2015-05-12T11:08:51-05:00 2014-06-30 ERNST & YOUNG US LLP 41 S HIGH ST 1100 HUNTINGTON CTR COLUMBUS OH 43215 990 2013-07-01 383369438 COVENANT MEDICAL CENTER INC % KEVIN ALBOSTA COVE 9895836006 1447 N Harrison Suite Saginaw MI 48602 KEVIN ALBOSTA VP/CFO 2015-05-12 Diane L Bean P00104972 2013 2016-04-25 22:37:26Z Covenant Healthcare ED BRUFF 1447 N HARRISON SAGINAW MI 48602 566582470 false X www.covenanthealthcare.com X 1997 MI TO PROVIDE DIVERSE MEDICAL CARE TO MEET THE HEALTH CARE NEEDS of the 14 COUNTIES IN EAST CENTRAL MICHIGAN WE SERVE. 14 10 4826 425 127853 84000 2937916 1896301 483843245 541016102 18379563 18550948 7836405 5119119 512997129 566582470 0 0 0 0 266122545 276136928 0 0 0 215302133 256106011 481424678 532242939 31572451 34339531 555736306 594924132 292035317 278471450 263700989 316452682 X TO PROVIDE DIVERSE MEDICAL CARE TO MEET THE HEALTH CARE NEEDS OF THE 14 COUNTIES IN EAST CENTRAL MICHIGAN WE SERVE. false false 512889897 0 541016102 ONE OF THE LARGEST, MOST COMPREHENSIVE HEALTH CARE FACILITIES NORTH OF METRO DETROIT, COVENANT HEALTHCARE IS PREPARED TO RESPOND TO THE DIVERSE MEDICAL NEEDS OF OUR REGION. WE OFFER A BROAD SPECTRUM OF PROGRAMS AND SERVICES RANGING FROM OBSTETRICS, NEONATAL AND PEDIATRIC CARE, TO ACUTE CARE INCLUDING CARDIOLOGY, ONCOLOGY, SURGERY AND MANY OTHER SERVICES ON THE LEADING EDGE OF MEDICINE. ALL OF OUR PROGRAMS AND SERVICES EXEMPLIFY OUR COMMITMENT TO PROVIDING QUALITY, COMPASSIONATE CARE. AS A MEDICAL FACILITY WITH MORE THAN 600 BEDS AND A COMPLETE RANGE OF MEDICAL SERVICES, COVENANT HEALTHCARE STANDS READY TO MEET THE NEEDS OF THE 14 COUNTIES IN EAST CENTRAL MICHIGAN WE SERVE. WITH MORE THAN 20 INPATIENT AND OUTPATIENT FACILITIES, COVENANT HEALTHCARE OFFERS CONVENIENCE AND EASY ACCESS TO HIGH QUALITY CARE. THE MEDICAL CENTER PROVIDED THE FOLLOWING FOR THE FISCAL YEAR 2014: 6,889 WOMEN'S AND CHILDREN'S CASES, 2,955 CARDIOLOGY CASES, 3,703 GENERAL MEDICAL CASES, 2,785 ORTHOPEDIC CARE CASES, AND 2,395 PULMONARY cases. 512889897 true true false true false false false false false false true true false false true false false true false false true false false false false false true true false false true true false false false false false false false false true false true false false false true true true true false false true 259 0 true 4826 true true true true CJ false false false false false false false false X 14 10 false false false false true true true true true false false true true true true true true true true true true X KEVIN ALBOSTA 9895832769 1447 N HARRISON SAGINAW MI 48602 X JOHN SHELTON BOARD MEMBER 4.0 0.0 X 1198 CULLI DAMUTH BOARD MEMBER 4.0 0.0 X SPENCER MAIDLOW PRESIDENT/CEO 50.0 8.0 X X 1345037 0 318066 Gene Pickelman Board Member 4.0 0.0 X LAWRENCE SIMS VICE CHAIRMAN 4.0 0.0 X X GREGORY LUBBEN TREASURER 4.0 0.0 X X 864 MORRISON STEVENS SR BOARD MEMBER 4.0 0.0 X GARY RUMMEL BOARD MEMBER 4.0 0.0 X TERRY NEIDERSTADT CHAIRMAN 4.0 0.0 X X 1130 MORTON WELDY SECRETARY 4.0 0.0 X X 1198 SUSAN STEMLER BOARD MEMBER 4.0 0.0 X 1147 JOHN JOHNSON MD BOARD MEMBER 4.0 0.0 X 1130 DAVID MEYER BOARD MEMBER 4.0 0.0 X 864 DWIGHT MCNALLY BOARD MEMBER 4.0 0.0 X MARK GRONDA VICE PRESIDENT/CFO 50.0 8.0 X 646822 0 201115 EDWARD BRUFF VICE PRESIDENT 50.0 4.0 X 647848 0 259487 CAROL STOLL VICE PRESIDENT 50.0 4.0 X 339487 0 211702 DR JOHN KOSANOVICH VICE PRESIDENT 50.0 4.0 X 528347 0 198486 DANIEL GEORGE VICE PRESIDENT 50.0 4.0 X 349505 0 88692 TIM WENZEL VICE PRESIDENT 50.0 4.0 X 310987 0 165276 DR Anthony DeBari PHYSICIAN 50.0 0.0 X 715047 0 0 DR Umesh Badami PHYSICIAN 50.0 0.0 X 704459 0 0 Firas Alani Physician 50.0 0.0 X 702053 0 0 Manoj Sharma Physician 50.0 0.0 X 699436 0 0 Brian Debeaubien Physician 50.0 0.0 X 736851 0 0 STACY GOLDSHOLL FORMER VP/CMG 0.0 0.0 X 340205 0 0 8073615 0 1442824 175 true true false EPIC SYSTEMS CORP PO BOX 88314 MILWAUKEE WI 53288 IT MTC SUPPORT 2913319 REHABCARE GROUP PO BOX 502096 ST LOUIS MO 631502096 REHAB SERVICES 2559014 EXECUTIVE HEALTH RESOURCES PO BOX 822688 PHILADELPHIA PA 19182 CONSULTING SERVICES 1877427 OWENS AND MINOR 12199 COLLECTION CENTER DRIVE CHICAGO IL 60693 EQUIPMENT SERVICE 1323538 DICKINSON WRIGHT PLC 4800 FASHION SQ BLVD SAGINAW MI 48604 LEGAL SERVICES 1210190 83 0 615608 1280693 615608 1896301 PATIENT SERVICE REVENUE 621990 532872960 532872960 0 0 JOINT VENTURE OPERATIONS 621990 5469392 5469392 0 0 REBATE INCOME 900099 943772 943772 0 0 LAB BILLING 621500 1044534 940190 104344 0 EDUCATIONAL INCOME 611710 526135 526135 0 0 159309 159309 0 541016102 18203416 18203416 0 0 1756399 1756399 0 1756399 1756399 347532 347532 347532 347532 0 0 0 CAFETERIA SALES 722210 3359684 0 23509 3336175 MISCELLANEOUS REVENUE 900099 3036 0 0 3036 3362720 566582470 540911758 127853 23646558 0 0 0 0 0 0 0 0 6570512 6570512 0 0 476311 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false false SCHEDULE H, PART V, LINE 3 INPUT FROM COMMUNITY REPRESENTATIVES THE CHNA DATA WAS GATHERED USING THE FOUR MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) ASSESSMENTS: COMMUNITY THEMES AND STRENGTHS, LOCAL PUBLIC HEALTH SYSTEM, COMMUNITY HEALTH STATUS, AND FORCES OF CHANGE. IN AN ATTEMPT TO ACQUIRE BROAD COMMUNITY INPUT REGARDING THE HEALTH CONCERNS OF SAGINAW COUNTY RESIDENTS, INFORMATION WAS GATHERED AT VARIOUS PUBLIC MEETINGS THROUGHOUT THE COUNTY AND FROM AREA AGENCIES USING SURVEYS CONDUCTED. SCHEDULE H, PART V, LINE 4 CHNA HOSPITAL FACILITIES THE HOSPITAL CONTRIBUTES AND PARTICIPATES IN THE SAGINAW COUNTY ROAD MAP TO HEALTH (CHNA) PARTICIPATING WITH SAGINAW COUNTY DEPARTMENT OF PUBLIC HEALTH, ST MARY'S OF MICHIGAN, HEALTH DELIVERY, INC, SAGINAW INTERMEDIATE SCHOOL DISTRICT, SAGINAW COUNTY COMMUNITY MENTAL HEALTH AUTHORITY, AND ALIGNMENT SAGINAW. PART V, SECTION B, LINE 5A THE COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE FOUND AT THE FOLLOWING WEBSITE URL: HTTP://WWW.COVENANTHEALTHCARE.COM/MAIN/COMMUNITYINVOLVEMENT.ASPX SCHEDULE H, PART V, LINE 7 tHERE ARE SOME SERVICES THAT COVENANT CANNOT PROVIDE DUE TO LACK OF EXPERTISE AND FACILITIES. ONE SUCH NEED IS MENTAL HEALTH SERVICIES.IN THESE INSTANCES, COVANENT WORKS WITH SAGINAW COUNTY MENTAL HEALTH AUTHORITY TO PROVIDE THESE SERVICES. SCHEDULE H, PART V, LINE 19 THE HOSPITAL BILLS UNINSURED PATIENT GROSS CHARGES LESS ANY APPLICABLE FINANCIAL ASSISTANCE. SCHEDULE H, PART V, LINE 20D THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IS THE NET OF STANDARD CHARGES LESS APPLICABLE FINANCIAL ASSISTANCE. 28 IRVING CAMPUS 600 IRVING AVE SAGINAW MI 48602 PM&R, OCC HEALTH, EMPLOYEE WELLNESS HOUGHTON CAMPUS 1000 HOUGHTON AVE SAGINAW MI 48602 LABORATORY DR CASTILLO 6614 DIXIE HWY BRIDGEPORT TOWNSHIP MI 48722 PHYSICIAN OFFICE MED EXPRESS BAY CITYBAY PRIMARY CARE 2997 WILDER RD BAY CITY MI 48706 URGENT CARE/PHYSICIAN OFFICE MED EXPRESSBREAST IMAGING 5570 STATE STREET SAGINAW MI 48602 URGENT CARE COVENANT POB 800 COOPER AVE SAGINAW MI 48602 PHYSICIAN OFFICE COVT BREAST IMAGINGMED EXPRESSPRIMARY 600 N MAIN ST FRANKENMUTH MI 48734 URGENT CARE, IMAGING, PMR, PHYSICAIN OFFICE DR EASTONLAB 8767 GRATIOT RD SAGINAW MI 48609 PHYSICIAN OFFICE/LAB VNA 500 S HAMILTON SAGINAW MI 48602 HOME CARE HEMLOCK FAMILY MEDICINEMED EXPRESS 16440 GRATIOT RD HEMLOCK MI 48626 URGENT CARE/PHYSICIAN OFFICE VASSAR PRIMARY CARE 201 W HURON AVE VASSAR MI 48768 PHYSICIAN OFFICE FREELAND PRIMARY CARE 7362 MIDLAND RD FREELAND MI 48623 PHYSICIAN OFFICE/LAB SBIM 3875 BAY ROAD 2S SAGINAW MI 48602 PHYSICIAN OFFICE VNA CARTWRIGHT CENTER 3443 HOSPITAL RD SAGINAW MI 48602 HOME HEALTH SAGINAW TWP FAMILY PRACTICE 3875 BAY RD SAGINAW MI 48602 PHYSICIAN OFFICE SILVERWOOD FAMILY MEDICINE 3037 SILVERWOOD DR SAGINAW MI 48602 PHYSICIAN OFFICE COVENANT PHYSIATRY 3350 SHATTUCK RD SAGINAW MI 48602 PHYSICIAN OFFICE MACKINAW CAMPUS 5400 MACKINAW RD SAGINAW MI 48602 HEALTHCARE OFFICE ECC 900 COOPER AVE SAGINAW MI 48602 ER-24 HRS DR JOHNSON 1430 N CENTER RD SAGINAW MI 48602 PHYSICIAN OFFICE GRATIOT FAMILY PRACTICE 1910 PINE AVE ALMA MI 48801 PHYSICIAN OFFICE COVENANT OCC HEALTH 1549 WASHINGTON ST MIDLAND MI 48640 OCC HEALTH CENTER FOR THE HEART 4884 BERL DR SAGINAW MI 48604 PHYSICIAN OFFICE WEST BRANCH PRIMARY CARE 335 E HOUGHTON AVE WEST BRANCH MI 48661 PHYSICIAN OFFICE BIRCH RUN PRIMARY CARE 8470 MAIN ST BIRCH RUN MI 48415 PHYSICIAN OFFICE SAGINAW VALLEY PRIMARY CAREMED EXPRESS 2970 PIERCE RD SAGINAW MI 48604 PHY OFFICE/PRIMARY CARE/URgent CARE DR BEAUBIEN 4701 TOWNE CENTRE RD SAGINAW MI 48604 PHYSICIAN OFFICE SEBEWAING PRIMARY CARE 616 UNIONVILLE RD SEBEWAING MI 48759 PHYSICIAN OFFICE SCHEDULE H, PART I, LINE 7 THE BEST AVAILABLE INFORMATION WAS USED TO CALCULATE THE COST IN LINE 7. COST IS BASED ON THE COST-TO-CHARGE RATIO. MEDICAID COST ON ROW (B.) CALCULATED USING RATIO OF COST TO CHARGE FROM WORKSHEET 3. SCHEDULE H, PART I, LINE 7, COLUMN (F) BAD DEBT EXPENSE THAT WAS SUBTRACTED FROM TOTAL EXPENSE TO OBTAIN THE PERCENTAGE OF THE COMMUNITY BENEFIT TO TOTAL EXPENSES AMOUNTED TO $32,542,991. THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE AND CURRENT MARKET CONDITIONS. THE RESULTS OF THESE REVIEWS ARE USED TO MAKE ANY MODIFICATIONS TO THE METHODOLOGY FOR ESTIMATING THE PROVISION FOR BAD DEBTS AND ESTABLISHING THE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, COVENANT HEALTHCARE FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES. SCHEDULE H, PART III, LINE 2 and 3 METHODOLOGY USED IN DETERMINING BAD DEBT THIS FIGURE IS A RESULT OF THE SHIFT FROM BAD DEBT TO FINANCIAL ASSISTANCE DUE TO PRESUMPTIVE CHARITY & THE IMPLEMENTATION OF SELF-PAY DISCOUNTING. ANOTHER CONTRIBUTING FACTOR IS THE EXPANSION OF MEDICAID, THEREFORE DECREASING THE NUMBER OF SELF-PAY ACCOUNTS. FOOTNOTE TO AUDITED FINANCIAL STATEMENTS SCHEDULE H, PART III, LINE 4 THE PROVISION FOR BAD DEBTS IS BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE AND CURRENT MARKET CONDITIONS. THE RESULTS OF THESE REVIEWS ARE USED TO MAKE ANY MODIFICATIONS TO THE METHODOLOGY FOR ESTIMATING THE PROVISION FOR BAD DEBTS AND ESTABLISHING THE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, COVENANT HEALTHCARE FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES. (FOOTNOTE 2, PAGE 10). SCHEDULE H, PART III, LINE 8 THE HOSPITAL REPORTED MEDICARE ALLOWABLE COST, AS REPORTED ON THE MEDICARE COST REPORT, ON WORKSHEET H, PART III, SECTION B, LINE 6. THE METHODOLOGY REMOVES NON-ALLOWABLE COST PER MEDICARE RULES AND OFFSETS OTHER OPERATING REVENUE AGAINST COST. PROFESSIONAL PART B COST IS ALSO REMOVED. THE COST OF SUPPORT DEPARTMENTS IS ALLOCATED TO REVENUE PRODUCING DEPARTMENTS USING THE STEP-DOWN METHODOLOGY. APPLICATION OF COLLECTION PRACTICES TO THOSE QUALIFYING FOR FINANCIAL ASSISTANCE SCHEDULE H, PART III, LINE 9B IT IS NOT OUR POLICY TO PURSUE COLLECTION AGAINST PATIENTS KNOWN TO QUALIFY FOR CHARITY CARE OR OTHER FINANCIAL ASSISTANCE. IN CERTAIN CASES IT MAY NOT BE EASILY DETERMINED WHETHER OR NOT A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE; HOWEVER; IF AFTER COLLECTION PRACTICES HAVE BEGUN IT LATER BECOMES KNOWN THAT A PATIENT QUALIFIES, THE COLLECTION EFFORTS CEASE. NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2 COVENANT HEALTHCARE WITH THE SAGINAW COUNTY HEALTH DEPARTMENT, SAGINAW SCHOOLS AND OTHER KEY PLAYERS TO DEVELOP A COMMUNITY HEALTH IMPROVEMENT PLAN. DATA FROM NUMEROUS SOURCES ARE UTILIZED TO PROVIDE THE STATISTICAL FOUNDATION FOR THE PLAN. THE METHOD USED TO DEVELOP THE PLAN FOLLOWS THE NATIONAL MODEL KNOWN AS MAPP - MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS. THIS MODEL WAS DEVELOPED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AND THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS (NACCHO). THE FOUR MAPP ASSESSMENTS INCLUDED COMMUNITY THEMES AND STRENGTHS, LOCAL PUBLIC HEALTH SYSTEM, COMMUNITY HEALTH ASSESSMENT, AND FORCES OF CHANGE. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI, LINE 3 COVENANT COMMUNICATES OUR CHARITY CARE AND FINANCIAL ASSISTANCE POLICY VIA THE COVENANT WEBSITE, A LETTER TO THE GUARANTOR IF BENEFIT ELIGIBILITY IS NOT ESTABLISHED, OR IN PERSON IF GUARANTOR INDICATES FINANCIAL NEED. COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4 COVENANT HEALTHCARE IS LOCATED IN SAGINAW COUNTY AND CLOSE TO 90% OF INPATIENT DISCHARGES ARE FROM PATIENT WITHIN THE COUNTY. HOWEVER, COVENANT DOES REACH OUT INTO THE SURROUNDING COUNTIES AND HAS RELATIONSHIPS WITH SEVERAL CRITICAL ACCESS HOSPITALS IN THE REGION. COVENANT CONSIDERS SIX COUNTIES (SAGINAW, BAY, MIDLAND, TUSCOLA, HURON, AND SANILAC) AS ITS PRIMARY MARKET. ANOTHER 14 COUNTIES IN THE REGION ARE CONSIDERED THE SECONDARY SERVICE AREA. COVENANT HEALTHCARE IS LOCATED IN CBSA 40980 SAGINAW-SAGINAW TOWNSHIP NORTH WITHIN SAGINAW COUNTY, MICHIGAN. AS OF THE 2010 CENSUS, SAGINAW COUNTY'S POPULATION WAS 200,169. THERE WERE 80,430 HOUSEHOLDS OUT OF WHICH 32.70% HAD CHILDREN UNDER THE AGE OF 18 LIVING WITH THEM, 50.20% WERE MARRIED COUPLES LIVING TOGETHER, 15.40% HAD A FEMALE HOUSEHOLDER WITH NO HUSBAND PRESENT, AND 30.60% WERE NON-FAMILIES. IN THE COUNTY THE POPULATION WAS SPREAD OUT WITH 26.60% UNDER THE AGE OF 18, 9.00% FROM 18 TO 24, 27.60% FROM 25 TO 44, 23.20% FROM 45 TO 64, AND 13.50% WHO WERE 65 YEARS OF AGE OR OLDER. THE MEDIAN AGE WAS 36 YEARS. THE MEDIAN INCOME FOR A HOUSEHOLD IN THE COUNTY WAS $38,637, AND THE MEDIAN INCOME FOR A FAMILY WAS $46,494. THE PER CAPITA INCOME FOR THE COUNTY WAS $19,438. ABOUT 11.00% OF FAMILIES AND 13.90% OF THE POPULATION WERE BELOW THE POVERTY LINE, INCLUDING 20.70% OF THOSE UNDER AGE 18 AND 9.50% OF THOSE AGE 65 OR OVER. THE JOBLESS RATE IN CALENDAR YEAR 2009 WAS 20.8% IN THE CITY OF SAGINAW, 12.5% IN SAGINAW COUNTY COMPARED TO 13.6% FOR THE STATE OF MICHIGAN AS A WHOLE. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5 COVENANT HEALTHCARE IS ACTIVELY INVOLVED IN COMMUNITY BUILDING INITIATIVES. LEADERSHIP FROM THROUGHOUT THE ORGANIZATION HOLD VOLUNTARY BOARD AND COMMITTEE POSITIONS IN COMMUNITY GROUPS AND ORGANIZATIONS FOCUSED ON IMPROVING THE QUALITY OF LIFE IN THE REGION, PARTICULARLY AROUND ISSUES OF COMMUNITY HEALTH. ADDITIONALLY, THE ORGANIZATION CONDUCTS COMMUNITY OUTREACH AND SCREENING ACTIVITIES IN THE VARIOUS COMMUNITIES IN OUR REGION TO IMPACT HEALTH IN SUCH WAYS AS EARLY DISEASE DETECTION TO TRAUMA PREVENTION. UNDER THE DIRECTION OF A VOLUNTEER COMMUNITY BOARD, COVENANT HEALTHCARE IS AN INTEGRAL PART OF THE COMMUNITIES IT SERVES. THE COVENANT VISION IS TO CONSISTENTLY DELIVER ON A PROMISE OF CARING AND A COMMITMENT TO SERVICE. GUIDED BY A SEPARATE VOLUNTEER BOARD, THE COVENANT HEALTHCARE FOUNDATION ASSISTS THE MEDICAL CENTER IN CARRYING OUT ITS SERVICE MISSION THROUGH THE ACQUISITION OF PHILANTHROPIC FUNDS TO SERVE AS A PRIME RESOURCE IN THE DELIVERY OF CARE TO THOSE COVENANT HEALTHCARE SERVES. THE ORGANIZATION USES ITS SURPLUS FUNDS TO CONDUCT COMMUNITY OUTREACH AND SCREENING ACTIVITIES IN THE VARIOUS COMMUNITIES IN OUR REGION TO IMPACT HEALTH IN SUCH WAYS AS EARLY DISEASE DETECTION TO TRAUMA PREVENTION. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM COVENANT MEDICAL CENTER IS A PART OF THE COVENANT HEALTH SYSTEM (DOING BUSINESS AS COVENANT HEALTHCARE). COVENANT HEALTHCARE IS A NON-PROFIT HEALTH SYSTEM THAT OFFERS A BROAD SPECTRUM OF PROGRAMS AND SERVICES RANGING FROM HIGH RISK OBSTETRICS, NEONATAL AND PEDIATRIC INTENSIVE CARE, TO ACUTE CARE INCLUDING A LEVEL II ADULT AND PEDIATRIC TRAUMA CENTER, CARDIOLOGY, ONCOLOGY, ORTHOPEDICS, ROBOTIC SURGERY AND MANY OTHER SERVICES ON THE LEADING EDGE OF MEDICINE. ALL PROGRAMS AND SERVICES EXEMPLIFY THE COVENANT COMMITMENT TO PROVIDING EXTRAORDINARY CARE FOR EVERY GENERATION. AS A MEDICAL FACILITY WITH 623 ACUTE CARE LICENSED BEDS, AND A COMPLETE RANGE OF MEDICAL SERVICES, COVENANT HEALTHCARE STANDS READY TO MEET THE HEALTH CARE NEEDS OF EAST CENTRAL MICHIGAN. WITH MORE THAN 20 INPATIENT AND OUTPATIENT FACILITIES AND A TRAUMA/EMERGENCY DEPARTMENT THAT PROVIDES 85,000 VISITS PER YEAR, COVENANT HEALTHCARE OFFERS CONVENIENCE AND EASY ACCESS TO HIGH QUALITY CARE THROUGHOUT THE REGION. SCHEDULE H, PART VI, LINE 7, STATE FILING STATE FILING OF COMMUNITY BENEFIT REPORT MICHIGAN X true true X X X true true false false false false false false false SPENCER MAIDLOW PRESIDENT/CEO 756629 0 231308 0 357100 0 305273 0 12793 0 1663103 0 14709 0 MARK GRONDA VICE PRESIDENT/CFO 402211 0 123348 0 121263 0 188049 0 13066 0 847937 0 27266 0 EDWARD BRUFF VICE PRESIDENT 485153 0 142388 0 20307 0 246421 0 13066 0 907335 0 14144 0 CAROL STOLL VICE PRESIDENT 252760 0 75503 0 11224 0 204919 0 6783 0 551189 0 15168 0 DR JOHN KOSANOVICH VICE PRESIDENT 393426 0 123312 0 11609 0 185693 0 12793 0 726833 0 14727 0 DANIEL GEORGE VICE PRESIDENT 253980 0 75747 0 19778 0 88692 0 0 0 438197 0 14127 0 TIM WENZEL VICE PRESIDENT 231518 0 66811 0 12658 0 152210 0 13066 0 476263 0 14202 0 DR Anthony DeBari PHYSICIAN 715047 0 0 0 0 0 0 0 0 0 715047 0 0 0 DR Umesh Badami PHYSICIAN 668745 0 35714 0 0 0 0 0 0 0 704459 0 0 0 Firas Alani Physician 652053 0 50000 0 0 0 0 0 0 0 702053 0 0 0 Manoj Sharma Physician 609102 0 90334 0 0 0 0 0 0 0 699436 0 0 0 STACY GOLDSHOLL FORMER VP/CMG 340205 0 0 0 0 0 0 0 0 0 340205 0 0 0 Brian Debeaubien Physician 714590 0 22261 0 0 0 0 0 0 0 736851 0 0 0 Supplemental Compensation Information SOCIAL CLUB AND HEALTH CLUB DUES SCHEDULE J, PART I, LINE 1A OFFICERS OF COVENANT MEDICAL CENTER GET HEALTH AND SOCIAL CLUB DUES PAID AND ARE INCLUDED AS TAXABLE INCOME. SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B THE ORGANIZATION MAINTAINS A NONQUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) FOR CERTAIN OF ITS EXECUTIVES. THE SERP HAS BEEN ESTABLISHED FOR THESE EXECUTIVES BY THE ORGANIZATION, FOLLOWING APPROPRIATE BOARD LEVEL REVIEW IN A MANNER INTENDED TO COMPLY WITH THE REBUTTABLE PRESUMPTION OF REASONABLENESS PROVISION UNDER IRC SECTION 4958. SPENCER MAIDLOW - $5,829 MARK GRONDA - $8,224 EDWARD BRUFF - $112,406 CAROL STOLL - $46,542 JOHN KOSANOVICH - $175,518 DANIEL GEORGE - $79,792 TIM WENZEL - $26,866 THE FOLLOWING SERP AMOUNTS ARE CURRENTLY TAXABLE TO THE INDIVIDUALS LISTED AND HAVE BEEN INCLUDED IN SCHEDULE J, PART II, COLUMN B(III): SPENCER MAIDLOW - $345,487 MARK GRONDA - $121,263 EDWARD BRUFF - $10,155 CAROL STOLL - $11,224 JOHN KOSANOVICH - $11,609 DANIEL GEORGE - $19,778 TIM WENZEL - $11,609 Severance Payments Stacy Goldscholl terminated in 2012. A separation payment of $340,204 was made January 2013. A CITY OF SAGINAW HOSP FIN AUTH 386004647 786744HJ4 2010-10-28 76448883 RETIRE 7/7/99 AND 7/12/00 BONDS false false false B CITY OF SAGINAW HOSP FIN AUTH 386004647 2014-04-25 31505000 RETIRE 4/7/2004 BONDS & NEW CONSTR false false false A 0 0 76458097 0 0 0 423626 0 0 0 76034471 0 2010 true false true true B 0 0 31506478 0 0 0 203513 0 0 10477943 20825022 0 2014 true false true true A 0 B false false false false 0.00000 0.00000 0.00000 false false false true A false true false false false false 0 false 0 false true B false true false false false false 0 false 0 false true A true B true INVESTMENT AMOUNTS INCLUDED IN PROCEEDS SCHEDULE K, PART II, LINE 3 COLUMN B BOND 2010 H - $76,458,097 - INCLUDES SALE PROCEEDS OF $76,448,883 PLUS ESCROW ACCOUNT EARNINGS $9,214. COLUMN C BOND 2014 - $31,506,478 - INCLUDES SALE PROCEEDS OF $31,505,000 PLUS THE DEBT SERVICE RESERVE FUND EARNINGS OF $1,478. DR JAMIE ROSS FAMILY OF BOARD MEMBER 322693 REPORTABLE COMPENSATION false Dr T DAMUTH FAMILY OF BOARD MEMBER 110000 REPORTABLE COMPENSATION false MARY PICKELMAN FAMILY OF BOARD MEMBER 43618 REPORTABLE COMPENSATION false Business Transactions Form 990, Schedule L, Part IV, Column C FEES FOR ALL SERVICES ARE AT ARM'S LENGTH MARKET RATES AND ARE CONTRACTED IN ACCORDANCE WITH THE HOSPITAL'S CONFLICT OF INTEREST POLICY. X EQUIP. (SUPPORT ORG) 1 615608 FMV false false false DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS Form 990, Part VI, Line 6 COVENANT HEALTHCARE SYSTEM IS THE SOLE CORPORATE MEMBER OF COVENANT MEDICAL CENTER COVENANT. DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS Form 990, Part VI, Line 7a THE CORPORATE MEMBER COVENANT HEALTHCARE SYSTEM MAY ELECT MEMBERS OF THE GOVERNING BODY. DESCRIPTION OF DECISIONS SUBJECT TO APPROVAL BY MEMBERS, STOCKHOLDERS OR OTHER PERSONS. Form 990, Part VI, Line 7b POWERS RESERVED BY THE SOLE MEMBER. THE FOLLOWING POWERS SHALL BE RESERVED FROM THE HOSPITAL, AND/OR SHALL REQUIRE THE AFFIRMATIVE ACTION OF THE SOLE MEMBER (ACTING THROUGH ITS BOARD OF DIRECTORS) IN ORDER TO BE EFFECTIVE: A. ALL MATTERS REQUIRING ACTION BY THE MEMBER OF A NONPROFIT CORPORATION UNDER THE LAWS OF THE STATE OF MICHIGAN; B. THE ELECTION OF THE BOARD OF DIRECTORS OF THE HOSPITAL; C. APPROVAL OF THE HOSPITAL BOARD'S SELECTION, OR VOTE TO TERMINATE THE PRESIDENT/CEO OF THE CORPORATION; D. APPROVAL OF THE INITIAL ARTICLES OF INCORPORATION AND BYLAWS OF THE corporation; E. APPROVAL OF THE AMENDMENT OF THE CORPORATION'S ARTICLES OF INCORPORATION OR BYLAWS; F. APPROVAL OF THE STATEMENT OF MISSION, VISION, VALUES, ROLES AND GOALS OF THE HOSPITAL, TOGETHER WITH ANY AMENDMENTS THERETO; G. APPROVAL OF THE ANNUAL OPERATING AND CAPITAL EXPENDITURE BUDGETS AND FINANCIAL GUIDELINES OF THE HOSPITAL; H. APPROVAL OF UNBUDGETED CAPITAL EXPENDITURES BY THE HOSPITAL IN EXCESS OF AN ANNUAL AGGREGATE PERCENTAGE OF THE TOTAL CAPITAL EXPENDITURE BUDGET FOR THE HOSPITAL AS ESTABLISHED FROM TIME TO TIME BY RESOLUTION OF THE SOLE MEMBER; I. APPROVAL OF ALL SECURED BORROWINGS OF THE HOSPITAL, OTHER THAN BORROWINGS SECURED FROM THE SOLE MEMBER; J. APPROVAL OF ALL UNSECURED BORROWINGS OF THE HOSPITAL, OTHER THAN FROM THE SOLE MEMBER, IN AN AMOUNT IN EXCESS OF $750,000 OR IN EXCESS OF AN ANNUAL AGGREGATE PERCENTAGE OF THE TOTAL ASSETS OF THE HOSPITAL AS ESTABLISHED FROM TIME TO TIME BY RESOLUTION OF THE SOLE MEMBER; K. APPROVAL OF THE GUARANTEE BY THE HOSPITAL OF THE INDEBTEDNESS OF ANOTHER IN AN AMOUNT IN EXCESS OF A PERCENTAGE OF THE TOTAL ASSETS OF THE HOSPITAL AS ESTABLISHED FROM TIME TO TIME BY RESOLUTION OF THE SOLE MEMBER; L. APPROVAL OF THE SALE, ALIENATION, EXCHANGE, LEASE OR OTHER DISPOSITION OF ASSETS OF THE HOSPITAL IN AN UNBUDGETED AMOUNT IN EXCESS OF AN ANNUAL AGGREGATE PERCENTAGE OF THE TOTAL ASSETS OF THE HOSPITAL AS ESTABLISHED FROM TIME TO TIME BY RESOLUTION OF THE SOLE MEMBER; M. APPROVAL OF THE ESTABLISHMENT OF ANY SUBSIDIARIES OR AFFILIATES OF THE HOSPITAL; N. APPROVAL OF THE ADOPTION, REVOCATION OR ABANDONMENT OF ANY PLAN OF DISSOLUTION OF THE HOSPITAL, OR ANY SUBSIDIARY OR AFFILIATE OF THE HOSPITAL; O. APPROVAL OF THE ADOPTION, REVOCATION OR ABANDONMENT OF ANY PLAN OF MERGER, CONSOLIDATION, SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS AND/OR PROPERTY OF THE HOSPITAL OR ANY SUBSIDIARY OR AFFILIATE OF THE HOSPITAL, OR ANY OTHER PLAN OF MAJOR CORPORATE CHANGE ADOPTED BY THE HOSPITAL OR ANY SUBSIDIARY OR AFFILIATE OF THE HOSPITAL; AND P. APPROVAL OF THE SELECTION OF AUDITORS BY THE HOSPITAL. DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 Form 990, Part VI, Line 11b MANAGEMENT PRESENTS AND REVIEWS THE 990 WITH THE BOARD FOR ITS APPROVAL PRIOR TO FILING. THE BOARD IS PROVIDED FINAL COPIES FOR REVIEW VIA THE INTERNET, ONCE APPROVED BY THE BOARD, THE FINAL 990 IS ULTIMATELY FILED WITH THE IRS. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST Form 990, Part VI, Line 12c THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST DISCLOSURE STATEMENTS TO ITS OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES. EACH PERSON COVERED BY THE POLICY IS REQUIRED TO SUBMIT AND AFFIRM IN WRITING TO THE CHIEF EXECUTIVE OFFICER AN ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENT LISTING ALL FINANCIAL INTERESTS, FAMILY AND BUSINESS RELATIONSHIPS, AND POTENTIAL CONFLICTS OF INTEREST AND PROVIDE UPDATES TO THIS AS NECESSARY. IN ADDITION, SUCH PERSONS HAVE AN OBLIGATION TO DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST AND ALL MATERIAL FACTS TO THE BOARD AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS. POTENTIAL CONFLICTS THAT ARE IDENTIFIED ARE BROUGHT TO THE ATTENTION OF THE CHAIRMAN AND VICE CHAIRMAN OF THE BOARD. THE CHAIRMAN OF THE BOARD IS REQUIRED TO BE AWARE OF SUCH POTENTIAL CONFLICTS SO AS TO BE ABLE TO DETERMINE THE PROPER COURSE OF ACTION SHOULD A MATTER INVOLVING SUCH SITUATION ARISE THAT WOULD REQUIRE ACTION. AFTER DISCLOSURE OF A POTENTIAL CONFLICT TO THE BOARD OR COMMITTEE, SUCH PERSON IS EXCUSED AND ALL OTHER REMAINING BOARD OR COMMITTEE MEMBERS MAKE A DETERMINATION OF WHETHER A CONFLICT EXISTS. ANY PERSON WITH A POTENTIAL CONFLICT CAN MAKE A PRESENTATION TO THE BOARD OR COMMITTEE ON THE PROPOSED TRANSACTION, BUT MUST RECUSE HIMSELF FROM DELIBERATION AND VOTING ON THE PROPOSED TRANSACTION OR ARRANGEMENT. THE BOARD OR COMMITTEE SHALL EXPLORE WHETHER A MORE ADVANTAGEOUS TRANSACTION OR AGREEMENT WITH REASONABLE EFFORTS CAN BE ENTERED INTO WITH A PERSON OR ENTITY THAT DOES NOT HAVE A CONFLICT OF INTEREST. IF NO REASONABLE ALTERNATIVE EXISTS, THE BOARD OR COMMITTEE SHALL DECIDE WHETHER SUCH TRANSACTION IS IN THE BEST INTERESTS OF THE ORGANIZATION AND IS FAIR AND REASONABLE BEFORE MAKING ITS DECISION ON WHETHER OR NOT TO ENTER INTO THE TRANSACTION. IF THE BOARD HAS REASONABLE CAUSE TO BELIEVE THAT AN OFFICER, DIRECTOR, KEY EMPLOYEE, OR TRUSTEE FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTERESTS, IT SHALL INFORM THE OFFICER, DIRECTOR, TRUSTEE, OR KEY EMPLOYEE OF THE BASIS FOR SUCH BELIEF AND AFFORD SAID PERSON AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. CORRECTIVE ACTION WILL BE TAKEN IF IT IS DETERMINED THAT A CONFLICT THAT WAS NOT DISCLOSED DOES EXIST. OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN Form 990, Part VI, Lines 15a and 15b EXECUTIVE SALARY RANGES ARE ESTABLISHED THROUGH IN DEPTH EXTERNAL MARKET STUDIES AND APPROVED BY THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS AND APPROVES COMPENSATION CHANGES FOR VICE PRESIDENTS, AS RECOMMENDED BY THE CEO. THE COMPENSATION COMMITTEE RECOMMENDS ANNUALLY TO THE BOARD OF DIRECTORS A PERFORMANCE RATING AND COMPENSATION CHANGES FOR THE CEO. THE BOARD OF DIRECTORS ACTS ON ALL RECOMMENDATIONS FROM THE COMPENSATION COMMITTEE. THIS PROCESS IS CONDUCTED ANNUALLY. AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY & FIN STMTS GEN PUBLIC Form 990, Part VI, Line 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. REPORTABLE COMPENSATION FROM THE ORGANIZATION FORM 990, PART VII, SECTION A, COLUMN (D) A 1099-MISC WAS ISSUED BY COVENANT MEDICAL CENTER TO THE FOLLOWING MEMBERS OF THE BOARD OF DIRECTORS: JOHN JOHNSON, JOHN SHELTON, DAVID MEYER, SUE STEMLER, TERRY NIEDERSTADT, GREG LUBBEN, AND MORT WELDY. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 9 PENSION OBLIGATION ADJUSTMENT - $6,840,476 OTHER ADJUSTMENT - ($3) TRANSFER TO VNA - ($333,906) OPEB ADJUSTMENT - ($3,827,805) TOTAL - $2,678,762 COVENANT MEDICAL OFFICE II LLC 1447 N HARRISON SAGINAW MI 48602 INACTIVE MI 0 0 NA COVENANT MACKINAW OFFICE LLC 1447 N HARRISON SAGINAW MI 48602 INACTIVE MI 0 0 NA J&F HOLDINGS 1447 N HARRISON SAGINAW MI 48602 382640101 INACTIVE MI 0 0 NA COVENANT HEALTHCARE FOUNDATION 1447 MN HARRISON SAGINAW MI 48602 382572154 SUPPORT MI 501(c)(3) 11 Type III CHS true VISITING NURSE SPECIAL SERVICES 502 S HAMILTON SAGINAW MI 48602 382762248 NURSE VISITS MI 501(c)(3) 9 CHS true COVENANT HEALTHCARE SYSTEM 1447 N HARRISON SAGINAW MI 48602 383369443 HEALTHCARE MI 501(c)(3) 11 Type II NA false VISITING NURSE ASSOCIATION OF SAGINAW 500 S HAMILTON SAGINAW MI 48602 454929618 HOME CARE MI 501(c)(3) 3 CHS true COVENANT HLCR MACKINAW PC 11221 ROE AVE SUITE 320 LEAWOOD KS 66211 205257296 rental MI CMC RELATED 176430 1215780 false 0 true 0.49020 COVENANT DEVELOPMENT CORP 1447 N HARRISON SAGINAW MI 48602 382640101 HEALTH SERVICES MI CHS C CORP true COVENANT MEDICAL CTR OFFICE CONDO ASSN 1447 N HARRISON SAGINAW MI 48602 371477767 CONDOMINIUM MI NA C Corp 12543 -181721 0.98740 true COVENANT HEALTHCARE MACKINAW CONDO 1447 N HARRISON SAGINAW MI 48602 453327179 CONDOMINIUM MI NA C Corp 41375 320917 0.49751 true COVENANT SERVICES CORP 1447 N Harrison Saginaw MI 48602 HEALTHCARE MI CHS C Corp true false false true false false false false false false false false false false false true false true true false COVENANT HEALTHCARE FOUNDATION c 615608 FMV COVENANT HEALTHCARE FOUNDATION o 459560 FMV COVENANT HEALTHCARE FOUNDATION q 935371 FMV VISITING NURSE ASSOCIATION r 333906 FMV