2011-05-09T16:02:22-05:00 2010-06-30 ERNST & YOUNG US LLP TWO NORTH CENTRAL AVENUE STE 2300 PHOENIX AZ 85004 990 2009-07-01 752743883 COVENANT MEDICAL GROUP COVE 8067259800 3420 22ND PLACE LUBBOCK TX 79410 STEVE MCCAMEY 2011-05-09 6023223000 2009 2016-02-24 21:20:13Z STEVE MCCAMY 3420 22ND PLACE LUBBOCK TX 79410 102804265 false X WWW.COVMEDGROUP.ORG X 1997 TX SEE SCHEDULE O 14 0 835 0 0 0 34094107 654709 102274185 102090263 102599 59293 0 0 136470891 102804265 0 0 0 0 94993677 91376180 0 0 0 26387422 33746324 121381099 125122504 15089792 -22318239 44514789 38165390 33300482 49514146 11214307 -11348756 SEE SCHEDULE O false false 101377450 0 102090263 SEE SCHEDULE O 101377450 true true false false false false false false false true false true false false false false false false false false false false false true false false false true false false false false false false false false false true true false false true 27 0 true 835 true false false false false false false false false false 14 0 false false false false true true true true true false false true true true true true true true true false X MARK STEWART 8067254639 3420 22ND PLACE LUBBOCK TX 79410 KERRY HENDERSHOT MD 40.0 X X 365016 0 17861 DONALD QUICK MD 40.0 X X 654464 0 34271 DAVID GRAY DO 40.0 X X 362136 0 29861 BILL ATKINSON MD 40.0 X 775693 0 26299 CHARLES BARTON MD 40.0 X 473165 0 27861 JAMES BURKE MD 40.0 X 792536 0 21169 BID COOPER MD 40.0 X 358576 0 28091 SUSAN HAEFNER MD 40.0 X 358011 0 15698 PIYUSH MITTAL MD 40.0 X 1147367 0 15771 NILESH PATEL MD 40.0 X 314154 0 35071 CATHERINE RONAGHAN MD 40.0 X 611272 0 33071 IKECHUKWU UMEZURIKE MD 40.0 X 296521 0 30933 PAUL WALTER MD 40.0 X 727547 0 27861 JOHN ZIAS MD 40.0 X 788952 0 27861 BRUCE OWENS MD 40.0 X 349812 0 11169 STEVE MCCAMY 40.0 X 0 388797 28110 KRISTEN KOTHMANN 40.0 X 0 195177 36172 MARK STEWART 40.0 X 33988 0 2880 JUAN KURDI MD 40.0 X 1851145 0 15698 THOMAS KERR MD 40.0 X 1450044 0 31487 JASON BRADLEY MD 40.0 X 1174136 0 28054 ATUL JOSHI MD 40.0 X 976054 0 28527 JANE GOLDTHORN MD 40.0 X 901923 0 20698 GLEN FRICK 0.0 X 92044 0 23241 14854556 583974 597715 171 true true false ROSE-TEXT INC PMB-218 PO BOX 65600 LUBBOCK TX 79464 TRANSCRIPTION 667869 COLLECTECH DIVERSIFIED INC PO BOX 12027 LUBBOCK TX 79452 COLLECTION AGENCY 387600 AMERI PRIDE LINEN 3508 MAGNOLIA LUBBOCK TX 79404 LINEN SERVICE 289066 MEDICAL DOCTOR ASSOCIATES INC PO BOX 277185 ATLANTA GA 303847185 MEDICAL SERVICES 168787 JAMES GOEN 10601 SALEM AVE LUBBOCK TX 79424 MEDICAL SERVICES 129400 14 654709 654709 NET PATIENT SERVICES 621110 73776565 73776565 SVCS PROVIDED TO EXEMPT AFFILIATES 561110 27914056 27914056 OTHER OPERATING REVENUE 900099 399642 399642 102090263 59293 59293 0 0 0 0 0 0 0 102804265 102090263 0 59293 0 0 0 0 8069359 6374794 1694565 0 0 68491835 54108550 14383285 0 1893365 1495758 397607 0 9453520 7468281 1985239 0 3468101 2739800 728301 0 270467 213669 56798 0 13596 10741 2855 0 0 0 0 0 6432219 5081453 1350766 0 162643 128488 34155 0 5313124 4197368 1115756 0 95146 75166 19980 0 0 5744968 4538525 1206443 0 61808 48828 12980 0 0 105181 83093 22088 0 0 0 692023 546698 145325 0 2378222 1878793 499429 0 BAD DEBT 12050824 12050824 0 0 PHYSICIAN LOAN FORGIVENESS 426103 336621 89482 0 125122504 101377450 23745054 0 4777327 173935 2280235 7485721 14519894 11133239 64032 44421 1229784 887726 160269 190632 12629373 10785208 2940669 1844165 18542579 16405551 44514789 38165390 9861011 10160595 1319445 486111 22120026 38867440 33300482 49514146 X 11214307 -11348756 11214307 -11348756 44514789 38165390 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 12629373 10785208 1844165 1844165 TMLT SURPLUS 879212 PHYSICIAN RETIREMENT 457(F) 1654782 PHYSICIAN RETIREMENT 457(B) 12553848 PHYSICIAN DEFERRED COMP. 1317709 16405551 0 DUE TO PHYSICIANS - 457(F) & 457(B) 14208630 DUE TO AFFILIATES 23341101 DUE TO PHYSICIANS - DEFERRED COMP 1317709 38867440 false true false false false false false true false KERRY HENDERSHOT MD 350930 0 8146 0 5941 0 0 0 17861 0 382877 0 0 0 DONALD QUICK MD 641061 0 4091 0 9312 0 15000 0 19271 0 688735 0 0 0 DAVID GRAY DO 325418 0 32043 0 4675 0 12000 0 17861 0 391997 0 0 0 BILL ATKINSON MD 689977 0 78060 0 7656 0 15000 0 11299 0 801992 0 0 0 CHARLES BARTON MD 444107 0 20553 0 8505 0 10000 0 17861 0 501026 0 0 0 JAMES BURKE MD 717695 0 61569 0 13272 0 10000 0 11169 0 813705 0 0 0 BID COOPER MD 328042 0 25399 0 5135 0 15000 0 13091 0 386667 0 0 0 SUSAN HAEFNER MD 346716 0 3942 0 7353 0 10000 0 5698 0 373709 0 0 0 PIYUSH MITTAL MD 415583 0 725466 0 6318 0 10000 0 5771 0 1163138 0 0 0 NILESH PATEL MD 281566 0 23061 0 9527 0 15000 0 20071 0 349225 0 0 0 CATHERINE RONAGHAN MD 575617 0 28008 0 7648 0 15000 0 18071 0 644343 0 0 0 IKECHUKWU UMEZURIKE MD 185516 0 78553 0 32452 0 10000 0 20933 0 327454 0 0 0 PAUL WALTER MD 717569 0 0 0 9978 0 10000 0 17861 0 755408 0 0 0 JOHN ZIAS MD 753748 0 24856 0 10348 0 10000 0 17861 0 816813 0 0 0 STEVE MCCAMY 0 306253 0 20327 0 62218 0 6191 0 21920 0 416908 0 0 KRISTEN KOTHMANN 0 144756 0 10070 0 40351 0 11776 0 24395 0 231348 0 0 JUAN KURDI MD 876744 0 964183 0 10218 0 10000 0 5698 0 1866843 0 0 0 THOMAS KERR MD 337351 0 36955 0 1075738 0 16500 0 14987 0 1481531 0 1064981 0 JASON BRADLEY MD 871344 0 248003 0 54788 0 10000 0 18054 0 1202190 0 0 0 ATUL JOSHI MD 967080 0 0 0 8974 0 10000 0 18527 0 1004581 0 0 0 JANE GOLDTHORN MD 833883 0 58862 0 9178 0 15000 0 5698 0 922621 0 0 0 GLEN FRICK 84534 0 0 0 7510 0 4698 0 18543 0 115285 0 0 0 BRUCE OWENS MD 334028 0 7628 0 8156 0 0 0 11169 0 360981 0 0 0 FORM 990, 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. FORM 990, 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 DECEMBER 31, 2007 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 PROVISIONS OF THE PLAN. THOMAS KERR RECEIVED A PAYMENT OF $1,064,981 FROM THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. FORM 990, 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. JASON BRADLEY MD EDUC. STIPEND X 126000 7981 false true true BRUCE OWENS MD SIGNING BONUS X 30000 36440 false true true 44421 FORM 990, PART I, LINE 1 & PART III, LINE 1 ORGANIZATION'S MISSION 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. MISSION TO EXTEND CHRISTIAN MINISTRY BY CARING FOR THE WHOLE PERSON - BODY, MIND AND SPIRIT - AND BY WORKING WITH OTHERS TO IMPROVE HEALTH AND QUALITY OF LIFE IN OUR COMMUNITIES. FORM 990, PART III, LINE 4 PROGRAM SERVICE ACCOMPLISHMENTS 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 LARGE METROPOLITAN AREA, INTERNATIONAL AIRPORT, GREAT SHOPPING AND RESTAURANTS, AND EXCELLENT PUBLIC AND PRIVATE SCHOOLS, YET RETAINING A WONDERFUL "SMALL-TOWN" ATMOSPHERE. IT IS BLESSED WITH A MAJOR UNIVERSITY, TEXAS TECH, WHICH ADDS MUCH TO OUR QUALITY OF LIFE WITH BIG 12 CONFERENCE SPORTING EVENTS, AND A VARIETY OF CULTURAL, AND ACADEMIC ACTIVITIES. TEXAS TECH UNIVERSITY SCHOOL OF MEDICINE ADDS HIGH QUALITY CONTINUING MEDICAL EDUCATION AND RESEARCH TO OUR REGION. COVENANT MEDICAL GROUP HAS NO FORMAL RESIDENCY TRAINING PROGRAMS OF ITS OWN, BUT SEVERAL OF OUR PHYSICIANS VOLUNTEER THEIR TIME FOR MEDICAL STUDENT AND RESIDENT TRAINING VIA A TEXAS TECH ASSOCIATION. OUR HEALTH SYSTEM'S REGIONAL CLINICS ARE LOCATED THROUGHOUT WEST TEXAS AND EASTERN NEW MEXICO. THESE CLINICS ARE LOCATED IN A VARIETY OF GEOGRAPHIC AREAS; FROM ROLLING RANCHLAND, TO HIGH PLATEAU FARMLAND, TO DESERT OIL FIELDS, TO RIVER VALLEYS WITH NEARBY ROCKY MOUNTAINS. THIS AREA OF REGIONAL CLINICS EXTENDS 100 TO 175 MILES FROM LUBBOCK AND COVERS A 63,000 SQUARE MILE AREA. THERE ARE TWO BEAUTIFUL NATIONAL PARKS (CARLSBAD CAVERNS AND GUADALUPE MOUNTAINS), A SCENIC SKI RESORT COMMUNITY (RUIDOSO, NEW MEXICO), AND TEXAS'S LARGEST STATE PARK (PALO DURO) WITHIN OUR REGIONAL CLINIC SERVICE AREA. OUR REGIONAL CLINIC NETWORK CONTAINS SEVERAL OPERATIONAL 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. OUR AREA'S TRUE STRENGTH IS ITS PEOPLE. THEY ARE SPIRITUAL, CARING, PROUD, INDEPENDENT, AND EXHIBIT A STRONG WORK ETHIC. OUR UNEMPLOYMENT RATE IS TYPICALLY IN THE 2 TO 3% RANGE. OUR ECONOMY IS DIVERSE, WITH ELEMENTS ASSOCIATED WITH MECHANIZED AGRICULTURE, THE PETROLEUM INDUSTRY, DISTRIBUTION CENTERS, HIGH TECH ENTITIES, AS WELL AS STRONG ELEMENTS BASED ON HIGHER EDUCATION AND HEALTHCARE. ITS DIVERSITY AND PROVINCIAL NATURE TYPICALLY ALLOWS IT TO REMAIN SOMEWHAT INSULATED FROM THE WIDE SWINGING CYCLES OF THE NATIONAL ECONOMY. OUR WEATHER FEATURES AN AVERAGE OF 18 INCHES OF PRECIPITATION ANNUALLY, LOW HUMIDITY, AND PLENTY OF SUNSHINE WHICH ENCOURAGES OUR POPULATION TO ENGAGE IN OUTDOOR ACTIVITIES. OUR 3,500 FOOT ELEVATION TENDS TO MAKE FOR COOL MORNINGS AND EVENINGS EVEN DURING A HOT SUMMER, AND RARELY DO WE EXPERIENCE PERSISTENT SNOW OR ICE. FOR THOSE WHO ENJOY WINTER AND MOUNTAIN SPORTS, WE ARE CONVENIENT TO THE ROCKY MOUNTAIN RESORTS OF RUIDOSO AND SANTA FE, NEW MEXICO. FOR THOSE THAT ENJOY BIG CITY WEEKEND ACTIVITIES AND PROFESSIONAL SPORTS, WE ARE 50 MINUTES FROM DALLAS AND 90 MINUTES FROM HOUSTON BY AIR. 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 12 PHYSICIANS WHO PROVIDE THE OVERSIGHT OF THE GROUP'S STRATEGIC PLANNING, POLICY DEVELOPMENT, RECRUITMENT AND CREDENTIALLING, 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. OUR ADMINISTRATION INCLUDES: STEVE MCCAMY (PRESIDENT AND CHIEF EXECUTIVE OFFICER), KRISTEN KOTHMANN (VICE PRESIDENT AND CHIEF OPERATING OFFICER), AND SEVEN DIRECTORS. CMG IS BY FAR THE AREA'S LARGEST MEDICAL GROUP WITH MORE THAN 200 PROVIDERS IN APPROXIMATELY 26 SPECIALTIES INCLUDING 20 MID-LEVEL PRACTITIONERS. OUR SPECIALTIES: WE CURRENTLY HAVE MEMBERS PRACTICING IN THE FOLLOWING SPECIALTIES. CMG OPERATES AS AN INTEGRATED GROUP PRACTICE FROM A REFERRAL STANDPOINT. WE ALLOW OUR PATIENTS IN CONSULTATION WITH THEIR PHYSICIAN TO BE THE PRIMARY DECISION-MAKER REGARDING REFERRALS FOR THE TERTIARY CARE THAT CANNOT BE PROVIDED IN THEIR LOCAL COMMUNITY. - ALLERGY & IMMUNOLOGY FAMILY - CARDIOLOGY - CARDIOVASCULAR/THORACIC SURGERY - ELECTROPHYSIOLOGY - EMERGENCY MEDICINE - FAMILY PRACTICE - FAMILY PRACTICE/SPORTS MEDICINE - HEMATOLOGY & MEDICAL ONCOLOGY - IN-PATIENT MEDICINE (HOSPITALISTS) - INTERNAL MEDICINE - MATERNAL-FETAL MEDICINE - NEPHROLOGY - NEUROLOGY - OBSTETRICS / GYNECOLOGY - ONCOLOGY - ORTHOPEDIC HAND SURGERY - ORTHOPEDIC SURGERY AND SPORTS MEDICINE - PEDIATRICS (GENERAL) - PEDIATRIC CARDIOLOGY - PEDIATRIC CARDIOVASCULAR/THORACIC SURGERY - PEDIATRIC GASTROENTEROLOGY - PEDIATRIC HEMATOLOGY/ONCOLOGY - PEDIATRIC INTENSIVE CARE - PEDIATRIC NEUROLOGY - PEDIATRIC SURGERY & TRAUMA SURGERY - PULMONARY - SURGERY (GENERAL) - SURGERY (ONCOLOGY) - SURGERY (WOUND CARE) 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 FORM 990,PART VI, LINE 1B INDEPENDENT BOARD MEMBERS 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. FORM 990, PART VI, LINE 6 DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS COVENANT HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER OF COVENANT MEDICAL GROUP. FORM 990, PART VI, LINE 7A DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS COVENANT MEDICAL GROUP HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT DIRECTORS TO THE COVENANT MEDICAL GROUP BOARD. ALL DIRECTOR APPOINTMENTS THAT COME FROM THE COVENANT MEDICAL GROUP BOARD AS NOMINATIONS MUST BE APPROVED BY 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. FORM 990, PART VI, LINE 7B DECISIONS REQUIRING APPROVAL 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. FORM 990, PART VI, LINE 11A PROCESS USED BY MANAGMENT AND/OR GOVERNING BODY TO REVIEW 990 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(S) OF THE ORGANIZATION. A COPY OF THE FORM 990 FILING IS THEN DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING. FORM 990, PART VI, LINE 12C DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST OFFICERS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE 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 SUBJECT OF THE POTENTIAL CONFLICT OF INTEREST. WHEN A CONFLICT OF INTEREST IS IDENTIFIED, SUCH CONFLICT IS DISCLOSED TO THE CONFLICTS & COMPENSATION COMMITTEE OF COVENANT HEALTH SYSTEM. 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 ITS 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. FORM 990, PART VI, LINES 15A AND 15B PROCESS USED TO DETERMINE COMPENSATION 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 REGULARLY 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. THEY MEET AT LEAST 3 TIMES A YEAR AND MAKE ALL CRITICAL DECISIONS IN EXECUTIVE SESSIONS. THESE DECISIONS ARE DOCUMENTED IN DETAILED MINUTES AND APPROVED IN SUBSEQUENT 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, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, AND THE CHIEF EXECUTIVE OFFICER IN JUNE 2010. FORM 990, PART VI, LINE 19 AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS TO THE GENERAL PUBLIC THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE SJHS COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE SJHS INTERNET SITE. FORM 990, PART VII SUPPLEMENTAL COMPENSATION INFORMATION 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. FORM 990, PART VII HOURS DEVOTED TO RELATED ORGANIZATIONS STEVE MCCAMY (PRESIDENT AND CEO OF COVENANT MEDICAL GROUP) AND KRISTEN KOTHMANN (VP AND COO OF COVENANT MEDICAL GROUP) ARE COMPENSATED BY COVENANT HEALTH SYSTEM, THE TAX-EXEMPT PARENT OF COVENANT MEDICAL GROUP. THEY DEVOTE 40 HOURS PER WEEK TO COVENANT MEDICAL GROUP AND 10 HOURS PER WEEK TO COVENANT HEALTH SYSTEM. FORM 990, PART XI, QUESTION 2C OVERSIGHT OR SELECTION PROCESS THE ST. JOSEPH HEALTH SYSTEM BOARD APPROVES THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT. SCHEDULE R, PART V, LINE 2 TRANSACTION WITH RELATED ORGANIZATIONS THE AMOUNTS REPORTED ON SCHEDULE R, PART V, LINE 2 ARE DETERMINED USING THE ACCRUAL METHOD OF ACCOUNTING. SECTION 409A RELIEF UNDER SECTION V.D. OF IRS NOTICE 2008-113 OPERATIONAL DEFECTS (A) NAMES AND SOCIAL SECURITY NUMBERS OF AFFECTED PARTICIPANTS: SEE (C) BELOW. NONE OF THE AFFECTED PARTICIPANTS ARE INSIDERS. (B) THE SECTION 409A FAILURE OCCURRED WITH RESPECT TO THE COVENANT MEDICAL GROUP DEFERRED COMPENSATION PLAN ("PLAN"). (C) OPERATIONAL DEFECT (1): IN FEBRUARY 2010 IT WAS DISCOVERED THAT THE PLAN FAILED TO COMPLY WITH SECTION 409A BECAUSE IT PROVIDED FOR IMPERMISSIBLE ALTERNATIVE PAYMENT SCHEDULES FOR VOLUNTARY AND INVOLUNTARY SEPARATIONS FROM SERVICE AND DID NOT SPECIFY THAT PAYMENT WILL BE MADE ON THE 90TH DAY FOLLOWING VOLUNTARY SEPARATION FROM SERVICE PROVIDED THE PARTICIPANT RETURNS BY THIS DEADLINE A SIGNED NON-COMPETE AGREEMENT. IN ACCORDANCE WITH SECTIONS VI.B, VII.C AND XI.A OF NOTICE 2010-6, THE PLAN WAS AMENDED EFFECTIVE AS OF JANUARY 1, 2009 TO APPLY THE TIMING RULE APPLICABLE TO INVOLUNTARY TERMINATIONS TO VOLUNTARY TERMINATIONS AND TO PROVIDE THAT PAYMENT WILL BE MADE ON THE 90TH DAY FOLLOWING VOLUNTARY SEPARATION FROM SERVICE PROVIDED THE PARTICIPANT RETURNS BY THIS DEADLINE A SIGNED NON-COMPETE AGREEMENT. THIS AMENDMENT WAS SIGNED BY THE EMPLOYER ON SEPTEMBER 12, 2010. THEREFORE, THE DATE ON WHICH THE FAILURE OCCURRED WAS THE 90TH DAY FOLLOWING THE PARTICIPANT SEPARATION FROM SERVICE DATE FOR THE FOLLOWING PARTICIPANTS WHO VOLUNTARILY TERMINATED IN 2009. (BECAUSE THE FORM 990 IS OPEN TO PUBLIC INSPECTION AND THE THREAT OF IDENTITY THEFT, SSNS WILL BE PROVIDED UPON REQUEST) NAME/SOCIAL SECURITY NUMBER: ENRICO AGUAS DATE OF WHEN THE FAILURE OCCURRED: 07/02/2009 12/31/2009 ACCOUNT BALANCE: $12,343 PAYMENT DATE: 12/17/2010 GROSS AMOUNT DISTRIBUTED*: $37,340 NAME/SOCIAL SECURITY NUMBER: THOMAS MCGILL DATE OF WHEN THE FAILURE OCCURRED: 10/29/2009 12/31/2009 ACCOUNT BALANCE: $139,194 PAYMENT DATE: 12/17/2010 GROSS AMOUNT DISTRIBUTED*: $139,194 NAME/SOCIAL SECURITY NUMBER: SATISH PATEL DATE OF WHEN THE FAILURE OCCURRED: 10/29/2009 12/31/2009 ACCOUNT BALANCE: $25,042 PAYMENT DATE: 12/17/2010 GROSS AMOUNT DISTRIBUTED*: $25,040 * DISTRIBUTIONS DID NOT INCLUDE ANY INTEREST EARNED AFTER DECEMBER 31, 2009 FOR PARTICIPANTS WHO TERMINATED IN 2009. OPERATIONAL DEFECT (2): IN 2010 IT WAS DISCOVERED THAT 3 PARTICIPANTS EMPLOYED BY OTHER PARTICIPATING EMPLOYERS WERE NOT TIMELY PAID THEIR PLAN ACCOUNTS FOLLOWING INVOLUNTARY TERMINATIONS IN 2009, AS REQUIRED BY THE PLAN. USUALLY, SUCH DISTRIBUTIONS ARE MADE WITHIN 30 DAYS FOLLOWING THE INVOLUNTARY TERMINATION DATE. THEREFORE, THE DATE ON WHICH THE FAILURE OCCURRED WAS THE 30TH DAY FOLLOWING THE INVOLUNTARY TERMINATION DATE. THE PLAN'S ADMINISTRATIVE PROCEDURES HAVE BEEN REVIEWED TO ASSURE THAT IN THE FUTURE PLAN BENEFITS ARE PAID PROMPTLY AFTER ALL INVOLUNTARY TERMINATIONS. COVENANT MEDICAL GROUP DID NOT HAVE ANY EMPLOYEES WHO WERE INVOLUNTARILY TERMINATED AND NOT TIMELY PAID THEIR PLAN BENEFIT. (D) THE PLAN QUALIFIED FOR RELIEF UNDER SECTIONS VI.B, VII.C AND XI.A OF IRS NOTICE 2010-6 AND ON OCTOBER 6, 2010, A PLAN AMENDMENT WAS SIGNED. THE AMENDMENT PROVIDES THAT EFFECTIVE AS OF JANUARY 1, 2009, ALL BENEFITS WILL BE PAID IMMEDIATELY UPON AN INVOLUNTARY SEPARATION FROM SERVICE (CURRENTLY THE STATUS QUO) AND ON THE 90TH DAY FOLLOWING VOLUNTARY SEPARATION FROM SERVICE PROVIDED THE PARTICIPANT RETURNS BY THIS DEADLINE A SIGNED NON COMPETE AGREEMENT. ANY PARTICIPANT WHO VOLUNTARILY SEPARATED FROM SERVICE ON OR AFTER JANUARY 1, 2009 AND ON OR BEFORE DECEMBER 31, 2009 WAS PAID HIS CURRENT PLAN ACCOUNT BALANCE AFTER THE DATE THE AMENDMENT WAS SIGNED, BUT REDUCED FOR ANY INTEREST EARNED IN 2010 (IF ANY). SECTION 409A RELIEF UNDER SECTION V.D. OF IRS NOTICE 2008-113 (CONT.) AS ALLOWED BY NOTICE 2010-80, THE EMPLOYER SIGNED AN AMENDMENT ON DECEMBER 20, 2010 TO PROVIDE THAT PAYMENT WILL NO LONGER BE REQUIRED ON THE 90TH DAY FOLLOWING A VOLUNTARY SEPARATION FROM SERVICE, BUT WITHIN 90 DAYS FOLLOWING THE VOLUNTARY SEPARATION FROM SERVICE. HOWEVER, IF THE 90TH DAY FALLS IN THE SUBSEQUENT TAX YEAR, PAYMENT WILL BE MADE IN THE SUBSEQUENT TAX YEAR. THE PLAN'S ADMINISTRATIVE PROCEDURES HAVE BEEN CHANGED TO PAY PLAN ACCOUNTS IMMEDIATELY FOLLOWING A PARTICIPANT'S INVOLUNTARY SEPARATION FROM SERVICE (CURRENTLY THE STATUS QUO) AND WITHIN 90 DAYS FOLLOWING A VOLUNTARY SEPARATION FROM SERVICE PROVIDED THE PARTICIPANT RETURNS BY THIS DEADLINE A SIGNED NON-COMPETE AGREEMENT AND SUBJECT TO THE REQUIREMENT THAT IF THE 90TH DAY FALLS IN THE SUBSEQUENT TAX YEAR THEN PAYMENT WILL BE MADE IN THE SUBSEQUENT TAX YEAR. (E) THESE OPERATIONAL FAILURES ARE ELIGIBLE FOR THE CORRECTION UNDER THE TERMS OF IRS NOTICE 2008-113 AND THE EMPLOYER HAS TAKEN ALL ACTIONS REQUIRED, AND OTHERWISE MET ALL REQUIREMENTS, FOR SUCH CORRECTION ST JOSEPH HEALTH SYSTEM 500 S MAIN STREET 1000 ORANGE CA 928684507 953589356 HEALTHCARE CA 501(C)(3) 11, I NA COVENANT HEALTH SYSTEM 3615 19TH STREET LUBBOCK TX 79410 752765566 HEALTHCARE TX 501(C)(3) 3 SJHS 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 METHODIST CHILDREN'S HOSPITAL 3610 21ST STREET LUBBOCK TX 79410 752428911 HEALTHCARE TX 501(C)(3) 3 CHS HOSPICE OF LUBBOCK 1102 SLIDE ROAD LUBBOCK TX 79414 752133781 HEALTHCARE TX 501(C)(3) 9 CHS COVENANT HEALTH SYSTEM FOUNDATION 4000 24TH STREET LUBBOCK TX 79410 752897026 FOUNDATION TX 501(C)(3) 7 CHS ST MARY OF THE PLAINS HOSPITAL FDN 4000 24TH STREET LUBBOCK TX 79410 751652181 FOUNDATION TX 501(C)(3) 11, I CHS LUBBOCK METHODIST HOSPITAL FOUNDATION 3615 19TH STREET LUBBOCK TX 79410 752220963 FOUNDATION TX 501(C)(3) 7 CHS COVENANT HEALTH PARTNERS 3615 19TH STREET LUBBOCK TX 79410 611573313 HEALTHCARE TX 501(C)(3) 11, I CHS ST JOSEPH HEALTH MINISTRY 500 S MAIN STREET SUITE 400 ORANGE CA 92868 271666576 RELIGIOUS ORG CA 501(C)(3) 1 NA SISTERS OF ST JOSEPH OF ORANGE 480 S BATAVIA ORANGE CA 92868 951643383 RELIGIOUS ORG CA 501(C)(3) 1 NA LUBBOCK SURGERY CTR 4000 24TH ST LUBBOCK TX 79410 752177401 HEALTHCARE SVCS TX CHS RELATED 0 0 false 0 false CHS HOLDING LP 4000 24TH ST LUBBOCK TX 79410 205477251 HEALTHCARE SVCS TX CHS RELATED 0 0 false 0 false LUBBOCK METHODIST HOSPITAL PRACTICE MGMT 2107 OXFORD STREET SUITE 300 LUBBOCK TX 79410 752578995 INACTIVE TX CHS C-CORP 0 0 0.00000 LUBBOCK METHODIST HOSPITAL SERVICES INC PO BOX 1201 LUBBOCK TX 79410 752118585 HEALTHCARE SVCS TX CHS C-CORP 0 0 0.00000 false false true false false false false false false false true false false false false false false false METHODIST HOSPITAL LEVELLAND 0 METHODIST HOSPITAL PLAINVIEW 0 METHODIST CHILDREN'S HOSPITAL 0 HOSPICE OF LUBBOCK 0 COVENANT HEALTH SYSTEM FOUNDATION 0 ST MARY OF THE PLAINS HOSIPTAL FOUNDATION 0 LUBBOCK METHODIST HOSPITAL FOUNDATION 0 COVENANT HEALTH PARTNERS 0 LUBBOCK SURGERY CENTER LTD 0 CHS HOLDING LP 0 LUBBOCK METHODIST HOSPITAL PRACTICE MGMT 0 LUBBOCK METHODIST HOSPITAL SERVICES INC 0