2021-05-11T18:01:43-05:00 2020-06-30 470617373 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2019-07-01 943006034 Dignity Health Hospital & Professional Liability Self-Insurance Trust DIGN 4154385500 185 BERRY STREET SUITE 200 SAN FRANCISCO CA 94107 DANIEL MORISSETTE SEVP, CFO 2021-05-11 true MARK STOCKI P00642127 3032989100 2021-05-10 2019 2022-09-23 18:48:47Z Daniel Morissette 185 BERRY STREET SUITE 200 SAN FRANCISCO CA 94107 468629251 false X www.dignityhealth.org X 1986 CA SELF-INSURANCE PROGRAM FOR RELATED EXEMPT ORGANIZATIONS. 1 1 0 0 310794 246318 0 0 62815589 92286944 19244601 9042710 0 0 82060190 101329654 0 0 0 0 0 84460207 122672496 84460207 122672496 -2400017 -21342842 400230273 403829150 398005510 428519556 2224763 -24690406 SELF-INSURANCE PROGRAM FOR RELATED EXEMPT ORGANIZATIONS. false false 120346928 92286944 ADMINISTRATION OF PROFESSIONAL AND GENERAL LIABILITY SELF-INSURANCE PROGRAM AND OBTAINMENT OF OTHER GROUP INSURANCE COVERAGE FOR AFFILIATED CHARITABLE HEALTHCARE ORGANIZATIONS. 120346928 true false false false false false false false false false true false true true true false true false false true false false false false false false false false true false false false false false false false false false false false false false true false false false true X 163 0 true 0 true true false false false false false false false false false false false X 1 1 true false false false false true true true true false false false true true true true true false false false CA X Mary Tyren 4154385592 185 Berry Street 200 San Francisco CA 94107 NORTHERN TRUST Institutional Trustee 0.0 0.0 X 0 0 0 STATE STREET Institutional Trustee 0.0 0.0 X 164677 1148149 0 Daniel J Morissette CPA SEVP, Chief Financial Officer 2.0 50.0 X 0 3332751 378955 Lloyd H Dean President/ CEO 2.0 50.0 X 0 13327537 3417690 Mitch Melfi Esq Secretary/Chief Legal Officer 2.0 50.0 X 0 1640990 37534 Phil Foster SVP, Chief Risk Officer 25.0 15.0 X 0 897129 42658 Rick Grossman EVP, Legal Services/General Counsel 0.0 0.0 X 0 7620277 192517 Teresa M Kielhorn VP Risk Services 0.0 0.0 X 0 715664 96251 164677 28682496 4165605 0 true true false Alternative Insurance Management Services Inc 3900 OLYMPIC BLVD STE 40 ERLANGER KY 41018 outsourced risk management services 20422093 Ogletree Deakins Nahs Smoak & Stewart PC 50 International Drive Ste 300 Greenville SC 29615 Legal Services 1507150 Kronick Moskovitz Tiedemann & Girard 400 Capitol Mall 27th Floor Sacramento CA 95814 Legal Services 1261838 Manatt Phelps & Phillips LLP 2019 Century Park East Ste 1700 Los Angeles CA 90067 Legal Services 1255736 Atkinson Andelson Loya Ruud & Romo 12800 Center Court Drive Ste 300 Cerritos CA 90703 Legal Services 1143818 49 0 MANAGEMENT SERVICES FOR SELF-INSURANCE 900099 92286944 92286944 0 0 0 0 92286944 3126051 310794 2815257 0 0 373216256 367299597 5916659 0 5916659 5916659 0 0 0 0 0 101329654 92286944 310794 8731916 41993 41993 24492 24492 618197 618197 8618794 7119232 1499562 0 11916 11916 113227696 113227696 Licenses and Taxes 47188 47188 82220 0 82220 0 122672496 120346928 2325568 0 11233755 0 6108054 7786184 0 0 44299157 31526402 0 0 0 168118520 165810633 150487045 165967971 0 19983742 32737960 400230273 403829150 96317761 101773057 0 301687749 326746499 398005510 428519556 X 2224763 -24690406 2224763 -24690406 400230273 403829150 -21342842 -5572327 0 X false true X true false X X 1 Dignity Health 941196203 3 true 0 122672495 1 0 122672495 true false false false false false false false false false false false false false false true false Schedule A, Part I, Line 12g Supported Organization THE TRUST PROVIDED OR PURCHASED FOR THE BENEFIT OF DIGNITY HEALTH, VARIOUS SERVICES, FACILITIES AND GOODS. SEE FORM 990, PART IX FOR FURTHER DETAILS. Schedule A, Part IV, Section A, Line 1 Supported Organization THE TRUST IS ORGANIZED AND OPERATED EXCLUSIVELY FOR THE BENEFIT OF, AND TO CARRY OUT THE PURPOSES OF, DIGNITY HEALTH AND ITS SUBSIDIARY CHARITABLE ORGANIZATIONS. THE TRUST IS ORGANIZED EXCLUSIVELY FOR CHARITABLE PURPOSES AND IS INTENDED TO BE FOR THE BENEFIT OF AND SUPPORT OF THE TRUSTOR AND PROVIDERS, TO SERVE AS A REPOSITORY FOR FUNDS PAID IN BY THE TRUSTOR AND PROVIDERS, TO MAKE PAYMENTS ON BEHALF OF THE TRUSTOR AND PROVIDERS PURSUANT TO ARTICLE VI, AND TO OPERATE AS AN INTEGRAL PART OF, AND IN SUPPORT OF THE OPERATIONS OF, THE TRUSTOR AND PROVIDERS. Schedule A, Part IV, Section B, Line 1 Supported Organization DIGNITY HEALTH, THE TRUSTOR OF THE ORGANIZATION, HAS THE POWER TO APPOINT AND REMOVE THE INSTITUTIONAL TRUSTEE. TRUSTOR MAY AMEND, ALTER OR REVOKE TRUST AGREEMENT IN WHOLE OR IN PART AT ANY TIME BY AN INSTRUMENT IN WRITING DELIVERED TO TRUSTEE PROVIDED, HOWEVER, THAT TRUSTEE'S RIGHTS, DUTIES, POWERS, AND LIABILITIES SHALL NOT BE CHANGED WITHOUT ITS WRITTEN CONSENT. TRUSTEE MAY RESIGN AT ANY TIME UPON SIXTY DAYS NOTICE TO TRUSTOR OR MAY BE REMOVED AT ANY TIME BY TRUSTOR UPON SIXTY DAYS NOTICE TO TRUSTEE. SHOULD THE OFFICE OF TRUSTEE BE VACATED, A SUCCESSOR SHALL BE APPOINTED BY TRUSTOR AND TRUSTEE SHALL ASSIGN, TRANSFER AND PAY OVER THE TRUST ESTATE, AS THEN CONSTITUTED, TO SUCH SUCCESSOR TRUSTEE. IF A SUCCESSOR TRUSTEE IS NOT SO APPOINTED, A SUCCESSOR TRUSTEE SHALL BE A RECOGNIZED INDEPENDENT CORPORATE FIDUCIARY SUCH AS A BANK OR TRUST COMPANY AND SHALL SATISFY SUCH OTHER REQUIREMENTS AS MAY BE IMPOSED. Pooled Investments 165967971 F 165967971 Other Long Term Assets 22119731 Due from Related Parties 10618229 32737960 Self-Insurance Liabilities 326746499 326746499 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE ORGANIZATION 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. Central America and the Caribbean Program Services Captive Insurance 3285211 Central America and the Caribbean Investments N/A 65777742 Europe (Including Iceland and Greenland) Investments N/A 3633441 0 0 0 0 0 0 72696394 0 72696394 true false true true true false Schedule F, Part I, Line 3 Foreign Expenditures PREMIUM AMOUNTS ARE RECORDED TO PREPAID INSURANCE AND AMORTIZED OVER THE TWELVE MONTH PERIOD GENERALLY OF DECEMBER THROUGH NOVEMBER. THE EXPENDITURES LISTED ON PART I ARE DETERMINED BASED ON THE ACCRUAL METHOD OF ACCOUNTING. true true false false false false false false false STATE STREET Institutional Trustee 164677 1148149 0 0 0 0 0 0 0 0 164677 1148149 0 0 Rick Grossman EVP, Legal Services/General Counsel 0 395883 0 1208149 0 6016245 0 150493 0 42025 0 7812794 0 2793750 Teresa M Kielhorn VP Risk Services 0 320327 0 385376 0 9961 0 70602 0 25649 0 811915 0 0 Lloyd H Dean President/ CEO 0 1942477 0 8157579 0 3227481 0 3302242 0 115448 0 16745227 0 3042693 Phil Foster SVP, Chief Risk Officer 0 547127 0 286824 0 63178 0 16675 0 25983 0 939787 0 0 Mitch Melfi Esq Secretary/Chief Legal Officer 0 856473 0 624970 0 159547 0 15625 0 21909 0 1678524 0 0 Daniel J Morissette CPA SEVP, Chief Financial Officer 0 1349240 0 1975581 0 7930 0 340398 0 38557 0 3711705 0 0 Schedule J, Part I, Line 3 Compensation of Top Management Official THE ORGANIZATION RELIED ON A RELATED ORGANIZATION, DIGNITY HEALTH, THAT USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3, TO ESTABLISH THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15 FOR ADDITIONAL INFORMATION. Schedule J, Part II Additional information DIGNITY HEALTH'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST DIGNITY HEALTH IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE DIGNITY HEALTH TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES DIGNITY HEALTH SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND DIGNITY HEALTH'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE, REVENUES AND COMPLEXITY. PAYMENTS PURSUANT TO A LONG-TERM FINANCIAL PERFORMANCE GOAL WERE PAID IN CALENDAR YEAR 2019. Schedule J, Part I, Line 4a Severance or change-of-control payment CERTAIN LISTED PERSONS PARTICIPATE IN A SEVERANCE PLAN THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 1 TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE PLAN. A PAYMENT PURSUANT TO THE PLAN ARRANGEMENTS FOR ONE FORMER OFFICER OCCURRED DURING 2019 INCLUDE R. GROSSMAN; $2,900,392. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan CERTAIN LISTED PERSONS PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN, A NONQUALIFIED SUPPLEMENTAL BENEFIT PLAN LIMITED TO PARTICIPANTS IN THE DIGNITY HEALTH RETIREMENT PLAN WHOSE BENEFITS ARE AFFECTED BY THE LIMITATIONS IMPOSED BY SECTIONS 401(A)(17) AND 415 OF THE INTERNAL REVENUE CODE. BENEFIT SERVICE UNDER THIS PLAN WAS FROZEN AS OF JANUARY 1, 2008. A PAYMENT PURSUANT TO THE PLAN ARRANGEMENTS FOR ONE FORMER OFFICER OCCURRED DURING 2019 INCLUDE R. GROSSMAN; $2,793,750. CERTAIN LISTED PERSONS ARE ELIGIBLE TO PARTICIPATE IN NON-QUALIFIED 457(F) PLANS THAT ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE, AS REQUIRED BY THE IRS. THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR EXECUTIVES HIRED PRIOR TO JUNE 30, 2006. THE BENEFIT IS INTENDED TO BRIDGE THE DIFFERENCE, IF ANY, BETWEEN THE BENEFIT PROVIDED UNDER THE DIGNITY HEALTH EXCESS BENEFIT PLAN HAD BENEFIT SERVICE NOT BEEN FROZEN AT JANUARY 1, 2008, AND THE BENEFITS PROVIDED FROM ALL OTHER QUALIFIED AND NON-QUALIFIED PLANS. BENEFITS VEST UNDER THIS 457(F) PLAN AT THE LATER OF THE DATE THE PARTICIPANT ATTAINS AGE 62 OR IS CREDITED WITH 15 YEARS OF SERVICE. THE 2010 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR CERTAIN OFFICERS AND KEY EMPLOYEES, PRIMARILY THOSE WHO ARE NOT ELIGIBLE TO PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN OR THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN DESCRIBED ABOVE. THIS BENEFIT PROVIDES AN ANNUAL ACCRUAL OF 10% OF TOTAL COMPENSATION AND IS PAYABLE ANNUALLY ON JULY 1 ONCE VESTED, WHICH IS AGE 62 WITH 5 YEARS OF SERVICE; THE PLAN ALSO ALLOWS FOR SPECIAL AWARDS. A PAYMENT PURSUANT TO THE PLAN ARRANGEMENTS FOR ONE OFFICER OCCURRED DURING 2019 INCLUDE L. DEAN; $3,042,693. CERTAIN LISTED PERSONS EMPLOYED BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION, PARTICIPATE IN A DEFERRED COMPENSATION PLAN. DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRIT HEALTH'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 (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. PAYMENTS PURSUANT TO THE PLAN ARRANGEMENTS OF THE SUPER VESTING RULES DURING 2019 INCLUDE: P. FOSTER, $47,346 AND M. MELFI, $141,771. CERTAIN LISTED PERSONS PARTICIPATE IN THE DIGNITY HEALTH SUPPLEMENTAL EXECUTIVE RETENTION/RETIREMENT PLAN, A NONQUALIFIED SUPPLEMENTAL BENEFIT PLAN WHICH IN 2002 WAS OFFERED TO MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM BY THE DIGNITY HEALTH BOARD OF DIRECTORS AND WOULD BE PAID ONLY IF THE EXECUTIVES STAYED WITH THE ORGANIZATION FOR A SPECIFIED NUMBER OF YEARS AS THE PRIMARY PURPOSE OF THIS PLAN IS TO PROVIDE FOR THE RETENTION AND RETIREMENT OF THE PARTICIPANTS. THE EXECUTIVE MANAGEMENT TEAM IS RECRUITED FROM STABLE CAREERS IN ORGANIZATIONS FROM ACROSS THE COUNTRY AND FROM VARIOUS INDUSTRIES. DUTIES ARE BOTH EXTENSIVE AND COMPLEX AND REQUIRE SUBSTANTIAL AND DIVERSE EXPERIENCE AND SKILL SETS TO EXECUTE SUCCESSFULLY. THE CALCULATION FOR THE PAYMENTS TO EACH EXECUTIVE IS BASED ON THE VALUE OF A FINAL AVERAGE PAY ANNUITY BENEFIT BASED ON RETIREMENT AGE AND SERVICE YEARS TO THE ORGANIZATION. DISTRIBUTION OCCURS EACH JULY 1 IF THE PLAN FORMULA WARRANTS A PAYMENT. NO PAYMENTS RELATED TO THIS PLAN OCCURED IN 2019. COMPENSATION AMOUNTS FOR THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS DISCUSSED ABOVE ARE REPORTED AS DEFERRED COMPENSATION IN THE YEAR ACCRUED (SCHEDULE J, PART II, COLUMN C) AND ARE REFLECTED AGAIN AS REPORTABLE COMPENSATION IN THE YEAR PAID (SCHEDULE J, PART II, COLUMN B(III)). Form 990, Part V, Line 2a Number of employees THE ORGANIZATION DOES NOT HAVE EMPLOYEES. THE ORGANIZATION OPERATES AS THE ADMINISTRATION COMPANY OF THE PROFESSIONAL AND GENERAL LIABILITY SELF-INSURANCE PROGRAM FOR THE SUPPORTED ORGANIZATION, DIGNITY HEALTH, AND ITS RELATED ENTITIES. Form 990, Part VI, Line 15 Determination of compensation FOR 2019, THE RELATED ORGANIZATION, COMMONSPIRIT HEALTH'S BOARD OF STEWARDSHIP TRUSTEES APPOINTS A HUMAN RESOURCES AND COMPENSATION COMMITTEE, COMPRISED OF EXCLUSIVELY INDEPENDENT DIRECTORS, WHO ARE ACCOUNTABLE FOR SETTING REASONABLE COMPENSATION PACKAGES FOR EACH OFFICER AND CERTAIN KEY EXECUTIVES (INCLUDING THE PRESIDENT/CEO). THE HUMAN RESOURCES AND COMPENSATION COMMITTEE APPROVES, CONSISTENT WITH THE ORGANIZATION'S PHILOSOPHY AND PRINCIPLES, THE ANNUAL PERFORMANCE GOALS AND CRITERIA TO BE USED IN DETERMINING MERIT INCREASES AND VARIABLE COMPENSATION CRITERIA FOR OFFICERS AND KEY EMPLOYEES. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ALSO ENGAGES OUTSIDE LEGAL COUNSEL AS NECESSARY AND QUALIFIED INDEPENDENT COMPENSATION AND BENEFITS SPECIALISTS (INDEPENDENT EXPERTS) TO REVIEW, ANALYZE AND PROVIDE BENCHMARKING DATA FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGES OF OFFICERS AND KEY EXECUTIVES. APPROPRIATE COMPARABLE DATA IS OBTAINED FROM THE INDEPENDENT EXPERTS, (E.G., TOTAL ECONOMIC BENEFITS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR SIMILAR JOB RESPONSIBILITIES). KEY DELIBERATIONS OF THE COMMITTEE ARE DOCUMENTED IN MEETING MINUTES WHICH ARE APPROVED AT THE NEXT COMMITTEE MEETING AND PROVIDED TO THE BOARD OF DIRECTORS. THE DOCUMENTATION OF THE DELIBERATIONS INCLUDES (A) THE TERMS OF THE AGREEMENT APPROVED AND THE DATE APPROVED; (B) THE MEMBERS OF THE COMMITTEE WHO WERE PRESENT DURING DISCUSSION OF THE APPROVED AGREEMENT AND THOSE WHO VOTED ON IT; AND (C) THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE COMMITTEE AND HOW THE DATA WAS OBTAINED. Form 990, Part VI, Line 2 Family/business relationships amongst interested persons R. GROSSMAN AND D. MORISSETTE - Business relationship, M. MELFI, P. FOSTER AND D. MORISSETTE - Business relationship, M. MELFI AND P. FOSTER - Business relationship Form 990, Part VI, Line 7a Members or stockholders electing members of governing body DIGNITY HEALTH, THE TRUSTOR OF THE ORGANIZATION, HAS THE POWER TO APPOINT AND REMOVE THE INSTITUTIONAL TRUSTEE BY DELIVERY TO THE INSTITUTIONAL TRUSTEE OF WRITTEN NOTICE TO THAT EFFECT. THE INSTITUTIONAL TRUSTEE, AND ANY SUCCESSOR TRUSTEE, MAY RESIGN AS TRUSTEE UPON WRITTEN NOTICE TO THAT EFFECT DELIVERED TO THE TRUSTOR. SUCH REMOVAL OR RESIGNATION SHALL BECOME EFFECTIVE 60 DAYS FROM THE DATE OF THE DELIVERY OF SUCH WRITTEN NOTICE, UNLESS AN EARLIER OR LATER DATE IS AGREED UPON BY TRUSTOR AND THE TRUSTEE. ON FEBRUARY 1, 2019, DIGNITY HEALTH AND CATHOLIC HEALTH INITIATIVES ("CHI"), A COLORADO NONPROFIT CORPORATION, EFFECTED A BUSINESS COMBINATION. ON THAT DATE, CHI CHANGED ITS NAME TO COMMONSPIRIT HEALTH AND BECAME THE SOLE CORPORATE MEMBER OF DIGNITY HEALTH. COMMONSPIRIT HEALTH IS A CATHOLIC HEALTHCARE SYSTEM SPONSORED BY THE PUBLIC JURIDIC PERSON, CATHOLIC HEALTH CARE FEDERATION ("CHCF"). Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders DIGNITY HEALTH, THE TRUSTOR OF THE ORGANIZATION, HAS THE POWER TO APPOINT AND REMOVE THE INSTITUTIONAL TRUSTEE BY DELIVERY TO THE INSTITUTIONAL TRUSTEE OF WRITTEN NOTICE TO THAT EFFECT. THE INSTITUTIONAL TRUSTEE, AND ANY SUCCESSOR TRUSTEE, MAY RESIGN AS TRUSTEE UPON WRITTEN NOTICE TO THAT EFFECT DELIVERED TO THE TRUSTOR. SUCH REMOVAL OR RESIGNATION SHALL BECOME EFFECTIVE 60 DAYS FROM THE DATE OF THE DELIVERY OF SUCH WRITTEN NOTICE, UNLESS AN EARLIER OR LATER DATE IS AGREED UPON BY TRUSTOR AND THE TRUSTEE. ON FEBRUARY 1, 2019, DIGNITY HEALTH AND CATHOLIC HEALTH INITIATIVES ("CHI"), A COLORADO NONPROFIT CORPORATION, EFFECTED A BUSINESS COMBINATION. ON THAT DATE, CHI CHANGED ITS NAME TO COMMONSPIRIT HEALTH AND BECAME THE SOLE CORPORATE MEMBER OF DIGNITY HEALTH. COMMONSPIRIT HEALTH IS A CATHOLIC HEALTHCARE SYSTEM SPONSORED BY THE PUBLIC JURIDIC PERSON, CATHOLIC HEALTH CARE FEDERATION ("CHCF"). Form 990, Part VI, Line 11b Review of form 990 by governing body COMMONSPIRIT HEALTH'S SVP/CHIEF RISK OFFICER AND VICE PRESIDENT, RISK FINANCE AND INSURANCE REVIEWED THE FORM 990. IN ADDITION, THE SUPPORTED ORGANIZATION'S ACCOUNTING DEPARTMENT WORKED CLOSELY WITH COMMONSPIRIT HEALTH'S TAX DEPARTMENT TO REVIEW THE FORM 990. THE FINAL VERSION OF THE FORM 990 WAS NOT PROVIDED TO THE INSTITUTIONAL TRUSTEE BEFORE THE RETURN WAS FILED. Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION HAS ADOPTED DIGNITY HEALTH'S CONFLICTS OF INTEREST POLICIES (THE "COI POLICIES"). DURING THE PERIOD JULY 1, 2019 - JUNE 30, 2020, DIGNITY HEALTH WAS SUBJECT TO WRITTEN CONFLICT OF INTEREST POLICIES (THE "COI POLICIES."). THESE POLICIES, PROVIDE FOR THE DISCLOSURE AND SUBSEQUENT REVIEW AND MANAGEMENT OF CONFLICTS OF INTEREST THAT MAY EXIST FOR MEMBERS OF DIGNITY HEALTH'S GOVERNING BODIES, INCLUDING ITS BOARD OF DIRECTORS AND BOARD COMMITTEES, AS WELL AS DIGNITY HEALTH'S OFFICERS AND EXECUTIVE LEADERS, KEY EMPLOYEES, MANAGEMENT PERSONNEL AT THE VICE PRESIDENT LEVEL AND ABOVE, AND ANY OTHER DESIGNATED PERSONNEL ("COVERED PERSONS"). ALL COVERED PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS ARISING FROM THE BUSINESS, OWNERSHIP, FINANCIAL AND PERSONAL INTERESTS HELD BY SUCH COVERED PERSONS OR THEIR FAMILY MEMBERS. COVERED PERSONS ARE REQUIRED TO DISCLOSE TO THEIR SUPERVISORS OR RELEVANT DECISION MAKERS ANY INTEREST THAT MAY PRESENT A CONFLICT OF INTEREST, OR THE APPEARANCE OF A CONFLICT OF INTEREST. SUCH DISCLOSURE IS REQUIRED ON A TRANSACTIONAL BASIS AT THE TIME SUCH CONFLICTS ARISE, WHEN AN INDIVIDUAL BECOMES A COVERED PERSON (E.G. UPON HIRING OR UPON PROMOTION), AND ANNUALLY THEREAFTER. AS PART OF THE ANNUAL DISCLOSURE SURVEY CONDUCTED PURSUANT TO THE COI POLICIES, EACH COVERED PERSON IS REQUIRED TO CERTIFY THAT HE/SHE: (1) HAS RECEIVED A COPY OF THE COI POLICY OR COI POLICIES APPLICABLE TO HIS/HER POSITION; (2) HAS READ THE COI POLICY AND UNDERSTANDS SAID POLICY; AND (3) AGREES TO COMPLY WITH ALL REQUIREMENTS OF THE COI POLICY, INCLUDING COMPLETING THE CONFLICTS OF INTEREST DISCLOSURE SURVEY AS REQUIRED BY THE COI POLICIES. THE INFORMATION FROM THE ANNUAL DISCLOSURE SURVEY IS USED TO MONITOR AND MANAGE DISCLOSED CONFLICTS OF INTEREST AND ASSURE DECISIONS ARE MADE IN THE ORGANIZATION'S BEST INTERESTS. THE PROCEDURES FOR ADDRESSING A CONFLICT OF INTEREST RELATED TO A PROPOSED TRANSACTION IN THE CASE OF GOVERNING BODIES REQUIRE THAT THE BOARD SHALL CAREFULLY SCRUTINIZE AND MUST IN GOOD FAITH EITHER APPROVE OR DISAPPROVE ANY TRANSACTION IN WHICH DIGNITY HEALTH OR A DIGNITY HEALTH ENTITY IS A PARTY AND IN WHICH THE DIRECTOR EITHER: HAS A MATERIAL FINANCIAL INTEREST OR IS A DIRECTOR OR CORPORATE OFFICER OF THE OTHER PARTY (OTHER THAN A DIGNITY HEALTH-AFFILIATED ORGANIZATION). THE BOARD MUST APPROVE THE TRANSACTION BY MAJORITY OF THE DIRECTORS ON THE BOARD, WITHOUT COUNTING THE VOTE OF ANY INDIVIDUAL WHO HAS AN INTEREST IN THE TRANSACTION. IN REVIEWING SUCH TRANSACTIONS BETWEEN DIGNITY HEALTH OR DIGNITY HEALTH ENTITIES AND VENDORS OR OTHER CONTRACTORS WHO ARE, OR ARE AFFILIATED WITH, DIRECTORS, THE BOARD SHALL ACT NO MORE OR LESS FAVORABLY THAN IT WOULD IN REVIEWING TRANSACTIONS WITH UNRELATED THIRD PARTIES. THE TRANSACTION WILL NOT BE APPROVED UNLESS THE BOARD DETERMINES THAT THE TRANSACTION IS FAIR TO DIGNITY HEALTH OR THE DIGNITY HEALTH ENTITY. Form 990, Part VI, Line 19 Required documents available to the public FEDERAL TAX LAWS DO NOT MANDATE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS BE MADE AVAILABLE FOR PUBLIC INSPECTION. THE ORGANIZATION IS INCLUDED IN COMMONSPIRIT HEALTHS' CONSOLIDATED FINANCIAL STATEMENTS WHICH ARE AVAILABLE ON BOTH COMMONSPIRIT HEALTH'S AND DIGNITY HEALTH'S WEBSITES AND UPON REQUEST. ALEGENT CREIGHTON CLINIC 12809 W DODGE RD OMAHA NE 68154 470765154 HOSPITAL NE 501(c)(3) 3 ACH false ALEGENT CREIGHTON HEALTH 12809 W DODGE RD OMAHA NE 68154 470757164 HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA false ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM 7500 MERCY RD OMAHA NE 68124 470484764 HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA false ALEGENT HEALTH - IMMANUEL MEDICAL CENTER 6901 N 72ND ST OMAHA NE 68122 470376615 HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA false ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER 104 W 17TH ST SCHUYLER NE 68661 470399853 HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA false ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA PO BOX 368 CORNING IA 50841 420782518 HOSPITAL IA 501(c)(3) 3 CHI NEBRASKA false ALEGENT HEALTH-COMMUNITY MEMORIAL HOSP OF MISSOURI VALLEY IA 631 N 8TH ST MISSOURI VALLEY IA 51555 420776568 HOSPITAL IA 501(c)(3) 3 CHI NEBRASKA false ALVERNA APARTMENTS 300 SE 8TH AVE LITTLE FALLS MN 56345 411351177 Long-TERM CARE MN 501(c)(3) 10 CSH false APPLETREE COURT 601 OAK ST BRECKENRIDGE MN 56520 411850500 SENIOR LIVING MN 501(c)(3) 10 SFH false Arroyo Grande Community Hospital Foundation 345 S Halcyon Rd Arroyo Grande CA 93420 203256066 FUNDRAISING FOUNDATION CA 501(c)(3) Type I Dignity Health false Bakersfield Memorial Hospital 420 34TH Street Bakersfield CA 93301 951802779 HOSPITAL CA 501(c)(3) 3 Dignity Community Care false Barrow Foundation UK 13 CHURCH STREET Nunney ENGLAND UK BA114LW 311724184 Fundraising Foundation 501(c)(3) Type III-O NA false Barrow Neurological Foundation 350 West Thomas Road Phoenix AZ 85013 860174371 Fundraising Foundation AZ 501(c)(3) 7 Dignity Health false BAYLOR ST LUKE'S HEALTH VENTURES 17200 ST LUKES WAY STE 170 THE WOODLANDS TX 77384 274499340 PHYSICIANS TX 501(c)(3) Type I SLCHS false BAYLOR ST LUKE'S MEDICAL GROUP 6624 FANNIN ST STE 1100 HOUSTON TX 77030 760458535 PHYSICIANS TX 501(c)(3) 3 SLHS false BORNEMANN HEALTHCARE CORPORATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 232187242 HEALTHCARE PA 501(c)(3) Type I CSH false BRAZOSPORT HEALTH FOUNDATION INC 1 West Way Ct LAKE JACKSON TX 77566 760080110 FUNDRAISING FOUNDATION TX 501(c)(3) Type I BRHS false BRAZOSPORT REGIONAL PHYSICIAN SERVICES 100 MEDICAL DRIVE LAKE JACKSON TX 77566 800240261 PHYSICIANS TX 501(c)(3) 3 BRHS false BURLESON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742759890 HOSPITAL TX 501(c)(3) 3 SJSC false BURLESON ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN TX 77802 742913931 HEALTHCARE TX 501(c)(3) 10 SJSC false California Hospital Medical Center Foundation 1401 South Grand Avenue Los Angeles CA 90015 954000909 FUNDRAISING FOUNDATION CA 501(c)(3) Type I Dignity Community Care false CARRINGTON HEALTH CENTER 800 N 4TH ST CARRINGTON ND 58421 450227311 HOSPITAL ND 501(c)(3) 3 CSH false CATHOLIC HEALTH INITIATIVES - COLORADO 9100 East Mineral Circle Centennial CO 80112 840405257 HOSPITAL CO 501(c)(3) 3 CSH false CATHOLIC HEALTH INITIATIVES - IOWA CORP 1111 6TH AVE DES MOINES IA 50314 420680448 HOSPITAL IA 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