2016-05-11T17:30:43-05:00 2015-06-30 ERNST & YOUNG US LLP 18101 VON KARMAN AVENUE SUITE 1700 IRVINE CA 92612 990 2014-07-01 752428911 METHODIST CHILDREN'S HOSPITAL % DYANA KERR METH 8067251011 3610 21ST STREET LUBBOCK TX 794101218 JOHN GRIGSON CFO 8067251011 2016-05-09 true KARA ADAMS P00023315 9497942300 2014 2016-08-17 19:52:53Z COVENANT CHILDREN'S HOSPITAL RICHARD PARKS 3615 19TH STREET LUBBOCK TX 794101203 86432582 false X WWW.COVENANTCHILDRENS.ORG X 1998 TX SEE SCHEDULE O 18 12 294 100 0 0 151229 40167 76210741 85214244 993309 1178171 0 0 77355279 86432582 0 62500 0 0 29940077 27982572 0 0 0 32602731 39205782 62542808 67250854 14812471 19181728 81809182 99812353 2758005 2461479 79051177 97350874 X 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. false false 64836218 62500 85214244 SEE SCHEDULE O 64836218 true true false false false false false false false false true false false true true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true true true false false true 36 0 true 294 true false false false false false false false false false false X 18 12 false false false false true true true true true false false true true true true true true false false false X DYANA KERR 8067255234 2107 OXFORD LUBBOCK TX 79410 VAL COCHRAN BOARD MEMBER 3.0 3.0 X 0 0 0 MIKE CUNNINGHAM BOARD MEMBER 3.0 3.0 X 0 0 0 JOHN HAMILTON BD MEMBER V. CHAIR/COMM CHAIR 6.0 6.0 X 0 0 0 SAM HAWTHORNE BOARD MEMBER/COMM V. CHAIR 3.0 3.0 X 0 0 0 BRENT HOFFMAN BOARD MEMBER/COMMITTEE CHAIR 3.0 3.0 X 0 0 0 ROSALINDA R JIMENEZ BOARD MEMBER/COMM V. CHAIR 2.0 2.0 X 0 0 0 KEITH MANN BOARD MEMBER/COMM V. CHAIR 2.0 2.0 X 0 0 0 DARRIN MONTALVO BOARD MEMBER 2.0 54.0 X 0 1556291 58114 JUAN SANCHEZ MUNOZ PHD BOARD MEMBER 2.0 2.0 X 0 0 0 MICHAEL O'NEILL MD BOARD MEMBER 48.0 2.0 X 0 485275 30265 RICHARD PARKS BOARD MEMBER/PRESIDENT/CEO 24.0 30.0 X X 0 1097478 27187 SR CHRISTINE RAY CSJ BOARD MEMBER 2.0 48.0 X 0 0 0 MICHAEL ROBERTSON MD BOARD MEMBER 2.0 48.0 X 0 345629 12243 TEB THAMES MD BOARD CHAIR/COMMITTEE CHAIR 6.0 6.0 X 0 0 0 LARRY WARMOTH MD BOARD MEMBER 2.0 48.0 X 0 434337 27958 KAREN WORLEY BOARD MEMBER 2.0 2.0 X 0 0 0 R BYRN BASS JR BOARD MEMBER (PART YEAR) 2.0 2.0 X 0 0 0 SUZANNE BLAKE BOARD MEMBER (PART YEAR) 2.0 2.0 X 0 0 0 JO ANN ESCASA-HAIGH BOARD MEMBER (PART YEAR) 2.0 54.0 X 0 731859 36805 JAMES GUTHEIL MD BOARD MEMBER (PART YEAR) 2.0 48.0 X 0 763826 28452 KITTY HARRIS-WILKES PHD BOARD MEMBER (PART YEAR) 2.0 2.0 X 0 0 0 JAMES KIRK MD BOARD MEMBER (PART YEAR) 2.0 48.0 X 0 197235 3899 SR SHARON BECKER CSJ BOARD MEMBER/COMMITTEE CHAIR 3.0 47.0 X 0 0 0 JOE DEE BROOKS BOARD MEMBER (PART YEAR) 2.0 7.0 X 0 0 0 BRIAN BRUENING MD BOARD MEMBER/COMM V. CHAIR 3.0 3.0 X 0 0 0 JANIE RAMIREZ BOARD MEMBER (PART YEAR) 2.0 2.0 X 0 0 0 VAN MAY BOARD MEMBER (PART YEAR) 2.0 2.0 X 0 0 0 SR MARY THERESE SWEENEY CSJ BOARD MEMBER (PART YEAR) 2.0 48.0 X 0 0 0 JOHN ZWIACHER BOARD MEMBER (PART YEAR) 2.0 2.0 X 0 0 0 CHRIS DOUGHERTY CEO CHILDREN'S HOSPITAL 50.0 0.0 X 0 450619 28132 JOHN GRIGSON CFO 12.0 38.0 X 0 600783 28575 JAMES KELLY SECRETARY 20.0 30.0 X 0 237298 12507 AMY THOMPSON MD CMO CQO CHILDREN'S HOSPITAL 50.0 0.0 X 0 327549 27265 STEPHEN GARR CLINICAL PHARMACIST 40.0 0.0 X 196503 0 23837 DONNA NEEL MGR NURSING 40.0 0.0 X 161114 0 36528 GARTH THOMAS CLINICAL PHARMACIST 40.0 0.0 X 144701 0 29481 LINDA DURBIN STAFF RN IV 40.0 0.0 X 138374 0 23059 WESLEY WELLS CLINICAL PHARMACIST 40.0 0.0 X 132835 0 30387 TROY THIBODEAUX FORMER OFFICER 0.0 50.0 X 0 668147 17476 773527 7896326 482170 12 true true false COMPHEALTH PO BOX 972651 DALLAS TX 75397 HEALTHCARE STAFFING 3000040 IKARIA ACQUISTION INC PO BO X642509 PITTSBURGH PA 15264 INO THERAPEUTICS 356459 PEDIATRIX MEDICAL SERVICES INC PO BOX 281034 ATLANTA GA 30384 MEDICAL SERVICES 248550 CURT COCKINGS MD PA 3802 22ND PLACE LUBBOCK TX 79410 MEDICAL SERVICES 139300 4 0 40167 0 0 40167 PATIENT CARE SERVICES REVENUE 622110 84092657 84092657 0 0 ALL OTHER PROGRAM SERVICE REVENUE 900099 1121587 1121587 0 0 85214244 1178171 1178171 0 0 0 0 0 0 0 0 0 0 86432582 85214244 0 1178171 X 62500 62500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19708509 18491860 1216649 0 730309 624763 105546 0 6521420 6335619 185801 0 1022334 959349 62985 0 10459772 10459772 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14365702 14046920 318782 25188 19150 6038 0 1322501 1013068 309433 0 0 0 0 0 0 0 0 0 829362 829362 0 0 48829 26125 22704 0 0 0 0 0 14268 5991 8277 0 800813 800813 0 0 0 0 0 0 4422690 4422690 0 0 399300 399300 0 0 MEDICAL SUPPLIES 6246371 6093474 152897 0 ALL OTHER EXPENSES 270986 245462 25524 0 67250854 64836218 2414636 0 0 731655 2596577 22103824 31782919 0 0 11376245 14764756 0 0 0 0 0 0 0 0 0 0 7034440 4670307 2386682 2364133 0 0 0 0 0 0 0 0 45210776 48303968 81809182 99812353 1416973 1585638 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1341032 875841 2758005 2461479 X 79051177 97350874 0 0 0 0 79051177 97350874 81809182 99812353 19181728 -882031 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 316511 160670 155841 6567746 4509637 2058109 150183 150183 2364133 LT DUE FROM AFFILIATES 46035074 OTHER RECEIVABLES 2268894 48303968 0 OTHER LIABILITIES 379214 THIRD PARTY PAYABLES 496627 875841 X SCHEDULE D, PART X, LINE 2 CONSOLIDATED AUDIT FOOTNOTE FOR FIN 48 (ASC 740) 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, 2015 OR 2014. true true X true X 175. true X true true true false true true 1091146 1091146 0.01620 31183621 24347706 6835915 0.10160 32274767 24347706 7927061 0.11780 1171 1171 148057 148057 0.00220 149228 149228 0.00220 32423995 24347706 8076289 0.12010 false 2498130 7590385 6919575 670810 X true true 1 1 METHODIST CHILDREN'S HOSPITAL 3610 21ST STREET 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 true true X SEE SCHEDULE H, PART V, SECTION C X true 13 true SEE SCHEDULE H, PART V, SECTION C false 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 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 ALL IDENTIFIED HEALTH NEEDS BASED ON SECONDARY DATA ANALYSIS WERE PRESENTED TO FOCUS GROUPS COMPRISED OF LUBBOCK COMMUNITY HEALTH LEADERS, LUBBOCK COMMUNITY SERVICE ORGANIZATION REPRESENTATIVES, INTERNAL COVENANT DEPARTMENT LEADERS AND THE COMMUNITY BENEFIT COMMITTEE. COVENANT HEALTH OBTAINED CONSULTATION ON THE COMMUNITY NEEDS ASSESSMENT FROM PUBLIC HEALTH EXPERT CATHERINE F. KINNEY, MSW, PHD. COVENANT MEDICAL GROUP PHYSICIANS WERE ASKED TO COMPLETE AN ON-LINE SURVEY RELATED TO THE IDENTIFIED NEEDS. THE FEEDBACK RECEIVED FROM THESE GROUPS COMBINED WITH THE SECONDARY DATA ANALYSIS HELPED SHAPE THE FINAL PRIORITIES. SCHEDULE H, PART V, SECTION B, LINE 6A & 6B 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 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 HEALTH NEEDS EXPLORED DURING OUR NEEDS ASSESSMENT AND PRIORITY SELECTION PROCESS THAT WERE NOT SELECTED AS A KEY FOCUS AREA FOR COVENANT HEALTH OUTREACH INCLUDED SUBSTANCE ABUSE (LEGAL, ILLICIT, INCLUDING TOBACCO USE), MATERNAL/CHILD HEALTH, CARDIOVASCULAR AND RESPIRATORY DISEASE, AND SEXUALLY TRANSMITTED DISEASE. WHEN APPLYING THE RANKING SYSTEM FOR THE REQUIRED ELEMENTS AND OPTIONAL CONSIDERATIONS THESE HEALTH ISSUES SCORED LOWER. CARDIOVASCULAR, MATERNAL/CHILD HEALTH AND RESPIRATORY NEEDS ARE CURRENTLY WELL ADDRESSED WITHIN COVENANT HEALTH'S AND COVENANT MEDICAL GROUP SERVICE LINES AND THROUGH OTHER COMMUNITY BASED INTERVENTION PROGRAMS. STD PREVENTION WAS NOT SELECTED AS A COVENANT HEALTH PRIORITY HOWEVER WE CONTINUED TO WORK WITH LOCAL AGENCIES FOR WHICH THIS IS A PRIORITY. COVENANT HEALTH ALSO ADDRESSED STD PREVENTION THROUGH AN EDUCATION PROGRAM TITLED "BOY TALK GIRL TALK". COVENANT COMMUNITY OUTREACH CONTINUED TO PARTNER WITH OTHER COMMUNITY OUTREACH PROGRAMS TO SUPPORT THEIR EFFORTS IN ADDRESSING THE COMMUNITY NEEDS THAT WERE NOT SELECTED AS PRIORITIES. ONE SUCH EFFORT IS BY PROVIDING GRANTS FUNDS TO THE LUBBOCK CHILDREN'S HEALTH CLINIC, THE SICK CHILDREN'S CLINIC, CATHOLIC FAMILY SERVICES, AND WOMEN'S PROTECTIVE SERVICES TO HELP ADDRESS A VARIETY OF HEALTH NEEDS AND SOCIAL BARRIERS IN THE COMMUNITY. 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. 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 16B http://www.covenanthealth.org/documents/CovenantFinancialAssistanceApplica tion-English.pdf SCHEDULE H, PART V, SECTION B, LINE 16C http://www.covenanthealth.org/Patients-and-Visitors/For-Patients/Billing-a nd-Payments/Patient-Financial-Assistance.aspx 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, INCLUDING BUT NOT LIMITED TO DISABILITY AND HOMELESSNESS ARE CONSIDERED WHEN DETERMINING ELIGIBILITY. SCHEDULE H, PART I, LINE 6A COVENANT HEALTH PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT THAT INCLUDES COVENANT CHILDREN'S HOSPITAL and it is publicly available at www.covenanthealth.org SCHEDULE H, PART I, LINE 7 THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM. 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 PAGE 11 OF FINANCIAL STATEMENTS - 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 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 DISPROPORTIONATE UNMET HEALTH NEEDS (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. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH COVENANT HEALTH HAS BEEN MEETING THE HEALTH AND QUALITY OF LIFE NEEDS OF THE PEOPLE IN THE LOCAL COMMUNITY FOR OVER 16 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 EMERGENT/URGENT CARE, NEURO SCIENCE, ORTHOPEDICS, CARDIAC SERVICES, MOBILE MAMMOGRAPHY, MOBILE DENTAL, OUTPATIENT CANCER TREATMENT, HEALTH EDUCATION, PRIMARY CARE, WOMEN'S AND CHILDREN'S SERVICES, LONG TERM CARE, AND REHAB SERVICES WITH OVER 4,000 EMPLOYEES COMMITTED TO REALIZING THE MISSION, COVENANT HEALTH IS ONE OF THE LARGEST EMPLOYERS IN THE WEST TEXAS REGION. COVENANT HEALTH IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE OF ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS: THERE IS A COMMUNITY BENEFIT COMMITTEE THAT HAS COMMUNITY REPRESENTATION, AN OPEN MEDICAL STAFF, AND THROUGH OUR COMMUNITY BENEFIT PROGRAMS WHICH ARE PARTLY FUNDED BY CARE FOR THE POOR DOLLARS. COVENANT HEALTH IS A HEALING MINISTRY OF ST. JOSEPH HEALTH SYSTEM, AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. ST. JOSEPH HEALTH SYSTEM IS ORGANIZED INTO THREE REGIONS: NORTHERN CALIFORNIA, SOUTHERN CALIFORNIA, AND WEST TEXAS/EASTERN NEW MEXICO. THE SYSTEM INCLUDES ACUTE CARE HOSPITALS, HOME HEALTH AGENCIES, HOSPITAL 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 PEOPLE IN THE COMMUNITIES WE SERVE. LOCAL COMMUNITY BENEFIT COMMITTEE: THE ROLE OF THE COVENANT HEALTH COMMUNITY BENEFIT COMMITTEE IS TO SUPPORT THE BOARD OF TRUSTEES IN OVERSEEING COMMUNITY BENEFIT EFFORTS. THE COMMITTEE ACTS IN ACCORDANCE WITH A BOARD-APPROVED CHARTER. THE COMMUNITY BENEFIT COMMITTEE IS CHARGED WITH DEVELOPING POLICIES AND PROGRAMS THAT ADDRESS IDENTIFIED NEEDS IN THE SERVICE AREA PARTICULARLY FOR UNDERSERVED POPULATIONS, OVERSEEING DEVELOPMENT AND IMPLEMENTATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY BENEFIT PLAN/IMPLEMENTATION STRATEGY REPORTS, AND PROVIDING DIRECTION OF COMMUNITY BENEFIT ACTIVITIES. THE COMMUNITY BENEFIT COMMITTEE HAS A MINIMUM OF EIGHT MEMBERS INCLUDING THREE MEMBERS OF THE BOARD OF TRUSTEES. THE COMMUNITY BENEFIT COMMITTEE HAS A MINIMUM OF EIGHT MEMBERS INCLUDING THREE MEMBERS OF THE BOARD OF TRUSTEES. CURRENT MEMBERSHIP INCLUDES SEVEN MEMBERS OF THE BOARD OF TRUSTEES AND FIVE COMMUNITY MEMBERS. A MAJORITY OF MEMBERS HAVE KNOWLEDGE AND EXPERIENCE WITH THE POPULATIONS MOST LIKELY TO HAVE DISPROPORTIONATE UNMET HEALTH NEEDS. THE COMMUNITY BENEFIT COMMITTEE GENERALLY MEETS BI-MONTHLY. COMMUNITY BENEFIT INVESTMENT: THIS IS DEMONSTRATED THROUGH THE FOLLOWING KEY PROGRAMS: COVENANT HEALTH OPERATES THREE DIRECT COMMUNITY OUTREACH PROGRAMS, PROVIDES GRANTS/CONTRIBUTIONS TO MANY LOCAL CHARITABLE ORGANIZATIONS AND PROVIDES FUNDING AND SUPPORT TO TEXAS TECH UNIVERSITY FOR A CHILDHOOD OBESITY PROGRAM (CBMI). THE THREE DIRECT COMMUNITY OUTREACH PROGRAMS ARE FOR LOW-INCOME PERSONS IN OUR COMMUNITY. DENTAL CLINIC: THE COMMUNITY OUTREACH DENTAL CLINIC SERVES LOW-INCOME FAMILIES IN OUR REGION. THE PROGRAM OFFERS COMPREHENSIVE DENTAL CARE TO PATIENTS AGED 5 AND UP. ADULT AND CHILDREN'S SERVICES ARE AVAILABLE AT A CLINIC IN LUBBOCK. AN ADULT MOBILE DENTAL UNIT SERVES PATIENTS IN A 75-MILE RADIUS OF LUBBOCK. A DENTAL SEALANT PROGRAM IS OFFERED TO LOW INCOME AREA SCHOOLS FREE OF CHARGE. PATIENTS MUST FINANCIALLY QUALIFY TO ACCESS THE CLINICAL SERVICES. SOME PATIENT CO-PAY AMOUNTS ARE REQUIRED. PATIENTS ARE NEVER TURNED AWAY DUE TO A LACK OF ABILITY TO PAY. COUNSELING CENTER PROGRAM: COVENANT COMMUNITY OUTREACH COUNSELING CENTER EMPLOYS THREE LICENSED PROFESSIONAL COUNSELORS TO PROVIDE COUNSELING SERVICES TO UNDERSERVED AND LOW-INCOME PERSONS IN OUR COMMUNITY. THE CENTER OFFERS INDIVIDUAL COUPLES AND FAMILY THERAPY, IN A SAFE AND ENCOURAGING ENVIRONMENT. CHARGES FOR SERVICES ARE BASED ON A SLIDING FEE SCALE AND PARTICIPANTS MUST FINANCIALLY QUALIFY. PATIENTS ARE NEVER TURNED AWAY DUE TO A LACK OF ABILITY TO PAY. DIABETES PREVENTION AND INTERVENTION PROGRAM (HEALTH EDUCATION): OFFERS FREE DIABETES CLASSES WITH AN EMPHASIS ON EMPOWERMENT AND SELF-MANAGEMENT. IN ADDITION FREE INDIVIDUAL APPOINTMENTS FOR EDUCATION ON DIABETES, CHOLESTEROL AND HYPERTENSION ARE AVAILABLE TO THE COMMUNITY. HEALTH EDUCATION IS AVAILABLE FOR ELEMENTARY SCHOOL CLASSROOM, COMMUNITY CLINICS, AND COMMUNITY CENTERS ON DIET AND EXERCISE FOR DISEASE PREVENTION. HEALTH PRESENTATIONS ARE AVAILABLE FOR COMMUNITY, FAITH-BASED AND SCHOOL GROUPS. COVENANT BODY MIND INITIATIVE: COVENANT PROVIDES FINANCIAL SUPPORT TO TEXAS TECH UNIVERSITY CENTER FOR ADOLESCENT RESILIENCY TO FUND CBMI WHICH IS A WELLNESS INTERVENTION PROGRAM BUILT INTO MIDDLE SCHOOL CURRICULUM. IT IS ALSO A LONGITUDINAL STUDY MEASURING THE EFFECTIVENESS OF A PREVENTION AND INTERVENTION PROGRAM THAT IMPACTS CHILDHOOD OBESITY. THOSE PERFORMING THE STUDY WILL PROVIDE THE CB COMMITTEE WITH QUARTERLY UPDATES ON STRATEGY AND MEASURES. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM COVENANT CHILDREN'S HOSPITAL IS A HEALING MINISTRY OF ST. JOSEPH HEALTH AN INTEGRATED HEALTHCARE DELIVERY SYSTEM SPONSORED BY 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 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 CREATED THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND (ALSO KNOWN AS THE ST. JOSEPH HEALTH SYSTEM FOUNDATION) TO IMPROVE THE HEALTH OF LOW-INCOME INDIVIDUALS RESIDING IN LOCAL COMMUNITIES. OUR FOUNDATIONAL DOCUMENT, A VISION OF VALUES, FORMALIZES A POLICY THROUGH WHICH THE HOSPITAL MINISTRIES RETURN TEN PERCENT OF THEIR NET INCOME TO ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND TO SUPPORT OUTREACH EFFORTS FOR THE MATERIALLY POOR. THE FOUNDATION THEN FUNDS PROGRAMS IN COMMUNITIES SERVED BY SYSTEM HOSPITALS THAT ALIGN WITH OUR MISSION AND EXEMPLIFY THE FOUR CORE VALUES OF ST. JOSEPH HEALTH: SERVICE, EXCELLENCE, DIGNITY, AND JUSTICE. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT TEXAS true TEXAS TECH UNIVERSITY PO BOX 41105 LUBBOCK TN 79409 752668014 GOVT 62500 HEALTHIEST COMM & CHILD OB PRG 1 SCHEDULE I, PART I, LINE 2 DESCR OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS 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. false false false false false false false true false DARRIN MONTALVO BOARD MEMBER 0 740382 0 585139 0 230770 0 23056 0 35058 0 1614405 0 0 MICHAEL O'NEILL MD BOARD MEMBER 0 392275 0 25430 0 67570 0 10000 0 20265 0 515540 0 0 RICHARD PARKS BOARD MEMBER/PRESIDENT/CEO 0 694129 0 247168 0 156181 0 10400 0 16787 0 1124665 0 0 MICHAEL ROBERTSON MD BOARD MEMBER 0 277213 0 26550 0 41866 0 0 0 12243 0 357872 0 0 LARRY WARMOTH MD BOARD MEMBER 0 386219 0 5854 0 42264 0 8000 0 19958 0 462295 0 0 JO ANN ESCASA-HAIGH BOARD MEMBER (PART YEAR) 0 456024 0 148369 0 127466 0 13000 0 23805 0 768664 0 0 JAMES GUTHEIL MD BOARD MEMBER (PART YEAR) 0 683759 0 9228 0 70839 0 8000 0 20452 0 792278 0 0 JAMES KIRK MD BOARD MEMBER (PART YEAR) 0 141724 0 1137 0 54374 0 0 0 3899 0 201134 0 0 CHRIS DOUGHERTY CEO CHILDREN'S HOSPITAL 0 314724 0 85385 0 50510 0 7800 0 20332 0 478751 0 0 JOHN GRIGSON CFO 0 411010 0 110258 0 79515 0 13000 0 15575 0 629358 0 0 AMY THOMPSON MD CMO CQO CHILDREN'S HOSPITAL 0 228964 0 62615 0 35970 0 6979 0 20286 0 354814 0 0 STEPHEN GARR CLINICAL PHARMACIST 195630 0 0 0 873 0 9918 0 13919 0 220340 0 0 0 DONNA NEEL MGR NURSING 146067 0 14175 0 872 0 16958 0 19570 0 197642 0 0 0 GARTH THOMAS CLINICAL PHARMACIST 143829 0 0 0 872 0 4680 0 24801 0 174182 0 0 0 LINDA DURBIN STAFF RN IV 136972 0 500 0 902 0 15304 0 7755 0 161433 0 0 0 WESLEY WELLS CLINICAL PHARMACIST 131963 0 0 0 872 0 9786 0 20601 0 163222 0 0 0 JAMES KELLY SECRETARY 0 184927 0 50254 0 2117 0 0 0 12507 0 249805 0 0 TROY THIBODEAUX FORMER OFFICER 0 443242 0 153321 0 71584 0 10400 0 7076 0 685623 0 0 SCHEDULE J, PART I, LINE 3 THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O FOR FORM 990, PART VI, LINES 15A AND 15B FOR THE PROCESS THAT IS COMPLETED BY ST. JOSEPH HEALTH SYSTEM. SCHEDULE J, PART I, LINE 7 A PORTION OF EXECUTIVES SALARIES ARE PLACED 'AT-RISK' AND ARE NOT AWARDED UNLESS SPECIFIC STRATEGIC OBJECTIVE TARGETS ARE MET OR EXCEEDED. THE AT-RISK EXECUTIVE PLAN IS DESIGNED TO MOTIVATE AND REWARD EXECUTIVES FOR TEAM PERFORMANCE THAT SUPPORTS THE STRATEGIC GOALS AND SUCCESSFUL PERFORMANCE OF ST. JOSEPH HEALTH SYSTEM. AT-RISK PAY IS AWARDED TO ASSISTANT VICE PRESIDENTS, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, AND THE CHIEF EXECUTIVE OFFICER BASED ON ACHIEVING OR SURPASSING SPECIFIC GOALS THAT ARE PREDETERMINED BY THE BOARD OF TRUSTEES PRIOR TO THE BEGINNING OF THE FISCAL YEAR. THE GOALS INCLUDE OUR STRATEGIC OBJECTIVES OF PERFECT CARE, SACRED ENCOUNTERS, AND HEALTHIEST COMMUNITIES 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 ORGANIZATION'S MISSION 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 III, LINE 4A PROGRAM SERVICE ACCOMPLISHMENTS 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 NEIGHBORS" AND MINISTER 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 FY15, COVENANT HEALTH MEDICAL CENTER PROVIDED $1,091,146 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 FY15, COVENANT HEALTH MEDICAL CENTER PROVIDED $6,835,915 IN MEDICAID SHORTFALL. PROGRAM SERVICE ACCOMPLISHMENTS COVENANT HEALTH OPERATES THREE DIRECT COMMUNITY OUTREACH PROGRAMS, PROVIDES GRANTS/CONTRIBUTIONS TO MANY LOCAL CHARITABLE ORGANIZATIONS AND PROVIDES FUNDING AND SUPPORT TO TEXAS TECH UNIVERSITY FOR A CHILDHOOD OBESITY PROGRAM (CBMI). THE THREE DIRECT COMMUNITY OUTREACH PROGRAMS ARE FOR LOW-INCOME PERSONS IN OUR COMMUNITY. DENTAL CLINIC: THE COMMUNITY OUTREACH DENTAL CLINIC SERVES LOW-INCOME FAMILIES IN OUR REGION. THE PROGRAM OFFERS COMPREHENSIVE DENTAL CARE TO PATIENTS AGED 5 AND UP. ADULT AND CHILDREN'S SERVICES ARE AVAILABLE AT A CLINIC IN LUBBOCK. AN ADULT MOBILE DENTAL UNIT SERVES PATIENTS IN A 75-MILE RADIUS OF LUBBOCK. A DENTAL SEALANT PROGRAM IS OFFERED TO LOW INCOME AREA SCHOOLS FREE OF CHARGE. PATIENTS MUST FINANCIALLY QUALIFY TO ACCESS THE CLINICAL SERVICES. SOME PATIENT CO-PAY AMOUNTS ARE REQUIRED. PATIENTS ARE NEVER TURNED AWAY DUE TO A LACK OF ABILITY TO PAY. COUNSELING CENTER PROGRAM: COVENANT COMMUNITY OUTREACH COUNSELING CENTER EMPLOYS THREE LICENSED PROFESSIONAL COUNSELORS TO PROVIDE COUNSELING SERVICES TO UNDERSERVED AND LOW-INCOME PERSONS IN OUR COMMUNITY. THE CENTER OFFERS INDIVIDUAL COUPLES AND FAMILY THERAPY, IN A SAFE AND ENCOURAGING ENVIRONMENT. CHARGES FOR SERVICES ARE BASED ON A SLIDING FEE SCALE AND PARTICIPANTS MUST FINANCIALLY QUALIFY. PATIENTS ARE NEVER TURNED AWAY DUE TO A LACK OF ABILITY TO PAY. DIABETES PREVENTION AND INTERVENTION PROGRAM (HEALTH EDUCATION): OFFERS FREE DIABETES CLASSES WITH AN EMPHASIS ON EMPOWERMENT AND SELF-MANAGEMENT. IN ADDITION FREE INDIVIDUAL APPOINTMENTS FOR EDUCATION ON DIABETES, CHOLESTEROL AND HYPERTENSION ARE AVAILABLE TO THE COMMUNITY. HEALTH EDUCATION IS AVAILABLE FOR ELEMENTARY SCHOOL CLASSROOM, COMMUNITY CLINICS, AND COMMUNITY CENTERS ON DIET AND EXERCISE FOR DISEASE PREVENTION. HEALTH PRESENTATIONS ARE AVAILABLE FOR COMMUNITY, FAITH-BASED AND SCHOOL GROUPS. COVENANT BODY MIND INITIATIVE: COVENANT PROVIDES FINANCIAL SUPPORT TO TEXAS TECH UNIVERSITY CENTER FOR ADOLESCENT RESILIENCY TO FUND CBMI WHICH IS A WELLNESS INTERVENTION PROGRAM BUILT INTO MIDDLE SCHOOL CURRICULUM. IT IS ALSO A LONGITUDINAL STUDY MEASURING THE EFFECTIVENESS OF A PREVENTION AND INTERVENTION PROGRAM THAT IMPACTS CHILDHOOD OBESITY. THOSE PERFORMING THE STUDY WILL PROVIDE THE CB COMMITTEE WITH QUARTERLY UPDATES ON STRATEGY AND MEASURES. 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 2016 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 PROCESS USED TO DETERMINE COMPENSATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. EXECUTIVE COMPENSATION IS APPROVED BY THE COVENANT CHILDRENS HOSPITAL 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 2015. DURING THE YEAR, THE METHODIST CHILDRENS HOSPITAL 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, VI, LINE 19 AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY & FIN STMTS 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. THE AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO FORM 990. FORM 990, PART IX, LINE 11G OTHER FEES EXCEEDING 10% PROFESSIONAL FEES - $12,075,158 PURCHASED SERVICES - $2,290,544 ------------ TOTAL $14,365,702 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:12075158 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:2290544 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) 11,I CHS 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 HMHP true HOAG MEMORIAL HOSPITAL PRESBYTERIAN 1 HOAG ROAD BOX 6100 NEWPORT BEACH CA 92663 951643327 HEALTHCARE CA 501(C)(3) 3 CHN true HOME CARE PARTNERS 1165 MONTGOMERY DR SANTA ROSA CA 95405 680318656 INACTIVE CA 501(C)(3) 3 SRMH true HOSPICE OF LUBBOCK 3702 21ST STREET LUBBOCK TX 79410 752133781 HEALTHCARE TX 501(C)(3) 9 CHS true LUBBOCK METHODIST HOSPITAL FOUNDATION 3615 19TH STREET LUBBOCK TX 79410 752220963 HEALTHCARE TX 501(C)(3) 7 CHS true METHODIST HOSPITAL LEVELLAND 1900 COLLEGE AVENUE LEVELLAND TX 79336 752246348 HEALTHCARE TX 501(C)(3) 3 CHS true METHODIST HOSPITAL PLAINVIEW 2601 DIMMITT ROAD PLAINVIEW TX 79072 752426010 HEALTHCARE TX 501(C)(3) 3 CHS true MISSION HOSPITAL REGIONAL MEDICAL CTR 27700 MEDICAL CENTER ROAD MISSION VIEJO CA 92691 951643360 HEALTHCARE CA 501(C)(3) 3 CHN true QUEEN OF THE VALLEY MEDICAL CENTER 1000 TRANCAS STREET NAPA CA 94558 941243669 HEALTHCARE CA 501(C)(3) 3 SJHS true REDWOOD MEMORIAL FOUNDATION 3300 RENNER DRIVE FORTUNA CA 95540 942779313 HEALTHCARE CA 501(C)(3) 7 RMH true REDWOOD MEMORIAL HOSPITAL 3300 RENNER DRIVE FORTUNA CA 95540 941384665 HEALTHCARE CA 501(C)(3) 3 SJHS true SANTA ROSA MEMORIAL HOSPITAL 1165 MONTGOMERY DR SANTA ROSA CA 95405 941231005 HEALTHCARE CA 501(C)(3) 3 SJHS true SISTERS OF ST JOSEPH OF ORANGE 480 S BATAVIA ORANGE CA 92868 951643383 RELIGIOUS ORG CA 501(C)(3) 1 NA false SRM ALLIANCE HOSPITAL SERVICES (PVH) 400 NORTH MCDOWELL BLVD PETALUMA CA 94954 680395200 HEALTHCARE CA 501(C)(3) 3 SRMH true ST JOSEPH HEALTH MINISTRY 3345 MICHELSON DRIVE STE 100 IRVINE CA 92612 271666576 RELIGIOUS ORG CA 501(C)(3) 1 SSJO false ST JOSEPH HEALTH SYSTEM 3345 MICHELSON DRIVE STE 100 IRVINE CA 92612 953589356 HEALTHCARE CA 501(C)(3) 11, I SJHM false ST JOSEPH HEALTH SYSTEM FOUNDATION 3345 MICHELSON DRIVE STE 100 IRVINE CA 92612 330143024 HEALTHCARE CA 501(C)(3) 7 SJHS true ST JOSEPH HOME CARE NETWORK 1111 SONOMA STE 308 SANTA ROSA CA 95405 680331084 HEALTHCARE CA 501(C)(3) 9 SJHS true ST JOSEPH HOSPITAL OF EUREKA 2700 DOLBEER STREET EUREKA CA 95501 941156596 HEALTHCARE CA 501(C)(3) 3 SJHS true ST JOSEPH HOSPITAL OF ORANGE 1100 WEST STEWART DRIVE ORANGE CA 92868 951643359 HEALTHCARE CA 501(C)(3) 3 CHN true ST JUDE HOSPITAL YORBA LINDA 200 WEST CENTER ST PROMENADE ANAHEIM CA 92805 330185031 HEALTHCARE CA 501(C)(3) 3 SJHS true ST JUDE HOSPITAL INC 101 EAST VALENCIA MESA DRIVE FULLERTON CA 92635 951643324 HEALTHCARE CA 501(C)(3) 3 CHN true ST MARY MEDICAL CENTER 18300 HIGHWAY 18 APPLE VALLEY CA 92307 951914489 HEALTHCARE CA 501(C)(3) 3 CHN true ST MARY OF THE PLAINS HOSPITAL FDN 4000 24TH STREET LUBBOCK TX 79410 751653181 HEALTHCARE TX 501(C)(3) 7 CHS true TALLER SAN JOSE 801 NORTH BROADWAY SANTA ANA CA 92701 593816355 WORK DEVELOPM CA 501(C)(3) 2 SSJO true COVENANT LONG-TERM CARE LP SEE PART VII LUBBOCK TX 79410 205477251 HEALTHCARE TX NA N/A HEALTHCARE DESIGN & CONSTRUCT SEE PART VII LUBBOCK TX 79410 REAL ESTATE DE NA N/A HEALTHCARE PROPERTY ADVISORS SEE PART VII LUBBOCK TX 79410 REAL ESTATE DE NA N/A HERITAGE INVESTMENT GROUP SEE PART VII LUBBOCK TX 79410 INVESTMENTS CA NA N/A HOAG ORTHOPEDIC INSTITUTE SEE PART VII LUBBOCK TX 79410 HEALTHCARE CA NA N/A LUBBOCK SURGERY CENTER LTD SEE PART VII LUBBOCK TX 79410 HEALTHCARE TX NA N/A METHODIST DIAGNOSTIC IMAGING SEE PART VII LUBBOCK TX 79410 HEALTHCARE TX NA N/A MISSION AMBULATORY SURGICENTER HEALTHCARE CA NA N/A NEWPORT IMAGING CENTER HEALTHCARE CA NA N/A SHA LLC INSURANCE TX NA N/A ST JOSEPH PHYSICIAN VENTURES REAL ESTATE CA NA N/A ST JOSEPH HLTH SYS HOME CARE HOME HEALTH CA NA N/A ST JOSEPH HLTH SYS HOME HLTH HOME HEALTH CA NA N/A THE INNOVATION INSTITUTE HEALTHCARE DE NA N/A TOTAL HEALTH ENVIRONMENT HEALTHCARE DE NA N/A ADVANCED SURGERY INSTITUTE LLC HEALTHCARE CA NA N/A NORTH BAY ENDOSCOPY CENTER HEALTHCARE CA NA N/A ALLIANCE PHYSICIAN SERVICES INACTIVE CA NA C-CORP AMERICAN UNITY GROUP LTD 90 PITTS BAY ROAD PEMBROKE HM08 BD CAPTIVE INSURANCE BD NA C-CORP COASTAL MANAGEMENT SERVICES ORGANIZATION 1 HOAG DRIVE BOX 6100 NEWPORT BEACH CA 92658 330676831 HEALTHCARE CA NA C-CORP DATU HEALTH INC 16150 MAIN CIRCLE DR SUITE 250 CHESTERFIELD MO 63017 463070062 IT SVCS MO NA C-CORP HMTS INC 1 HOAG DRIVE NEWPORT BEACH CA 92658 453583707 HEALTHCARE CA NA C-CORP HOAG MANAGEMENT SERVICES INC 1 HOAG DRIVE BOX 6100 NEWPORT BEACH CA 92658 330731587 HEALTHCARE CA NA C-CORP HPA REALTY INC 1 CENTERPOINTE DRIVE SUITE 200 LA PALMA CA 90623 300835291 REAL ESTATE 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 ST JOSEPH YORBA PARK INACTIVE CA NA C-CORP false false false false false false false false true true false true true false true true true true true 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 HEALTHCARE DESIGN AND CONSTRUCTION EIN: 46-2611662 ADDRESS: 1 CENTERPOINTE DRIVE SUITE 200, LA PALMA, CA 90623-1052 HEALTHCARE PROPERTY ADVISORS, LLC EIN: 46-5497794 ADDRESS: 1 CENTERPOINTE DRIVE SUITE 200, LA PALMA, CA 90623-1052 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 LUBBOCK SURGERY CENTER, LTD. EIN: 75-2177401 ADDRESS: 4000 24TH STREET, LUBBOCK, TX 79410 METHODIST DIAGNOSTIC IMAGING EIN: 75-2343261 ADDRESS: 4005 24TH STREET, LUBBOCK, TX 79410 MISSION AMBULATORY SURGICENTER, LTD EIN: 33-0355575 ADDRESS: 27800 MEDICAL CENTER ROAD, STE 362, MISSION VIEJO, CA 92691 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 ST. JOSEPH HEALTH SYSTEM HOME CARE SERVICES EIN: 33-0307672 ADDRESS: 1845 W. ORANGEWOOD AVENUE, STE 100, ORANGE, CA 92868-2012 ST. JOSEPH HEALTH SYSTEM HOME HEALTH AGENCY EIN: 33-0282945 ADDRESS: 1845 W. 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 TOTAL HEALTH ENVIRONMENT EIN: 46-4807513 ADDRESS: 1 CENTERPOINTE DRIVE SUITE 200, LA PALMA, CA 90623-1052 ADVANCED SURGERY INSTITUTE LLC EIN: 26-2299255 ADDRESS: 1739 4TH STREET, SANTA ROSA, CA 95404 NORTH BAY ENDOSCOPY CENTER, LLC EIN: 61-1559876 ADDRESS: 1383 N. MCDOWELL BLVD SUITE 110, PETALUMA, CA 94954