METHODIST HOSPITAL LEVELLAND: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- METHODIST HOSPITAL LEVELLAND (EIN 75-2246348)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-13
- IRS object ID
- 201621349349304767
- Schema version
- 2014v6.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-13T12:37:05-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18101 VON KARMAN AVENUE SUITE 1700 | AddressLine1Txt |
| City | IRVINE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92612 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 752246348 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | METHODIST HOSPITAL LEVELLAND | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % BRUCE WHITE | InCareOfNm |
| Business Name Control | METH | BusinessNameControlTxt |
| Phone | 8068944963 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 COLLEGE AVENUE | AddressLine1Txt |
| City | LUBBOCK | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 793366508 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRUCE WHITE | PersonNm |
| Person Title | EXEC. DIRECTOR/CEO | PersonTitleTxt |
| Phone | 8068944963 | PhoneNum |
| Signature | 2016-05-03 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KARA ADAMS | PreparerPersonNm |
| PTIN | P00023315 | PTIN |
| Phone | 9497942300 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COVENANT HOSPITAL LEVELLAND | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BRUCE WHITE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 COLLEGE AVENUE | AddressLine1Txt |
| City | LEVELLAND | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 793366508 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $20,987,450 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.COVENANTHOSPITALLEVELLAND.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1988 | FormationYr |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE O | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 247 | TotalEmployeeCnt |
| Total Volunteers | 22 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $21,054,905 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $20,718,544 | CYProgramServiceRevenueAmt |
| PY Investment Income | $344,865 | PYInvestmentIncomeAmt |
| CY Investment Income | $268,906 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $21,399,770 | PYTotalRevenueAmt |
| CY Total Revenue | $20,987,450 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $16,036 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $11,013,926 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,235,449 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,584,620 | PYOtherExpensesAmt |
| CY Other Expenses | $9,202,837 | CYOtherExpensesAmt |
| PY Total Expenses | $20,614,582 | PYTotalExpensesAmt |
| CY Total Expenses | $20,438,286 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $785,188 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $549,164 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $12,569,735 | TotalAssetsBOYAmt |
| Total Assets EOY | $11,945,718 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,905,813 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,931,578 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,663,922 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $10,014,140 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $16,854,085 | ExpenseAmt |
| Revenue | $20,718,544 | RevenueAmt |
| Desc | SEE SCHEDULE O | Desc |
| Total Program Service Expenses | $16,854,085 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 92 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 247 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRUCE WHITE | PersonNm |
| Phone | 8068944963 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 COLLEGE AVENUE | AddressLine1Txt |
| City | LEVELLAND | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 79336 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JANNA WORLEY | ||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| ANN CAPPS | ||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| BRUCE WHITE | ||||||||
| CEO COVENANT LEVELLAND/BD MBR | 50.0 | 0.0 | Yes (X) | $142,942 | $0 | $24,700 | Yes (X) | |
| SHARON PRATHER | ||||||||
| CHIEF GOVERNANCE OFF/BD MBR | 2.0 | 48.0 | Yes (X) | $0 | $330,766 | $41,024 | Yes (X) | |
| MIKE BAILEY MD | ||||||||
| CHIEF OF STAFF/BOARD MEMBER | 50.0 | 0.0 | Yes (X) | $0 | $199,644 | $22,446 | Yes (X) | |
| JOE DEE BROOKS | ||||||||
| BOARD MEMBER - CHAIR | 5.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| JESUS M RODRIGUEZ | ||||||||
| BOARD MEMBER - SECRETARY | 3.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| KELVIN SHARP | ||||||||
| BOARD MEMBER - VICE CHAIR | 5.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| NEWMAN WHEELER | ||||||||
| CFO | 50.0 | 0.0 | $52,745 | $15,618 | $13,004 | Yes (X) | ||
| GREG MCKAY | ||||||||
| PHYSICIAN ASSISTANT | 40.0 | 0.0 | $164,219 | $0 | $35,724 | Yes (X) | ||
| MARTY COTTENOIR | ||||||||
| DIRECTOR OF PHARMACY | 40.0 | 0.0 | $148,481 | $0 | $24,846 | Yes (X) | ||
| GARY JACKSON | ||||||||
| PHYSICIAN ASSISTANT | 40.0 | 0.0 | $126,429 | $0 | $22,523 | Yes (X) | ||
| RONDA CRUZ | ||||||||
| DIRECTOR OF REHAB | 40.0 | 0.0 | $104,725 | $0 | $10,178 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $739,541 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $546,028 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $194,445 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| COVENANT MEDICAL CENTER | |||||
| 3615 19TH STREET | LUBBOCK | TX | 79410 | MEDICAL SERVICES | $2,343,513 |
| TEXAS EMERGENCY ROOM SERVICES PA | |||||
| 7032 COLLECTION CENTER DRIVE | CHICAGO | IL | 60693 | PHYSICIAN SERVICES | $507,958 |
| DAVID GREEN CRNA PC | |||||
| 1505 S HIGHWAY 70 | SWEETWATER | TX | 79556 | PHYSICIAN SERVICES | $396,000 |
| CLEANCO CARPET CLEANING JANITORIA | |||||
| PO BOX 399 | LEVELLAND | TX | 79336 | CLEANING SERVICES | $107,388 |
| WIPFLI LLP | |||||
| PO BOX 3160 | MILWAUKEE | WI | 53201 | ACCOUNTING SERVICES | $106,073 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $0 | FundraisingAmt |
| Noncash Contributions | $0 | NoncashContributionsAmt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| NET PATIENT REVENUE | 622110 | $20,158,395 | $20,158,395 | $0 | $0 |
| CAFETERIA REVENUE | 722310 | $152,484 | $152,484 | $0 | $0 |
| MOB RENTAL | 531120 | $41,800 | $41,800 | $0 | $0 |
| LAB REVENUE | 622110 | $77,885 | $77,885 | $0 | $0 |
| REBATES & REFUNDS | 900099 | $43,042 | $43,042 | $0 | $0 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $244,938 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $244,938 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $20,718,544 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $268,906 | TotalRevenueColumnAmt |
| Exclusion | $268,906 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,987,450 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,718,544 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $268,906 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $195,687 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $195,687 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,712,622 | TotalAmt |
| Program Services | $6,616,608 | ProgramServicesAmt |
| Management And General | $1,096,014 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $477,978 | TotalAmt |
| Program Services | $398,471 | ProgramServicesAmt |
| Management And General | $79,507 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,196,151 | TotalAmt |
| Program Services | $1,761,408 | ProgramServicesAmt |
| Management And General | $434,743 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $653,011 | TotalAmt |
| Program Services | $549,844 | ProgramServicesAmt |
| Management And General | $103,167 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,864,963 | TotalAmt |
| Program Services | $2,841,029 | ProgramServicesAmt |
| Management And General | $23,934 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,469 | TotalAmt |
| Program Services | $30,526 | ProgramServicesAmt |
| Management And General | $103,943 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,955,614 | TotalAmt |
| Program Services | $1,600,605 | ProgramServicesAmt |
| Management And General | $1,355,009 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $338,951 | TotalAmt |
| Program Services | $330,247 | ProgramServicesAmt |
| Management And General | $8,704 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,033 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $10,033 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $311,235 | TotalAmt |
| Program Services | $311,235 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $173,460 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $173,460 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MEDICAL SUPPLIES | Desc |
| Total | $2,414,112 | TotalAmt |
| Program Services | $2,414,112 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,438,286 | TotalAmt |
| Program Services | $16,854,085 | ProgramServicesAmt |
| Management And General | $3,584,201 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Joint Costs TotalJointCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $592,330 | BOYAmt |
| EOY | $2,178,300 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,782,950 | BOYAmt |
| EOY | $4,126,854 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,841,512 | BOYAmt |
| EOY | $2,091,706 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,268 | BOYAmt |
| EOY | $757,009 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,398,115 | BOYAmt |
| EOY | $323,617 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,080 | BOYAmt |
| EOY | $16,206 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $9,645,104 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,236,641 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,757,546 | BOYAmt |
| EOY | $2,408,463 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,934 | BOYAmt |
| EOY | $43,563 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,569,735 | BOYAmt |
| EOY | $11,945,718 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,176,118 | BOYAmt |
| EOY | $1,502,320 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $729,695 | BOYAmt |
| EOY | $429,258 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,905,813 | BOYAmt |
| EOY | $1,931,578 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,663,922 | BOYAmt |
| EOY | $10,014,140 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,663,922 | BOYAmt |
| EOY | $10,014,140 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,569,735 | BOYAmt |
| EOY | $11,945,718 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $549,164 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$198,946 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $25,980 | OtherCostOrOtherBasisAmt |
| Book Value | $25,980 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,251,512 | OtherCostOrOtherBasisAmt |
| Depreciation | $765,232 | DepreciationAmt |
| Book Value | $486,280 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,395,210 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,073,028 | DepreciationAmt |
| Book Value | $322,182 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,737,061 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,398,381 | DepreciationAmt |
| Book Value | $1,338,680 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $235,341 | OtherCostOrOtherBasisAmt |
| Book Value | $235,341 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,408,463 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PAYABLE TO THIRD PARTY | Desc |
| Amt | $429,258 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $429,258 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART X, LINE 2 | FormAndLineReferenceDesc |
| Explanation | CONSOLIDATED AUDIT FOOTNOTE FOR FIN 48 (ASC 740) ACCOUNTING STANDARDS CODIFICATION (ASC 740), INCOME TAXES, CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING A MINIMUM RECOGNITION THRESHOLD THAT A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. ASC 740 ALSO PROVIDES GUIDANCE ON DERECOGNITION, MEASUREMENT, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE AND TRANSITION. THE GUIDANCE IS APPLICABLE TO PASS-THROUGH ENTITIES AND TAX-EXEMPT ORGANIZATIONS. NO SIGNIFICANT TAX LIABILITY FOR TAX BENEFITS, INTEREST OR PENALTIES WAS ACCRUED AT JUNE 30, 2015 OR 2014. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 175. | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,146,405 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,146,405 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05610 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,309,450 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,580,818 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $728,632 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03570 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $187,719 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $187,719 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00920 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,643,574 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,580,818 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,062,756 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10100 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,894 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,894 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,894 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,894 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,645,468 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,580,818 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,064,650 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10110 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,405,894 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $2,171,049 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,665,791 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,494,742 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | METHODIST HOSPITAL LEVELLAND | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 COLLEGE AVENUE | AddressLine1Txt |
| City | LEVELLAND | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 793366508 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.COVENANTHOSPITALLEVELLAND.ORG | WebsiteAddressTxt |
| State License | 307 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | RURAL HEALTH CLINIC | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | METHODIST HOSPITAL LEVELLAND | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SCHEDULE H, PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SCHEDULE H, PART V, SECTION C | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 175. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300. | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 5 | HEALTH ISSUES FOR THE BROADER COMMUNITY AND ECONOMICALLY POOR IN THE PRIMARY SERVICE AREA WERE IDENTIFIED IN PART THROUGH COMMUNITY INTERVIEWS. THESE INTERVIEWS IDENTIFIED ISSUES AND NEEDS FOR WHICH THERE ARE NO ADEQUATE RESOURCES IN PLACE BY OTHER PROVIDERS TO ADDRESS THOSE NEEDS. COMMUNITY INTERVIEWEES INCLUDED STAFF FROM THE FOLLOWING ORGANIZATIONS: - SOUTH PLAINS COMMUNITY ACTION - CITY OF LEVELLAND - HOSPICE OF LUBBOCK - BEEHIVE ASSISTED LIVING - TEXAS A&M AGGIE LIFE EXTENSION SERVICE ON PUBLIC HEALTH AND COMMUNITY EDUCATION - FORESIGHT CONSULTING - COVENANT LEVELLAND HOSPITAL - VETERANS SERVICES OFFICER - SOUTH PLAINS COMMUNITY ACTION ASSOCIATION - COMMUNITY LEADER REPRESENTING THE HISPANIC COMMUNITY |
| SCHEDULE H, PART V, SECTION B, LINE 7A | THE WEBSITE IS: HTTP://WWW.COVENANTHOSPITALLEVELLAND.ORG/DOCUMENTS/COMMUNITY_BENEFIT/CHNA_ COVENANT_LEVELLAND_REPORT_FORMAT_FINAL.PDF |
| SCHEDULE H, PART V, SECTION B, LINE 10A | THE WEBSITE IS: HTTP://WWW.COVENANTHOSPITALLEVELLAND.ORG/DOCUMENTS/COMMUNITY_BENEFIT/FY14_ CB_PLAN_IMPLEMENTATION_COVENANT_LEVELLAND_FINAL.PDF |
| SCHEDULE H, PART V, SECTION B, LINE 11 | ALTHOUGH THERE IS NO FORMAL PROGRAM TO ADDRESS PREMATURE DEATH AND HIGH CHRONIC DISEASE INCIDENCE, THE FINDINGS OF THE CHNA WILL BE THE FIRST STEP TO ENCOURAGE LOCAL COORDINATION OF SERVICES AND RESOURCES. THERE ARE OTHER NEEDS, NAMELY, OBESITY, ACCESS TO PREVENTIVE CARE, LACK OF TRANSPORTATION TO HEALTH AND HUMAN SERVICES, LINGUISTIC ISOLATION, PREMATURE DEATH AND SEXUALLY TRANSMITTED DISEASE THAT COVENANT LEVELLAND DOES NOT HAVE THE CURRENT RESOURCES TO ADDRESS OR THE STAFF AVAILABLE TO DEVELOP A FORMAL INITIATIVE AT THIS TIME. HOWEVER AFTER THE NEXT COMMUNITY BENEFIT CYCLE, THESE AREAS OF NEED WILL BE REVISITED FOR POSSIBLE INCLUSION IN FUTURE PROGRAMMING. AS IN ANY COMMUNITY, THERE ARE MANY UNMET HEALTH NEEDS. WE WILL WORK WITH OTHER COMMUNITY PARTNERS TO REFER PATIENTS TO PROGRAMS THAT ADDRESS UNMET HEALTH NEED. COVENANT HEALTH LEVELLAND WILL MONITOR AND EVALUATE STRATEGIES LISTED BELOW FOR THE PURPOSE OF TRACKING PROGRESS ON THE IMPLEMENTATION OF THOSE STRATEGIES AND DOCUMENT ANTICIPATED IMPACT. EVALUATION EFFORTS TO MONITOR EACH STRATEGY WILL INCLUDE THE COLLECTION AND DOCUMENTATION OF STRATEGY MEASURES, NUMBER OF PARTNERSHIPS MADE, PERCENT IMPROVEMENT IN HEALTH-RELATED METRICS, INCLUDING BEHAVIORAL AND HEALTH OUTCOMES AS APPROPRIATE. INITIATIVE: THE DENTAL SEALANT PROGRAM FOR 3RD GRADERS GOAL (ANTICIPATED IMPACT): TO IMPROVE THE ORAL HEALTH OF THE CHILDREN ENROLLED IN THIRD GRADE AT HOCKLEY AND COCHRAN COUNTIES SCHOOLS BY REDUCING CAVITIES. OUTCOME MEASURE: THE PERCENT OF 3RD GRADERS IN HOCKLEY AND COCHRAN COUNTIES IN NEED OF SEALANTS WHO RECEIVE THEM. STRATEGIES: 1. ESTABLISH AN UNDERSTANDING WITH LOCAL SCHOOL DISTRICTS GRANTING PERMISSION TO PROVIDE DENTAL EXAMS FOR DENTAL SEALANTS FOR 3RD GRADERS. 2. SCREEN 3RD GRADE CHILDREN FOR ORAL HEALTH ISSUES. 3. STRENGTHEN 3RD GRADERS KNOWLEDGE AND SKILLS ABOUT ORAL HYGIENE THROUGH INFORMATION PROVIDED TO THE STUDENTS THE DAY OF THE DENTAL EXAMS AND SEALANT APPLICATION. KEY COMMUNITY PARTNERS: COVENANT HEALTH COMMUNITY OUTREACH DENTAL PROGRAM, LOCAL DENTISTS, LOCAL SCHOOL DISTRICTS IN HOCKLEY AND COCHRAN COUNTIES. INITIATIVE: SUICIDE PREVENTION PROGRAM GOAL: TO PROVIDE THE COMMUNITY INFORMATION THAT WILL HELP REDUCE THE NUMBER OF SUICIDES IN HOCKLEY COUNTY. OUTCOME MEASURE: A REDUCTION IN THE NUMBER OF SUICIDES IN HOCKLEY COUNTY. STRATEGIES: 1. PROVIDE A SUICIDE PREVENTION CONFERENCE OPEN TO THE ENTIRE COMMUNITY. 2. PROVIDE INFORMATION ON THE WARNING SIGNS OF SUICIDE. 3. PROVIDE INFORMATION ON THE QUESTION, PERSUADE, AND REFER (QPR) METHOD FOR THE LAY COMMUNITY TO PROVIDE HELP TO A SUICIDAL PERSON TO GET PROFESSIONAL COUNSELING. KEY COMMUNITY PARTNERS: LICENSED PROFESSIONAL COUNSELORS, SOUTH PLAINS RURAL HEALTH, SOUTH PLAINS COMMUNITY ACTION, THE CHAMPS PROGRAM, LEVELLAND ISD, SOUTH PLAINS COLLEGE, THE FAITH COMMUNITY, LEVELLAND LAW ENFORCEMENT, CATHOLIC FAMILY SERVICES, BOY SCOUTS AND GIRL SCOUTS. INITIATIVE: THE STORK'S NEST PRE-NATAL EDUCATION PROGRAM GOAL: TO PROVIDE FREE PRE-NATAL EDUCATION TO PREGNANT WOMEN AND TEENS IN HOCKLEY AND COCHRAN COUNTY. OUTCOME MEASURE: TO INCREASE CLASS ATTENDANCE BY 10% IN 2015. STRATEGIES: 1. INCREASE RADIO MARKETING ON KLVT RADIO. 2. INCREASE NEWSPAPER MARKETING IN THE LEVELLAND NEWS PRESS NEWSPAPER. 3. COLLABORATE WITH LEVELLAND ISD AND ALL SCHOOLS IN HOCKLEY & COCHRAN COUNTY TO ADVERTISE THE STORK'S NEST PROGRAM CLASSES TO ENCOURAGE PREGNANT TEENS TO ATTEND. 4. PROVIDE INFORMATION TO COCHRAN COUNTY PHYSICIANS ABOUT THE STORK'S NEST PROGRAM. 5. CONTACT SOUTH PLAINS RURAL HEALTH TO ENCOURAGE ATTENDANCE TO THE STORK'S NEST PROGRAM. KEY COMMUNITY PARTNERS: KLVT RADIO, THE LEVELLAND NEWS PRESS, LEVELLAND ISD AND SCHOOLS IN HOCKLEY & COCHRAN COUNTY, COCHRAN COUNTY PHYSICIANS, SOUTH PLAINS RURAL HEALTH. IN ADDITION TO THE PRECEDING PRIORITY AREAS, COVENANT HEALTH LEVELLAND PLANS TO PROVIDE OTHER COMMUNITY BENEFIT PROGRAMS RESPONSIVE TO THE HEALTH NEEDS IDENTIFIED IN THE 2014 CHNA. COMMUNITY BENEFIT PROGRAMS LISTED BELOW ONLY INCLUDES ADDITIONAL COMMUNITY SERVICES FOR THE LOW-INCOME AND BROADER COMMUNITY THAT HAVE NOT BEEN PREVIOUSLY COVERED IN THIS CB PLAN/IMPLEMENTATION STRATEGY REPORT. FOOD INSECURITY - HOSPITAL FOOD DRIVE, SHARE THE WARMTH COAT DRIVE, FREE PROSTATE SCREENING CLINIC, DIABETES EDUCATION - DIABETES EDUCATION SEMINAR. THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MINISTRY CHNA WILL NOT BE DIRECTLY ADDRESSED THROUGH PROGRAMMING OR FUNDING AND AN EXPLANATION IS PROVIDED BELOW: o SEXUALLY TRANSMITTED DISEASES o PREMATURE DEATH o OBESITY o COMMUNITY LIVING IN FOOD DESERTS o LACK OF TRANSPORTATION TO HEALTH & HUMAN SERVICES COVENANT HEALTH LEVELLAND WILL COLLABORATE WITH SOUTH PLAINS RURAL HEALTH, SOUTH PLAINS COMMUNITY ACTION, TEXAS AGRI-LIFE EXTENSION AND OTHER LOCAL NON PROFIT SOCIAL SERVICE THAT ADDRESS AFOREMENTIONED COMMUNITY NEEDS, TO COORDINATE CARE AND REFERRAL AND ADDRESS THESE UNMET NEEDS. |
| SCHEDULE H, PART V, SECTION B, LINE 13H | THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT ARE INITIALLY CLASSIFIED AS BAD DEBT. |
| SCHEDULE H, PART V, SECTION B, LINE 16B | THE WEB ADDRESS IS: HTTPS://COVENANTTX.PATIENTCOMPASS.COM/HC/MEDIA/FINANCIALASSISTANCEAPPLICAT ION-ENGLISH.PDF |
| SCHEDULE H, PART V, SECTION B, LINE 16C | THE WEB ADDRESS IS: HTTP://WWW.COVENANTHEALTH.ORG/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-A ND-PAYMENTS/PATIENT-FINANCIAL-ASSISTANCE.ASPX |
| SCHEDULE H, PART V, SECTION B, LINE 16I | THE ORGANIZATION POSTS ITS SUMMARIZED FINANCIAL ASSISTANCE NOTICE IN ALL ADMITTING AREAS IN BOTH ENGLISH AND SPANISH AND PROVIDES THE FULL POLICY UPON REQUEST. SUMMARIZED NOTICES OF THE POLICY ARE AVAILABLE ON ITS WEBSITE ALONG WITH CONTACT INFORMATION IN THE EVENT OF ADDITIONAL INQUIRIES. NOTICES OF FINANCIAL ASSISTANCE ARE INCLUDED WITH BILLINGS FOR UNINSURED PATIENTS. BILINGUAL PATIENT ACCOUNT REPRESENTATIVES ARE AVAILABLE TO ADDRESS QUESTIONS AND ASSIST IN THE COMPLETION OF A FINANCIAL ASSISTANCE APPLICATION IN ENGLISH OR SPANISH. |
| SCHEDULE H, PART V, SECTION B, LINE 22D | FOR PATIENTS WITH A FAMILY INCOME BETWEEN 176% AND 300% OF FEDERAL POVERTY GUIDELINES (FPG), THE HOSPITAL FACILITY USED MEDICARE RATES WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED. FOR CATASTROPHIC CASES WITH A PATIENT RESPONSIBILITY GREATER THAN $75,000, THE HOSPITAL FACILITY USED MEDICARE RATES TO DETERMINE THE MAXIMUM AMOUNT THAT CAN BE CHARGED. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 4 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| FAMILY MEDICINE CLINIC | ||||
| 116 A JOHN DUPREE | LEVELLAND | TX | 79339 | RURAL HEALTH CLINIC |
| LEVELLAND CLINIC SOUTH | ||||
| 1804 S COLLEGE AVE | LEVELLAND | TX | 79336 | RURAL HEALTH CLINIC |
| LEVELLAND CLINIC NORTH | ||||
| 103 JOHN DUPREE | LEVELLAND | TX | 79336 | RURAL HEALTH CLINIC |
| SUNDOWN RHC | ||||
| 209 E RICHARDSON | SUNDOWN | TX | 79372 | RURAL HEALTH CLINIC |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 3C | IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS. |
| SCHEDULE H, PART I, LINE 7 | THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM. |
| SCHEDULE H, PART III, SECTION A, LINE 2 | THE ORGANIZATION ANALYZES ITS HISTORICAL EXPERIENCE AND TRENDS TO ESTIMATE THE APPROPRIATE BAD DEBT EXPENSE. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED PRIOR TO CALCULATING BAD DEBT EXPENSE. |
| SCHEDULE H, PART III, SECTION A, LINE 3 | THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USED AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT WERE INITIALLY CLASSIFIED AS BAD DEBT. COLLECTION ACTIONS WERE NOT PURSUED ON THESE ACCOUNTS ONCE THEY WERE RECLASSIFIED BECAUSE RECLASSIFIED ACCOUNTS RECEIVED A 100% WRITE-OFF OF THE BALANCE DUE. AFTER THE RECLASSIFICATION THERE WAS NO REMAINING AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY. |
| SCHEDULE H, PART III, SECTION A, LINE 4 | BAD DEBT EXPENSE 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 CREDIT RISKS ASSOCIATED WITH RECEIVABLES FROM GOVERNMENT PROGRAMS. RECEIVABLES FROM CONTRACTED PAYORS ARE SUBJECT TO DIFFERING ECONOMIC CONDITIONS AND DO NOT REPRESENT ANY CONCENTRATED RISKS TO THE ORGANIZATION. THE ORGANIZATION REGULARLY ANALYZES ITS HISTORICAL EXPERIENCE AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. |
| SCHEDULE H, PART III, SECTION B, LINE 8 | TREATMENT OF MEDICARE SHORTFALL AS COMMUNITY BENEFIT THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT. MEDICARE COSTS ARE DETERMINED FROM THE MEDICARE COST REPORT USING CMS STANDARD COSTING METHODS. THIS INCLUDES STEP-DOWN ALLOCATION PROCESSES WHICH ARE APPLIED TO CALCULATE ALLOWABLE MEDICARE COSTS. |
| SCHEDULE H, PART III, SECTION C, LINE 9C | APPLICATION OF COLLECTION PRACTICES TO THOSE QUALIFUING FONR FINANCIAL ASSISTANCE COVENANT HOSPITAL LEVELLAND PATIENT ACCOUNTS WERE NOT FORWARDED TO COLLECTION STATUS WHEN THE PATIENT MADE A GOOD FAITH EFFORT TO RESOLVE OUTSTANDING ACCOUNT BALANCES. SUCH EFFORTS INCLUDE APPLYING FOR FINANCIAL ASSISTANCE, NEGOTIATING A PAYMENT PLAN, OR APPLYING FOR MEDICAID COVERAGE. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMED AN EVALUATION TO IDENTIFY IF THE ACCOUNT QUALIFIED FOR FINANCIAL ASSISTANCE. ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR FREE CARE WERE WRITTEN OFF AND COLLECTION EFFORTS WERE NOT PURSUED. THE ORGANIZATION'S COLLECTION POLICY ALSO APPLIED TO ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR DISCOUNTED CARE. |
| SCHEDULE H, PART VI, LINE 2 | NEEDS ASSESMENT THE COMMUNITY NEEDS ASSESSMENT WAS DEVELOPED TO ASSIST THE COMMUNITY IN ITS DELIBERATIONS TO IDENTIFY HEALTH PRIORITIES AND ISSUES. THE COMMUNITY NEEDS ASSESSMENT HAD TWO MAJOR COMPONENTS. THE FIRST WAS A PRIMARY DATA COLLECTION PHASE IN THE COMMUNITY CONDUCTED THROUGH INTERVIEWS (CONDUCTED FEBRUARY AND APRIL) WITH A CROSS-SECTION OF COMMUNITY REPRESENTATIVES AND LEADERS TO DETERMINE LOCAL ISSUES AND CONCERNS THAT AFFECTED THE HEALTH OF THE COMMUNITY. THE SECOND PHASE WAS THE COLLECTION AND COMPILATION OF SECONDARY DATA FROM PUBLIC SOURCES THAT COULD BE USED TO DEFINE THE STATUS OF THE COMMUNITYS HEALTH AND WELL-BEING. THESE TWO DATA SOURCES WERE COMBINED INTO A SUMMARY REPORT THAT COULD BE USED BY COVENANT HOSPITAL LEVELLAND LEADERSHIP TO DETERMINE PRIORITIES AND DEVELOP A PLAN AND STRATEGIES TO IMPROVE COMMUNITY HEALTH. THE COVENANT HOSPITAL LEVELLAND CHNA RELIED HEAVILY ON DATA COMPILED BY CHNA.ORG. |
| SCHEDULE H, PART VI, LINE 3 | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE THE ORGANIZATION POSTED NOTICES INFORMING THE PUBLIC OF THE FINANCIAL ASSISTANCE PROGRAM. NOTICES WERE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES WERE ALSO POSTED AT LOCATIONS WHERE A PATIENT COULD PAY THEIR BILL. NOTICES INCLUDED CONTACT INFORMATION ON HOW A PATIENT COULD OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES WERE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT WERE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATED LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS WERE OFFERED AN OPPORTUNITY TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND WERE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY HAVE BEEN ELIGIBLE. |
| SCHEDULE H, PART VI, LINE 4 | COMMUNITY INFORMATION COVENANT HOSPITAL LEVELLAND SERVES PATIENTS FROM HOCKLEY AND COCHRAN COUNTY AS WELL AS OTHER SURROUNDING COUNTIES. ACCORDING TO RESULTS FROM THE COVENANT HOSPITAL LEVELLAND 2013 CHNA REPORT, INFORMED BY CHNA.ORG, HOCKLEY AND COCHRAN COUNTIES' PER CAPITA INCOME ($20,255 AND $16,018, RESPECTIVELY) IS SIGNIFICANTLY LOWER THAN THE STATE OF TEXAS ($24,870) AND THE U.S. ($27,334). THE PERCENTAGE OF INDIVIDUALS WHOSE PRIMARY LANGUAGE IS SPANISH AND WHO SPEAK ENGLISH LESS THAN VERY WELL ARE COMPARABLE TO TEXAS (43.4%) AND THE U.S. AVERAGE (46.1%). THE PERCENTAGE OF CHILDREN BELOW POVERTY LEVEL IN HOCKLEY COUNTY IS 22% AND 42.7% IN COCHRAN COUNTY COMPARED TO 23.8% IN TEXAS AND 19.2% IN THE U.S. THE PERCENTAGE OF AGED 65+ BELOW THE POVERTY LEVEL IS 18.1% IN HOCKLEY COUNTY AND 6.9% IN COCHRAN COUNTY WHILE THAT OF THE STATE IS 11.6% AND 9.5% IN THE U.S. THE OTHER SURROUNDING COUNTIES HAVE HEALTH CARE FACILITIES WHICH PROVIDE SERVICES TO THEIR RESIDENTS. OTHER HOSPITALS IN THE COMMUNITY INCLUDE: COCHRAN MEMORIAL HOSPITAL. ACCORDING TO CHNA.ORG, THE LACK OF HEALTH INSURANCE IS CONSIDERED A KEY DRIVER OF HEALTH STATUS. THIS INDICATOR REPORTS THE PERCENTAGE OF THE TOTAL CIVILIAN NON-INSTITUTIONALIZED POPULATION WITHOUT HEALTH INSURANCE COVERAGE. THIS INDICATOR IS RELEVANT BECAUSE LACK OF INSURANCE IS A PRIMARY BARRIER TO HEALTHCARE ACCESS INCLUDING REGULAR PRIMARY CARE, SPECIALTY CARE, AND OTHER HEALTH SERVICES THAT CONTRIBUTES TO POOR HEALTHSTATUS. OVERALL, HOCKLEY COUNTY REPORTS A LOWER PERCENTAGE OF UNINSURED (21.47%) THAN TEXAS AS A WHOLE (23.55%), HOWEVER, THE PERCENTAGE OF UNINSURED IS FIVE PERCENTAGE POINTS HIGHER THAN THE U.S (15.05%). FOR A COMPLETE LIST OF OTHER HEALTH CARE FACILITIES WITHIN THE HOCKLEY COUNTY AND COCHRAN COUNTY SERVICE AREA GO TO APPENDIX 3 OF COVENANT HOSPITAL LEVELLAND'S COMMUNITY HEALTH NEEDS ASSESSMENT AVAILABLE ONLINE AT: HTTP://WWW.COVENANTHOSPITALLEVELLAND.ORG/DOCUMENTS/COMMUNITY_BENEFIT/CHNA_ COVENANT_LEVELLAND_REPORT_FORMAT_FINAL.PDF |
| SCHEDULE H, PART VI, LINE 5 | THE GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN HOCKLEY COUNTY AND WHO ARE NOT EMPLOYEES, CONTRACTORS, OR FAMILY MEMBERS. THE GOVERNING BOARD, ACTING AS THE COMMUNITY BENEFIT COMMITTEE, OVERSAW THE DEVELOPMENT AND IMPLEMENTATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY BENEFIT PLAN. THE COMMITTEE ALSO PROVIDES GENERAL DIRECTION TO COVENANT HOSPITAL LEVELLAND COMMUNITY BENEFIT REPORTING. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. GIVING BACK TO THE COMMUNITY IS INTEGRATED INTO EVERY ASPECT OF OUR ORGANIZATION. AS A MEMBER OF THE FAITH-BASED HEALTH MINISTRY OF ST. JOSEPH HEALTH SYSTEM, WE PROVIDE FREE AND DISCOUNTED CARE VIA OUR FINANCIAL ASSISTANCE PROGRAM AND HAVE A FUNDING STREAM TO ADDRESS THE NEEDS OF THE ECONOMICALLY POOR AND VULNERABLE IN THE COMMUNITIES WE SERVE. THIS PAST FISCAL YEAR OUR HOSPITAL PROMOTED HEALTH AND ACCESS TO CARE BY PROVIDING CLINIC COVERAGE DURING BUSINESS WORKING DAYS, WEEKEND CLINICS, COMMUNITY SCREENINGS AND OTHER HEALTHCARE RELATED EVENTS AND EDUCATION ACTIVITIES. COVENANT HOSPITAL LEVELLAND BELIEVES THAT NO ONE SHOULD DELAY SEEKING NEEDED MEDICAL CARE BECAUSE THEY LACK HEALTH INSURANCE. THAT IS WHY COVENANT HOSPITAL LEVELLAND, AS A MINISTRY OF ST. JOSEPH HEALTH SYSTEM, HAS A PATIENT FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES FREE OR DISCOUNTED SERVICES TO ELIGIBLE PATIENTS. |
| SCHEDULE H, PART VI, LINE 6 | affiliated health care system COVENANT HOSPITAL LEVELLAND IS A HEALING MINISTRY OF ST. JOSEPH HEALTH SYSTEM, AN INTEGRATED HEALTHCARE DELIVERY SYSTEM SPONSORED BY THE ST. JOSEPH HEALTH MINISTRY. ST. JOSEPH HEALTH SYSTEM IS ORGANIZED INTO THREE REGIONS: NORTHERN CALIFORNIA, SOUTHERN CALIFORNIA, AND WEST TEXAS/EASTERN NEW MEXICO. THE SYSTEM INCLUDES 14 ACUTE CARE HOSPITALS, HOME HEALTH AGENCIES, HOSPICE CARE, OUTPATIENT SERVICES, COMMUNITY CLINICS, AND PHYSICIAN ORGANIZATIONS. EACH ASSOCIATED MINISTRY WORKS TO LIVE OUT ITS MISSION TO EXTEND 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 THE COMMUNITIES IT SERVES. IN 1986, ST. JOSEPH HEALTH SYSTEM CREATED A PLAN AND BEGAN AN EFFORT TO FURTHER ITS COMMITMENT TO NEIGHBORS IN NEED. WITH A VISION OF REACHING BEYOND THE WALLS OF ITS HEALTHCARE FACILITIES AND TRANSCENDING TRADITIONAL EFFORTS OF PROVIDING FINANCIAL ASSISTANCE FOR THOSE IN NEED OF ACUTE SERVICES, ST. JOSEPH HEALTH SYSTEM CREATED THE ST. JOSEPH HEALTH SYSTEM FOUNDATION TO IMPROVE THE HEALTH OF LOW-INCOME INDIVIDUALS RESIDING IN LOCAL COMMUNITIES. OUR FOUNDATIONAL DOCUMENT, A VISION OF VALUES, FORMALIZES A POLICY THROUGH WHICH THE HOSPITAL MINISTRIES RETURN TEN PERCENT OF THEIR NET INCOME TO THE ST. JOSEPH HEALTH SYSTEM FOUNDATION TO SUPPORT OUTREACH EFFORTS FOR THE MATERIALLY POOR. THE FOUNDATION THEN FUNDS PROGRAMS IN COMMUNITIES SERVED BY ST. JOSEPH HEALTH HOSPITALS THAT EXEMPLIFY THE FOUR CORE VALUES OF ST. JOSEPH HEALTH: SERVICE, EXCELLENCE, DIGNITY, AND JUSTICE. |
| SCHEDULE H, PART VI, LINE 7 | STATE FILING OF COMMUNITY BENEFIT REPORT TEXAS |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRUCE WHITE | ||||||||||||||
| CEO COVENANT LEVELLAND/BD MBR | $120,969 | $0 | $17,342 | $0 | $4,631 | $0 | $10,154 | $0 | $14,546 | $0 | $167,642 | $0 | $0 | $0 |
| SHARON PRATHER | ||||||||||||||
| CHIEF GOVERNANCE OFF/BD MBR | $0 | $228,207 | $0 | $56,816 | $0 | $45,743 | $0 | $25,778 | $0 | $15,246 | $0 | $371,790 | $0 | $0 |
| MIKE BAILEY MD | ||||||||||||||
| CHIEF OF STAFF/BOARD MEMBER | $0 | $195,782 | $0 | $0 | $0 | $3,862 | $0 | $8,000 | $0 | $14,446 | $0 | $222,090 | $0 | $0 |
| GREG MCKAY | ||||||||||||||
| PHYSICIAN ASSISTANT | $37,321 | $0 | $0 | $0 | $126,898 | $0 | $15,394 | $0 | $20,330 | $0 | $199,943 | $0 | $0 | $0 |
| MARTY COTTENOIR | ||||||||||||||
| DIRECTOR OF PHARMACY | $131,068 | $0 | $11,220 | $0 | $6,193 | $0 | $12,760 | $0 | $12,086 | $0 | $173,327 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| schedule j, part i, line 3 | THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX EXEMPT PARENT, COVENANT HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O FOR FORM 990, PART VI, LINE 15A AND 15B FOR THE PROCESS THAT IS COMPLETED BY ST. JOSEPH HEALTH SYSTEM. |
| schedule j, part i, line 7 | description of non-fixed payments A PORTION OF EXECUTIVES SALARIES ARE PLACED 'AT-RISK' AND ARE 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 O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 1 AND PART III, LINE 1 | ORGANIZATIONS MISSION WE ARE 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. |
| FORM 990, PART III, LINE 4A | REALIZING OUR MISSION COVENANT HEALTH LEVELLAND HAS BEEN MEETING THE HEALTH AND QUALITY OF LIFE NEEDS OF THE PEOPLE IN THE LOCAL COMMUNITY FOR OVER 16 YEARS. COVENANT HOSPITAL LEVELLAND IS DEDICATED TO PROVIDING WORLD CLASS HEALTH CARE CLOSE TO HOME FOR HOCKLEY AND COCHRAN COUNTIES. COVENANT HEALTH LEVELLAND PROVIDES QUALITY CARE IN THE AREAS OF 24-HOUR EMERGENCY CARE, OUTPATIENT SURGERY, MATERNITY SERVICES, PHYSICAL THERAPY, REHAB SERVICES, CLINIC AND HOSPITAL LAB SERVICES, DIGITAL MAMMOGRAPHY, MRI SERVICES, CAT SCANS, AND 3-D ULTRASOUND SERVICES. COVENANT HEALTH LEVELLAND IS A HOSPITAL WITHIN COVENANT HEALTH WHICH HAS OVER 4,000 EMPLOYEES COMMITTED TO REALIZING THE MISSION, COVENANT HEALTH IS ONE OF THE LARGEST EMPLOYERS IN THE WEST TEXAS REGION. AS A MEMBER OF THE ST. JOSEPH HEALTH, COVENANT HEALTH IS COMMITTED TO EXTEND THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE. THIS MISSION HAS GUIDED OUR CATHOLIC HEALTHCARE MINISTRY SINCE THE OPENING OF OUR FIRST HOSPITAL IN EUREKA, CALIFORNIA NEARLY 100 YEARS AGO. THE SISTERS OF ST. JOSEPH OF ORANGE TRACE THEIR ROOTS BACK TO 17TH CENTURY FRANCE AND THE UNIQUE VISION OF A JESUIT PRIEST NAMED JEAN-PIERRE MEDAILLE. HE SOUGHT TO ORGANIZE AN ORDER OF RELIGIOUS WOMEN WHO, RATHER THAN REMAINING SAFELY CLOISTERED IN A CONVENT, VENTURED OUT INTO THE COMMUNITY TO SEEK OUT "THE DEAR NEIGHBORS" AND MINISTER TO THEIR NEEDS. THE CONGREGATION MANAGED TO SURVIVE THE TURBULENCE OF THE FRENCH REVOLUTION AND EVENTUALLY EXPANDED, NOT ONLY THROUGHOUT FRANCE, BUT THROUGHOUT THE WORLD. IN 1912 A SMALL GROUP OF SISTERS OF ST. JOSEPH WENT TO EUREKA, CALIFORNIA, AT THE INVITATION OF THE LOCAL BISHOP, TO ESTABLISH A SCHOOL. A FEW YEARS LATER, THE GREAT INFLUENZA EPIDEMIC OF 1918 CAUSED THE SISTERS TO TEMPORARILY SET ASIDE THEIR EDUCATION EFFORTS TO CARE FOR THE ILL. THEY REALIZED IMMEDIATELY THAT THE SMALL COMMUNITY DESPERATELY NEEDED A HOSPITAL. THROUGH BOLD FAITH, FORESIGHT, AND FLEXIBLITY IN 1920, THE SISTERS OPENED THE 28-BED ST. JOSEPH HOSPITAL OF EUREKA, THE FIRST ST. JOSEPH HEALTH SYSTEM MINISTRY. FINANCIAL ASSISTANCE PROGRAM COVENANT HEALTH LEVELLAND BELIEVES THAT NO ONE SHOULD DELAY SEEKING NEEDED MEDICAL CARE BECAUSE THEY LACK HEALTH INSURANCE. THAT IS WHY COVENANT HEALTH LEVELLAND HAS A PATIENT FINANCIAL ASSISTANCE PROGRAM (FAP) THAT PROVIDES FREE OR DISCOUNTED SERVICES TO ELIGIBLE PATIENTS. IN FY15, COVENANT HEALTH LEVELLAND PROVIDED $1,146,405 IN FREE AND DISCOUNTED CARE. MEDICAID PROGRAM COVENANT HEALTH LEVELLAND PROVIDED ACCESS TO UNINSURED AND UNDERINSURED PERSONS BY PARTICIPATING IN THE FEDERAL AND STATE SPONSORED MEDICAID PROGRAM. IN FY15, COVENANT HEALTH LEVELLAND PROVIDED $728,632 IN MEDICAID SHORTFALL. PROGRAM SERVICE ACCOMPLISHMENTS DURING THE YEAR WE SAW MORE THAN 44,287 PATIENTS IN OUR THREE RURAL HEALTH CLINICS. 2,568 OF THOSE PATIENTS WERE SEEN DURING OUR WEEKEND CLINIC. THERE WERE MORE THAN 6,582 PATIENTS EVALUATED IN OUR EMERGENCY ROOM AND OVER 34,209 OUT PATIENT DIAGNOSTIC AND TREATMENT TEST PERFORMED WITHIN OUR HOSPITAL. THROUGHOUT THE YEAR WE PROVIDED A VARIETY OF PROGRAMS FOR THE COMMUNITIES IN WHICH WE SERVE. THROUGHOUT THE YEAR COVENANT HOSPITAL LEVELLAND PROVIDES VARIOUS FREE EVALUATIONS AND CONSULTATIONS FOR PROSTRATE SCREENING AND HIGH BLOOD PRESSURE. FOR MORE INFORMATION ABOUT COVENANT LEVELLAND PLEASE VISIT: WWW.COVENANTHEALTH.ORG FOR MORE INFORMATION ABOUT ST. JOSEPH HEALTH SYSTEM, PLEASE VISIT WWW.STJHS.ORG |
| FORM 990, PART VI, LINE 6 | DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS COVENANT HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER OF COVENANT HOSPITAL LEVELLAND. |
| FORM 990, PART VI, LINE 7A | DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS COVENANT HOSPITAL LEVELLAND HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE COVENANT HOSPITAL LEVELLAND BOARD. ALL TRUSTEE APPOINTMENTS THAT COME FROM THE COVENANT HOSPITAL LEVELLAND BOARD AS NOMINATIONS MUST BE APPROVED BY THE COVENANT HEALTH SYSTEM (CHS), AS THE CORPORATE MEMBER, AND THE ST. JOSEPH HEALTH SYSTEM, AS THE TAX-EXEMPT PARENT OF CHS, AND THE ST. JOSEPH HEALTH MINISTRY, AS THE ORGANIZATIONAL SPONSOR. |
| FORM 990, PART VI, LINE 7B | DESCR CLASSES OF PERSONS, DECISIONS REQ APPR & TYPE OF VOTING RIGHTS THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE ST. JOSEPH HEALTH SYSTEM MEMBER OF FINANCING, BUDGETS, UNBUDGETED EXPENDITURES OF DEFINED AMOUNTS, STRATEGIC PLAN, APPOINTMENT OF AUDITORS, CREATION OR INVESTMENT IN A LEGALLY RECOGNIZED ENTITY, JOINT VENTURES, PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. |
| FORM 990, PART VI, LINE 11B | DESCR THE PROCESS USED BY MANAGEMENT &/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 OF THE ORGANIZATION. A COPY OF THE FORM 990 FILING IS DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD FOR THE APRIL 2016 FINANCE COMMITTEE MEETING. DURING THE 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 THE EXISTENCE AND NATURE OF ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICTS OF INTEREST HE/SHE MAY HAVE THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT IN CONNECTION WITH THAT INDIVIDUAL SATISFYING THEIR FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES SHALL BE MADE PROMPTLY ANY TIME AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST ARISES AND BEFORE THE CONSUMMATION OF ANY CONTRACT, TRANSACTION OR ARRANGEMENT THAT IS THE SUBJECT OF THE POTENTIAL CONFLICT OF INTEREST. WITH GUIDANCE FROM THE ST. JOSEPH HEALTH SYSTEM CHIEF COMPLIANCE OFFICER (CCO), THE CHIEF EXECUTIVE AND/OR THE GOVERNING BOARD CHAIRPERSON, AS APPROPRIATE, CONSIDERS THE MATTER INITIALLY. IF THE MATTER CANNOT BE RESOLVED AT THAT LEVEL, THE MATTER IS ESCALATED TO THE CCO. THE CCO, IN CONSULTATION WITH THE ST. JOSEPH HEALTH SYSTEM GENERAL COUNSEL, REVIEWS THE MATTER AND PRESENTS RECOMMENDATIONS TO THE GOVERNING BOARD AND/OR BOARD COMMITTEE, AS APPROPRIATE, FOR DISCUSSION AND VOTE. THE INDIVIDUAL WHOSE POTENTIAL CONFLICT IS BEING REVIEWED MAY BE REQUESTED TO BE PRESENT DURING ANY MEETING IN WHICH THE BOARD OR BOARD COMMITTEE CONDUCTS ITS EVALUATION BUT SHALL BE EXCUSED FOR ANY DISCUSSION OR VOTE. ONCE ALL NECESSARY INFORMATION HAS BEEN OBTAINED, THE COMMITTEE CONDUCTS ITS EVALUATION AND FORWARDS ITS FINDINGS AND RECOMMENDATIONS TO THE SJHS CHIEF COMPLIANCE OFFICER. IF THE COMMITTEE DETERMINES AN UNRESOLVED CONFLICT OF INTEREST EXISTS, THE COMMITTEE WILL EVALUATE AND RECOMMEND CONFLICT MITIGATION STRATEGIES. THE SJHS CHIEF COMPLIANCE OFFICER, IN CONSULTATION WITH SJHS GENERAL COUNSEL, WILL REVIEW THE COMMITTEE FINDINGS, RECOMMENDATIONS, AND MITIGATION STRATEGIES, AND PRESENT RECOMMENDATIONS TO THE BOARD FOR DISCUSSION AND VOTE. |
| FORM 990, PART VI, LINES 15A & 15B | THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX EXEMPT PARENT, COVENANT HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. EXECUTIVE COMPENSATION IS APPROVED BY THE COVENANT HOSPITAL OF LEVELLAND WORKLIFE COMPENSATION COMMITTEE, WHICH IS COMPRISED OF INDEPENDENT PERSONS. THE COMMITTEE REVIEWS COMPARABILITY DATA PREPARED FOR AND COMPILED BY THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE, A COMMITTEE OF THE ST. JOSEPH HEALTH SYSTEM BOARD OF TRUSTEES COMPRISED OF INDEPENDENT MEMBERS. THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE ACTS IN ACCORDANCE WITH A COMMITTEE CHARTER APPROVED BY THE ST. JOSEPH HEATLH SYSTEM BOARD OF TRUSTEES AND AN EXECUTIVE COMPENSATION PHILOSOPHY. THE CHARTER DIRECTS THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE TO ADMINISTER THE EXECUTIVE COMPENSATION PROGRAM AND TO APPROVE PROGRAM CHANGES, AS NECESSARY, TO ENSURE ALIGNMENT WITH THE STATED PHILOSOPHY AND ENSURE CONTINUED COMPLIANCE WITH FEDERAL AND STATE REGULATIONS ON BEHALF OF THE ST. JOSEPH HEALTH SYSTEM BOARD OF TRUSTEES. OVERALL, THE PHILOSOPHY IS INTENDED TO REWARD A BROAD SPECTRUM OF HIGH ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE EXPECTATIONS, AS WELL AS RETENTION OF KEY MANAGEMENT TALENT. THE EXECUTIVE COMPENSATION PHILOSOPHY DEFINES THE MARKET FOR ADMINISTERING COMPENSATION AS A COMPARABLE SET OF FOR PROFIT AND NOT-FOR-PROFIT HEALTH CARE DELIVERY SYSTEMS. ST. JOSEPH HEALTH SYSTEM PROVIDES COMPENSATION TO ITS EXECUTIVES IN THE FORM OF BASE SALARY, AN ANNUAL INCENTIVE PROGRAM, AND BENEFITS. TO ENSURE COMPENSATION PHILOSOPHY ADHERENCE AND GENERAL FAIR MARKET VALUE COMPENSATION, THE COMMITTEE REGULARLY REVIEWS INFORMATION FROM MULTIPLE SOURCES OF MARKET DATA AND ENGAGES LEGAL COUNSEL AND CONSULTING SUPPORT, AS NEEDED. THEY USE THIS INFORMATION TO SUPPORT ONGOING EFFECTIVENESS AND ADMINISTRATION OF THE PROGRAM. THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE MEETS AT LEAST 3 TIMES A YEAR AND TAKES ACTION IN EXECUTIVE SESSION. THESE ACTIONS ARE DOCUMENTED IN DETAILED MINUTES AND APPROVED IN SUBSEQUENT MEETINGS. A FULL COMPENSATION REVIEW IS CONDUCTED ON A BIENNIAL BASIS AND THE LAST REVIEW WAS PERFORMED IN JUNE 2015. DURING THE YEAR, THE COVENANT HOSPITAL OF LEVELLAND WORKLIFE COMPENSATION COMMITTEE REVIEWED AND APPROVED ANY CHANGES IN COMPENSATION FOR KEY EXECUTIVES PREDICATED ON THE ANALYSIS AND RECOMMENDATION BY AN INDEPENDENT THIRD PARTY CONSULTNG FIRM WITH EXPERTISE IN HEALTHCARE EXECUTIVE COMPENSATION. IN ADDITION, ANNUAL INCENTIVE AWARDS ARE REVIEWED AND APPROVED PRIOR TO PAYMENT CONSISTENT WITH THE MOST RECENT COMPENSATION BIENNIAL REVIEW AND IN ACCORDANCE WITH THE PLAN DOCUMENT. THESE ACTIONS ARE DOCUMENTED IN DETAILED MINUTES WHICH ARE SUBSEQUENTLY APPROVED AT THE COMMITTEE MEETING. |
| FORM 990, PART VI, QUESTION 19 | AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO 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. THE AUDITED FINANCIAL STATEMENTS ARE ALSO ATTACHED TO THE FORM 990. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PURCHASED MEDICAL SERVICES TOTAL FEES:2864963 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (32 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| COVENANT HEALTH NETWORK INC | ||||||||||
| 3345 MICHELSON DRIVE STE 100 | IRVINE | CA | 92612 | 461259908 | HEALTHCARE | CA | 501(C)(3) | 11,III | SJHS | Yes (true) |
| COVENANT ACO | ||||||||||
| 3615 19TH STREET | LUBBOCK | TX | 79410 | 611573313 | HEALTHCARE | TX | 501(C)(3) | 11,I | CHS | Yes (true) |
| COVENANT HEALTH SYSTEM | ||||||||||
| 3615 19TH STREET | LUBBOCK | TX | 79410 | 752765566 | HEALTHCARE | TX | 501(C)(3) | 3 | SJHS | Yes (true) |
| COVENANT HEALTH SYSTEM FOUNDATION | ||||||||||
| 3623 22ND PLACE | LUBBOCK | TX | 79410 | 752897026 | HEALTHCARE | TX | 501(C)(3) | 7 | CHS | Yes (true) |
| COVENANT MEDICAL GROUP | ||||||||||
| 3420 22ND PLACE | LUBBOCK | TX | 79410 | 752743883 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (true) |
| COVENANT HEALTH PARTNERS | ||||||||||
| 3615 19TH STREET | LUBBOCK | TX | 79410 | 463516417 | HEALTHCARE | TX | 501(C)(3) | 11, I | CHS | Yes (true) |
| HOAG CHARITY SPORTS | ||||||||||
| 330 PLACENTIA AVE | NEWPORT BEACH | CA | 92663 | 452982422 | SUPPORT | CA | 501(C)(3) | 7 | HHF | Yes (true) |
| HOAG HOSPITAL FOUNDATION | ||||||||||
| 330 PLACENTIA AVE | NEWPORT BEACH | CA | 92663 | 953222343 | FUNDRAISING | CA | 501(C)(3) | 7 | HMHP | Yes (true) |
| HOAG MEMORIAL HOSPITAL PRESBYTERIAN | ||||||||||
| 1 HOAG ROAD BOX 6100 | NEWPORT BEACH | CA | 92663 | 951643327 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (true) |
| HOME CARE PARTNERS | ||||||||||
| 1165 MONTGOMERY DR | SANTA ROSA | CA | 95405 | 680318656 | INACTIVE | CA | 501(C)(3) | 3 | SRMH | Yes (true) |
| HOSPICE OF LUBBOCK | ||||||||||
| 3702 21ST STREET | LUBBOCK | TX | 79410 | 752133781 | HEALTHCARE | TX | 501(C)(3) | 9 | CHS | Yes (true) |
| LUBBOCK METHODIST HOSPITAL FOUNDATION | ||||||||||
| 3615 19TH STREET | LUBBOCK | TX | 79410 | 752220963 | HEALTHCARE | TX | 501(C)(3) | 7 | CHS | Yes (true) |
| METHODIST CHILDREN'S HOSPITAL | ||||||||||
| 3610 21ST STREET | LUBBOCK | TX | 79410 | 752428911 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (true) |
| METHODIST HOSPITAL PLAINVIEW | ||||||||||
| 2601 DIMMITT ROAD | PLAINVIEW | TX | 79072 | 752426010 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (true) |
| MISSION HOSPITAL REGIONAL MEDICAL CTR | ||||||||||
| 27700 MEDICAL CENTER ROAD | MISSION VIEJO | CA | 92691 | 951643360 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (true) |
| QUEEN OF THE VALLEY MEDICAL CENTER | ||||||||||
| 1000 TRANCAS STREET | NAPA | CA | 94558 | 941243669 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (true) |
| REDWOOD MEMORIAL FOUNDATION | ||||||||||
| 3300 RENNER DRIVE | FORTUNA | CA | 95540 | 942779313 | HEALTHCARE | CA | 501(C)(3) | 7 | RMH | Yes (true) |
| REDWOOD MEMORIAL HOSPITAL | ||||||||||
| 3300 RENNER DRIVE | FORTUNA | CA | 95540 | 941384665 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (true) |
| SANTA ROSA MEMORIAL HOSPITAL | ||||||||||
| 1165 MONTGOMERY DR | SANTA ROSA | CA | 95405 | 941231005 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (true) |
| SISTERS OF ST JOSEPH OF ORANGE | ||||||||||
| 480 S BATAVIA | ORANGE | CA | 92868 | 951643383 | RELIGIOUS ORG | CA | 501(C)(3) | 1 | NA | false |
| SRM ALLIANCE HOSPITAL SERVICES (PVH) | ||||||||||
| 400 NORTH MCDOWELL BLVD | PETALUMA | CA | 94954 | 680395200 | HEALTHCARE | CA | 501(C)(3) | 3 | SRMH | Yes (true) |
| ST JOSEPH HEALTH MINISTRY | ||||||||||
| 3345 MICHELSON DRIVE STE 100 | IRVINE | CA | 92612 | 271666576 | RELIGIOUS ORG | CA | 501(C)(3) | 1 | SSJO | false |
| ST JOSEPH HEALTH SYSTEM | ||||||||||
| 3345 MICHELSON DRIVE STE 100 | IRVINE | CA | 92612 | 953589356 | HEALTHCARE | CA | 501(C)(3) | 11, I | SJHM | false |
| ST JOSEPH HEALTH SYSTEM FOUNDATION | ||||||||||
| 3345 MICHELSON DRIVE STE 100 | IRVINE | CA | 92612 | 330143024 | HEALTHCARE | CA | 501(C)(3) | 7 | SJHS | Yes (true) |
| ST JOSEPH HOME CARE NETWORK | ||||||||||
| 1111 SONOMA STE 308 | SANTA ROSA | CA | 95405 | 680331084 | HEALTHCARE | CA | 501(C)(3) | 9 | SJHS | Yes (true) |
| ST JOSEPH HOSPITAL OF EUREKA | ||||||||||
| 2700 DOLBEER STREET | EUREKA | CA | 95501 | 941156596 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (true) |
| ST JOSEPH HOSPITAL OF ORANGE | ||||||||||
| 1100 WEST STEWART DRIVE | ORANGE | CA | 92868 | 951643359 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (true) |
| ST JUDE HOSPITAL YORBA LINDA | ||||||||||
| 200 WEST CENTER ST PROMENADE | ANAHEIM | CA | 92805 | 330185031 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (true) |
| ST JUDE HOSPITAL INC | ||||||||||
| 101 EAST VALENCIA MESA DRIVE | FULLERTON | CA | 92635 | 951643324 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (true) |
| ST MARY MEDICAL CENTER | ||||||||||
| 18300 HIGHWAY 18 | APPLE VALLEY | CA | 92307 | 951914489 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (true) |
| ST MARY OF THE PLAINS HOSPITAL FDN | ||||||||||
| 4000 24TH STREET | LUBBOCK | TX | 79410 | 751653181 | HEALTHCARE | TX | 501(C)(3) | 7 | CHS | Yes (true) |
| TALLER SAN JOSE | ||||||||||
| 801 NORTH BROADWAY | SANTA ANA | CA | 92701 | 593816355 | WORK DEVELOPM | CA | 501(C)(3) | 2 | SSJO | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (17 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt |
|---|---|---|---|---|---|---|---|
| HEALTHCARE DESIGN & CONSTRUCT | |||||||
| SEE PART VII | LUBBOCK | TX | 79410 | REAL ESTATE | DE | NA | N/A |
| HEALTHCARE PROPERTY ADVISORS | |||||||
| SEE PART VII | LUBBOCK | TX | 79410 | REAL ESTATE | DE | NA | N/A |
| HERITAGE INVESTMENT GROUP | |||||||
| SEE PART VII | LUBBOCK | TX | 79410 | INVESTMENTS | CA | NA | N/A |
| HOAG ORTHOPEDIC INSTITUTE | |||||||
| SEE PART VII | LUBBOCK | TX | 79410 | HEALTHCARE | CA | NA | N/A |
| LUBBOCK SURGERY CENTER LTD | |||||||
| SEE PART VII | LUBBOCK | TX | 79410 | HEALTHCARE | TX | NA | N/A |
| METHODIST DIAGNOSTIC IMAGING | |||||||
| HEALTHCARE | TX | NA | N/A | ||||
| MISSION AMBULATORY SURGICENTER | |||||||
| HEALTHCARE | CA | NA | N/A | ||||
| NEWPORT IMAGING CENTER | |||||||
| HEALTHCARE | CA | NA | N/A | ||||
| SHA LLC | |||||||
| INSURANCE | TX | NA | N/A | ||||
| ST JOSEPH PHYSICIAN VENTURES | |||||||
| REAL ESTATE | CA | NA | N/A | ||||
| ST JOSEPH HLTH SYS HOME CARE | |||||||
| HOME HEALTH | CA | NA | N/A | ||||
| ST JOSEPH HLTH SYS HOME HLTH | |||||||
| HOME HEALTH | CA | NA | N/A | ||||
| THE INNOVATION INSTITUTE | |||||||
| HEALTHCARE | DE | NA | N/A | ||||
| TOTAL HEALTH ENVIRONMENT | |||||||
| HEALTHCARE | DE | NA | N/A | ||||
| ADVANCED SURGERY INSTITUTE LLC | |||||||
| HEALTHCARE | CA | NA | N/A | ||||
| NORTH BAY ENDOSCOPY CENTER | |||||||
| HEALTHCARE | CA | NA | N/A | ||||
| COVENANT LONG TERM CARE LP | |||||||
| HEALTHCARE | TX | NA | N/A | ||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (14 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALLIANCE PHYSICIAN SERVICES | |||||||||||||
| INACTIVE | CA | NA | C-CORP | ||||||||||
| AMERICAN UNITY GROUP LTD | |||||||||||||
| CAPTIVE INSURANCE | NA | C-CORP | 90 PITTS BAY ROAD | PEMBROKE | BD | HM08 | BD | ||||||
| COASTAL MANAGEMENT SERVICES ORGANIZATION | |||||||||||||
| HEALTHCARE | CA | NA | C-CORP | 1 HOAG DRIVE BOX 6100 | NEWPORT BEACH | CA | 92658 | 330676831 | |||||
| DATU HEALTH INC | |||||||||||||
| IT SVCS | MO | NA | C-CORP | 16150 MAIN CIRCLE DR SUITE 250 | CHESTERFIELD | MO | 63017 | 463070062 | |||||
| HMTS INC | |||||||||||||
| HEALTHCARE | CA | NA | C-CORP | 1 HOAG DRIVE | NEWPORT BEACH | CA | 92658 | 453583707 | |||||
| HOAG MANAGEMENT SERVICES INC | |||||||||||||
| HEALTHCARE | CA | NA | C-CORP | 1 HOAG DRIVE BOX 6100 | NEWPORT BEACH | CA | 92658 | 330731587 | |||||
| HPA REALTY INC | |||||||||||||
| REAL ESTATE | CA | NA | C-CORP | 1 CENTERPOINTE DRIVE SUITE 200 | LA PALMA | CA | 90623 | ||||||
| LUBBOCK METHODIST HOSP PRACTICE MGMT | |||||||||||||
| INACTIVE | TX | NA | C-CORP | 2107 OXFORD STREET STE 300 | LUBBOCK | TX | 79410 | 752578995 | |||||
| LUBBOCK METHODIST HOSPITAL SVCS | |||||||||||||
| HEALTHCARE | TX | NA | C-CORP | PO BOX 1201 | LUBBOCK | TX | 79410 | 752118585 | |||||
| MISSION VIEJO MEDICAL VENTURES | |||||||||||||
| HEALTHCARE | CA | NA | C-CORP | 27800 MEDICAL CENTER RD 354 | MISSION VIEJO | CA | 92691 | 330212905 | |||||
| ST JOSEPH HEALTH | |||||||||||||
| HOLDING COMPANY | CA | NA | C-CORP | 3345 MICHELSON DRIVE SUITE 100 | IRVINE | CA | 92612 | 462340232 | |||||
| ST JOSEPH HEALTH SOURCE INC | |||||||||||||
| HEALTHCARE | CA | NA | C-CORP | 3345 MICHELSON DRIVE SUITE 100 | IRVINE | CA | 92612 | 461900168 | |||||
| ST JOSEPH PROF SVCS ENTERPRISES INC | |||||||||||||
| HEALTHCARE | CA | NA | C-CORP | 3345 MICHELSON DRIVE SUITE 100 | IRVINE | CA | 92612 | 330155323 | |||||
| ST JOSEPH YORBA PARK | |||||||||||||
| INACTIVE | CA | NA | C-CORP | ||||||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| COVENANT MEDICAL CENTER | ||
| O | $1,905,339 | ACCRUAL |
| COVENANT MEDICAL CENTER | ||
| Q | $3,697,384 | ACCRUAL |
| COVENANT MEDICAL CENTER | ||
| R | $429,756 | ACCRUAL |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART III | FormAndLineReferenceDesc |
| Explanation | IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP COVENANT LONG-TERM CARE, LP EIN: 20-5033419 ADDRESS: 4000 24TH STREET, LUBBOCK, TX 79410 HEALTHCARE DESIGN AND CONSTRUCTION EIN: 46-2611662 ADDRESS: 1 CENTERPOINTE DRIVE SUITE 200, LA PALMA, CA 90623-1052 HEALTHCARE PROPERTY ADVISORS, LLC EIN: 46-5497794 ADDRESS: 1 CENTERPOINTE DRIVE SUITE 200, LA PALMA, CA 90623-1052 HERITAGE INVESTMENT GROUP I, LLC EIN: 27-1000061 ADDRESS: 500 S. MAIN STREET, STE 1000, ORANGE, CA 92868 HOAG ORTHOPEDIC INSTITUTE EIN: 61-1588294 ADDRESS: 1 HOAG DRIVE, BOX 6100, NEWPORT BEACH, CA 92658 LUBBOCK SURGERY CENTER, LTD. EIN: 75-2177401 ADDRESS: 4000 24TH STREET, LUBBOCK, TX 79410 METHODIST DIAGNOSTIC IMAGING EIN: 75-2343261 ADDRESS: 4005 24TH STREET, LUBBOCK, TX 79410 MISSION AMBULATORY SURGICENTER, LTD EIN: 33-0355575 ADDRESS: 27800 MEDICAL CENTER ROAD, STE 362, MISSION VIEJO, CA 92691 NEWPORT IMAGING CENTER EIN: 33-0191776 ADDRESS: 360 SAN MIGUEL, NEWPORT BEACH, CA 92660 SHA, LLC EIN: 75-2569094 ADDRESS: 12940 NORTH HIGHWAY 183, AUSTIN, TX 78750 ST. JOSEPH PHYSICIAN VENTURES I, LLC EIN: 45-4521884 ADDRESS: 1100 WEST STEWART DRIVE, ORANGE, CA 92868 ST. JOSEPH HEALTH SYSTEM HOME CARE SERVICES EIN: 33-0307672 ADDRESS: 1845 W. ORANGEWOOD AVENUE, STE 100, ORANGE, CA 92868-2012 ST. JOSEPH HEALTH SYSTEM HOME HEALTH AGENCY EIN: 33-0282945 ADDRESS: 1845 W. ORANGEWOOD AVENUE, STE 200 ORANGE, CA 92868-2012 THE INNOVATION INSTITUTE EIN: 90-0745066 ADDRESS: 1 CENTERPOINTE DRIVE SUITE 200, LA PALMA, CA 90623-1052 TOTAL HEALTH ENVIRONMENT EIN: 46-4807513 ADDRESS: 1 CENTERPOINTE DRIVE SUITE 200, LA PALMA, CA 90623-1052 ADVANCED SURGERY INSTITUTE LLC EIN: 26-2299255 ADDRESS: 1739 4TH STREET, SANTA ROSA, CA 95404 NORTH BAY ENDOSCOPY CENTER, LLC EIN: 61-1559876 ADDRESS: 1383 N. MCDOWELL BLVD SUITE 110, PETALUMA, CA 94954 | ExplanationTxt |