2022-05-11T19:03:11-05:00 2021-06-30 470617373 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2020-07-01 710830696 ST VINCENT MEDICAL GROUP STVI 5015523000 2 ST VINCENT CIRCLE LITTLE ROCK AR 72205 TYLER BLAIR MARKET VP OF FINANCE 5015523000 2022-05-11 1 TYLER BLAIR 999009999 HEATHER ADKINS P01725376 3032989100 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z CHI ST VINCENT MEDICAL GROUP CHAD ADUDDELL 2 ST VINCENT CIRCLE LITTLE ROCK AR 72205 114934419 0 X WWW.CHISTVINCENT.COM/HOSPITALS-LOCATIONS/CLINICS X 1999 AR PROVIDING HOLISTIC CARE FOCUSING ON THE PHYSICAL, SPIRITUAL & PSYCHO-SOCIAL NEEDS OF PATIENTS. THESE ACTIVITIES TAKE PLACE IN VARIOUS SETTINGS, BUT ALL SPRING FROM THE SAME MISSION & FUNDAMENTAL PURPOSE. 16 12 387 0 0 0 2707888 126850 113451589 114803084 1907 4485 0 0 116161384 114934419 0 0 0 0 74635146 80529101 0 0 0 57957665 59076030 132592811 139605131 -16431427 -24670712 172997057 55492284 318254556 225475163 -145257499 -169982879 X AS AN AFFILIATE OF COMMONSPIRIT HEALTH, WE MAKE THE HEALING PRESENCE OF GOD KNOWN IN OUR WORLD BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL. 0 0 139605131 114803084 ST. VINCENT MEDICAL GROUP (SVMG) IS AN ARKANSAS NONPROFIT CORPORATION THAT WAS CREATED TO PROVIDE MEDICAL SERVICES IN THE LITTLE ROCK, ARKANSAS METROPOLITAN AREA. SVMG OWNS AND OPERATES PHYSICIAN CLINICS AND RELATED FACILITIES AND ENGAGES IN ACTIVITIES DESIGNED TO PROMOTE THE HEALTH CARE NEEDS OF THE COMMUNITY, INCLUDING THE PROVISION OF HEALTH CARE SERVICES BY PHYSICIANS AND OTHER HEALTH CARE PROFESSIONALS.SVMG CURRENTLY PROVIDES PHYSICIAN SERVICES AT SEVENTEEN CLINIC LOCATIONS AND THREE HOSPITAL LOCATIONS THROUGH ONE HUNDRED TWO PHYSICIAN EMPLOYEES. SVMG PROVIDES A BROAD RANGE OF PROFESSIONAL MEDICAL SERVICES AT ITS CLINICS OF THE TYPE NORMALLY PROVIDED AT OUTPATIENT CLINICS. THESE CLINICS PROVIDE THE HEALTH CARE SERVICES OF NONPHYSICIAN PROFESSIONALS, INCLUDING A NURSE PRACTITIONER AND NURSES. SVMG ALSO PROVIDES ANCILLARY SERVICES, INCLUDING RADIOLOGY (INCLUDING SCREENING MAMMOGRAPHY, BONE DENSITOMETRY SCANNING, AND GENERAL EXTREMITY AND CHEST X-RAY), CLIA-WAIVED LABORATORY TESTING, TREADMILL STRESS TESTING, EKG, PULSE OXIMETRY, AUDIOMETRY, PHYSICAL THERAPY, INJECTION AND ULTRASOUND SERVICES. SVMG PROVIDES MEDICAL CARE SERVICES ON A NONDISCRIMINATORY BASIS TO ALL PERSONS IN THE COMMUNITY. SVMG PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMS IN A NONDISCRIMINATORY MANNER. IN ADDITION, SVMG PROVIDES HEALTH CARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, IN ACCORDANCE WITH SVMG'S CHARITY CARE POLICY. IN ADDITION, SVMG REQUIRES EACH EMPLOYED PHYSICIAN TO COOPERATE WITH THE COMMUNITY SERVICE ACTIVITIES CONSISTENT WITH FURTHERANCE OF SVMG'S CHARITABLE MISSION, INCLUDING THE PHYSICIAN'S PARTICIPATION IN COMMUNITY HEALTH AND WELLNESS EDUCATION, COMMUNITY SERVICE ACTIVITIES AND TREATMENT OF INDIGENT AND CHARITY CARE PATIENTS.SVMG'S SOLE CORPORATE MEMBER IS ST. VINCENT INFIRMARY MEDICAL CENTER (SVIMC), AN ARKANSAS NONPROFIT CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAX AS AN ORGANIZATION DESCRIBED UNDER 501 (C)(3) OF THE INTERNAL REVENUE CODE. 139605131 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 387 1 0 0 0 0 0 0 0 0 0 0 0 0 X 16 12 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 AR X PETER BURY 5015523929 2 ST VINCENT CIRCLE LITTLE ROCK AR 72205 ALI KRISHT NEUROSURGEON 40.00 0.00 X 2639974 0 41267 LARRY SCHUMACHER SENIOR VP-OPERATIONS-CEO / BOARD MEMBER 1.00 50.00 X X 0 1962777 220294 CHRISTOPHER YOUNG ORTHOPEDIST GENERAL 5.00 40.00 X 493 1339613 41381 STYLIANOS RAMMOS NEUROSURGEON 40.00 0.00 X 1287350 0 40727 TAREK ABUELEM BOARD MEMBER 40.00 0.00 X 1225780 0 39600 CHAD ADUDDELL MARKET CEO 1.00 59.00 X X 0 1070370 44309 LANCE BURNS SURGEON 40.00 0.00 X 1041405 0 44647 ANDREW KUMPURIS CARDIOLOGIST INVASIVE 0.00 55.00 X 0 830465 36087 TROY HAMMETT DIV SVP CFO 0.00 59.00 X 0 752985 98103 SAYYADUL SIDDIQUI MD BOARD MEMBER /CHIEF OF STAFF 1.00 40.00 X 0 776018 35552 SHAWN BARNETT FORMER MKT SVP COO CFO 1.00 59.00 X 0 570803 32436 LISA POUNDERS-SAJOVITZ MD BOARD MEMBER / VICE CHIEF OF STAFF 40.00 1.00 X 523271 0 41290 BILL DILLARD III BOARD CHAIR 1.00 1.00 X X 0 0 0 CHUCK ERWIN BOARD MEMBER 1.00 1.00 X 0 0 0 SR GERTRUDE FOSTER SCN BOARD MEMBER 1.00 1.00 X 0 0 0 ERIC JACKSON BOARD MEMBER 1.00 1.00 X 0 0 0 CHARLES NABHOLZ BOARD MEMBER 1.00 1.00 X 0 0 0 JAMES NEWMAN BOARD MEMBER 1.00 1.00 X 0 0 0 SR JUDITH RALEY SCN BOARD MEMBER 1.00 1.00 X 0 0 0 DR TEDD SAER BOARD MEMBER 1.00 1.00 X 0 0 0 SUSIE SMITH BOARD MEMBER 1.00 1.00 X 0 0 0 PHILLIP TAPPAN BOARD MEMBER 1.00 1.00 X 0 0 0 BARBARA G WILLIAMS PHD RN BOARD MEMBER 1.00 1.00 X 0 0 0 MARLIN BOYLE BOARD MEMBER 1.00 1.00 X 0 0 0 6718273 7303031 715693 130 1 1 0 ENGAGEMED INC 5125 NORTHSHORE DRIVE LITTLE ROCK AR 72118 CONSULTING SERVICES 24567069 LABORATORY CORPORATION OF AMERICA 8490 UPLAND DRIVE ENGLEWOOD CO 80112 LAB AND DIAGNOSTIC SERVICES 537561 GRIFOLS USA LLC 2410 LILLYVALE AVE LOS ANGELES CA 90032 MEDICAL SERVICES 473824 SMART STAFF 2024 ARKANSAS VALLEY DR 603 LITTLE ROCK AR 72212 STAFFING SERVICES 244055 AMERICAN ESOTERIC LABORATORIES 1701 CENTURY CENTER COVE MEMPHIS TN 38134 COVID TESTING SERVICES 215950 10 59181 67669 126850 PATIENT SERVICES 900099 114672946 114672946 0 0 RENTAL INCOME 900099 130138 130138 0 0 114803084 4485 4485 114934419 114803084 0 4485 566636 566636 69950158 69950158 567545 567545 6330563 6330563 3114199 3114199 4157 4157 12102014 12102014 834 834 899286 899286 1852679 1852679 6546682 6546682 41101 41101 2574 2574 3340859 3340859 2227120 2227120 464599 464599 MEDICAL SUPPLIES 31507836 31507836 0 0 REPAIRS AND MAINTENANCE 380607 380607 0 0 RECRUITMENT AND RELOCAT 135157 135157 0 0 DUES & SUBSCRIPTIONS 114561 114561 0 0 -544036 -544036 139605131 139605131 0 0 5104 5503 122101413 3857253 0 6481445 10438399 0 0 0 1508001 1983991 17600 12782309 6917115 7082828 5865194 0 0 0 0 35818266 33324344 172997057 55492284 10633216 13360633 0 0 0 0 0 0 0 307621340 212114530 318254556 225475163 X -145257499 -169982879 0 -145257499 -169982879 172997057 55492284 X -24670712 -54668 X 0 1 X 1 0 X 46701 32861 39307 2707888 126850 2953607 51441596 51176121 95539440 113451589 114803084 426411830 51488297 51208982 95578747 116159477 114929934 429365437 0 0 0 429365437 409 1925 4485 6819 409 1925 4485 6819 51488297 51208982 95579156 116161402 114934419 429372256 1.00000 1.00000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 150000 150000 2242288 1434338 807950 4409373 942912 3466461 5653970 4238657 1415313 326678 301208 25470 5865194 ROU OPERATING ASSET 33452609 INTERCOMPANY RECEIVABLES -128265 33324344 INTERCOMPANY PAYABLES 174951425 CURRENT PORTION OF OPERATING LEASE LIABILITY 3774738 LT PORTION OF OPERATING LEASE LIABILITY 33388367 212114530 X PART X, LINE 2: ST. VINCENT MEDICAL GROUP'S FINANCIAL INFORMATION IS INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS, WHICH INCLUDES THE FOLLOWING DISCLOSURE: COMMONSPIRIT REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. 0 1 0 1 0 0 0 0 0 ALI KRISHT NEUROSURGEON 2632862 0 275 0 6837 0 17280 0 23987 0 2681241 0 0 0 LARRY SCHUMACHER SENIOR VP-OPERATIONS-CEO / BOARD MEM 0 1053841 0 748629 0 160307 0 197895 0 22399 0 2183071 0 140400 CHRISTOPHER YOUNG ORTHOPEDIST GENERAL 0 1334847 493 0 0 4766 0 16975 15992 8414 16485 1365002 0 0 STYLIANOS RAMMOS NEUROSURGEON 1285123 0 275 0 1952 0 16321 0 24406 0 1328077 0 0 0 TAREK ABUELEM BOARD MEMBER 1224163 0 187 0 1430 0 15974 0 23626 0 1265380 0 0 0 CHAD ADUDDELL MARKET CEO 0 614127 0 394640 0 61603 0 16975 0 27334 0 1114679 0 0 LANCE BURNS SURGEON 1038752 0 265 0 2388 0 18241 0 26406 0 1086052 0 0 0 ANDREW KUMPURIS CARDIOLOGIST INVASIVE 0 797895 0 23794 0 8776 0 16666 0 19421 0 866552 0 0 TROY HAMMETT DIV SVP CFO 0 544077 0 203065 0 5843 0 69019 0 29084 0 851088 0 0 SAYYADUL SIDDIQUI MD BOARD MEMBER /CHIEF OF STAFF 0 748473 0 23794 0 3751 0 16443 0 19109 0 811570 0 0 SHAWN BARNETT FORMER MKT SVP COO CFO 0 434229 0 132823 0 3751 0 16975 0 15461 0 603239 0 0 LISA POUNDERS-SAJOVITZ MD BOARD MEMBER / VICE CHIEF OF STAFF 521044 0 362 0 1865 0 16975 0 24315 0 564561 0 0 0 PART I, LINE 3 DURING THE CALENDAR YEAR 2020, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY ST.VINCENT INFIRMARY MEDICAL CENTER, A RELATED ORGANIZATION. ST. VINCENT INFIRMARY MEDICAL CENTER USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT; (2) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART 1, LINE 4A: FOR REPORTABLE INDIVIDUALS EMPLOYED PRIOR TO 2019, POST-TERMINATION PAYMENTS ARE ADDRESSED IN EXECUTIVE EMPLOYMENT AGREEMENTS FOR EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE. THESE EMPLOYMENT AGREEMENTS REQUIRE THAT IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT AGREEMENT. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. OFFICERS, KEY EMPLOYEES AND CERTAIN HIGHLY COMPENSATED EMPLOYEES WHO BEGAN EMPLOYMENT AFTER NOVEMBER 1ST OF 2019 ARE COVERED BY THE COMMONSPIRIT HEALTH EXECUTIVE SEVERANCE POLICY. THIS POLICY PROVIDES FOR SEVERANCE PAY WHICH VARIES BASED UPON THE EXECUTIVE'S POSITION LEVEL, IN THE EVENT OF A POSITION ELIMINATION OR OTHER QUALIFYING EVENT, IN ACCORDANCE WITH THE GUIDELINES OF THE EXECUTIVE SEVERANCE POLICY. AN EXECUTIVE'S WRITTEN EMPLOYMENT OR SEVERANCE AGREEMENT SHALL CONTROL WHERE THE SEVERANCE PAY AMOUNTS IN THE POLICY CONFLICT WITH THE EXECUTIVE'S WRITTEN EMPLOYMENT OR SEVERANCE AGREEMENT. IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT OF CLAIMS. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. PART 1, LINE 4B: DURING THE 2020 CALENDAR YEAR, COMMONSPIRIT MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/HOSPITAL PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DURING 2020 THE FOLLOWING DISTRIBUTIONS WERE MADE BY COMMONSPIRIT FROM THE DEFERRED COMPENSATION PLAN: LAWRENCE P SCHUMACHER $142,712 DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRIT'S DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2019 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. DURING 2020, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: CHAD ADUDDELL - $60,294 PART I, LINE 5A: ST. VINCENT MEDICAL GROUP PROVIDED INCENTIVE COMPENSATION FOR CERTAIN PHYSICIANS BASED UPON "NET COLLECTED REVENUE". THESE AMOUNTS WERE NOT DETERMINED WITH REFERENCE TO ORGANIZATIONAL NET COLLECTED REVENUE OR ORGANIZATIONAL NET INCOME. RATHER, THESE AMOUNTS WERE DETERMINED BASED UPON THE PHYSICIAN'S CONTRIBUTION TO NET COLLECTED REVENUE BASED ON SERVICES PERFORMED BY THAT INFDIVIDUAL PHYSICIAN IN EXCESS OF A THRESHOLD. PHYSICIAN TOTAL COMPENSATION IS APPROVED IN ADVANCE BY A COMMITTEE OF THE BOARD OF DIRECTORS OF SVIMC FOLLOWING IRC SEC. 4958 REBUTTABLE PRESUMPTION OF REASONABLENESS PROCEDURES. TOTAL COMPENSATION IS SUBJECT TO A CAP THAT ENSURES COMPENSATION IS AT FAIR MARKET VALUE. FORM 990, PART VI, SECTION A, LINE 6 ACCORDING TO THE BYLAWS OF ST. VINCENT MEDICAL GROUP, THE ENTITY'S SOLE MEMBER IS ST. VINCENT INFIRMARY MEDICAL CENTER D/B/A ST. VINCENT HEALTH SYSTEM, AN ARKANSAS NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY THE CORPORATE MEMBER. THE CORPORATE MEMBER MAY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS, AND MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS OF THE CORPORATION SHALL BE APPOINTED BY THE CORPORATE MEMBER NO LATER THAN JUNE 30 OF EACH YEAR. THE CORPORATE MEMBER SHALL SELECT THE PHYSICIAN DIRECTORS FROM A SLATE OF QUALIFIED CANDIDATES PROVIDED TO IT BY THE BOARD'S NOMINATING ADVISORY COMMITTEE. THE CORPORATE MEMBER MAY UNILATERALLY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS SHOULD NOMINATING ADVISORY COMMITTEE FAIL TO FURNISH THE CORPORATE MEMBER WITH A LIST OF INDIVIDUALS QUALIFIED TO SERVE ON THE BOARD OF DIRECTORS OF THE CORPORATION. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION'S CORPORATE MEMBER IS ST. VINCENT INFIRMARY MEDICAL CENTER. PURSUANT TO SECTION 5.4 OF THE ORGANIZATION'S BYLAWS, BOTH ST. VINCENT INFIRMARY MEDICAL CENTER AND COMMONSPIRIT HEALTH (ST. VINCENT INFIRMARY MEDICAL CENTER'S SOLE CORPORATE MEMBER) HAVE RESERVED POWERS AS OUTLINED IN THE COMMONSPIRIT HEALTH GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE HELD BY THE ST. VINCENT INFIRMARY MEDICAL CENTER BOARD: *APPROVE MEMBERS OF THE ST. VINCENT MEDICAL GROUP BOARD *AMENDMENT OF THE CORPORATE DOCUMENTS OF THE ST. VINCENT MEDICAL GROUP *APPROVE REMOVAL OF A MEMBER OF THE GOVERNING BODY OF THE ST. VINCENT MEDICAL GROUP *ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR THE ST. VINCENT MEDICAL GROUP THE FOLLOWING RIGHTS ARE RESERVED TO THE COMMONSPIRIT HEALTH BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE COMMONSPIRIT HEALTH CHIEF EXECUTIVE OFFICER: *SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF THE ST. VINCENT MEDICAL GROUP *REMOVAL OF A MEMBER OF THE GOVERNING BODY OF THE ST. VINCENT MEDICAL GROUP *APPROVAL OF ISSUANCE OF DEBT BY ST. VINCENT MEDICAL GROUP *APPROVAL OF PARTICIPATION OF ST. VINCENT MEDICAL GROUP IN A JOINT VENTURE *APPROVAL OF FORMATION OF A NEW CORPORATION BY ST. VINCENT MEDICAL GROUP *APPROVAL OF A MERGER INVOLVING THE ST. VINCENT MEDICAL GROUP *APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ST. VINCENT MEDICAL GROUP *TO REQUIRE THE TRANSFER OF ASSETS BY THE ST. VINCENT MEDICAL GROUP TO COMMONSPIRIT HEALTH TO ACCOMPLISH COMMONSPIRIT HEALTH'S GOALS AND OBJECTIVES, AND TO SATISFY COMMONSPIRIT HEALTH DEBTS. PURSUANT TO SECTION 5.5.2 OF THE ORGANIZATION'S BYLAWS, ST. VINCENT INFIRMARY MEDICAL CENTER OR COMMONSPIRIT HEALTH MAY, IN EXERCISE OF THEIR APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND ITS PRESIDENT AND THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. FORM 990, PART VI, SECTION B, LINE 11B ONCE THE RETURN IS PREPARED, THE RETURN IS REVIEWED BY THE CHIEF FINANCIAL OFFICER. AFTER THE RETURN IS REVIEWED BY THE CFO, THE COMMONSPIRIT HEALTH TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NONSUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RESUBMITTED TO THE CFO. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") IN PLACE TO PROTECT THE INTERESTS OF COMMONSPIRIT HEALTH ("COMMONSPIRIT") IN CIRCUMSTANCES THAT MAY RESULT IN A CONFLICT BETWEEN PERSONAL INTERESTS OF A PERSON AND THE INTERESTS OF THE ORGANIZATION AND THOSE IT SERVES. THE POLICY WAS LAST UPDATED DURING THE TAX YEAR ENDED 6/30/2021. COMMONSPIRIT'S COI POLICY APPLIES TO COMMONSPIRIT, ITS DIRECT AFFILIATES AND SUBSIDIARIES AND ANY RELATED ENTITY THE GOVERNING DOCUMENTS OF WHICH REQUIRE THE ENTITY TO COMPLY WITH COMMONSPIRIT POLICY (COLLECTIVELY THE "SYSTEM ENTITIES"). THE FOLLOWING PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AT LEAST ANNUALLY (VIA A FORMAL SYSTEM-ADMINISTERED SURVEY) IF THE PERSON'S AFFILIATION WITH COMMONSPIRIT CONTINUES: - MEMBERS OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF COMMITTEES OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM ("ELT") OF COMMONSPIRIT - CORPORATE OFFICERS OF SYSTEM ENTITIES - EMPLOYEES OF SYSTEM ENTITIES AT THE VICE PRESIDENT LEVEL AND ABOVE - ALL INDIVIDUALS ENGAGED IN RESEARCH AT INSTITUTIONS OWNED OR OPERATED BY A SYSTEM ENTITY. - SELECT EMPLOYEES AS DETERMINED FROM TIME TO TIME BY LEADERSHIP (WHICH INCLUDES KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES AS SPECIFIED BY THE INTERNAL REVENUE SERVICE FOR FORM 990 PURPOSES WHO ARE NOT OTHERWISE INCLUDED IN THE CATEGORIES ABOVE). DISCLOSURE, REVIEW, AND MANAGEMENT OF PERCEIVED, POTENTIAL, OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. EACH PERSON IS REQUIRED TO PROMPTLY AND FULLY DISCLOSE ANY SITUATION OR CIRCUMSTANCE THAT MAY CREATE A CONFLICT OF INTEREST AS SOON AS SHE/HE BECOMES AWARE OF IT. IN ADDITION, AT THE INCEPTION OF AN INDIVIDUAL'S RELATIONSHIP WITH COMMONSPIRIT (E.G. HIRING, BOARD APPOINTMENT), AND FOR CERTAIN POSITIONS, ANNUALLY THEREAFTER, WRITTEN CONFLICT OF INTEREST DISCLOSURE FORMS MUST BE COMPLETED. A FAILURE TO DISCLOSE MAY RESULT IN DISCIPLINARY OR CORRECTIVE ACTIONS. REPORTED POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE INITIALLY REVIEWED BY LEGAL, CORPORATE RESPONSIBILITY OR RESEARCH INTEGRITY STAFF. IF NECESSARY, A CONFLICT OF INTEREST MANAGEMENT PLAN IS DEVELOPED, WHICH PLAN SHALL BE SUBJECT TO ACCEPTANCE BY THE APPROPRIATE DIRECT MANAGER, SUPERVISOR, MEDICAL STAFF OFFICE, BOARD OR BOARD COMMITTEE (FOR BOARD, BOARD COMMITTEE, ELT OR CORPORATE OFFICER CONFLICTS), OR OTHER APPROPRIATE INDIVIDUAL OR BODY. ONCE ACCEPTED, THE CONFLICT OF INTEREST MANAGEMENT PLAN IS COMMUNICATED TO THE PERSON WITH THE ACTUAL OR POTENTIAL CONFLICT AND THE INDIVIDUAL MUST CONDUCT THEMSELVES IN CONFORMITY WITH THE PLAN. IN THE EVENT THAT A TRANSACTIONAL CONFLICT INTEREST ARISES IN CONNECTION WITH A SYSTEM ENTITY BOARD MEETING, THE CONFLICTED INDIVIDUAL MUST DISCLOSE THAT CONFLICT PRIOR TO OR AT THE BEGINNING OF THE MEETING IN WHICH THE MATTER IS TO BE CONSIDERED. THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE TRANSACTION AND IS PROHIBITED FROM USING PERSONAL INFLUENCE WITH RESPECT TO THE MATTER, BUT IS NOT PROHIBITED FROM PROVIDING INPUT IF REQUESTED TO DO SO. FORM 990, PART VI, SECTION B, LINE 15 DURING THE TAX YEAR ENDED 6/30/2021, NO OFFICERS RECEIVED COMPENSATION FROM THE ORGANIZATION. ANY EXECUTIVE COMPENSATION PAID TO OFFICERS BY RELATED ORGANIZATIONS WAS SET BY THE RELATED ORGANIZATION'S COMPENSATION COMMITTEE UTILIZING BOTH AN INDEPENDENT CONSULTANT AND COMPARABILITY STUDIES TO DETERMINE COMPENSATION. THEREFORE, THESE QUESTIONS ARE MORE APPROPRIATELY ANSWERED AS N/A. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.COMMONSPIRIT.ORG. FORM 990, PART XI, LINE 9: REALLOCATION OF CARES ACT REVENUE -54,668. 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601 OAK ST BRECKENRIDGE MN 56520 411850500 SENIOR LIVING MN 501(C)(3) LINE 10 SFH 0 ARROYO GRANDE COMMUNITY HOSPITAL FOUNDATION 345 S HALCYON RD ARROYO GRANDE CA 93420 203256066 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DH 0 BAKERSFIELD MEMORIAL HOSPITAL 420 34TH STREET BAKERSFIELD CA 93301 951802779 HOSPITAL CA 501(C)(3) LINE 3 DCC 0 BARROW NEUROLOGICAL FOUNDATION 350 WEST THOMAS ROAD PHOENIX AZ 85013 860174371 FUNDRAISING FOUNDATION AZ 501(C)(3) LINE 7 DH 0 BAYLOR ST LUKE'S HEALTH VENTURES 17200 ST LUKES WAY STE 170 THE WOODLANDS TX 77384 274499340 PHYSICIANS TX 501(C)(3) LINE 12A, I SLHS 0 BAYLOR ST LUKE'S MEDICAL GROUP 6624 FANNIN ST STE 1100 HOUSTON TX 77030 760458535 PHYSICIANS TX 501(C)(3) LINE 3 BSLHV 0 BORNEMANN HEALTHCARE CORPORATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 232187242 INACTIVE PA 501(C)(3) LINE 12A, I CSH 0 BRAZOSPORT HEALTH FOUNDATION INC 1 WEST WAY CT LAKE JACKSON TX 77566 760080110 FUNDRAISING FOUNDATION TX 501(C)(3) LINE 12A, I TCHB 0 BRAZOSPORT 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