COVENANT MEDICAL GROUP: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
COVENANT MEDICAL GROUP (EIN 75-2743883)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-13
IRS object ID
201311339349304936
Schema version
2011v1.5
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-05-13T19:26:07-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1401 CONGRESS AVENUE SUITE 1800AddressLine1
CityAUSTINCity
StateTXState
ZIP Code78701ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN752743883EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1COVENANT MEDICAL GROUPBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% MARK STEWARTInCareOfName
Name ControlCOVENameControl
Phone8067259800Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line13420 22ND PLACEAddressLine1
CityLUBBOCKCity
StateTXState
ZIP Code794101314ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJEANNA ADLERName
TitleCHIEF ACCOUNTING OFFICERTitle
Date Signed2013-05-13DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone5124789881Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSTEVE MCCAMYNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line13420 22ND PLACEAddressLine1
CityLUBBOCKCity
StateTXState
ZIP Code794101314ZIPCode
FieldValueIRS element (for citing)
Gross Receipts94731075GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.COVMEDGROUP.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1997YearFormation
State Legal DomicileTXStateLegalDomicile
Activity Or Mission DescriptionSEE SCHEDULE OActivityOrMissionDescription
Nbr Voting Members Governing Body17NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees792TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year92532435ProgramServiceRevenuePriorYear
Program Service Revenue CY94722277ProgramServiceRevenueCY
Investment Income Prior Year31571InvestmentIncomePriorYear
Investment Income Current Year8798InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year92564006TotalRevenuePriorYear
Total Revenue Current Year94731075TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year90997942SalariesEtcPriorYear
Salaries Etc Current Year93170796SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year22187717OtherExpensePriorYear
Other Expenses Current Year26764635OtherExpensesCurrentYear
Total Expenses Prior Year113185659TotalExpensesPriorYear
Total Expenses Current Year119935431TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-20621653RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-25204356RevenuesLessExpensesCY
Total Assets BOY32900572TotalAssetsBOY
Total Assets EOY29164572TotalAssetsEOY
Total Liabilities BOY58531854TotalLiabilitiesBOY
Total Liabilities EOY80000210TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-25631282NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-50835638NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSEE SCHEDULE OMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense111180680Expense
Grants0Grants
Revenue94722277Revenue
DescriptionSEE SCHEDULE ODescription
Total Program Service Expense111180680TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiestrueForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109646NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees792NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members17NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMARK STEWARTNamePerson
Telephone Number8067254639TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13420 22ND PLACEAddressLine1
CityLUBBOCKCity
StateTXState
ZIP Code79410ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
KERRY HENDERSHOT MD
BOARD MEMBER/CHAIRMAN50.0XX469231031800
DONALD QUICK MD
BOARD MEMBER/VICE CHAIRMAN50.0XX652933032271
DAVID GRAY DO
BOARD MEMBER/SECRETARY47.0XX368091029169
BILL ATKINSON MD
BOARD MEMBER50.0X740689022879
CHARLES BARTON MD
BOARD MEMBER50.0X481087020482
BID COOPER MD
BOARD MEMBER50.0X362101024422
SUSAN HAEFNER MD
BOARD MEMBER (PART YEAR)50.0X335785014588
PIYUSH MITTAL MD
BOARD MEMBER48.0X466945014888
NILESH PATEL MD
BOARD MEMBER50.0X371476030844
IKECHUKWU UMEZURIKE MD
BOARD MEMBER48.0X475051021561
PAUL WALTER MD
BOARD MEMBER/CMO48.0XX752496032498
JOHN ZIAS MD
BOARD MEMBER50.0X856601027515
CATHERINE RONAGHAN MD
BOARD MEMBER50.0X651359027616
MICHAEL OWEN MD
BOARD MEMBER50.0X447761022559
DAVID BLANN MD
BOARD MEMBER50.0X600825019633
FREDERICK HENSAL MD
BOARD MEMBER50.0X559533020799
LAURA BAKER MD
BOARD MEMBER50.0X000
KATIE HENDLEY MD
BOARD MEMBER50.0X6544706677
STEVE MCCAMY
PRESIDENT/CEO OF CMG45.0X068060633969
KRISTEN KOTHMANN
VP/COO OF CMG50.0X025586239117
MARK STEWART
VP OF FINANCE/TREASURER50.0X182597027816
JUAN KURDI MD
PHYSICIAN50.0206839606862X
JASON BRADLEY MD
PHYSICIAN50.01284596027323X
DARRELL FRANKS MD
PHYSICIAN50.01080675016707X
RICHARD RANNE MD
PHYSICIAN50.01042875020850X
WILLIAM SPRINGER MD
PHYSICIAN50.01016731019113X
FieldValueIRS element (for citing)
Total Reportable Comp From Org15333281TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs936468TotalReportableCompFrmRltdOrgs
Total Other Compensation591958TotalOtherCompensation
Number Individuals GT100 K166NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MEDICUS HOSPITALISTS
7 INDUSTRIAL WAY UNIT 5SALEMNH03079MEDICAL SERVICES1529521
MEDICUS EMERGENCY MEDICINE LLC
7 INDUSTRIAL WAY UNIT 5SALEMNH03079MEDICAL SERVICES817407
MARK GITTINGS DO
3571 FAR WEST BLVDAUSTINTX78731MEDICAL SERVICES370620
JAMES WILLIAMS DO
1400 CARROLLTON AVEBALTIMOREMD21204MEDICAL SERVICES280160
JAMES GOEN
10601 SALEM AVELUBBOCKTX79424MEDICAL SERVICES141800
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICES6211107179234771792347
SVCS PROVIDED TO EXEMPT AFFILIATES5611102064611620646116
OTHER OPERATING REVENUE90009922838142283814
FieldValueIRS element (for citing)
Total Program Service Revenue94722277TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column8798TotalRevenueColumn
Exclusion$8,798ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column94731075TotalRevenueColumn
Related Or Exempt Function Income94722277RelatedOrExemptFunctionIncome
Exclusion$8,798ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total8847600Total
Program Services8657408ProgramServices
Management And General190192ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total68283735Total
Program Services65345517ProgramServices
Management And General2938218ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2276721Total
Program Services2043588ProgramServices
Management And General233133ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total10177845Total
Program Services9327287ProgramServices
Management And General850558ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3584895Total
Program Services3229517ProgramServices
Management And General355378ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total347748Total
Program Services71421ProgramServices
Management And General276327ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total12184Total
Management And General12184ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total10356038Total
Program Services9744475ProgramServices
Management And General611563ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total117857Total
Management And General117857ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total867084Total
Program Services698766ProgramServices
Management And General168318ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total836099Total
Program Services747763ProgramServices
Management And General88336ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total5774910Total
Program Services5344876ProgramServices
Management And General430034ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total81456Total
Program Services68926ProgramServices
Management And General12530ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total67768Total
Program Services17760ProgramServices
Management And General50008ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total406659Total
Program Services1924ProgramServices
Management And General404735ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1701393Total
Management And General1701393ManagementAndGeneral

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES54263155426315
ALL OTHER EXPENSES769124455137313987

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total119935431Total
Program Services111180680ProgramServices
Management And General8754751ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY472715BOY
EOY807833EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2018172BOY
EOY1157382EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY12550311BOY
EOY8702169EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY36440BOY
EOY153003EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY678622BOY
EOY318397EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY46277BOY
EOY49921EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis12629373LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec11796121LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1239911BOY
EOY833252EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY15858124BOY
EOY17142615EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY32900572BOY
EOY29164572EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY8509947BOY
EOY6060215EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY50021907BOY
EOY73939995EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY58531854BOY
EOY80000210EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-25631282BOY
EOY-50835638EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-25631282BOY
EOY-50835638EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY32900572BOY
EOY29164572EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-25204356ReconcilationRevenueExpenses
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis12629373OtherCostOrOtherBasis
Depreciation11796121Depreciation
Book Value833252BookValue
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildings
Total Of Book Value Land Buildings833252TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
PHYSICIAN RETIREMENT 457(B)14019954
PHYSICIAN RETIREMENT 457(F)1691139
PHYSICIAN DEFERRED COMP.1431522
FieldValueIRS element (for citing)
Total Book Value Other Assets17142615TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
DUE TO AFFILIATES$56,797,380
DUE TO PHYSICIANS - 457(F) & 457(B)$15,711,093
DUE TO PHYSICIANS DEFERRED COMP.$1,431,522
FieldValueIRS element (for citing)
Total Of Amounts73939995TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierCONSOLIDATED AUDIT FOOTNOTE FOR FIN 48 (ASC 740)Identifier
Return ReferenceSCHEDULE D, PART X, LINE 2ReturnReference
ExplanationACCOUNTING 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, 2012 OR 2011.Explanation

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable

FieldValueIRS element (for citing)
RegionCentral America and the CaribbeanRegion
Type Of Activities ConductedProgram ServicesTypeOfActivitiesConducted
Specific Services ProvidedCAPTIVE INSURANCESpecificServicesProvided
Total Expenditures65262TotalExpenditures
FieldValueIRS element (for citing)
Subtotal Amount Spent65262SubtotalAmountSpent
Total Amount Spent65262TotalAmountSpent
Transfer To Foreign CorptrueTransferToForeignCorp
Interest In Foreign TrustfalseInterestInForeignTrust
Own Foreign CorpfalseOwnForeignCorp
Passive Foreign Invest CofalsePassiveForeignInvestCo
Foreign PartnershipfalseForeignPartnership
Boycott CountriesfalseBoycottCountries

Form990 Schedule F Part V Form990ScheduleFPartV

FieldValueIRS element (for citing)
IdentifierMETHOD OF ACCOUNTINGIdentifier
Return ReferenceSCHEDULE F, Part I, LINE 3, COLUMN (F)ReturnReference
ExplanationTHE AMOUNT IN COLUMN (F) WAS DETERMINED USING THE ACCRUAL METHOD OF ACCOUNTING.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Discretionary Spending AccountXDiscretionarySpendingAccount
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredfalseSubstantiationRequired
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (24 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
KERRY HENDERSHOT MD
430590033244053970100000218000501031000
DONALD QUICK MD
64258203937064140100000222710685204000
DAVID GRAY DO
348335014615051410100000191690397260000
BILL ATKINSON MD
637829093612092480100000128790763568000
CHARLES BARTON MD
44660506343028139016670188150501569000
BID COOPER MD
326503030993046050100000144220386523000
SUSAN HAEFNER MD
325396035000688908000065880350373000
PIYUSH MITTAL MD
29844601592450925408000068880481833000
NILESH PATEL MD
305277057512086870100000208440402320000
IKECHUKWU UMEZURIKE MD
351670011813005251000215610496612000
PAUL WALTER MD
67977206533807386080000244980784994000
JOHN ZIAS MD
79950505062206474080000195150884116000
CATHERINE RONAGHAN MD
6409870395806414080000196160678975000
MICHAEL OWEN MD
374881065210076700100000125590470320000
DAVID BLANN MD
55305304135806414080000116330620458000
FREDERICK HENSAL MD
5494350368406414080000127990580332000
STEVE MCCAMY
0315698027189609301209800024169071457500
KRISTEN KOTHMANN
0156111058737041014017548021569029497900
MARK STEWART
112954044678024965066150212010210413000
JUAN KURDI MD
9603780109904208976000686202075258000
JASON BRADLEY MD
90902803652830102850800001932301311919000
DARRELL FRANKS MD
1014166060294062150100000670701097382000
RICHARD RANNE MD
1011461000314140800001285001063725000
WILLIAM SPRINGER MD
8208930189424064140001911301035844000

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SUPPLEMENTAL COMPENSATION INFORMATIONSCHEDULE J, PART I, LINE 1AEXECUTIVES RECEIVE A PERCENTAGE OF BASE COMPENSATION FOR DISCRETIONARY SPENDING. THESE AMOUNTS ARE INCLUDED IN OTHER REPORTABLE COMPENSATION.
FORM 990, SCHEDULE J, PART I, LINE 3THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX EXEMPT PARENT, COVENANT HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION.
FORM 990, SCHEDULE J, PART I, LINE 4BEXECUTIVES COULD PARTICIPATE IN A NON-QUALIFIED DEFERRED COMPENSATION PLAN UNDER INTERNAL REVENUE CODE 457(F). THE PLAN WAS FROZEN EFFECTIVE 12-31-07 AFTER WHICH TIME NO FURTHER CONTRIBUTIONS WERE PERMITTED TO THE PLAN. THIS PLAN WILL CEASE TO EXIST ONCE ALL BENEFITS HAVE BEEN DISTRIBUTED IN ACCORDANCE WITH THE PROVISIONS OF THE PLAN.
FORM 990, SCHEDULE J, PART I, LINE 7A PORTION OF THE EXECUTIVE'S SALARY IS PLACED "AT-RISK" AND IS 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. COVENANT MEDICAL GROUP (CMG) HAS A PAY FOR PERFORMANCE PROGRAM BASED ON OBTAINING RESULTS FOR SPECIFIC QUALITY METRICS. EACH PHYSICIAN IS MEASURED AGAINST THEIR ANNUAL PERFORMANCE REGARDING CLINICAL METRICS TIED TO THEIR SPECIALTY. A SCORECARD IS GENERATED FOR EACH PHYSICIAN THAT MEETS CMG'S ANNUAL ADMINISTRATIVE CRITERIA. THE PHYSICIANS ARE THEN ELIGIBLE TO RECEIVE A DISBURSEMENT GENERATED BY CMG'S SHARED SAVINGS CONTRACTS. EACH PHYSICIAN SCORECARD CONTAINS INDIVIDUAL, SPECIALTY, AND AGGREGATE QUALITY PERFORMANCE MEASURES WHERE A MONETARY PAYOUT IS ESTABLISHED BASED ON OBTAINING THE GOAL SET FOR EACH INDIVIDUAL MEASURE. FOR EXAMPLE: AN INTERNAL MEDICINE PHYSICIAN COULD HAVE A POTENTIAL MAXIMUM OF $10,000 AND HAS A SCORECARD WITH 10 METRICS EQUALLY WEIGHTED AT $1,000 EACH. IF THE PHYSICIAN ONLY REACHES THE GOAL ESTABLISHED FOR 7 OF THE 10 METRICS; THE PHYSICIAN WILL RECEIVE A PAYMENT FOR $7,000.

Schedule L IRS990ScheduleL

Loan Table LoanTable (3 entries)

Purpose Of LoanPurposeOfLoanLoan From OrganizationLoanFromOrganizationOriginal PrincipalOriginalPrincipalAmountBalance DueBalanceDueDefaultDefaultApproved By BoardApprovedByBoardWritten AgreementWrittenAgreement
KERRY HENDERSHOT MD
RETENTION BONUSX$60,00061286falsetruetrue
KATIE HENDLEY
EDUCATION STIPENDX$52,00038966falsetruetrue
RICHARD RANNE MD
TAIL COVERAGEX$70,00052751falsetruetrue
FieldValueIRS element (for citing)
Total Balance Due153003TotalBalanceDue

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990, PART I, LINE 1 & PART III, LINE 1AS A MEMBER OF THE ST. JOSEPH HEALTH SYSTEM (SJHS), COVENANT MEDICAL GROUP IS COMMITTED TO EXTENDING 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 PEOPLE IN THE COMMUNITIES WE SERVE. OUR MISSION IS REALIZED THROUGH THE DELIVERY OF QUALITY IN-PATIENT AND OUT-PATIENT SERVICES, AND FOCUSED COMMUNITY INITIATIVES AND PROGRAMS THAT ARE DEDICATED TO IMPROVING THE LIVES OF ALL WE SERVE.
PROGRAM SERVICE ACCOMPLISHMENTSFORM 990, PART III, LINE 4GROUNDED IN OUR COMMITMENT TO COMMUNITY AS A MEMBER OF THE ST. JOSEPH HEALTH SYSTEM (SJHS), COVENANT MEDICAL GROUP IS COMMITTED TO EXTENDING THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE. THAT MISSION HAS GUIDED OUR CATHOLIC HEALTHCARE MINISTRY SINCE THE OPENING OF OUR FIRST HOSPITAL IN EUREKA, CALIFORNIA NEARLY 100 YEARS AGO. BUT THE ROOTS OF COVENANT MEDICAL GROUP AND THE LESSONS TO SERVE OUR DEAR NEIGHBORS DATE BACK TO THE YEAR 1650 WHEN THE SISTERS FIRST CONGREGATION WAS FORMED IN LE PUY, FRANCE. SINCE THAT TIME, THE PEOPLE OF OUR ORGANIZATION CONTINUE TO ASSESS THE NEEDS OF THE COMMUNITIES WE SERVE, BUILD COLLABORATIVE PARTNERSHIPS WITH LOCAL RESIDENTS, BUSINESS AND COMMUNITY NOT-FOR-PROFITS, AND TOGETHER THROUGH THOSE PARTNERSHIPS, MEET COMMUNITY NEEDS. THE HEALTH SYSTEM IS ORGANIZED INTO THREE REGIONS--NORTHERN CALIFORNIA, SOUTHERN CALIFORNIA, AND WEST TEXAS/EASTERN NEW MEXICO - AND CONSISTS OF 14 ACUTE CARE HOSPITALS, AS WELL AS HOME HEALTH AGENCIES, HOSPICE CARE, OUT-PATIENT SERVICES, SKILLED NURSING FACILITIES, COMMUNITY CLINICS, AND PHYSICIAN ORGANIZATIONS. WHO WE ARE AND WHAT WE DO COVENANT MEDICAL GROUP "CARING FOR THE PEOPLE OF OUR REGION" OUR REGION: COVENANT MEDICAL GROUP IS HEADQUARTERED IN LUBBOCK, TEXAS, THE SITE OF THE SOUTHWEST'S PREEMINENT MEDICAL CENTER BETWEEN THE DALLAS / FORT WORTH METROPLEX AND PHOENIX. WITH A COUNTY POPULATION OF 250,000 AND SERVING AN AREA OF 1.2 MILLION PEOPLE IN THE REGION, LUBBOCK HAS MANY OF THE AMENITIES OF A LARGER METROPOLITAN AREA, INTERNATIONAL AIRPORT, GREAT SHOPPING AND RESTAURANTS, AND EXCELLENT PUBLIC AND PRIVATE SCHOOLS, YET RETAINING A WONDERFUL "SMALL-TOWN" ATMOSPHERE. OUR HEALTH SYSTEM'S REGIONAL CLINICS ARE LOCATED THROUGHOUT WEST TEXAS AND EASTERN NEW MEXICO. OUR REGIONAL CLINIC NETWORK CONTAINS SEVERAL OPERATIONALLY DIFFERENT MODELS. SOME ARE DIRECTLY OWNED AND OPERATED BY CMG; SOME ARE RURAL HEALTH CLINICS IN WHICH CMG SUPPLIES ITS EMPLOYED PHYSICIANS TO WORK FOR A RURAL HOSPITAL-OWNED FACILITY; SOME ARE RURAL HEALTH CLINICS IN WHICH THE PHYSICIANS ARE INDEPENDENT CONTRACTORS; AND SOME ARE SATELLITE CLINIC SITES TO WHICH CMG SUBSPECIALISTS TRAVEL A FEW TIMES PER MONTH. THESE REGIONAL CLINICS ARE INTEGRAL TO THE PROVISION OF PRIMARY CARE SERVICES TO THEIR LOCAL COMMUNITIES, AND ALSO SEND SUBSTANTIAL NUMBERS OF PATIENTS TO LUBBOCK FOR TERTIARY CARE THAT IS NOT AVAILABLE LOCALLY. COVENANT MEDICAL GROUP IS A NON-PROFIT, TAX-EXEMPT MEDICAL FOUNDATION THAT IS CERTIFIED UNDER TEXAS LAW TO EMPLOY PHYSICIANS AND PRACTICE MEDICINE. IT IS OWNED BY COVENANT HEALTH SYSTEM, BUT IS SELF-GOVERNING IN MOST ASPECTS, OTHER THAN FISCAL MATTERS. THERE IS A BOARD OF 17 PHYSICIANS WHO PROVIDE THE OVERSIGHT OF THE GROUP'S STRATEGIC PLANNING, POLICY DEVELOPMENT, RECRUITMENT AND CREDENTIALING, QUALITY IMPROVEMENT TASKS, RESEARCH, AND MEDICAL EDUCATION ACTIVITIES. ALL OF THE BOARD MEMBERS ARE ACTIVELY PRACTICING WITHIN CMG. THIS SELF-GOVERNING ASPECT OF CMG TENDS TO MAKE IT QUITE PHYSICIAN-FRIENDLY IN ITS POLICY DEVELOPMENT AND PLANNING IN THAT THE BOARD MEMBERS ARE IMMEDIATELY PERSONALLY IMPACTED IN THEIR OWN PRACTICE BY THEIR BOARD DECISIONS. FOR MORE INFORMATION ON COVENANT MEDICAL GROUP GO TO: WWW.COVMEDGROUP.ORG FOR MORE INFORMATION ON THE ST. JOSEPH HEALTH SYSTEM GO TO: WWW.STJOE.ORG
INDEPENDENT BOARD MEMBERSFORM 990,PART VI, LINE 1BCOVENANT MEDICAL GROUP HAS NO INDEPENDENT BOARD MEMBERS BECAUSE ALL BOARD MEMBERS ARE REQUIRED TO BE ACTIVE PHYSICIANS WITH LOYALTIES TO COVENANT HEALTH SYSTEM, THE TAX-EXEMPT PARENT.
DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PART VI, LINE 6COVENANT HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER OF COVENANT MEDICAL GROUP.
DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTSFORM 990, PART VI, LINE 7ACOVENANT MEDICAL GROUP HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE COVENANT MEDICAL GROUP BOARD. ALL TRUSTEE APPOINTMENTS THAT COME FROM THE COVENANT MEDICAL GROUP BOARD AS NOMINATIONS AND MUST BE APPROVED BY THE COVENANT HEALTH SYSTEM, AS THE CORPORATE MEMBER, ST. JOSEPH HEALTH SYSTEM, AS THE TAX-EXEMPT PARENT OF COVENANT HEALTH SYSTEM, AND THE ST. JOSEPH HEALTH MINISTRY, AS THE ORGANIZATIONAL SPONSOR.
DECISIONS REQUIRING APPROVALFORM 990, PART VI, LINE 7BTHE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE COVENANT HEALTH SYSTEM 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.
PROCESS USED BY MANAGMENT AND/OR GOVERNING BODY TO REVIEW 990FORM 990, PART VI, LINE 11BTHE FORM 990 IS PREPARED BY THE FINANCE DEPARTMENT BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION AS APPLICABLE. THE FORM 990 IS THEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. A COPY OF THE FORM 990 FILING IS THEN DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD FOR THE APRIL 2013 MEETING. DURING THE FINANCE COMMITTEE MEETING, MANAGEMENT PRESENTED AND DISCUSSED CERTAIN DISCLOSURES AND INFORMATION INCLUDED IN THE FORM 990. THE FINANCE COMMITTEE CHAIR THEN PROVIDES A SUMMARY AT THE FULL BOARD MEETING.
DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTERESTFORM 990, PART VI, LINE 12COFFICERS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANNUALLY ON THE CONFLICT OF INTEREST DISCLOSURE FORM THE EXISTENCE AND NATURE OF ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICT OF INTEREST HE/SHE MAY HAVE. ADDITIONALLY, DISCLOSURES SHALL BE MADE PROMPTLY ANYTIME 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. WHEN A CONFLICT OF INTEREST IS IDENTIFIED, SUCH CONFLICT IS DISCLOSED TO THE CONFLICTS & COMPENSATION COMMITTEE. IF THE CONFLICT INVOLVES A MEMBER OF THAT COMMITTEE, THE REMAINING COMMITTEE MEMBERS WILL REVIEW THE MATTER AND DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. THE OFFICER, TRUSTEE, OR KEY EMPLOYEE MAY NOT BE PRESENT DURING ANY MEETING IN WHICH THE COMMITTEE CONDUCTS IS EVALUATION, EXCEPT TO ANSWER QUESTIONS AS MAY BE NECESSARY. 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.
PROCESS USED TO DETERMINE COMPENSATIONFORM 990, PART V1, LINES 15A AND 15BTHE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX EXEMPT PARENT, COVENANT HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. THE EXECUTIVE COMPENSATION PROCESS AT ST. JOSEPH HEALTH SYSTEM IS ADMINISTERED BY A COMMITTEE OF INDEPENDENT TRUSTEES. THEY FOLLOW A BOARD-APPROVED CHARTER AND OVERALL EXECUTIVE COMPENSATION PHILOSOPHY. THE CHARTER EMPOWERS THE SJHS BOARD WORK LIFE COMMITTEE TO ADMINISTER THE EXECUTIVE COMPENSATION PROGRAM AND PROCESS ON BEHALF OF THE FULL BOARD OF TRUSTEES OF SJHS. OVERALL, THE PHILOSOPHY IS INTENDED TO REWARD A BROAD SPECTRUM OF HIGH ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE EXPECTATIONS, AS WELL AS THE RETENTION OF KEY MANAGEMENT TALENT. THE SJHS EXECUTIVE COMPENSATION PHILOSOPHY DEFINES THE MARKET FOR ADMINISTERING COMPENSATION AS A COMPARABLE SET OF NOT-FOR-PROFIT HEALTH CARE DELIVERY SYSTEMS. SJHS PROVIDES COMPENSATION TO ITS SENIOR EXECUTIVES IN THE FORM OF BASE SALARY, AN ANNUAL INCENTIVE PROGRAM, AND BENEFITS. TO FULFILL THEIR RESPONSIBILITY, THE COMMITTEE REGULARLY REVIEWS INFORMATION FROM MULTIPLE SOURCES OF MARKET DATA. THEY USE THIS INFORMATION TO SUPPORT THEIR DECISIONS REGARDING ONGOING EFFECTIVENESS AND ADMINISTRATION OF THE PROGRAM. THE WORK LIFE COMMITTEE IS COMPRISED OF SEVERAL INDEPENDENT MEMBERS OF THE BOARD. THE MEET AT LEAST 3 TIMES A YEAR AND MAKE ALL CRITICAL DECISIONS IN EXECUTIVE SESSION. THESE DECISIONS ARE DOCUMENTED IN DETAILED MINUTES AND APPROVED IN SUBSEQUENT MEETINGS. THE COMMITTEE IS EMPOWER TO ENGAGE OUTSIDE COUNSEL AND CONSULTING SUPPORT AS NEEDED. THE WORK LIFE COMMITTEE PERFORMED ITS LAST COMPENSATION REVIEW FOR ASSISTANT VICE PRESIDENTS, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, AND THE CHIEF EXECUTIVE OFFICER IN JUNE 2012.
AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLICFORM 990, PART VI, LINE 19THE 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.
SUPPLEMENTAL COMPENSATION INFORMATIONFORM 990 PART VIITHE BOARD MEMBERS LISTED IN FORM 990, PART VII THAT RECEIVED COMPENSATION FROM COVENANT MEDICAL GROUP WERE PAID FOR MEDICAL SERVICES PROVIDED TO THE ORGANIZATION, NOT FOR BOARD MEMBER SERVICES.
HOURS DEVOTED TO RELATED ORGANIZATIONSFORM 990, PART VIICERTAIN EXECUTIVES AND BOARD MEMBERS OF THIS ORGANIZATION ALSO DEVOTED TIME TO OTHER ENTITIES RELATED TO THE FILING ORGANIZATION. THE HOURS DEVOTED TO THE RELATED ORGANIZATIONS ARE NOT GENERALLY TRACKED BY THE ENTITY.
OVERSIGHT OR SELECTION PROCESSFORM 990, PART XII, QUESTION 2CTHE ST. JOSEPH HEALTH SYSTEM BOARD APPROVES THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (30 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
COVENANT HEALTH PARTNERS
3615 19TH STREETLUBBOCKTX79410611573313HEALTHCARETX501(C)(3)11, ICHStrue
COVENANT HEALTH SYSTEM
3615 19TH STREETLUBBOCKTX79410752765566HEALTHCARETX501(C)(3)3SJHSfalse
COVENANT HEALTH SYSTEM FOUNDATION
4000 24TH STREETLUBBOCKTX79410752897026HEALTHCARETX501(C)(3)7CHStrue
HOME CARE PARTNERS
1165 MONTGOMERY DRSANTA ROSACA95405680318656INACTIVECA501(C)(3)3SRMHtrue
HOSPICE OF LUBBOCK
1102 SLIDE ROADLUBBOCKTX79414752133781HEALTHCARETX501(C)(3)9CHStrue
LUBBOCK METHODIST HOSPITAL FOUNDATION
3615 19TH STREETLUBBOCKTX79410752220963HEALTHCARETX501(C)(3)7CHStrue
METHODIST CHILDREN'S HOSPITAL
3610 21ST STREETLUBBOCKTX79410752428911HEALTHCARETX501(C)(3)3CHStrue
METHODIST HOSPITAL LEVELLAND
1900 COLLEGE AVENUELEVELLANDTX79336752246348HEALTHCARETX501(C)(3)3CHStrue
METHODIST HOSPITAL PLAINVIEW
2601 DIMMITT ROADPLAINVIEWTX79072752426010HEALTHCARETX501(C)(3)3CHStrue
MISSION HOSPITAL REG MED CTR FDN
27700 MEDICAL CENTER ROADMISSION VIEJOCA92691330406118HEALTHCARECA501(C)(3)7MHRMCtrue
MISSION HOSPITAL REGIONAL MEDICAL CENTER
27700 MEDICAL CENTER ROADMISSION VIEJOCA92691951643360HEALTHCARECA501(C)(3)3SJHStrue
QUEEN OF THE VALLEY MEDICAL CENTER
1000 TRANCAS STREETNAPACA94558941243669HEALTHCARECA501(C)(3)3SJHStrue
REDWOOD MEMORIAL FOUNDATION
3300 RENNER DRIVEFORTUNACA95540942779313FOUNDATIONCA501(C)(3)7RMHtrue
REDWOOD MEMORIAL HOSPITAL
3300 RENNER DRIVEFORTUNACA95540941384665HEALTHCARECA501(C)(3)3SJHStrue
SANTA ROSA MEMORIAL HOSPITAL
1165 MONTGOMERY DRSANTA ROSACA95405941231005HEALTHCARECA501(C)(3)3SJHStrue
SISTERS OF ST JOSEPH OF ORANGE
480 S BATAVIAORANGECA92868951643383RELIGIOUS ORGCA501(C)(3)1NAfalse
SRM ALLIANCE HOSPITAL SERVICES
400 NORTH MCDOWELL BLVDPETALUMACA94954680395200HEALTHCARECA501(C)(3)3SRMHtrue
ST JOSEPH HEALTH FDN OF N CALIFORNIA
PO BOX 552SANTA ROSACA95405680338070INACTIVECA501(C)(3)11, ISRMHtrue
ST JOSEPH HEALTH MINISTRY
3345 MICHELSON DR STE 100IRVINECA92612271666576RELIGIOUS ORGCA501(C)(3)1SSJOfalse
ST JOSEPH HEALTH SYSTEM
3345 MICHELSON DR STE 100IRVINECA92612953589356HEALTHCARECA501(C)(3)11, ISJHMfalse
ST JOSEPH HEALTH SYSTEM FOUNDATION
3345 MICHELSON DR STE 100IRVINECA92612330143024HEALTHCARECA501(C)(3)7SJHStrue
ST JOSEPH HOME CARE NETWORK
170 PROFESSIONAL CENTER DR BROHNERT PARKCA94928680331084HEALTHCARECA501(C)(3)9SJHStrue
ST JOSEPH HOSPITAL OF EUREKA
2700 DOLBEER STREETEUREKACA95501941156596HEALTHCARECA501(C)(3)3SJHStrue
ST JOSEPH HOSPITAL OF ORANGE
1100 WEST STEWART DRIVEORANGECA92868951643359HEALTHCARECA501(C)(3)3SJHStrue
ST JUDE HOSPITAL YORBA LINDA
279 E IMPERIAL HWY 750FULLERTONCA92835330185031HEALTHCARECA501(C)(3)3SJHStrue
ST JUDE HOSPITAL INC
101 EAST VALENCIA MESA DRIVEFULLERTONCA92835951643325HEALTHCARECA501(C)(3)3SJHStrue
ST JUDE MEMORIAL FOUNDATION
1440 N HARBOR BLVD 200FULLERTONCA92835953607229HEALTHCARECA501(C)(3)11, ISJMCtrue
ST MARY MEDICAL CENTER
18300 HIGHWAY 18APPLE VALLEYCA92307951914489HEALTHCARECA501(C)(3)3SJHStrue
ST MARY OF THE PLAINS HOSPITAL FDN
4000 24TH STREETLUBBOCKTX79410751653181HEALTHCARETX501(C)(3)7CHStrue
TALLER SAN JOSE
801 NORTH BROADWAYSANTA ANACA92701593816355WORKFORCE DEVCA501(C)(3)2SSJOtrue

Form990 Schedule R Part III Form990ScheduleRPartIII (10 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsCode VCodeVAmountGeneral Or Managing PartnerGeneralOrManagingPartner
ST JOSEPH HLTH SYS HOME HLTH
SEE PART VIILUBBOCKTX79410752177401HOME HEALTHCANAN/A00false$0false
ST JOSEPH HLTH SYS HOME CARE
SEE PART VIILUBBOCKTX79410205477251HOME HEALTHCANAN/A00false$0false
METHODIST DIAGNOSTIC IMAGING
HEALTHCARE SVCSTXNAN/A00false$0false
SHA LLC
HEALTHCARE SVCSTXNAN/A00false$0false
LUBBOCK SURGERY CENTER LTD
HEALTHCARE SVCSTXNAN/A00false$0false
COVENANT LONG-TERM CARE LP
HEALTHCARE SVCSTXNAN/A00false$0false
HERITAGE INVESTMENT GROUP
INVESTMENTCANAN/A00false$0false
MISSION AMBULATORY SURGICENTER
HEALTHCARE SVCSCANAN/A00false$0false
COMPREHENSIVE IMAGING PARTNERS
HEALTHCARE SVCSCANAN/A00false$0false
ST JOSEPH PHYSICIAN VENTURES
REAL ESTATECANAN/A00false$0false

Form990 Schedule R Part IV Form990ScheduleRPartIV (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
ST JOSEPH PROF SVCS ENTERPRISES INC
3345 MICHELSON DR STE 100IRVINECA92612330155323HEALTHCARE SVCSCANAC-CORP00
AMERICAN UNITY GROUP LTD
CAPTIVE INSURANCENAC-CORP0058 PAR-LA-VILLE ROADHAMILTONHXBDBD
ALLIANCE PHYSICIAN SERVICES
INACTIVECANAC CORP00
MISSION VIEJO MEDICAL VENTURES
27800 MEDICAL CENTER RD 354MISSION VIEJOCA92691330212905HEALTHCARE SVCSCANAC CORP00
MISSION MEDICAL CENTER ASSOCIATION
27800 MEDICAL CENTER RD 354MISSION VIEJOCA92691330201044HEALTHCARE SVCSCANAC CORP00
ST JOSEPH YORBA PARK
INACTIVECANAC CORP00
LUBBOCK METHODIST HOSP SVCS
PO BOX 1201LUBBOCKTX79410752118585HEALTHCARE SVCSTXNAC CORP00
LUBBOCK METHODIST HOSP PRACTICE MGMT
2107 OXFORD STREET SUITE 300LUBBOCKTX79410752578995INACTIVETXNAC CORP00
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierIDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIPIdentifier
Return ReferenceSCHEDULE R, PART IIIReturnReference
ExplanationST. JOSEPH HEALTH SYSTEM HOME HEALTH AGENCY EIN: 33-0282945 ADDRESS: 1845 W. ORANGEWOOD AVENUE, STE. 200 ORANGE, CA 92868-2012 ST. JOSEPH HEALTH SYSTEM HOME CARE SERVICES EIN: 33-0307672 ADDRESS: 1845 W. ORANGEWOOD AVENUE, STE. 100 ORANGE, CA 92868-2012 METHODIST DIAGNOSTIC IMAGING EIN: 75-2343261 ADDRESS: 4005 24TH STREET LUBBOCK, TX 79410 SHA, LLC EIN: 75-2569094 ADDRESS: 12940 NORTH HIGHWAY 183 AUSTIN, TX 78750 LUBBOCK SURGERY CENTER, LTD. EIN: 75-2177401 ADDRESS: 4000 24TH STREET LUBBOCK, TX 79410 COVENANT LONG-TERM CARE, LP EIN: 20-5033419 ADDRESS: 4000 24TH STREET LUBBOCK, TX 79410 HERITAGE INVESTMENT GROUP I, LLC EIN: 27-1000061 ADDRESS: 3345 MICHELSON DR, STE 100 IRVINE, CA 92612 MISSION AMBULATORY SURGICENTER, LTD EIN: 33-0355575 ADDRESS: 27800 MEDICAL CENTER ROAD, STE. 362 MISSION VIEJO, CA 92691 COMPREHENSIVE IMAGING PARTNERS OF ORANGE COUNTY, LLC EIN: 26-4591502 ADDRESS: ONE CITY BOULEVARD WEST, SUITE 1100 ORANGE, CA 92868 ST. JOSEPH PHYSICIAN VENTURES I, LLC EIN: 45-4521884 ADDRESS: 1100 WEST STEWART DRIVE ORANGE, CA 92868Explanation

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