ROAD, MISSION VIEJO, CA 92691 ADVANCED SURGERY INSTITUTE LLC EIN: 26-2299255 ADDRESS: 1739 4TH STREET, SANTA ROSA, CA 95404