COVENANT MEDICAL GROUP: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- COVENANT MEDICAL GROUP (EIN 75-2743883)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-05-14
- IRS object ID
- 201241359349305394
- Schema version
- 2010v3.7
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-05-14T15:41:37-05:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 MAIN STREET SUITE 1100 | AddressLine1 |
| City | FORT WORTH | City |
| State | TX | State |
| ZIP Code | 76102 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 752743883 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COVENANT MEDICAL GROUP | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COVE | NameControl |
| Phone | 8067259800 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3420 22ND PLACE | AddressLine1 |
| City | LUBBOCK | City |
| State | TX | State |
| ZIP Code | 794101314 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JEANNA ADLER | Name |
| Title | CONTROLLER | Title |
| Date Signed | 2012-05-14 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8173351900 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | STEVE MCCAMY | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3420 22ND PLACE | AddressLine1 |
| City | LUBBOCK | City |
| State | TX | State |
| ZIP Code | 794101314 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 92564006 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.COVMEDGROUP.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1997 | YearFormation |
| State Legal Domicile | TX | StateLegalDomicile |
| Activity Or Mission Description | SEE SCHEDULE O | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 781 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 654709 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 102090263 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 92532435 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 59293 | InvestmentIncomePriorYear |
| Investment Income Current Year | 31571 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 102804265 | TotalRevenuePriorYear |
| Total Revenue Current Year | 92564006 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 91376180 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 90997942 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 33746324 | OtherExpensePriorYear |
| Other Expenses Current Year | 22187717 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 125122504 | TotalExpensesPriorYear |
| Total Expenses Current Year | 113185659 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -22318239 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -20621653 | RevenuesLessExpensesCY |
| Total Assets BOY | 38165390 | TotalAssetsBOY |
| Total Assets EOY | 32900572 | TotalAssetsEOY |
| Total Liabilities BOY | 49514146 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 58531854 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -11348756 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -25631282 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | SEE SCHEDULE O | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 103757039 | Expense |
| Grants | 0 | Grants |
| Revenue | 92532435 | Revenue |
| Description | SEE SCHEDULE O | Description |
| Total Program Service Expense | 103757039 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | true | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 36 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 781 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MARK STEWART | NamePerson |
| Telephone Number | 8067254639 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3420 22ND PLACE | AddressLine1 |
| City | LUBBOCK | City |
| State | TX | State |
| ZIP Code | 79410 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (26 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| KERRY HENDERSHOT MD | |||||||
| BOARD MEMBER/CHAIRMAN | 50.0 | X | X | 391973 | 0 | 17849 | |
| DONALD QUICK MD | |||||||
| BOARD MEMBER/VICE CHAIRMAN | 50.0 | X | X | 651123 | 0 | 26120 | |
| DAVID GRAY DO | |||||||
| BOARD MEMBER/SECRETARY | 50.0 | X | X | 307452 | 0 | 25138 | |
| BILL ATKINSON MD | |||||||
| BOARD MEMBER | 50.0 | X | 642313 | 0 | 19857 | ||
| CHARLES BARTON MD | |||||||
| BOARD MEMBER | 50.0 | X | 570036 | 0 | 14927 | ||
| JAMES BURKE MD | |||||||
| BOARD MEMBER (PARTIAL YEAR) | 50.0 | X | 633781 | 0 | 21857 | ||
| BID COOPER MD | |||||||
| BOARD MEMBER | 50.0 | X | 342899 | 0 | 21567 | ||
| SUSAN HAEFNER MD | |||||||
| BOARD MEMBER | 50.0 | X | 326389 | 0 | 13039 | ||
| PIYUSH MITTAL MD | |||||||
| BOARD MEMBER | 50.0 | X | 719389 | 0 | 13317 | ||
| NILESH PATEL MD | |||||||
| BOARD MEMBER | 50.0 | X | 339721 | 0 | 28349 | ||
| IKECHUKWU UMEZURIKE MD | |||||||
| BOARD MEMBER | 50.0 | X | 350027 | 0 | 17611 | ||
| PAUL D WALTER MD | |||||||
| BOARD MEMBER/CMO | 44.0 | X | X | 814806 | 0 | 28138 | |
| JOHN ZIAS MD | |||||||
| BOARD MEMBER | 50.0 | X | 821890 | 0 | 23138 | ||
| JOSEPH KILLEEN MD | |||||||
| BOARD MEMBER (PARTIAL YEAR) | 50.0 | X | 598779 | 0 | 25349 | ||
| JAMES HIGGINS MD | |||||||
| BOARD MEMBER (PARTIAL YEAR) | 50.0 | X | 301676 | 0 | 24638 | ||
| CATHERINE RONAGHAN MD | |||||||
| BOARD MEMBER | 50.0 | X | 671639 | 0 | 25349 | ||
| MICHAEL OWEN MD | |||||||
| BOARD MEMBER | 50.0 | X | 462490 | 0 | 19775 | ||
| DAVID BLANN MD | |||||||
| BOARD MEMBER | 50.0 | X | 610681 | 0 | 17932 | ||
| STEVE MCCAMY | |||||||
| PRESIDENT/CEO OF CMG | 50.0 | X | 0 | 505700 | 29893 | ||
| KRISTEN KOTHMANN | |||||||
| VP/COO OF CMG | 50.0 | X | 0 | 254787 | 36592 | ||
| MARK STEWART | |||||||
| VP OF FINANCE/TREASURER | 50.0 | X | 164864 | 0 | 18115 | ||
| JUAN KURDI MD | |||||||
| PHYSICIAN | 50.0 | 1687430 | 0 | 4967 | X | ||
| JANE GOLDTHORN | |||||||
| PHYSICIAN | 50.0 | 1278401 | 0 | 14932 | X | ||
| JASON BRADLEY MD | |||||||
| PHYSICIAN | 50.0 | 1249139 | 0 | 23138 | X | ||
| WILLIAM SPRINGER MD | |||||||
| PHYSICIAN | 50.0 | 966548 | 0 | 14927 | X | ||
| MUHAMMED ALI MD | |||||||
| PHYSICIAN | 50.0 | 938727 | 0 | 24769 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 15842173 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 760487 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 551283 | TotalOtherCompensation |
| Number Individuals GT100 K | 163 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| ROSE-TEXT INC | |||||
| PMB-218 PO BOX 65600 | LUBBOCK | TX | 79464 | TRANSCRIPTION SVCS | 602804 |
| COLLECTECH DIVERSIFIED INC | |||||
| PO BOX 12027 | LUBBOCK | TX | 79452 | COLLECTION AGENCY | 378890 |
| MEDICUS HOSPITALISTS | |||||
| 7 INDUSTRIAL WAY UNIT 5 | SALEM | NH | 03079 | MEDICAL SERVICES | 371623 |
| AMERI PRIDE LINEN | |||||
| 3508 MAGNOLIA | LUBBOCK | TX | 79404 | LINEN SERVICE | 281955 |
| JAMES GOEN | |||||
| 10601 SALEM AVE | LUBBOCK | TX | 79424 | MEDICAL SERVICES | 137400 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 9 | NumberOfContractorsGT100K |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SERVICES | 621110 | 68131989 | 68131989 |
| SVCS PROVIDED TO EXEMPT AFFILIATES | 561110 | 23564017 | 23564017 |
| OTHER OPERATING REVENUE | 900099 | 836429 | 836429 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 92532435 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 31571 | TotalRevenueColumn |
| Exclusion | $31,571 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 92564006 | TotalRevenueColumn |
| Related Or Exempt Function Income | 92532435 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $31,571 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9707694 | Total |
| Program Services | 9543981 | ProgramServices |
| Management And General | 163713 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 65904714 | Total |
| Program Services | 62741919 | ProgramServices |
| Management And General | 3162795 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2093980 | Total |
| Program Services | 1898407 | ProgramServices |
| Management And General | 195573 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9950220 | Total |
| Program Services | 8445700 | ProgramServices |
| Management And General | 1504520 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3341334 | Total |
| Program Services | 3079697 | ProgramServices |
| Management And General | 261637 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 489961 | Total |
| Program Services | 248556 | ProgramServices |
| Management And General | 241405 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34228 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 34228 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8198858 | Total |
| Program Services | 7358307 | ProgramServices |
| Management And General | 840551 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 106034 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 106034 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4594219 | Total |
| Program Services | 4500996 | ProgramServices |
| Management And General | 93223 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1010971 | Total |
| Program Services | 964267 | ProgramServices |
| Management And General | 46704 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5023653 | Total |
| Program Services | 4535735 | ProgramServices |
| Management And General | 487918 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72920 | Total |
| Program Services | 57344 | ProgramServices |
| Management And General | 15576 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 45103 | Total |
| Program Services | 6495 | ProgramServices |
| Management And General | 38608 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 604254 | Total |
| Program Services | 1924 | ProgramServices |
| Management And General | 602330 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1633805 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 1633805 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PHYSICIAN LOAN FORGIVENESS | Description |
| Total | 373711 | Total |
| Program Services | 373711 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 113185659 | Total |
| Program Services | 103757039 | ProgramServices |
| Management And General | 9428620 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 173935 | BOY |
| EOY | 472715 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7485721 | BOY |
| EOY | 2018172 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11133239 | BOY |
| EOY | 12550311 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44421 | BOY |
| EOY | 36440 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 887726 | BOY |
| EOY | 678622 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 190632 | BOY |
| EOY | 46277 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 12629373 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 11389462 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1844165 | BOY |
| EOY | 1239911 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16405551 | BOY |
| EOY | 15858124 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38165390 | BOY |
| EOY | 32900572 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10160595 | BOY |
| EOY | 8509947 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 486111 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38867440 | BOY |
| EOY | 50021907 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49514146 | BOY |
| EOY | 58531854 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -11348756 | BOY |
| EOY | -25631282 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -11348756 | BOY |
| EOY | -25631282 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38165390 | BOY |
| EOY | 32900572 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -20621653 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 6339127 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Land | Land | |
| Buildings | Buildings | |
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 12629373 | OtherCostOrOtherBasis |
| Depreciation | 11389462 | Depreciation |
| Book Value | 1239911 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildings | |
| Total Of Book Value Land Buildings | 1239911 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| PHYSICIAN RETIREMENT 457(B) | 12619606 |
| PHYSICIAN RETIREMENT 457(F) | 1810672 |
| PHYSICIAN DEFERRED COMP. | 1427846 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 15858124 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO AFFILIATES | $34,163,783 |
| DUE TO PHYSICIANS-457(F) & 457(B) | $14,430,278 |
| DUE TO PHYSICIANS DEFERRED COMP. | $1,427,846 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 50021907 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | CONSOLIDATED AUDIT FOOTNOTE FOR FIN 48 (ASC 740) | Identifier |
| Return Reference | SCHEDULE D, PART X, LINE 2 | ReturnReference |
| Explanation | 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 OR TAX BENEFITS, INTEREST OR PENALTIES WAS ACCRUED AT JUNE 30, 2011 OR 2010. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Discretionary Spending Account | X | DiscretionarySpendingAccount |
| Written Policy Re T And E Expenses | false | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (26 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KERRY HENDERSHOT MD | |||||||||||||
| 358292 | 0 | 26893 | 0 | 6788 | 0 | 0 | 0 | 17849 | 0 | 409822 | 0 | 0 | 0 |
| DONALD QUICK MD | |||||||||||||
| 638992 | 0 | 2852 | 0 | 9279 | 0 | 10000 | 0 | 16120 | 0 | 677243 | 0 | 0 | 0 |
| DAVID GRAY DO | |||||||||||||
| 305943 | 0 | 0 | 0 | 1509 | 0 | 10000 | 0 | 15138 | 0 | 332590 | 0 | 0 | 0 |
| BILL ATKINSON MD | |||||||||||||
| 639651 | 0 | 0 | 0 | 2662 | 0 | 10000 | 0 | 9857 | 0 | 662170 | 0 | 0 | 0 |
| CHARLES BARTON MD | |||||||||||||
| 444817 | 0 | 22383 | 0 | 102836 | 0 | 0 | 0 | 14927 | 0 | 584963 | 0 | 92756 | 0 |
| JAMES BURKE MD | |||||||||||||
| 615944 | 0 | 2681 | 0 | 15156 | 0 | 8000 | 0 | 13857 | 0 | 655638 | 0 | 0 | 0 |
| BID COOPER MD | |||||||||||||
| 318638 | 0 | 18976 | 0 | 5285 | 0 | 10000 | 0 | 11567 | 0 | 364466 | 0 | 0 | 0 |
| SUSAN HAEFNER MD | |||||||||||||
| 315652 | 0 | 2949 | 0 | 7788 | 0 | 8000 | 0 | 5039 | 0 | 339428 | 0 | 0 | 0 |
| PIYUSH MITTAL MD | |||||||||||||
| 299669 | 0 | 410223 | 0 | 9497 | 0 | 8000 | 0 | 5317 | 0 | 732706 | 0 | 0 | 0 |
| NILESH PATEL MD | |||||||||||||
| 289162 | 0 | 41427 | 0 | 9132 | 0 | 10000 | 0 | 18349 | 0 | 368070 | 0 | 0 | 0 |
| IKECHUKWU UMEZURIKE MD | |||||||||||||
| 246703 | 0 | 68874 | 0 | 34450 | 0 | 0 | 0 | 17611 | 0 | 367638 | 0 | 0 | 0 |
| PAUL D WALTER MD | |||||||||||||
| 685936 | 0 | 116756 | 0 | 12114 | 0 | 8000 | 0 | 20138 | 0 | 842944 | 0 | 0 | 0 |
| JOHN ZIAS MD | |||||||||||||
| 715989 | 0 | 92954 | 0 | 12947 | 0 | 8000 | 0 | 15138 | 0 | 845028 | 0 | 0 | 0 |
| JOSEPH KILLEEN MD | |||||||||||||
| 519927 | 0 | 70325 | 0 | 8527 | 0 | 10000 | 0 | 15349 | 0 | 624128 | 0 | 0 | 0 |
| JAMES HIGGINS MD | |||||||||||||
| 264170 | 0 | 31071 | 0 | 6435 | 0 | 10000 | 0 | 14638 | 0 | 326314 | 0 | 0 | 0 |
| CATHERINE RONAGHAN MD | |||||||||||||
| 582422 | 0 | 81491 | 0 | 7726 | 0 | 10000 | 0 | 15349 | 0 | 696988 | 0 | 0 | 0 |
| MICHAEL OWEN MD | |||||||||||||
| 364181 | 0 | 85717 | 0 | 12592 | 0 | 10000 | 0 | 9775 | 0 | 482265 | 0 | 0 | 0 |
| DAVID BLANN MD | |||||||||||||
| 519923 | 0 | 83042 | 0 | 7716 | 0 | 8000 | 0 | 9932 | 0 | 628613 | 0 | 0 | 0 |
| STEVE MCCAMY | |||||||||||||
| 0 | 306806 | 0 | 103807 | 0 | 95087 | 0 | 9772 | 0 | 20121 | 0 | 535593 | 0 | 0 |
| KRISTEN KOTHMANN | |||||||||||||
| 0 | 145985 | 0 | 51428 | 0 | 57374 | 0 | 14932 | 0 | 21660 | 0 | 291379 | 0 | 0 |
| MARK STEWART | |||||||||||||
| 110424 | 0 | 28412 | 0 | 26028 | 0 | 2417 | 0 | 15698 | 0 | 182979 | 0 | 0 | 0 |
| JUAN KURDI MD | |||||||||||||
| 883938 | 0 | 791627 | 0 | 11865 | 0 | 0 | 0 | 4967 | 0 | 1692397 | 0 | 0 | 0 |
| JANE GOLDTHORN | |||||||||||||
| 1030131 | 0 | 107980 | 0 | 140290 | 0 | 10000 | 0 | 4932 | 0 | 1293333 | 0 | 0 | 0 |
| JASON BRADLEY MD | |||||||||||||
| 881716 | 0 | 324512 | 0 | 42911 | 0 | 8000 | 0 | 15138 | 0 | 1272277 | 0 | 0 | 0 |
| WILLIAM SPRINGER MD | |||||||||||||
| 814274 | 0 | 144892 | 0 | 7382 | 0 | 0 | 0 | 14927 | 0 | 981475 | 0 | 0 | 0 |
| MUHAMMED ALI MD | |||||||||||||
| 715330 | 0 | 215231 | 0 | 8166 | 0 | 8000 | 0 | 16769 | 0 | 963496 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SUPPLEMENTAL COMPENSATION INFORMATION | SCHEDULE J, PART I, LINE 1A | ST. JOSEPH HEALTH SYSTEM ALLOWS FOR COMPANION TRAVEL FOR CERTAIN PRE-APPROVED, MINISTRY SPONSORED EVENTS. COMPANION TRAVEL IS TREATED AS TAXABLE COMPENSATION IN MOST CASES. IN THE CASE THAT COMPANION TRAVEL IS NOT TREATED AS TAXABLE COMPENSATION, THE INDIVIDUAL IS PROVIDING A SERVICE TO THE HEALTH SYSTEM AS A REPRESENTATIVE WITH KNOWLEDGE OF THE COMMUNITIES AND MINISTRIES WE SERVE. MEMBERS OF THE BOARD AND EXECUTIVE MANAGEMENT TEAM ARE SELECTED TO PARTICIPATE IN AN ANNUAL PILGRIMAGE TO LE PUY, FRANCE, WHERE THE SISTERS' FIRST CONGREGATION WAS FORMED. THE PURPOSE OF THE PILGRIMAGE IS FOR THE ORGANIZATION'S LEADERS TO DEVELOP A DEEPER UNDERSTANDING OF THE ROOTS AND HERITAGE OF THE ORGANIZATION IN ORDER TO CARRY OUT THE MISSION. COMPANION TRAVEL IS CONSIDERED TO BE AN ESSENTIAL PART OF THIS EXPERIENCE AND THE COMPANION ACTS AS A REPRESENTATIVE WITH KNOWLEDGE OF THE COMMUNITIES AND MINISTRIES WE SERVE. THE FOLLOWING OFFICER RECEIVED A BENEFIT FOR COMPANION TRAVEL THAT WAS INTENDED TO BE COMPENSATION. THE BENEFITS WERE PAID BY ST. JOSEPH HEALTH SYSTEM. STEVE MCCAMY - $7,014 EXECUTIVES RECEIVE A PERCENTAGE OF BASE COMPENSATION FOR DISCRETIONARY SPENDING. THESE AMOUNTS ARE INCLUDED IN OTHER REPORTABLE COMPENSATION. |
| SCHEDULE J, PART I, LINE 3 | THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX EXEMPT PARENT, COVENANT HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O FOR FORM 990, PART VI, LINE 15A FOR THE PROCESS USED BY COVENANT HEALTH SYSTEM'S PARENT TO DETERMINE EXECUTIVE COMPENSATION. | |
| SCHEDULE J, PART I, LINE 4B | EXECUTIVES 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. THE FOLLOWING INDIVIDUAL RECEIVED PAYMENT FROM THE 457(F) PLAN DURING THE YEAR: CHARLES BARTON, MD. - $92,756 | |
| SCHEDULE J, PART I, LINE 7 | A 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | BRUCE OWENS MD | NamePerson |
| Purpose Of Loan | SIGNING BONUS | PurposeOfLoan |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $30,000 | OriginalPrincipalAmount |
| Balance Due | 36440 | BalanceDue |
| Default | false | Default |
| Approved By Board | true | ApprovedByBoard |
| Written Agreement | true | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 36440 | TotalBalanceDue |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | TRANSACTIONS WITH INTERESTED PERSONS | Identifier |
| Return Reference | SCHEDULE L, PART II | ReturnReference |
| Explanation | SETTLEMENT REACHED WITH DR. BRUCE OWENS DECEMBER 2011. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (15 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990, PART I, LINE 1 & PART III, LINE 1 | 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 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 ACCOMPLISHMENTS | FORM 990, PART III, LINE 4 | GROUNDED 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 15 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 MEMBERS | FORM 990,PART VI, LINE 1B | COVENANT 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 STOCKHOLDERS | FORM 990, PART VI, LINE 6 | COVENANT HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER OF COVENANT MEDICAL GROUP. |
| DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS | FORM 990, PART VI, LINE 7A | COVENANT 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 ST. JOSEPH HEALTH SYSTEM, AS THE CORPORATE MEMBER, AND THE ST. JOSEPH HEALTH MINISTRY, AS THE ORGANIZATIONAL SPONSOR. |
| DECISIONS REQUIRING APPROVAL | FORM 990, PART VI, LINE 7B | THE 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 990 | FORM 990, PART VI, LINE 11B | THE 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 DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD FOR THE APRIL 2012 MEETING. DURING THE BOARD FINANCE COMMITTEE MEETING, MANAGEMENT PRESENTS AND DISCUSSES CERTAIN DISCLOSURES AND INFORMATION INCLUDED IN THE FORM 990. THE BOARD FINANCE COMMITTEE CHAIR THEN PROVIDES A SUMMARY AT THE FULL BOARD MEETING. |
| DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST | FORM 990, PART VI, LINE 12C | OFFICERS, 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 COMPENSATION | FORM 990, PART VI, LINES 15A AND 15B | 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 WORKLIFE 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 REGULARY REVIEWS INFORMATION FROM MULTIPLE SOURCES OF MARKET DATA. THEY USE THIS INFORMATION TO SUPPORT THEIR DECISIONS REGARDING ONGOING EFFECTIVENESS AND AMINISTRATION OF THE PROGRAM. THE WORKLIFE COMMITTEE IS COMPRISED OF SEVERAL INDEPENDENT MEMBERS OF THE BOARD. THE MEET AT LEAST 3 TIMES A YEAR. DECISIONS ARE DOCUMENTED IN DETAILED MINUTES AND APPROVED IN MEETINGS. THE COMMITTEE IS EMPOWERED TO ENGAGE OUTSIDE COUNSEL AND CONSULTING SUPPORT AS NEEDED. THE WORKLIFE COMMITTEE PERFORMED ITS LAST COMPENSATION REVIEW FOR ASSISTANT VICE PRESIDENTS, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, AND THE CHIEF EXECUTIVE OFFICER IN SEPTEMBER 2011. |
| AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC | FORM 990, PART VI, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE SJHS COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE SJHS INTERNET SITE. |
| SUPPLEMENTAL COMPENSATION INFORMATION | FORM 990, PART VII | THE 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 ORGANIZATIONS | FORM 990, PART VII | DURING THE FISCAL YEAR, THE FOLLOWING COVENANT MEDICAL GROUP (CMG) BOARD MEMBERS WERE ALSO BOARD MEMBERS OF COVENANT HEALTH PARTNERS (CHP), A RELATED TAX EXEMPT ORGANIZATION. THEY DEVOTED 46-48 HOURS PER WEEK TO CMG AND 2-4 HOURS PER WEEK TO CHP: DAVID GRAY, D.O. PIYUSH MITTAL, M.D. IKECHUKWU UMEZURIKE, M.D. MICHAEL OWEN, M.D. STEVE MCCAMY (PRESIDENT AND CEO OF COVENANT MEDICAL GROUP) IS COMPENSATED BY COVENANT HEALTH SYSTEM, THE TAX-EXEMPT PARENT OF COVENANT MEDICAL GROUP. HE DEVOTES 45 HOURS PER WEEK TO COVENANT MEDICAL GROUP AND 5 HOURS TO COVENANT HEALTH SYSTEM. KRISTIN KOTHMAN (VICE PRESIDENT AND COO OF COVENANT MEDICAL GROUP) IS COMPENSATED BY COVENANT HEALTH SYSTEM, THE TAX-EXEMPT PARENT OF COVENANT MEDICAL GROUP. SHE DEVOTES 50 HOURS PER WEEK TO COVENANT MEDICAL GROUP AND 0 HOURS TO COVENANT HEALTH SYSTEM. PAUL WALTER, M.D. SERVES ON THE BOARD OF DIRECTORS OF COVENANT HEALTH SYSTEM (CHS), COVENANT CHILDRENS HOSPITAL (CCH), COVENANT MEDICAL GROUP (CMG), AND COVENANT HEALTH PARTNERS (CHP). HE DEVOTES 2 HOURS PER WEEK TO CHS, 2 HOURS PER WEEK TO CCH, 2 HOURS PER WEEK TO CHP, AND 44 HOURS PER WEEK TO CMG. |
| OTHER CHANGES IN NET ASSETS OR FUND BALANCES | FORM 990, PART XI, LINE 5 | EQUITY TRANSFER OF $6,339,127 FROM COVENANT HEALTH SYSTEM. |
| OVERSIGHT OR SELECTION PROCESS | FORM 990, PART XII, QUESTION 2C | THE ST. JOSEPH HEALTH SYSTEM BOARD APPROVES THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT. |
| 409A DOCUMENT CORRECTION UNDER VI.B, VII.C & XI.A OF IRS NOTICE 2010-06 | DOCUMENT DEFECTS | 1) NAME AND SOCIAL SECURITY NUMBERS OF AFFECTED PARTICIPANTS: SEE (4) BELOW. NONE OF THE EMPLOYEES ARE INSIDERS. 2) THE 409A FAILURE OCCURRED WITH RESPECT TO THE COVENANT MEDICAL GROUP DEFERRED COMPENSATION PLAN ("PLAN"). 3) THE 409A PLAN FAILURES ARE ELIGIBLE FOR CORRECTION UNDER THE TERMS OF VI.B, VII.C AND XI.A OF IRS NOTICE 2010-6. THE EMPLOYER HAS TAKEN ALL ACTIONS REQUIRED BEFORE DECEMBER 31, 2010, AND OTHERWISE MET ALL REQUIREMENTS FOR SUCH CORRECTION. NO PARTICIPANT IS REQUIRED TO REPAY ANY AMOUNT TO THE PLAN IN A SUBSEQUENT TAX YEAR, NOR IS ANY AMOUNT REQUIRED TO BE INCLUDED IN INCOME UNDER 409A AS PART OF THE CORRECTION. THE CORRECTIVE AMENDMENT WAS SIGNED ON SEPTEMBER 12 6, 2010. THE DATE OF THE EVENT CAUSING THE AFFECTED PARTICIPANT TO INCLUDE HIS PLAN ACCOUNT IN GROSS INCOME WAS HIS VOLUNTARY TERMINATION DATE. 4) DESCRIPTION OF EACH FAILURE: NAME/SOCIAL SECURITY NUMBER: ENRICO AGUAS VOLUNTARY TERMINATION DATE: 4/3/2009 GROSS AMOUNT INVOLVED IN DOCUMENT FAILURE: $37,340 AMOUNT REPORTED AS INCLUDIBLE IN INCOME UNDER 409A: $0 PERCENTAGE OF AMOUNT INVOLVED IN DOCUMENT FAILURE REQUIRED TO BE INCLUDED IN INCOME UNDER 409A: 0% NAME/SOCIAL SECURITY NUMBER: THOMAS MCGILL VOLUNTARY TERMINATION DATE: 7/31/2009 GROSS AMOUNT INVOLVED IN DOCUMENT FAILURE: $139,194 AMOUNT REPORTED AS INCLUDIBLE IN INCOME UNDER 409A: $0 PERCENTAGE OF AMOUNT INVOLVED IN DOCUMENT FAILURE REQUIRED TO BE INCLUDED IN INCOME UNDER 409A: 0% NAME/SOCIAL SECURITY NUMBER: SATISH PATEL VOLUNTARY TERMINATION DATE: 7/31/2009 GROSS AMOUNT INVOLVED IN DOCUMENT FAILURE: $25,040 AMOUNT REPORTED AS INCLUDIBLE IN INCOME UNDER 409A: $0 PERCENTAGE OF AMOUNT INVOLVED IN DOCUMENT FAILURE REQUIRED TO BE INCLUDED IN INCOME UNDER 409A: 0% BECAUSE FORM 990 IS OPEN TO PUBLIC INSPECTION AND THE THREAT OF IDENTITY THEFT, SOCIAL SECURITY NUMBERS WILL BE PROVIDED BY SEPARATE COVER UPON WRITTEN REQUEST. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (31 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| CAMINO HEALTH CENTER | |||||||||
| 30300 CAMINO CAPISTRANO | SAN JUAN CAPISTRANO | CA | 92675 | 330574214 | HEALTHCARE | CA | 501(C)(3) | 7 | MHRMC |
| COVENANT HEALTH PARTNERS | |||||||||
| 3615 19TH STREET | LUBBOCK | TX | 79410 | 611573313 | HEALTHCARE | TX | 501(C)(3) | 11, I | CHS |
| COVENANT HEALTH SYSTEM | |||||||||
| 3615 19TH STREET | LUBBOCK | TX | 79410 | 752765566 | HEALTHCARE | TX | 501(C)(3) | 3 | SJHS |
| COVENANT HEALTH SYSTEM FOUNDATION | |||||||||
| 4000 24TH STREET | LUBBOCK | TX | 79410 | 752897026 | HEALTHCARE | TX | 501(C)(3) | 7 | CHS |
| HOME CARE PARTNERS | |||||||||
| 1165 MONTGOMERY DR | SANTA ROSA | CA | 95405 | 680318656 | INACTIVE | CA | 501(C)(3) | 3 | SRMH |
| HOSPICE OF LUBBOCK | |||||||||
| 1102 SLIDE ROAD | LUBBOCK | TX | 79414 | 752133781 | HEALTHCARE | TX | 501(C)(3) | 9 | CHS |
| LUBBOCK METHODIST HOSPITAL FOUNDATION | |||||||||
| 3615 19TH STREET | LUBBOCK | TX | 79410 | 752220963 | HEALTHCARE | TX | 501(C)(3) | 7 | CHS |
| METHODIST CHILDREN'S HOSPITAL | |||||||||
| 3610 21ST STREET | LUBBOCK | TX | 79410 | 752428911 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS |
| METHODIST HOSPITAL LEVELLAND | |||||||||
| 1900 COLLEGE AVENUE | LEVELLAND | TX | 79336 | 752246348 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS |
| METHODIST HOSPITAL PLAINVIEW | |||||||||
| 2601 DIMMITT ROAD | PLAINVIEW | TX | 79072 | 752426010 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS |
| MISSION HOSPITAL REG MED CTR FDN | |||||||||
| 27700 MEDICAL CENTER ROAD | MISSION VIEJO | CA | 92691 | 330406118 | HEALTHCARE | CA | 501(C)(3) | 7 | MHRMC |
| MISSION HOSPITAL REGIONAL MEDICAL CENTER | |||||||||
| 27700 MEDICAL CENTER ROAD | MISSION VIEJO | CA | 92691 | 951643360 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS |
| QUEEN OF THE VALLEY MEDICAL CENTER | |||||||||
| 1000 TRANCAS STREET | NAPA | CA | 94558 | 941243669 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS |
| REDWOOD MEMORIAL FOUNDATION | |||||||||
| 3300 RENNER DRIVE | FORTUNA | CA | 95540 | 942779313 | FOUNDATION | CA | 501(C)(3) | 7 | RMH |
| REDWOOD MEMORIAL HOSPITAL | |||||||||
| 3300 RENNER DRIVE | FORTUNA | CA | 95540 | 941384665 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS |
| SANTA ROSA MEMORIAL HOSPITAL | |||||||||
| 1165 MONTGOMERY DRIVE | SANTA ROSA | CA | 95405 | 941231005 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS |
| SISTERS OF ST JOSEPH OF ORANGE | |||||||||
| 480 S BATAVIA | ORANGE | CA | 92868 | 951643383 | RELIGIOUS ORG | CA | 501(C)(3) | 1 | NA |
| SRM ALLIANCE HOSPITAL SERVICES | |||||||||
| 400 NORTH MCDOWELL BLVD | PETALUMA | CA | 94954 | 680395200 | HEALTHCARE | CA | 501(C)(3) | 3 | SRMH |
| ST JOSEPH HEALTH FDN OF N CALIFORNIA | |||||||||
| PO BOX 552 | SANTA ROSA | CA | 95405 | 680338070 | INACTIVE | CA | 501(C)(3) | 11, I | SRMH |
| ST JOSEPH HEALTH MINISTRY | |||||||||
| 500 S MAIN STREET SUITE 400 | ORANGE | CA | 92868 | 271666576 | RELIGIOUS ORG | CA | 501(C)(3) | 1 | SSJO |
| ST JOSEPH HEALTH SYSTEM | |||||||||
| 500 S MAIN STREET SUITE 700 | ORANGE | CA | 92868 | 953589356 | HEALTHCARE | CA | 501(C)(3) | 11, I | SJHM |
| ST JOSEPH HEALTH SYSTEM FOUNDATION | |||||||||
| 500 S MAIN STREET SUITE 1000 | ORANGE | CA | 92868 | 330143024 | HEALTHCARE | CA | 501(C)(3) | 7 | SJHS |
| ST JOSEPH HOME CARE NETWORK | |||||||||
| 170 PROFESSIONAL CENTER DR B | ROHNERT PARK | CA | 94928 | 680331084 | HEALTHCARE | CA | 501(C)(3) | 9 | SJHS |
| ST JOSEPH HOSPITAL OF EUREKA | |||||||||
| 2700 DOLBEER STREET | EUREKA | CA | 95501 | 941156596 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS |
| ST JOSEPH HOSPITAL OF ORANGE | |||||||||
| 1100 WEST STEWART DRIVE | ORANGE | CA | 92868 | 951643359 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS |
| ST JUDE HOSPITAL YORBA LINDA | |||||||||
| 279 E IMPERIAL HWY 750 | FULLERTON | CA | 92835 | 330185031 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS |
| ST JUDE HOSPITAL INC | |||||||||
| 101 EAST VALENCIA MESA DRIVE | FULLERTON | CA | 92835 | 951643325 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS |
| ST JUDE MEMORIAL FOUNDATION | |||||||||
| 1440 N HARBOR BLVD 200 | FULLERTON | CA | 92835 | 953607229 | HEALTHCARE | CA | 501(C)(3) | 11, I | SJMC |
| ST MARY MEDICAL CENTER | |||||||||
| 18300 HIGHWAY 18 | APPLE VALLEY | CA | 92307 | 951914489 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS |
| ST MARY OF THE PLAINS HOSPITAL FDN | |||||||||
| 4000 24TH STREET | LUBBOCK | TX | 79410 | 751653181 | HEALTHCARE | TX | 501(C)(3) | 7 | CHS |
| TALLER SAN JOSE | |||||||||
| 801 NORTH BROADWAY | SANTA ANA | CA | 92701 | 593816355 | WORKFORCE DEV | CA | 501(C)(3) | 2 | SSJO |
Form990 Schedule R Part III Form990ScheduleRPartIII (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | Code VCodeVAmount | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ST JOSEPH HLTH SYS HOME HLTH | ||||||||||||||
| SEE PART VII | LUBBOCK | TX | 79410 | 752177401 | HOME HEALTH | CA | NA | N/A | 0 | 0 | false | $0 | false | 0.00000 |
| ST JOSEPH HLTH SYS HOME CARE | ||||||||||||||
| SEE PART VII | LUBBOCK | TX | 79410 | 205477251 | HOME HEALTH | CA | NA | N/A | 0 | 0 | false | $0 | false | 0.00000 |
| METHODIST DIAGNOSTIC IMAGING | ||||||||||||||
| HEALTHCARE SVCS | TX | NA | N/A | 0 | 0 | false | $0 | false | 0.00000 | |||||
| SHA LLC | ||||||||||||||
| HEALTHCARE SVCS | TX | NA | N/A | 0 | 0 | false | $0 | false | 0.00000 | |||||
| LUBBOCK SURGERY CENTER LTD | ||||||||||||||
| HEALTHCARE SVCS | TX | NA | N/A | 0 | 0 | false | $0 | false | 0.00000 | |||||
| COVENANT LONG-TERM CARE LP | ||||||||||||||
| HEALTHCARE SVCS | TX | NA | N/A | 0 | 0 | false | $0 | false | 0.00000 | |||||
| HERITAGE INVESTMENT GROUP | ||||||||||||||
| INVESTMENT | CA | NA | N/A | 0 | 0 | false | $0 | false | 0.00000 | |||||
| MISSION AMBULATORY SURGICENTER | ||||||||||||||
| HEALTHCARE SVCS | CA | NA | N/A | 0 | 0 | false | $0 | false | 0.00000 | |||||
| COMPREHENSIVE IMAGING PARTNERS | ||||||||||||||
| HEALTHCARE SVCS | CA | NA | N/A | 0 | 0 | false | $0 | false | 0.00000 | |||||
Form990 Schedule R Part IV Form990ScheduleRPartIV (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LUBBOCK METHODIST HOSPITAL PRACTICE MGMT | |||||||||||||||
| 2107 OXFORD STREET SUITE 300 | LUBBOCK | TX | 79410 | 752578995 | INACTIVE | TX | NA | C-CORP | 0 | 0 | 0.00000 | ||||
| LUBBOCK METHODIST HOSPITAL SERVICES INC | |||||||||||||||
| PO BOX 1201 | LUBBOCK | TX | 79410 | 752118585 | HEALTHCARE SVCS | TX | NA | C-CORP | 0 | 0 | 0.00000 | ||||
| ST JOSEPH PROF SRVS ENTERPRISES INC | |||||||||||||||
| 500 S MAIN STREET SUITE 700 | ORANGE | CA | 92868 | 330155323 | HEALTHCARE SVCS | CA | NA | C-CORP | 0 | 0 | 0.00000 | ||||
| AMERICAN UNITY GROUP LTD | |||||||||||||||
| CAPTIVE INSURANCE | NA | C-CORP | 0 | 0 | 0.00000 | 58 PAR-LA-VILLA RD | HAMILTON, HX | BD | BD | ||||||
| MISSION VIEJO MEDICAL VENTURES | |||||||||||||||
| 27800 MEDICAL CENTER RD 354 | MISSION VIEJO | CA | 92691 | 330212905 | HEALTHCARE SVCS | CA | NA | C-CORP | 0 | 0 | 0.00000 | ||||
| MISSION MEDICAL CENTER ASSOCIATION | |||||||||||||||
| 27800 MEDICAL CENTER RD 354 | MISSION VIEJO | CA | 92691 | 330201044 | HEALTHCARE SVCS | CA | NA | C-CORP | 0 | 0 | 0.00000 | ||||
| ST JOSEPH YORBA PARK | |||||||||||||||
| INACTIVE | CA | NA | C-CORP | 0 | 0 | 0.00000 | |||||||||
| ALLIANCE PHYSICIAN SERVICES | |||||||||||||||
| INACTIVE | TX | NA | C-CORP | 0 | 0 | 0.00000 | |||||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (44 entries)
| Amount InvolvedAmountInvolved |
|---|
| CAMINO HEALTH CENTER |
| 0 |
| COVENANT HEALTH PARTNERS |
| 0 |
| COVENANT HEALTH SYSTEM FOUNDATION |
| 0 |
| HOME CARE PARTNERS |
| 0 |
| HOSPICE OF LUBBOCK |
| 0 |
| LUBBOCK METHODIST HOSPITAL FOUNDATION |
| 0 |
| METHODIST CHILDREN'S HOSPITAL |
| 0 |
| METHODIST HOSPITAL LEVELLAND |
| 0 |
| METHODIST HOSPITAL PLAINVIEW |
| 0 |
| MISSION HOSPITAL REG MED CTR FDN |
| 0 |
| MISSION HOSPITAL REGIONAL MEDICAL CENTER |
| 0 |
| QUEEN OF THE VALLEY MEDICAL CENTER |
| 0 |
| REDWOOD MEMORIAL FOUNDATION |
| 0 |
| REDWOOD MEMORIAL HOSPITAL |
| 0 |
| SANTA ROSA MEMORIAL HOSPITAL |
| 0 |
| SRM ALLIANCE HOSPITAL SERVICES |
| 0 |
| ST JOSEPH HEALTH FDN OF N CALIFORNIA |
| 0 |
| ST JOSEPH HEALTH SYSTEM FOUNDATION |
| 0 |
| ST JOSEPH HOME CARE NETWORK |
| 0 |
| ST JOSEPH HOSPITAL OF EUREKA |
| 0 |
| ST JOSEPH HOSPITAL OF ORANGE |
| 0 |
| ST JUDE HOSPITAL YORBA LINDA |
| 0 |
| ST JUDE HOSPITAL INC |
| 0 |
| ST JUDE MEMORIAL FOUNDATION |
| 0 |
| ST MARY MEDICAL CENTER |
| 0 |
| ST MARY OF THE PLAINS HOSPITAL FOUNDATION |
| 0 |
| TALLER SAN JOSE |
| 0 |
| ST JOSEPH HEALTH SYSTEM HOME HEALTH AGENCY |
| 0 |
| ST JOSEPH HEALTH SYSTEM HOME CARE SERVICES |
| 0 |
| METHODIST DIAGNOSTIC IMAGING |
| 0 |
| SHA LLC |
| 0 |
| LUBBOCK SURGERY CENTER LTD |
| 0 |
| COVENANT LONG-TERM CARE LP |
| 0 |
| HERITAGE INVESTMENT GROUP I LLC |
| 0 |
| MISSION AMBULATORY SURGICENTER LTD |
| 0 |
| COMPREHENSIVE IMAGING PARTNERS OF OC LLC |
| 0 |
| AMERICAN UNITY GROUP LTD |
| 0 |
| ST JOSEPH PROF SVCS ENTERPRISES INC |
| 0 |
| ALLIANCE PHYSICIAN SERVICES |
| 0 |
| MISSION VIEJO MEDICAL VENTURES |
| 0 |
| MISSION MEDICAL CENTER ASSOCIATION |
| 0 |
| ST JOSEPH YORBA PARK |
| 0 |
| LUBBOCK METHODIST HOSPITAL SERVICES |
| 0 |
| LUBBOCK METHODIST HOSPITAL PRACTICE MGMT |
| 0 |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP | Identifier |
| Explanation | ST. 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: 500 S. MAIN STREET STE. 1000 ORANGE, CA 92868 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 | Explanation |
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