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JOSEPH HEALTH SYSTEM HAS CONDUCTED AN ADVOCACY EFFORT WHICH INCLUDED SOME LOBBYING ACTIVITY. THESE INCLUDED MEETING WITH LOCAL, STATE, AND FEDERAL LEGISLATORS, THEIR STAFF AND OTHER GOVERNMENTAL OFFICIALS AND COMMUNICATIONS TO LEGISLATORS ADVOCATING POSITIONS ON LEGISLATION. 18349427 18349427 390769412 273899145 387646010 20093954 20093954 291333027 291333027 717422418 BOARD DESIGNATED ASSETS 380155 ASSETS HELD IN TRUSTS 5155386 LONG TERM DUE FROM AFFILIATES 67024904 OTHER RECEIVABLES 1038353 DUE FROM THIRD PARTY 4502860 DEFERRED FINANCING COSTS-NET 2121237 80222895 0 PAYABLE TO THIRD - PARTY PAYORS 8567841 CURRENT MATURITIES OF LT DEBT 11750602 LT TERM NOTES 159557038 OTHER LIABILITIES 8797835 188673316 true true X true X 175. true X true true false true true 12077368 12077368 0.02440 66652014 50123404 16528610 0.03340 3153109 3072747 80362 0.00020 81882491 53196151 28686340 0.05800 3957892 906731 3051161 0.00620 13398382 13398382 0.02710 5679 5679 0.00000 172837 172837 0.00030 2090838 2090838 0.00420 19625628 906731 18718897 0.03780 101508119 54102882 47405237 0.09580 80933 80933 0.00010 116007 116007 0.00020 196940 196940 0.00030 true 9916667 0 135083697 448400963 -313317266 X true true COVENANT L-T CARE LP LONG-TERM CARE 0.67000 0.00000 0.33000 LUBBOCK SURG CTR LTD HEALTHCARE 0.59000 0.00000 0.41000 METHODIST DIAGNOSTIC HEALTHCARE 0.60000 0.00000 0.40000 LUBBOCK GAMMA LP HEALTHCARE 0.40000 0.00000 0.60000 COVENANT MEDICAL CENTER

3615 19TH STREET LUBBOCK TX 794101203

X X X COVENANT HEART & VASCULAR INSTITUTE

3615 19TH STREET LUBBOCK TX 79410

X JOE ARRINGTON CANCER RSCH & TRTMT CENTER

4101 22ND PLACE LUBBOCK TX 79410

X ARRINGTON COMPREHENSIVE BREAST CENTER

41010 22ND PLACE LUBBOCK TX 79410

X COVENANT MED CENTER - LAKESIDE CAMPUS

4000 24TH STREET LUBBOCK TX 79410

X X X X SOUTHWEST MEDICAL PARK

4010 22ND PLACE LUBBOCK TX 79410

X FAMILY HEALTHCARE CENTER

6502 SLIDE ROAD LUBBOCK TX 79410

X MEDICAL CLINIC FAMILY HEALTHCARE CENTER

416 FRANKFORD ROAD LUBBOCK TX 79410

X MEDICAL CLINIC FAMILY HEALTHCARE CENTER

7601 QUAKER AVENUE LUBBOCK TX 79410

X MEDICAL CLINIC THE MEDICARE COST REPORT WAS USED TO DETERMINE COMMUNITY BENEFIT SERVICES ALONG WITH ADDITIONAL INFORMATION PROVIDED BY THE COMMUNITY BENEFITS DEPARTMENT. WORKSHEET 2 FROM THE IRS INSTRUCTIONS WAS USED TO HELP DETERMINE THE COST-TO-CHARGE RATIO FOR COMMUNITY BENEFIT DETERMINATION. BAD DEBT EXPENSE OF $57,306,537 WAS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT IS SUBTRACTED FOR THE PURPOSE OF CALCULATING THE PERCENTAGE OF NET COMMUNITY BENEFIT. BAD DEBT EXPENSE FOOTNOTE FROM AUDITED FINANCIAL STATEMENTS: THE ORGANIZATION RECEIVES PAYMENT FOR SERVICES RENDERED TO PATIENTS FROM FEDERAL AND STATE GOVERNMENTS UNDER THE MEDICARE AND MEDICAID PROGRAMS, PRIVATELY SPONSORED MANAGED CARE PROGRAMS FOR WHICH PAYMENT IS MADE BASED ON TERMS DEFINED UNDER FORMAL CONTRACTS, AND OTHER PAYORS. THE ORGANIZATION BELIEVES THERE ARE NO SIGNIFICANT RISKS ASSOCIATED WITH RECEIVABLES FROM GOVERNMENT PROGRAMS. RECEIVABLES FROM CONTRACTED AND OTHERS ARE FROM VARIOUS PAYORS WHO ARE SUBJECT TO DIFFERING ECONOMIC CONDITIONS AND DO NOT REPRESENT ANY CONCENTRATED RISKS TO THE ORGANIZATION. THE ORGANIZATION CONTINUALLY MONITORS AND ADJUSTS THE RESERVES ASSOCIATED WITH RECEIVABLES. THE ORGANIZATION ESTIMATES BAD DEBT EXPENSE AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON HISTORICAL COLLECTION EXPERIENCE. BAD DEBT WAS CALCULATED USING THE MEDICARE COST-TO-CHARGE RATIO. PATIENTS QUALIFY FOR CHARITY CARE BASED UPON THEIR COMPLETION OF THE CHARITY APPLICATION. IF APPLICATION PROCESS IS NOT COMPLETE, THEY ARE CLASSIFIED AS SELF PAY. ACCOUNT IS WRITTEN TO BAD DEBT IF UNPAID FOR A PERIOD OF TIME. AS A CATHOLIC HEALTH CARE MINISTRY, THE ORGANIZATION FOLLOWS THE CATHOLIC HEALTH ASSOCIATION'S COMMUNITY BENEFIT REPORTING GUIDELINES AND THEREFORE DOES NOT REPORT MEDICARE AS A COMMUNITY BENEFIT. THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6 IS AS FOLLOWS: THE COST-TO-CHARGE RATIO AS CALCULATED FOR FY10, BASED ON GROSS PATIENT REVENUE AND TOTAL OPERATING EXPENSES. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMS AN EVALUATION TO IDENTIFY IF THE ACCOUNT QUALIFIES FOR CHARITY CARE. ALL ACCOUNTS ARE SCREENED FOR CHARITY CARE ELIGIBILITY USING CRITERIA THAT CONSIDERS INSURANCE COVERAGE, CREDIT RATING, PAYMENT ACTIVITY, AND VALID SOCIAL SECURITY NUMBER AND/OR ACCURATE RESIDENCE ADDRESS. A NEEDS ASSESSMENT IS COMPILED FROM COVENANT'S 2008 ANNUAL MARKET ASSESSMENT WHICH DETAILS OVERARCHING HEALTHCARE CONCERNS FOR TEXAS IN GENERAL AS WELL AS MANY DETAILS AFFECTING THE LUBBOCK AREA IN PARTICULAR. SOME OF THE OTHER SOURCES USED FOR COVENANT'S NEEDS ASSESSMENT INCLUDED: ST. JOSEPH HEALTH SYSTEM'S NEEDS ASSESSMENT, THE UNITED WAY COMMUNITY STATUS REPORT, AND THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES. THE PROCESS USED FOR THE PRIORITIZATION OF THE PROGRAMS WAS DETERMINED BY GENERAL CONSENSUS. ALL ASSESSMENTS USED FOR THIS PLAN, PRIMARY AND SECONDARY DATA THAT WAS ANALYZED, INDIVIDUAL MEETINGS WITH GROUPS OF STAKEHOLDERS, AND MEMBERS OF THE COMMUNITY BENEFIT COMMITTEE ALL CONFIRMED THE PROGRAMS WHICH ARE PRIORITIZED FOR THIS PLAN. THE COMMUNITY BENEFIT COMMITTEE, WHICH IS COMPOSED OF FIVE COVENANT BOARD MEMBERS AND FIVE COMMUNITY MEMBERS, BRINGS A HISTORY OF WORK WITHIN THE COMMUNITIES WE SERVE. THE FIVE BOARD MEMBERS HAVE A BROAD OVERVIEW OF THE CORE AND SECONDARY SERVICE AREAS; THE COMMUNITY MEMBERS UNDERSTAND THE DEMOGRAPHICS AND SPECIFIC NEEDS, PARTICULARLY IN THE LUBBOCK AREA. BY HEAVILY RELYING ON THE EXPERTISE OF THESE TEN MEMBERS, PRIORITIZATION OF THE PROGRAM WAS FINALIZED. THE ORGANIZATION POSTS NOTICES INFORMING THE PUBLIC OF THE FINANCIAL ASSISTANCE PROGRAM. NOTICES ARE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES ARE ALSO POSTED AT LOCATIONS WHERE A PATIENT MAY PAY THEIR BILL. NOTICES INCLUDE CONTACT INFORMATION ON HOW A PATIENT CAN OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES ARE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT ARE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATE LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS ARE OFFERED AN OPPORTUNITY TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND ARE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT-SPONSORED PROGRAMS FOR WHICH THEY MAY BE ELIGIBLE. COVENANT IS THE ONLY SJHS MINISTRY PROVIDING SERVICES TO COMMUNITIES IN TWO STATES. COVENANT PROVIDES SERVICES IN NEW MEXICO AND DRAWS PATIENTS FROM NEW MEXICO COMMUNITIES INTO LUBBOCK. THE CIRCUMSTANCES OF THESE COMMUNITY MEMBERS PROFOUNDLY IMPACT THE ORGANIZATION AND THE SERVICES IT PROVIDES. COVENANT HEALTH SYSTEM'S COMMUNITY BENEFIT PRIORITIES ADDRESS DUHN POPULATIONS WITHIN BOTH CORE SERVICE AREAS AND SECONDARY SERVICE AREAS FOR COMMUNITY RESIDENTS WHO ARE FACED WITH MULTIPLE HEALTH PROBLEMS AND HAVE LIMITED ACCESS TO TIMELY, HIGH-QUALITY HEALTH CARE. CORE SERVICE AREAS INCLUDE THE TEXAS COUNTIES OF LUBBOCK, BAILEY, LAMB, HALE, FLOYD, MOTLEY, COCHRAN, HOCKLEY, CROSBY, DICKENS, YOAKUM, TERRY, LYNN, GARZA, KENT, GAINES, DAWSON, BORDEN, SCURRY, AND EDDY COUNTY IN NEW MEXICO. ESPECIALLY WITHIN LUBBOCK, FOUR NEIGHBORHOODS, ARNETT-BENSON, HARWELL, PARKWAY-CHERRY POINT AND DUNBAR-MANHATTAN HEIGHTS, ARE DESIGNATED AS MEDICALLY UNDERSERVED AREAS (MUA'S). SECONDARY SERVICE AREAS INCLUDE PARMER, CASTRO, AND KING COUNTIES IN TEXAS. LUBBOCK, THE LARGEST CITY WITHIN THE CORE AND SECONDARY SERVICE AREAS, IS LOCATED ON THE SOUTH PLAINS OF TEXAS AND HAS A POPULATION OF 204,737 AND A COUNTY (LUBBOCK COUNTY) POPULATION OF 250,446, ACCORDING TO THE 2003 ESTIMATES OF THE US CENSUS. LUBBOCK SERVES AS A MAJOR MEDICAL CENTER FOR THE ENTIRE SOUTH PLAINS OF TEXAS AND EASTERN NEW MEXICO REGION, CARING FOR PEOPLE WITHIN A 57-COUNTY, 80,000 SQUARE MILE RADIUS OF THE CITY. THE POPULATION OF COVENANT HEALTH SYSTEM'S CORE SERVICE AREA IS EXPECTED TO INCREASE. WHILE ONLY MODEST INCREASES ARE EXPECTED, THEY ARE WELCOMED, AS PREVIOUS ASSESSMENTS INDICATED A SLIGHT LOSS OF POPULATION FOR MOST OF OUR PRIMARY SERVICE AREAS. IT IS IMPORTANT TO FIRST MENTION SOME OF THE HEALTH CHARACTERISTICS OF TEXAS WHICH ALSO AFFECT THE LUBBOCK AREA. TEXAS HAS THE FIFTH HIGHEST POVERTY RATE AMONG THE STATES; ONE IN SIX TEXANS IS CONSIDERED POOR. TEXAS HAS THE EIGHTH HIGHEST RATE OF SENIOR CITIZENS LIVING IN POVERTY. ONE HALF OF CHILDREN IN TEXAS LIVE IN POVERTY OR ARE ECONOMICALLY DISADVANTAGED. TEXAS CONTINUES TO BE A LOW-WAGE, LOW-BENEFIT STATE. WITH THAT SAID, TEXAS HAS A CRISIS IN COVERAGE. THE ECONOMIC, EDUCATIONAL, CULTURAL, AND SOCIAL STRENGTH OF TEXAS DEPENDS UPON THE HEALTH OF ITS CITIZENS; ALARMINGLY, ABOUT 24% OF ITS POPULATION IS WITHOUT INSURANCE - THE HIGHEST IN THE NATION. THE INCREASING NUMBER OF UNINSURED PATIENTS PLACES AN EXTRAORDINARY ECONOMIC AND SERVICE BURDEN UPON HEALTHCARE PROVIDERS, HOSPITALS, AND THE COMMUNITIES THAT FUND THE HEALTHCARE SERVICES. THE OVERALL HEALTH STATUS OF TEXANS IS POOR IN COMPARISON WITH OTHER STATES AND LIKELY TO DECLINE FURTHER WITHOUT INTERVENTION. THE INCREASING NUMBER OF INDIVIDUALS WITHOUT INSURANCE OR ADEQUATE COVERAGE IS A SIGNIFICANT AND CONTINUING CONCERN FOR THE COUNTRY AND A MAJOR POLICY CHALLENGE FOR TEXAS. A MILLION UNINSURED TEXANS DO NOT RECEIVE ADEQUATE CARE FOR CHRONIC DISEASES AND 2,500 DIE PREMATURELY EACH YEAR. STUDIES INDICATE THE UNINSURED ARE LESS LIKELY TO SEEK PREVENTATIVE AND SCREENING SERVICES THAT MINIMIZE MORE COSTLY SERVICES LATER. 5.6 MILLION TEXANS ARE CONTINUOUSLY WITHOUT MEDICAL INSURANCE THROUGHOUT THE YEAR; 8.5 MILLION GO WITHOUT INSURANCE AT SOME POINT IN THE YEAR. MEDICAL EXPENSES ARE THE SINGLE LARGEST REASON FOR PERSONAL BANKRUPTCIES AMONG TEXANS. LUBBOCK, TX, ESPECIALLY WITHIN SERVICE AREAS, ALSO FACES ECONOMIC AND HEALTHCARE CHALLENGES. BECAUSE OF ITS DIVERSE ECONOMY, WHICH IS GROUNDED IN AGRICULTURE, MANUFACTURING, AND TRADE, THERE IS A SIGNIFICANT MIGRATION OF BOTH PERMANENT AND TEMPORARY DWELLERS INTO THE AREA. IT IS A YOUTHFUL POPULATION WITH A MEDIAN AGE OF 31 COMPARED TO THE STATE MEDIAN OF 33.2, WHICH IS PARTIALLY DRIVEN BY THE UNIVERSITIES' PRESENCE IN THE REGION. HOWEVER, THE REMAINING COMMUNITIES COVENANT CARES FOR WITHIN THE CORE AND SECONDARY SERVICE AREAS HAVE A DISPROPORTIONATE NUMBER OF PEOPLE WHO ARE BOTH BELOW THE FEDERAL POVERTY LEVEL AND WHO ARE ABOVE THE AGE OF 65 AND ARE IN NEED OF GREATER ACCESS TO HEALTHCARE. MANY OF THESE COMMUNITIES ARE MEDICALLY UNDERSERVED AREAS (MUA'S) OR PERSISTENT POVERTY AREAS (PPA'S) OR BOTH. SPECIFICALLY FOCUSING ON THE STATISTICS FOR THE ECONOMIC CHARACTERISTICS OF THE LUBBOCK AREA, THE MOST RECENT INDICATORS, FROM THE UNITED WAY'S 2008 COMMUNITY STATUS REPORT, SHOW THAT THE PERCENTAGE OF CHILDREN LIVING IN POVERTY IN LUBBOCK COUNTY IS 22.4% WHICH IS A 7% DECREASE FROM THE PREVIOUS YEAR AND 21% ABOVE THE US AVERAGE. THE PERCENTAGE OF ADULTS LIVING IN POVERTY IS 18% WHICH IS A 1.7% INCREASE FROM THE PREVIOUS YEAR AND 55% ABOVE THE US AVERAGE. THE PERCENTAGE OF INDIVIDUALS WITHOUT HEALTH INSURANCE IS 24.8% COMPARED TO 23.9% FOR TEXAS IN GENERAL AND 15.1% FOR THE US AVERAGE. IT IS CLEAR THAT COVENANT'S SERVICE TO DUHN POPULATIONS IN ADDRESSING HEALTHCARE CHALLENGES IS PRIMARILY FOCUSED ON ACCESS TO TIMELY, HIGH QUALITY HEALTHCARE. BOTH THE CORE AND SECONDARY SERVICE AREAS FACE MULTIPLE HEALTH PROBLEMS WHICH RANGE FROM CANCER TO UNHEALTHY LIVING HABITS. THE CANCER RATE FOR COVENANT (INCLUDING VARIOUS TYPES OF CANCER) IS ABOUT 931/100,000. THE DIABETES PREVALENCE FOR COVENANT'S SERVICE REGIONS IS 11.47% COMPARED TO THE NATIONAL AVERAGE OF 7.5%. WITH REGARD TO HYPERTENSION, COVENANT SERVICE REGIONS REPORT 34.99% COMPARED TO THE NATIONAL AVERAGE OF 25.5%. IN ADDRESSING THE RATES OF UNHEALTHY LIVING, 15.6% OF LUBBOCK COUNTY RESIDENTS ARE SMOKERS AND 12.9% HAVE PARTICIPATED IN BINGE DRINKING IN THE PAST MONTH. 71.8% OF LUBBOCK COUNTY'S ADULTS ARE OVERWEIGHT OR OBESE, AND 20.5% OF THE OVERWEIGHT OR OBESE ARE CHILDREN. THE HISPANIC POPULATION IS CLOSE TO 30%, NEARLY TWICE THE NATIONAL AVERAGE. ACCORDING TO THE UNITED WAY'S COMMUNITY PLANNING MODEL 2008: LUBBOCK COMMUNITY STATUS REPORT; BY 2040, IT IS PROJECTED THAT HISPANICS WILL BE AT LEAST ONE HALF OF ALL AGE GROUPS YOUNGER THAN 65, AND ABOUT TWO THIRDS OF ALL AGE GROUPS YOUNGER THAN 40. ALTHOUGH ANGLOS COMPRISED 63% OF LUBBOCK COUNTY'S POPULATION IN 2000 (WHICH ALSO REPRESENTS THE SURROUNDING COUNTIES' DEMOGRAPHICS), IT IS ESTIMATED THAT THEY WILL BE 50% OF THE POPULATION IN 2020 AND ONLY 42.8% OF THE POPULATION IN 2030. AS A VALUES-BASED, NONPROFIT ORGANIZATION, COVENANT HEALTH SYSTEM HAS AN ONGOING COMMITMENT TO REACH OUT TO THOSE IN NEED WITHIN THE COMMUNITIES WE SERVE. SINCE THE MID-1980S, OUR COMMUNITY OUTREACH INITIATIVE HAS OFFERED SUPPORT TO DISPROPORTIONATE UNMET HEALTH NEEDS (DUHN) POPULATIONS - THOSE WHO ARE VULNERABLE, UNINSURED OR GEOGRAPHICALLY ISOLATED FROM CONVENTIONAL HEALTHCARE FACILITIES. PROGRAMS INCLUDE RELAY FOR LIFE SURVIVOR DINNER, RAGIN CAJUN SPECIAL OLYMPICS, NICU BAKE SALE, RELAY FOR LIFE COMMITTEE MEETINGS, AND COMMUNITY SERVICE VOLUNTEERS. THESE COSTS ARE REPORTED ON SCHEDULE H, PART II, LINES 3 AND 6. PROMOTING THE HEALTH OF THE COMMUNITY OUR COMMUNITY BENEFIT COMMITTEE, A SUBCOMMITTEE OF CHS'S BOARD OF TRUSTEES, IS MADE UP OF HOSPITAL LEADERSHIP AND LOCAL COMMUNITY PROFESSIONALS. OUR EXECUTIVE MANAGEMENT TEAM (EMT) IS INVOLVED IN COMMUNITY BENEFIT PLANNING AND REPORTING BY HAVING THE VICE PRESIDENT OF MISSION INTEGRATION ATTEND COMMUNITY BENEFIT COMMITTEE MEETINGS. IN ADDITION, THE CHAIR OF THE COMMUNITY BENEFIT COMMITTEE REPORTS MONTHLY AT BOARD OF TRUSTEE MEETINGS, KEEPING THEM INFORMED ABOUT PROGRAM PROGRESS. THE COMMUNITY BENEFIT COMMITTEE CONSISTS OF FIVE CHS BOARD OF TRUSTEE MEMBERS AND FIVE AT-LARGE COMMUNITY MEMBERS. EACH HAS A UNIQUE INSIGHT TO THE COMMUNITIES WE SERVE. THE COMMITTEE CONSISTS OF A SISTER OF ST. JOSEPH, PHYSICIANS, A BANKING OFFICER, AN INVESTMENT BROKER, AN EMPLOYEE WITHIN TEXAS TECH UNIVERSITY - COLLEGE OF EDUCATION OUTREACH DEPARTMENT, CITY OF LUBBOCK ASSISTANT CITY MANAGER, VICE PRESIDENT OF UNITED WAY, VICE PRESIDENT CHAMBER OF COMMERCE -LEGISLATIVE AFFAIRS, LUBBOCK INDEPENDENT SCHOOL DISTRICT TRUSTEE WHO IS A RETIRED ELEMENTARY SCHOOL PRINCIPAL, AND A COMMUNITY VOLUNTEER WITH THE BOYS & GIRLS CLUB WHO IS RETIRED FROM THE LUBBOCK POLICE DEPARTMENT. COVENANT HEALTH SYSTEM'S EXECUTIVE MANAGEMENT TEAM (EMT) IS INVOLVED IN COMMUNITY BENEFIT PLANNING AND MONITORING. THE VICE PRESIDENT OF MISSION INTEGRATION ATTENDS THE COMMUNITY BENEFIT COMMITTEE MEETINGS. THE CHAIR OF THE COMMUNITY BENEFIT COMMITTEE ALSO REPORTS MONTHLY AT BOARD MEETINGS, WHICH INCLUDES THE CEO AND TRUSTEES OF THE HOSPITAL, KEEPING THEM ACTIVE AND INVOLVED IN THE PROGRAMS AND ISSUES. THE HOSPITAL ALSO PROMOTES THE HEALTH OF THE COMMUNITY THROUGH THE FOLLOWING MEANS. HAVING A COMMUNITY-BASED BOARD ENSURES THAT COMMUNITY PERSPECTIVES ON HEALTH AND SAFETY ARE INCLUDED AND CONSIDERED. STAFF PRIVILEGES ARE EXTENDED, OR GRANTED, TO THOSE QUALIFIED PHYSICIANS IN THE COMMUNITY WHO HAVE BEEN CREDENTIALED THROUGH THE MEDICAL STAFF'S CREDENTIALING PROCESS AND PRACTICE IN VARIOUS DEPARTMENTS THROUGHOUT COVENANT HEALTH SYSTEM. THROUGH PARTICIPATION IN HOSPITAL AND HEALTH SYSTEM INITIATIVES AND PROGRAMS, SURPLUS FUNDS ARE USED FOR PATIENT CARE, EDUCATION, OR RESEARCH. GIVING BACK TO THE COMMUNITY PERMEATES EVERY ASPECT OF OUR ORGANIZATION. AS A MEMBER OF THE FAITH-BASED HEALTHY MINISTRY OF ST. JOSEPH HEALTH SYSTEM, WE HAVE A FUNDING STREAM TO ADDRESS THE NEEDS OF THE ECONOMICALLY POOR AND VULNERABLE IN THE COMMUNITIES WE SERVE. ON AN ANNUAL BASIS, 10 PERCENT OF OUR NET OPERATING INCOME IS DEVOTED TO FUND COMMUNITY PROGRAMS FOR THE ECONOMICALLY POOR. THE ST. JOSEPH HEALTH SYSTEM FOUNDATION, A MEMBER OF ST. JOSEPH HEALTH SYSTEM, IS CHARGED WITH THE DISTRIBUTION OF THESE FUNDS. IN ADDITION TO DEVOTING A PERCENTAGE OF OUR NET OPERATING INCOME TO COMMUNITY BENEFIT SERVICES FOR THE ECONOMICALLY POOR, WE STRIVE TO ANNUALLY BUDGET A PORTION OF OUR TOTAL OPERATING EXPENSES FOR HEALTHY COMMUNITIES AND COMMUNITY HEALTH EFFORTS. SCHEDULE H, PART VI, LINE 8 COVENANT HEALTH SYSTEM IS A PART OF ST. JOSEPH HEALTH SYSTEM OF ORANGE, CALIFORNIA. AN ANNUAL COMMUNITY BENEFIT REPORT IS SUBMITTED TO ST. JOSEPH HEALTH SYSTEM, BUT THEY ARE NOT REQUIRED TO SUBMIT THE REPORT TO THE STATE OF CALIFORNIA. TX true LUBBOCK AREA UNITED WAY 1655 MAIN ST STE 101 LUBBOCK TX 79401 750961812 501(C)(3) 30000 CORPORATE PLEDGE FOR 2009-2010 AMERICAN CANCER SOCIETY 3411 73RD STREET LUBBOCK TX 79423 237040934 501(C)(3) 110000 RELAY FOR LIFE AND CATTLE BARON'S BALL SUSAN G KOMEN BREAST CANCER FOUNDATION 5121 69TH DR STE A-10A LUBBOCK TX 79424 751835298 501(C)(3) 25000 LUBBOCK 15TH ANNUAL RACE FOR THE CURE FIRST UNITED METHODIST CHURCH 1411 BROADWAY LUBBOCK TX 79401 501(c)(1) 7500 GRANT FOR FUMC TV WORSHIP SERVICE ST JOSEPH HEALTH SYSTEM FOUNDATION 500 S MAIN STREET SUITE 1000 ORANGE CA 928684507 330143024 501(C)(3) 2558700 CARE FOR THE POOR 4 1 SCHEDULE I, PART I, LINE 2 DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS DONATIONS MADE TO OTHER ORGANIZATIONS ARE APPROVED BY MANAGEMENT TO ENSURE THEY SUPPORT THE MISSION OF COVENANT HEALTH SYSTEM. NO ADDITIONAL MONITORING IS DONE. true true false false false false false true false JAMES E HARRELL MD 0 601758 0 0 0 8266 0 10000 0 18217 0 638241 0 0 JOE RANDOLPH 0 732429 0 228922 0 243404 0 21982 0 29984 0 1256721 0 0 CRAIG RUCKER -307 0 0 0 847426 0 0 0 2607 0 849726 0 694694 0 BRETT ESROCK 380001 0 51087 0 133626 0 8727 0 23176 0 596617 0 0 0 JOHN GRIGSON 343712 0 18812 0 67925 0 3391 0 19294 0 453133 0 0 0 SCOTT ROBINS MD 372936 0 24096 0 111201 0 19593 0 5984 0 533811 0 0 0 STEVEN MCCAMY 306253 0 20327 0 62218 0 6191 0 21920 0 416908 0 0 0 JAMES WURTS 29933 0 0 0 363779 0 5853 0 1152 0 400717 0 309228 0 ROXIE TAYLOR 245915 0 16115 0 84765 0 19586 0 11537 0 377918 0 0 0 SUSAN NEVES 249197 0 16115 0 71478 0 19425 0 5827 0 362042 0 0 0 SHARON PRATHER 219235 0 14386 0 84130 0 24296 0 11375 0 353421 0 22001 0 SHARYN IVORY 203943 0 13331 0 101945 0 25037 0 8054 0 352311 0 43751 0 KAREN BAGGERLY 231985 0 15010 0 60441 0 26798 0 5925 0 340159 0 0 0 WILLIAM BOPP 177727 0 14018 0 122789 0 9054 0 10193 0 333782 0 0 0 GWENDOLYN STAFFORD 207885 0 13985 0 79526 0 9491 0 16497 0 327383 0 19531 0 MELINDA CLARK 0 448599 0 45384 0 810638 0 9752 0 5690 0 1320063 0 0 ELLIOT STERNBERG 0 529569 0 165441 0 178880 0 17102 0 20734 0 911726 0 0 JIM HOUSER 259000 0 0 0 0 0 0 0 0 0 259000 0 0 0 SCHEDULE J, PART I, LINE 3 DESCRIPTION OF CEO PAID BY EXEMPT AGENT THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX-EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15 A FOR THE PROCESS THAT IS COMPLETED BY THE ST. JOSEPH HEALTH SYSTEM. SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS MELINDA CLARK RECEIVED $577,579 FOR SEVERANCE PAID THROUGH ST. JOSEPH HEALTH SYSTEM AND CRAIG RUCKER RECEIVED $136,556 FOR SERVERANCE PAID THROUGH COVENANT HEALTH SYSTEM. SCHEDULE J, PART I, LINE 4B DESCRIPTION OF SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN 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. DISTRIBUTIONS FOR THE YEAR WERE AS FOLLOWS: CRAIG RUCKER - $694,694 JAMES WURTS - $309,228 SHARON PRATHER - $22,001 SHARYN IVORY - $43,751 GWENDOLYN STAFFORD - $19,531 SCHEDULE J, PART I, LINE 7 DESCRIPTION OF NON-FIXED PAYMENTS 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. SCHEDULE J-2 JIM HOUSER RECEIVED COMPENSATION FOR HIS INTERIM CEO SERVICES FROM AN UNRELATED ORGANIZATION PAID BY COVENANT HEALTH SYSTEM. MARK JOHNSON, M.D. AND MICHAEL ROBERTSON, M.D. RECEIVED COMPENSATION FOR MEDICAL SERVICES PROVIDED, NOT FOR BOARD MEMBER SERVICES. LUBBOCK POWER LIGHT JOHN ZWIACHER/BD MEMBER 2249736 UTILITIES false PULMONARY ASSOCIATES CHEKURU/JOHNSON/PARTNERS 398380 MEDICAL SERVICES false MARTY HARRELL SPOUSE OF BOARD MEMBER 113874 EMPLOYEE OF CHS false FORM 990, PART I, LINE 1 & PART III, LINE 1 DESCRIBE ORGANIZATION'S MISSION AS A MEMBER OF THE ST. JOSEPH HEALTH SYSTEM (SJHS), COVENANT HEALTH SYSTEM 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. 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 HEALTH SYSTEM 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 HEALTH SYSTEM 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 AND 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 HEALTH SYSTEM (CHS) IS A MEMBER OF THE ST. JOSEPH HEALTH SYSTEM, SPONSORED BY THE ST. JOSEPH HEALTH MINISTRY, AND IS ONE OF THE LARGEST NON-PROFIT HEALTHCARE ORGANIZATIONS IN THE WEST TEXAS/EASTERN NEW MEXICO REGION, SERVING A 62 COUNTY AREA. WE CONSIST OF 977 LICENSED BEDS, APPROXIMATELY 5,000 EMPLOYEES, AND OVER 600 ADMITTING PHYSICIANS. COVENANT HEALTH SYSTEM HAS AN AVERAGE DAILY CENSUS OF 400, OVER 33,000 ANNUAL PATIENT DISCHARGES, AND MORE THAN 100,000 ANNUAL EMERGENCY ROOM VISITS. THREE MISSION OUTCOMES AS A MINISTRY OF THE ST. JOSEPH HEALTH SYSTEM WE ARE COMMITTED TO THREE SYSTEMWIDE MISSION OUTCOMES: - MAKING EVERY ENCOUNTER WITH OUR COMMUNITY A SACRED ENCOUNTER, - PROVIDING TO OUR PATIENTS IN THE COMMUNITY WITH PERFECT CARE, AND - MAKING THE COMMUNITY WE SERVE AMONG THE HEALTHIEST COMMUNITIES IN THE U.S. COVENANT HEALTH SYSTEM IS A HOSPITAL AND HEALTH SYSTEM, SERVING THE SOUTH PLAINS REGION. DURING FISCAL YEAR 2010, WE INVESTED A TOTAL OF $47,405,238 (8.58% OF OUR TOTAL OPERATING EXPENSES) IN COMMUNITY BENEFIT (INCLUDING TRADITIONAL CHARITY CARE, UNPAID COST TO STATE AND LOCAL PROGRAMS AND COMMUNITY BENEFIT SERVICES TO THE LOW-INCOME AND BROADER COMMUNITY), IN ALIGNMENT WITH CATHOLIC HEALTH ASSOCIATION GUIDELINES. IN ADDITION, OUR UNPAID COST OF MEDICARE PROGRAMS TOTALED $118,821,542. FINANCIAL ASSISTANCE POLICY (TRADITIONAL CHARITY CARE) OUR MISSION IS TO PROVIDE QUALITY CARE TO ALL OUR PATIENTS, REGARDLESS OF ABILITY TO PAY. WE BELIEVE THAT NO ONE SHOULD DELAY SEEKING NEEDED MEDICAL CARE BECAUSE THEY LACK HEALTH INSURANCE. THAT IS WHY ST. JOSEPH HEALTH SYSTEM HAS A PATIENT FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES FREE OR DISCOUNTED SERVICES TO ELIGIBLE PATIENTS. IN FY10, COVENANT HEALTH SYSTEM (LUBBOCK HOSPITALS AND COVENANT MEDICAL GROUP), PROVIDED $23,592,000 CHARITY CARE TO 17,078 PERSONS. ORGANIZATIONAL COMMITMENT AS A VALUES BASED ORGANIZATION, COVENANT HEALTH SYSTEM HAS A LONG-STANDING COMMITMENT TO THE COMMUNITY. FY10 COMMUNITY BENEFIT INITIATIVES AND/OR PROGRAMS NAME OF INITIATIVE OR PROGRAM: ADULT DENTAL GOAL: TO PROVIDE A "DENTAL HOME" FOR ADULTS AND PREVENTATIVE DENTAL TREATMENT FY10 ACCOMPLISHMENTS: THE ADULT DENTAL STAFF IS CONSCIOUS OF THE NEED TO ESTABLISH RELATIONSHIPS WITH THE PATIENTS WHO ARE SERVED BY OUR PROGRAM. EACH DENTAL PATIENT PARTICIPATING IN THE ADULT DENTAL PROGRAM HAS AN INDIVIDUALIZED TREATMENT PLAN THAT IS DISCUSSED WITH THE PATIENT AND REFERRED TO AT EACH APPOINTMENT AS PROGRESS IS MADE TOWARDS COMPLETION OF THE PLAN. THE PLAN REQUIRES NUMEROUS APPOINTMENTS (ENCOUNTERS) WITH THE DENTIST. AFTER EACH ENCOUNTER THE PATIENTS ARE GIVEN A PATIENT SATISFACTION SURVEY. THE COMMENTS RECEIVED ON THE SURVEYS VALIDATE THAT THESE RELATIONSHIPS HAVE BEEN ESTABLISHED. A SAMPLING OF COMMENTS FOLLOWS: "THIS IS A VERY ESSENTIAL AND NEEDED SERVICE WHICH WE APPRECIATED VERY MUCH. WE THANK YOU FOR THIS SERVICE." "ALL OF YOUR EMPLOYEES ARE WONDERFUL!" "ALL SERVICES I HAVE RECEIVED HAVE BEEN EXCEPTIONAL. THIS IS A VERY WELL-RUN PROGRAM AND HAS PROVIDED ME WITH EXCELLENT DENTAL HEALTHCARE. THANKS." "I AM REALLY EXCITED AND THANKFUL THAT I WILL BE ABLE TO RECEIVE THE DENTAL WORK I HAVE NEEDED FOR YEARS." "I WAS VERY IMPRESSED WITH THE DENTIST AND ASSISTANT. THEY MADE YOU FEEL AT EASE. THEY TOOK TIME TO EXPLAIN WHAT THEY WOULD DO TO TAKE CARE OF MY TEETH. "THANK GOD FOR PEOPLE WHO CARE." IN ADDITION TO HELPING PATIENTS AT THE COVENANT DENTAL FACILITIES, OUR DENTISTS AND THEIR ASSISTANTS FURTHER PROMOTED COVENANT'S MISSION BY PARTICIPATING ALONG WITH APPROXIMATELY 100 DENTISTS IN LUBBOCK'S FIRST "TEXAS MISSION OF MERCY," A TWO-DAY EVENT IN NOVEMBER 2009. THIS FREE DENTAL CARE PROJECT, IN COOPERATION WITH THE SOUTH PLAINS DISTRICT DENTAL SOCIETY, SERVED OVER 1,000 COMMUNITY MEMBERS IN NEED OF DENTAL CARE BY PROVIDING CLEANINGS, TOOTH EXTRACTIONS, IMPRESSIONS, AND ROOT CANALS. NAME OF INITIATIVE OR PROGRAM: COMMUNITY HEALTH SCREENINGS GOAL: REDUCE HEALTH RISKS THROUGH PREVENTATIVE SERVICES AND EDUCATION FY10 ACCOMPLISHMENTS: TWO ADULT HEALTH SCREENINGS WERE HELD IN SEPTEMBER AND MARCH. A TOTAL OF 716 PEOPLE FROM LUBBOCK AND 35 SURROUNDING TOWNS PARTICIPATED IN THE ADULT HEALTH SCREENING. POST CARDS WERE MAILED TO EACH HOUSEHOLD WITHIN THE 6 IDENTIFIED DISPROPORTIONATE UNMET HEALTH NEED (DUHN) POPULATIONS IN LUBBOCK AND WITHIN A SIXTY MILE RADIUS TO ADVERTISE THE SERVICES OFFERED AT THE SCREENINGS. FOR THE WOMEN'S SCREENING, 473 WOMEN RECEIVED PAP SMEARS, HPV TESTING, AND CLINICAL BREAST EXAMS. THE MEN'S SCREENING PROVIDED 151 MEN WITH DIGITAL RECTAL EXAMS, PSAS, AND TESTICULAR EXAMS. ALL THOSE ATTENDING THE ADULT HEALTH SCREENING WERE PROVIDED WITH A BLOOD PRESSURE TEST, HEIGHT/WEIGHT AND BMI CHECKS, FECAL OCCULT HOME TEST KITS, SKIN CANCER SCREENINGS, GLUCOSE FINGER STICKS, AND HEALTH EDUCATION MATERIALS. THE CHILDREN'S HEALTH SCREENINGS DONE IN PREVIOUS YEARS WERE DISCONTINUED IN FY10 BECAUSE THE IMMUNIZATION SERVICES PROVIDED ARE NOW BEING OFFERED BY THE SCHOOLS IN THE COMMUNITY. FORM 990, PART III, LINE 4 (Continued) NAME OF INITIATIVE OR PROGRAM: MOBILE MAMMOGRAPHY GOAL: TO PROVIDE A PREVENTIVE MAMMOGRAM SCREENING TO WOMEN 40 YEARS OLD AND OLDER. FY10 ACCOMPLISHMENTS:THIS PROGRAM CONTINUES TO PROVIDE A MUCH-NEEDED SERVICE (SCREENING MAMMOGRAM) TO THE WOMEN OF WEST TEXAS, ESPECIALLY THOSE WITH FINANCIAL OR GEOGRAPHIC BARRIERS. THE LUBBOCK AFFILIATE OF SUSAN G. KOMEN FOR THE CURE COMPLETED AN EXHAUSTED NEEDS ASSESSMENT THAT INCLUDED GRASSROOTS-LEVEL INPUT TO IDENTIFY PARTNERS IN EACH OF THE COUNTIES. AS A RESULT, COUNTY EXTENSION AGENCIES WERE RECOMMENDED AS LIAISONS BECAUSE THEY "KNOW" WHAT MAKES THEIR COMMUNITIES "TICK," AND HAVE THE SKILLS AND CONTACTS NEEDED TO ARRANGE AND PUBLICIZE THE EVENTS. COVENANT'S MOBILE MAMMOGRAPHY IS THE ONLY MOBILE SERVICE IN THE REGION. PRELIMINARY CONTACTS WITH EXTENSION AGENCIES HAVE BEEN MADE. MAINTAIN CURRENT LEVELS OF SERVICE: IN FY10, THE MOBILE MAMMOGRAPHY UNIT PERFORMED 1,640 SCREENING MAMMOGRAMS AT 43 DIFFERENT SITES. THIS IS A 7% DECREASE FROM FY09, WHICH IS DUE TO NOT ENOUGH PATIENTS ON THE SCHEDULE TO WARRANT DRIVING THE DISTANCE TO A SITE, AND ALSO INCLEMENT WEATHER DAYS. PROVIDE EDUCATIONAL BROCHURES ON BREAST HEALTH AWARENESS: THE STAFF ON THE MOBILE MAMMOGRAPHY UNIT PRESENTED THREE DIFFERENT TYPES OF EDUCATIONAL BROCHURES TO PATIENTS ON BREAST HEALTH AWARENESS, INCLUDING A TAKE-HOME SHOWER CARD WHICH EXPLAINED HOW TO PERFORM A SELF-BREAST EXAM. CULTURALLY APPROPRIATE BREAST MODELS WERE ALSO USED TO TEACH BREAST SELF-EXAMINATIONS. ALL PATIENTS WERE OFFERED EDUCATIONAL MATERIALS, AND AN EDUCATIONAL DVD RAN IN THE WAITING ROOM TO ENSURE THAT SOME FORM OF BREAST HEALTH EDUCATION WAS GIVEN TO 100% OF THE PATIENTS. NAME OF INITIATIVE OR PROGRAM: HEALTH AND NUTRITION EDUCATION GOAL: TO EDUCATE LOW INCOME ADULTS AND CHILDREN ON HIGH RISK HEALTH ISSUES. FY10 ACCOMPLISHMENTS: THE DIABETES MANAGEMENT EDUCATION CLASS IS A GROWING HEALTH EDUCATION PROGRAM. THIS FREE CLASS IS OFFERED FOR THOSE WHO HAVE BEEN RECENTLY DIAGNOSED WITH DIABETES. THERE ARE FOUR SESSIONS OVER THE SPAN OF 4 WEEKS THAT INCLUDE OVERALL TOPICS AND VIDEOS ON DIABETES, NUTRITION, DIET, EXERCISE, AND PREVENTION, WITH SPECIALIZED TOPICS ON HYPOGLYCEMIA AND HYPERGLYCEMIA, MEAL PLANNING, ALCOHOL, DEPRESSION, FOOD LABELS, CARBOHYDRATES, DINING OUT, AND SICK-DAY MANAGEMENT. THE PARTICIPANTS OF THE CLASS RECEIVE A FREE GLUCOMETER AFTER ATTENDING THREE CLASSES SO THAT THEY CAN KEEP TRACK OF THEIR BLOOD SUGAR. IN FY2010, 164 PEOPLE WERE EDUCATED THROUGH THIS PROGRAM, WHICH IS AN 80% INCREASE IN PARTICIPANTS FROM FY09. A HISPANIC MALE IN HIS EARLY THIRTIES PRESENTED A BLOOD SUGAR READING OF OVER 500 AT A LOCAL CLINIC. HE WAS REFERRED TO OUR DIABETES MANAGEMENT CLASS FROM THE PHYSICIAN AT PREMIER HEALTH CLINIC. HE ATTENDED TWO CLASSES BEFORE HE BROUGHT HIS WIFE, WHO HAD BEEN DIAGNOSED WITH HYPOGLYCEMIA, TO COMPLETE THE LAST TWO SESSIONS. THE COUPLE, WHO BOTH APPEARED HEALTHY BUT HAD A FAMILY HISTORY OF DIABETES, LIVED NEARLY 20 MILES AWAY AND HAD FOUR CHILDREN. THROUGH THE DIABETES MANAGEMENT EDUCATION CLASS, THEY REALIZED THE IMPORTANCE OF DIET AND NUTRITION AS A COMPONENT OF THEIR FAMILY'S HEALTH AND THEIR DIAGNOSES. INCREASE REFERRAL SOURCE BY DISTRIBUTING FLIERS, POSTERS, AND INTRODUCING OUR PROGRAM TO LOCAL AGENCIES: THE HEALTH EDUCATION PROGRAM STAFF DISTRIBUTED FLIERS AND POSTERS TO LOCAL AGENCIES TO MARKET THE FREE DIABETES MANAGEMENT EDUCATION PROGRAM. THE PARTICIPANTS WHO WERE SURVEYED SELF-REPORTED A 73% INCREASE ON NEW REFERRAL SOURCES. PARTICIPATE IN COVENANT COUNSELING CENTER'S COMMUNITY PRESENTATIONS AS A RESOURCE FOR NUTRITION AND EXERCISE: THIS STRATEGY WAS NOT IMPLEMENTED DUE TO UNEXPECTED BUDGET CONSTRAINTS AND A DECREASE IN STAFFING. NAME OF INITIATIVE OR PROGRAM: COUNSELING CENTER GOAL: PROVIDE PSYCHOEDUCATION TO INDIVIDUALS IN GROUP SETTINGS TO ASSIST THEM IN MAKING HEALTHY LIFESTYLE CHANGES FY10 ACCOMPLISHMENTS: FACILITATE PSYCHOEDUCATION GROUPS IN COUNSELING CENTER SETTING: THIS STRATEGY WAS NOT IMPLEMENTED DUE TO UNEXPECTED BUDGET CONSTRAINTS AND A DECREASE IN STAFFING. FACILITATE PSYCHOEDUCATION ON THE EMOTIONAL ASPECTS OF DIABETES: "THE EMOTIONAL ASPECTS OF DIABETES" WAS PRESENTED BY COVENANT COUNSELING CENTER (CCC) STAFF TO 164 PARTICIPANTS OF THE HEALTH EDUCATION PROGRAM'S (HEP) DIABETES EDUCATION CLASSES. THE PSYCHOEDUCATION IS OFFERED DURING EACH CLASS SESSION AND INCLUDES TOPICS SUCH AS "THE CONNECTION BETWEEN DIABETES AND DEPRESSION", SYMPTOMS OF DEPRESSION AND SYMPTOM MANAGEMENT, "HOW STRESS AFFECTS BLOOD SUGAR LEVELS", STRESS MANAGEMENT, COGNITIVE SKILLS SUCH AS REFRAMING AND INTERVENTION IN NEGATIVE THINKING, AND APPROPRIATE SELF-CARE TO ADDRESS THE EMOTIONAL ASPECTS OF DIABETES. MOOD SELF-REPORTS AND SURVEYS SHOWED THAT THERE WAS MOOD IMPROVEMENT IN DIRECT PROPORTION TO INCREASED KNOWLEDGE OF THE EMOTIONAL ASPECTS OF DIABETES AND SYMPTOM MANAGEMENT. ATTENDEES ARE INFORMED OF THE SERVICES AVAILABLE AT THE CCC AND THE EASE OF ACCESS TO THOSE SERVICES FOR PERSONS WITH FEW FINANCIAL RESOURCES. AS A RESULT, THERE WERE 8 REFERRALS TO CCC FROM THE HEP DIABETES EDUCATION CLASS REGARDING SYMPTOMS OF DEPRESSION. FORM 990, PART III, LINE 4 (Continued) CANCER COUNSELING SERVICES PROVIDED IN THE COMMUNITY: INDIVIDUAL, COUPLES, AND FAMILY COUNSELING SESSIONS WERE PROVIDED TO PATIENTS AND THEIR FAMILIES OF COVENANT HEALTH SYSTEM'S JOE ARRINGTON CANCER CENTER (JACC) IN THE CANCER CENTER SETTING TO ELIMINATE THE NECESSITY FOR THOSE PATIENTS TO TRAVEL TO AN ADDITIONAL OFF-SITE APPOINTMENT. THERE WERE 44 CLIENTS ASSISTED THROUGH THIS UNIQUE SERVICE. CLIENTS ATTENDING THESE CONFIDENTIAL COUNSELING SESSIONS WERE SERVED BY A LICENSED PROFESSIONAL COUNSELOR (LPC) AFTER BEING REFERRED BY PHYSICIANS, NURSES, SOCIAL WORKERS, CHAPLAINS, OR OTHER EMPLOYEES OF JACC. RANDY TUNGATE, ONE OF THE COUNSELORS AT COVENANT COUNSELING CENTER, RECEIVED A "VALUES IN ACTION AWARD" IN FY2010 FOR HIS WORK WITH THESE CANCER PATIENTS AND THEIR FAMILIES. ONE OF HIS STORIES INVOLVED THE FAMILY OF A WOMAN DYING OF PANCREATIC CANCER. RANDY COUNSELED THE FAMILY FROM FEBRUARY TO JUNE AS THEIR MOTHER BATTLED THE DISEASE, ULTIMATELY DYING IN THE SPRING. THE WOMAN'S TEENAGE DAUGHTER, WHO HAD ALSO LOST HER FATHER SEVERAL YEARS AGO, MET FOR SEVERAL INDIVIDUAL COUNSELING SESSIONS IN WORKING THROUGH HER INITIAL GRIEVING AND THE ADJUSTMENTS THAT FOLLOWED. THE SUPPORT PROVIDED BY THESE COUNSELING SERVICES PROVIDED THIS FAMILY WITH FACE-TO-FACE ENCOURAGEMENT AND ASSISTANCE IN NAVIGATING THE HUMAN SIDE OF CANCER, INCLUDING THE LOSS OF A LOVED ONE. NAME OF INITIATIVE OR PROGRAM: COMMUNITY OUTREACH - CHILDREN'S DENTAL CLINICS GOAL:TO PROVIDE A "DENTAL HOME" FOR CHILDREN AND OFFER PREVENTATIVE DENTAL TREATMENT FY10 ACCOMPLISHMENTS: A TOTAL OF 3,760 DENTAL ENCOUNTERS WERE COMPLETED IN BOTH THE LUBBOCK TX AREA AND THE ARTESIA NM AREA, WHICH IS A 19% INCREASE FROM FY 09. THESE DENTAL PROGRAMS CONTINUE TO MEET NEEDS IN BOTH THE LUBBOCK TX AREA AND THE ARTESIA NM AREA. AT EACH VISIT, THE DENTAL STAFF DISCUSSES THE PROCEDURES PERFORMED DURING THE VISIT WITH THE PATIENT AND THE PARENTS/GUARDIANS, OFTEN REVIEWING WITH THEM PROGRESS COMPLETED WITHIN THE DENTAL PLAN. EACH VISIT INCLUDES REMINDERS ABOUT THE IMPORTANCE OF GOOD ORAL HYGIENE BETWEEN VISITS. A DENTIST AND AN ASSISTANT ALSO PROVIDED SEALANT CLINICS TO 9 TITLE-1 ELEMENTARY SCHOOLS IN LUBBOCK, FLOYD, AND HALE COUNTIES IN FY 10. A TOTAL OF 769 CHILDREN, AGES KINDERGARTEN THROUGH FOURTH GRADE, WERE SCREENED AND 27% RECEIVED PREVENTATIVE SEALANTS. ONLY ONE SEALANT CLINIC WAS PROVIDED IN FY 09. ONE FAMILY'S EXPERIENCE EXEMPLIFIES THE DEEP APPRECIATION THAT THESE CHILDREN'S DENTAL PROGRAMS BRING TO THOSE WHO ARE PATIENTS OF THE PROGRAMS. ONE CHILD, AN 11-YEAR OLD BOY, WAS REFERRED TO THE CHILDREN'S CLINIC BY COVENANT'S JOE ARRINGTON CANCER CENTER (JACC). THE BOY'S FATHER WAS SEEKING CANCER TREATMENT AT JACC WHEN THE BOY WAS REFERRED BECAUSE HE WAS MISSING SCHOOL DUE TO INFECTIONS IN HIS MOUTH CAUSED BY THE PRESENCE OF 6 CAVITIES. THEY WERE NOT U.S. CITIZENS, AND BECAUSE OF THIS, NO ONE WOULD TREAT THE CHILD. OUR CHILDREN'S DENTAL CLINIC WAS ABLE TO QUALIFY THE CHILD FOR OUR FINANCIAL ASSISTANCE PROGRAM, SINCE MEDICAID WAS NOT AVAILABLE TO HIM. THE CHILD'S INFECTIONS WERE SO SEVERE THAT HE WAS FIRST PUT ON ANTIBIOTICS BEFORE TREATMENT ON HIS CAVITIES. AFTER 5 APPOINTMENTS, THE CHILD'S INFECTIONS HAD BEEN TREATED AND HIS CAVITIES WERE FILLED. THE PARENTS WERE OVERJOYED AT THE SERVICES WE WERE ABLE TO PROVIDE THEM DESPITE THEIR CITIZENSHIP STATUS. PROVIDING COMPREHENSIVE DENTAL PLANS: THE PARENTS/GUARDIANS OF EACH NEW PATIENT MEET WITH THE DENTIST AND DISCUSS A COMPREHENSIVE DENTAL PLAN FOR THE CHILD'S DENTAL HEALTH. A TOTAL OF 352 NEW PATIENTS WERE SEEN IN FY 10, WHICH IS A 17% INCREASE FROM FY 09. WE PLAN TO CONTINUE TO PROVIDE AND EXPLAIN COMPREHENSIVE DENTAL PLANS TO EACH NEW PATIENT AND PATIENT FAMILY/GUARDIAN. OUTSIDE REFERRAL SOURCES: THE MEMORANDUM OF UNDERSTANDING WITH THE COMBEST CENTER WAS IMPLEMENTED. THE CHILDREN'S DENTAL CLINIC RECEIVES REFERRALS FROM OUTSIDE DENTAL CLINICS IN THE COMMUNITY THAT CANNOT PROVIDE SPECIALTY SERVICES THAT WE ARE ABLE TO PROVIDE TO THEIR CLIENTS. THE CLINIC CONTINUES TO CULTIVATE A RELATIONSHIP WITH THE COMBEST CENTER, BUCKNER'S CHILDREN'S HOME, AND LUBBOCK CHILDREN'S HOME. THE MEDICAID PROVIDER WEBSITE ALSO SERVES AS A REFERRAL SOURCE FOR OUR CLINIC. NAME OF INITIATIVE OR PROGRAM: COVENANT BODY MIND INITIATIVE GOAL:LUBBOCK, TX. THIS PILOT PROGRAM WILL TARGET THE MIDDLE SCHOOLS OF: SCHOOL FOR YOUNG WOMEN LEADERS AND CHRIST THE KING CATHEDRAL MIDDLE SCHOOL FY10 ACCOMPLISHMENTS: TEXAS TECH UNIVERSITY (TTU) CENTER FOR PREVENTION AND RESILIENCY (CPR) FOCUSED ON PROGRAM DELIVERY AND COMMUNITY ENHANCEMENT ACTIVITIES AT THE SCHOOL FOR YOUNG WOMEN LEADERS (YWL). OTHER PARTICIPATING SCHOOLS INCLUDED CHRIST THE KING CATHEDRAL MIDDLE SCHOOL AND IRMA RANGEL MIDDLE SCHOOL WITHIN THE DALLAS INDEPENDENT SCHOOL DISTRICT. IRMA RANGEL MIDDLE SCHOOL WAS THE CONTROL GROUP FOR THE SCHOOL YEAR OF 2009-2010. THERE ARE SEVERAL ENHANCEMENT ACTIVITIES WITHIN THE CBMI CURRICULUM THAT ADDRESS HEALTH, WELLNESS, AND RESILIENCY FOR THE STUDENTS. ONE EXAMPLE OF THE ENHANCEMENT ACTIVITIES IS "MEET ME AT THE MARKET" WHICH TOOK PLACE AT UNITED MARKET STREET WHERE THE STUDENTS WENT ON A GROCERY STORE TOUR WITH THE UNITED SUPERMARKET'S DIETICIANS AND ALSO PARTICIPATED IN ACTIVITIES RELATED TO NUTRITION SUCH AS BRAND VS. GENERIC PRODUCTS, AND MAKING NUTRITIOUS MEALS ON A BUDGET. ANOTHER ENHANCEMENT ACTIVITY, "EXPRESS YOURSELF", TAUGHT EXPRESSION TO THE 8TH GRADE STUDENTS THROUGH ART AND WRITING. THESE ACTIVITIES WERE ADDED TO THE ALREADY POPULAR "WE FIT", "BE YOUR OWN TOP CHEF", AND "THE INNER BEAUTY PAGEANT". THE COVENANT BODYMIND INITIATIVE SPONSORED THE FIT4FUN KID'S TRIATHLON, PARTNERING WITH TEXAS TECH UNIVERSITY, AS A COMMUNITY OUTREACH ACTIVITY. THERE WERE 129 PARTICIPANTS AGES 7-14. FOLLOWING THE TRIATHLON, CBMI SPONSORED THE TEXAS TECH LEISURE POOL FOR THE ATHLETES AND THEIR FAMILIES TO ENJOY TIME TOGETHER. FORM 990, PART III, LINE 4 (Continued) REDUCTION IN THE PREVALENCE OF CHILDHOOD OBESITY AND WEIGHT-RELATED PROBLEMS: IN THE FALL OF THE 2009 SCHOOL YEAR, A BASELINE OF 99 STUDENTS BEGAN THE PROGRAM WITH THEIR BMI IN A HEALTHY RANGE, AND EIGHTY - THREE (83.8%) REMAINED IN A HEALTHY RANGE. OF 11 STUDENTS WITH BMI IN AN UNDERWEIGHT RANGE, ELEVEN (100%) INCREASED THEIR BMI BY 0.5 OR MORE. IN REGARDS TO WELLNESS, THIS IS A FAVORABLE OUTCOME. OF 50 STUDENTS WITH BMI IN AN OBESE RANGE, FOUR (8%) DECREASED THEIR BMI BY 0.5 OR MORE. ADDITIONALLY, OF THE 49 STUDENTS WITH BMI IN AN OVERWEIGHT RANGE, EIGHT (16.3%) DECREASED THEIR BMI BY 0.5 OR MORE. OF THESE 8 STUDENTS WITH BMI IN AN OVERWEIGHT RANGE, THREE (3.75%) MOVED INTO A HEALTHY BMI RANGE. BETWEEN THE 2009 AND 2010 FALL SEMESTERS 90 OUT OF 99 STUDENTS REMAINED IN THE PROGRAM. OF THESE 90 STUDENTS WITH BMI IN A HEALTHY RANGE, TEN (11.1%) DECREASED THEIR BMI BY 0.5 OR MORE. OVERALL IMPROVEMENT IN HEALTH AND WELLNESS OF PROJECT PARTICIPANTS: THE FIRST YEAR OF DATA SHOWED SOME PROMISING RESULTS. IN THE SIXTH GRADE CLASS, THERE WAS A SIGNIFICANT CHANGE IN THE STUDENTS' PERCEPTION OF BODY IMAGE OVER THE COURSE OF THE YEAR. THROUGH THE KIDS EATING DISORDER SURVEY (KEDS), CHILDREN ARE INSTRUCTED TO CIRCLE A DRAWING THAT MOST LOOKS LIKE THEM ON A SCALE FROM 1 TO 8, WITH 1 BEING EXTREMELY UNDERWEIGHT AND 8 BEING OVERWEIGHT. IN THE FALL, THE AVERAGE RATING WAS 8.33 AND IN THE SPRING, THE AVERAGE WAS 4.71. THIS MEANS THAT THEY SAW THEMSELVES AS HEALTHIER AFTER RECEIVING THE CBMI PROGRAM DURING THEIR 6TH GRADE YEAR, WHICH INDICATES THAT THE PROGRAM IS BUILDING RESILIENCY. ACCESS TO THE PROGRAM: THE STUDENTS WHO PARTICIPATED IN THE RESEARCH COMPONENT OF THE CBMI PROGRAM SHOWED THE FOLLOWING RACIAL/ETHNIC BREAKDOWN: 48.6% MEXICAN AMERICAN/HISPANIC, 32% CAUCASIAN, 10.8% AFRICAN AMERICAN AND 2.7% ASIAN AMERICAN. THIS WAS IN LINE WITH THE RACIAL/ETHNIC BREAKDOWN OF THE SCHOOL DISTRICTS WHERE THE PROGRAM WAS IMPLEMENTED. THE SOCIO-ECONOMIC STATUS IN THE SCHOOLS THAT RECEIVED THE CBMI PROGRAM RANGED FROM 66-70% LOWER SES. QUANTIFIABLE COMMUNITY BENEFIT IN FY 10 COVENANT HEALTH SYSTEM CONTRIBUTED OVER $47,405,238 IN UNSPONSORED QUANTIFIABLE COMMUNITY BENEFIT: TRADITIONAL CHARITY CARE $12,077,368 UNREIMBURSED MEDICAID $16,528,610 UNREIMBURSED COSTS - OTHER MEANS TESTED GOVERNMENT PROGRAMS COMMUNITY SERVICES FOR THE LOW-INCOME $80,362 COMMUNITY SERVICES FOR THE BROADER COMMUNITY $18,718,897 *IN ALIGNMENT WITH CATHOLIC HEALTH ASSOCIATION COMMUNITY BENEFIT REPORTING GUIDELINES UNPAID COST FOR MEDICARE PATIENTS $118,821,542 FOR MORE INFORMATION ON COVENANT HEALTH SYSTEM: WWW.COVENANTHEALTH.ORG FOR MORE INFORMATION ON THE ST. JOSEPH HEALTH SYSTEM GO TO: WWW.STJOE.ORG FORM 990, PART VI, LINE 6 DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS ST. JOSEPH HEALTH SYSTEM AND LUBBOCK METHODIST HOSPITAL SYSTEM ARE THE CORPORATE MEMBERS OF COVENANT HEALTH SYSTEM. FORM 990, PART VI, LINE 7A DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS COVENANT HEALTH SYSTEM HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE COVENANT HEALTH SYSTEM BOARD. ALL TRUSTEE APPOINTMENTS THAT COME FROM THE COVENANT HEALTH SYSTEM BOARD AS NOMINATIONS MUST BE APPROVED BY THE ST. JOSEPH HEALTH SYSTEM, AS THE CORPORATE MEMBER, AND THE ST. JOSEPH HEALTH MINISTRY, AS THE ORGANIZATIONAL SPONSOR. THE ST. JOSEPH HEALTH SYSTEM MEMBER APPROVES 50% OF THE BOARD NOMINATIONS, PLUS THE VOTING CEO. THE LUBBOCK METHODIST HEALTH SYSTEM MEMBER APPROVES THE OTHER 50% OF BOARD NOMINATIONS. FORM 990, PART VI, LINE 7B DECISIONS REQUIRING APPROVAL THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE ST. JOSEPH HEALTH SYSTEM AND LUBBOCK METHODIST HOSPITAL SYSTEM MEMBERS 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 MANAGEMENT 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 FOR THE APRIL 2011 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. 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. 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 WILL 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 ADMINISTRATION 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 SESSION. 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 / SCHEDULE J-2 HOURS DEVOTED TO RELATED ORGANIZATIONS MELINDA CLARK (THRU 10/1/09) SERVED AS CEO OF COVENANT HEALTH SYSTEM AND WAS COMPENSATED BY ST. JOSEPH HEALTH SYSTEM (SJHS), THE TAX-EXEMPT PARENT. SHE DEVOTED 47 HOURS PER WEEK TO CHS, 3 HOURS PER WEEK TO COVENANT CHILDREN'S HOSPITAL (CCH) AND NO HOURS TO SJHS. RICHARD PARKS SERVED ON THE BOARD OF HOSPICE OF LUBBOCK (HOL) AND WAS THE CEO OF COVENANT HEALTH SYSTEM (CHS). HE DEVOTED 47 HOURS PER WEEK TO CHS AND 3 HOURS PER WEEK TO CCH. JOE RANDOLPH SERVED ON THE BOARD OF CHS AND WAS THE EXECUTIVE VP/COO OF ST. JOSEPH HEALTH SYSTEM (SJHS). HE DEVOTED 50 HOURS PER WEEK TO SJHS AND 2 HOURS PER WEEK TO CHS. JAMES E. HARRELL, M.D. SERVED ON THE BOARD OF DIRECTORS OF CHS AND WAS COMPENSATED BY COVENANT MEDICAL GROUP (CMG) FOR MEDICAL SERVICES PROVIDED. HE DEVOTED 2 HOURS PER WEEK TO CHS AND 40 HOURS PER WEEK TO CMG. ELLIOT STERNBERG SERVED ON THE BOARD OF DIRECTORS OF CHS AND IS THE EVP/CMO OF SJHS. HE DEVOTED 50 HOURS PER WEEK TO SJHS AND 2 HOURS PER WEEK TO CHS. BRETT ESROCK DEVOTED 47 HOURS PER WEEK TO CHS AND 3 HOURS PER WEEK TO CCH. JOHN GRIGSON DEVOTED 47 HOURS PER WEEK TO CHS AND 3 HOURS PER WEEK TO CCH. FORM 990, PART XI, LINE 2C OVERSIGHT OR SELECTION PROCESS THE ST. JOSEPH HEALTH SYSTEM BOARD APPROVES THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT. FORM 990, SCHEDULE R, PART V, LINE 2 TRANSACTIONS 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) NAME AND SOCIAL SECURITY NUMBERS OF AFFECTED PARTICIPANTS: NOT APPLICABLE. (B) THE SECTION 409A FAILURE OCCURRED WITH RESPECT TO THE ST. JOSEPH HEALTH SYSTEM 457(F) 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 60TH 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 60TH 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 OCTOBER 6, 2010. THEREFORE, THE DATE ON WHICH THE FAILURE OCCURRED WAS THE 60TH DAY FOLLOWING THE SEPARATION FROM SERVICE DATE FOR PARTICIPANTS WHO VOLUNTARILY TERMINATED ON OR AFTER JANUARY 1, 2009 AND ON OR BEFORE DECEMBER 31, 2009. THE PLAN COVERS ELIGIBLE EMPLOYEES OF PARTICIPATING EMPLOYERS. COVENANT HEALTH SYSTEM PARTICIPATES IN THE PLAN AND HAD ONE EMPLOYEE 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: JAMES WURTS DATE OF WHEN THE FAILURE OCCURRED: 07/02/2009 12/31/2009 ACCOUNT BALANCE: $109,322 PAYMENT DATE: 12/17/2010 GROSS AMOUNT DISTRIBUTED*: $109,322 *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 HEALTH SYSTEM 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 60TH 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). 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 60TH DAY FOLLOWING INVOLUNTARY SEPARATION FROM SERVICE, BUT WITHIN 60 DAYS FOLLOWING SEPARATION FROM SERVICE. HOWEVER, IF THE 60TH DAY FALLS IN THE SECOND TAX YEAR, PAYMENT WILL BE MADE IN THE SECOND 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 60 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 60TH DAY FALLS IN THE SECOND TAX YEAR THEN PAYMENT WILL BE MADE IN THE SECOND 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. 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