TY 2018 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) DAVID BAYOUTH...................................................................... BOARD MEMBER	2.0 ................. 2.0	X		0	0
(2) SISTER SHARON BECKER CSJ...................................................................... BOARD MEMBER/COMMITTEE CHAIR	4.0 ................. 45.0	X		0	0
(3) BRIAN BRUENING MD...................................................................... BOARD MEMBER/COMMITTEE CHAIR	4.0 ................. 4.0	X		0	0
(4) VAL COCHRAN...................................................................... BOARD MEMBER/COMMITTEE V CHAIR	4.0 ................. 4.0	X		0	0
(5) JACK L COX MD...................................................................... BOARD MEMBER (PART YEAR)	2.0 ................. 48.0	X		901,816	33,238
(6) MIKE CUNNINGHAM...................................................................... BOARD MEMBER/COMMITTEE V CHAIR	4.0 ................. 4.0	X		0	0
(7) JEREMY DALTON MD...................................................................... BOARD MBR/CHIEF OF STAFF CCH	2.0 ................. 48.0	X		376,616	23,720
(8) JIM GILBREATH...................................................................... BOARD MEMBER/BOARD V. CHAIR	5.0 ................. 5.0	X		0	0
(9) KERRY HENDERSHOT MD...................................................................... BOARD MEMBER	2.0 ................. 2.0	X		525,793	35,613
(10) KEITH MANN...................................................................... BOARD MEMBER/BOARD CHAIR	5.0 ................. 5.0	X		0	0
(11) EDDIE MCBRIDE...................................................................... BOARD MEMBER/COMMITTEE V CHAIR	4.0 ................. 4.0	X		0	0
(12) CHRISTY MCCLENDON...................................................................... BOARD MEMBER/COMMITTEE V CHAIR	4.0 ................. 4.0	X		0	0
(13) JESSIE MENDOZA...................................................................... BOARD MEMBER	2.0 ................. 2.0	X		0	0
(14) BRIAN NICHOLSON MD...................................................................... BOARD MEMBER	2.0 ................. 48.0	X		631,862	23,966
(15) RICHARD PARKS...................................................................... BOARD MBR/REGIONAL CEO - PSJH	24.0 ................. 28.0	X	X	1,398,181	38,008
(16) DONALD QUICK MD...................................................................... BOARD MBR/CHIEF OF STAFF CMC	2.0 ................. 48.0	X		643,191	30,025
(17) SISTER CHRISTINE RAY CSJ...................................................................... BOARD MEMBER/COMMITTEE CHAIR	4.0 ................. 46.0	X		0	0

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) KAREN WORLEY........................................................................ BOARD MEMBER/COMMITTEE V CHAIR	4.0 .......................4.0	X					0	0	0
(19) WALTER CATHEY........................................................................ PRES CH OPERATIONS	50.0 .......................0.0		X				676,293	0	51,151
(20) JOHN GRIGSON........................................................................ REGIONAL CFO	26.0 .......................24.0		X				591,648	0	41,780
(21) JAMES KELLY........................................................................ SECRETARY	20.0 .......................30.0		X				0	388,617	39,870
(22) ROBERT TURNER........................................................................ VP MISSION INGEGRATION	26.0 .......................24.0		X				275,954	0	38,045
(23) KAREN BAGGERLY........................................................................ VP CHIEF NURSING EXEC	50.0 .......................0.0			X			397,797	0	36,332
(24) DYANA KERR........................................................................ CFO - SERVICE AREA COVANENT	46.0 .......................4.0			X			269,390	0	46,702
(25) SHARON PRATHER........................................................................ CHIEF GOVERNANCE OFFICER	31.0 .......................19.0			X			330,523	0	44,775
(26) CRAIG RHYNE MD........................................................................ REG CHIEF MEDICAL OFFICER	50.0 .......................0.0			X			731,445	0	47,182
(27) BRIAN SCHROEDER MD........................................................................ CHIEF MEDICAL OFFICER - CMC	50.0 .......................0.0			X			443,249	0	38,571
(28) CHRISTINE SHAVER........................................................................ VP CHIEF HUMAN RESOURCES	50.0 .......................0.0			X			292,253	0	40,623
(29) STEVEN BECK........................................................................ CHIEF ADMIN OFFICER-LB	30.0 .......................20.0				X		387,257	0	45,708
(30) RUEBAN LACY........................................................................ CHIEF REVENUE CYCLE - TEXAS	50.0 .......................0.0				X		252,766	0	27,775
(31) KELLY MCDANIEL........................................................................ EXECUTIVE DIR SUPPORT SERVICES	50.0 .......................0.0				X		262,730	0	39,835
(32) ROBERT SALEM MD........................................................................ EXEC MEDICAL DIRECTOR EMERITUS	50.0 .......................0.0				X		387,257	0	45,708
(33) DAVID SHAW........................................................................ VP NM HOSPITAL ADMINISTRATOR	50.0 .......................0.0				X		266,215	0	51,037
(34) STEVEN MCCAMY........................................................................ PRES/CEO CMG (FORMER KEY EMPL)	0.0 .......................50.0					X	0	500,821	559

(A) Name and business address	(B) Description of services	(C) Compensation
DUNN TEINERT, 1001 LOCUST KANSAS CITY,MO64106	CONSTRUCTION	9,840,522
HEALTHCARE DESIGN AND CONSTRUCTION, 836 TOWN AND COUNTRY RD ORANGE,CA92868	HEALTHCARE DESIGN	8,004,727
SOUND PHYSICIANS OF TEXAS, PO BOX 7429 IRVING,CA75038	PHYSICIAN SERVICES	6,658,284
NORTHSTAR ANESTHESIA PA, 6225 N STATE HIGHWAY 161 IRVING,TX75038	ANESTHESIA SERVICES	5,365,085
MCCARTHY BUILDING COMPANIES, 1341 NORTH ROCK HILL ROAD ST LOUIS,MO63124	CONSTRUCTION	5,067,843
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 241

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

Covenant Health System

Employer identification number

75-2765566

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2018. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2017. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2017. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2017. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2018

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2018

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2018

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2018 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Name of the organization

Covenant Health System

Employer identification number

75-2765566

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization Covenant Health System

Part I	Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

Name of organization Covenant Health System		Employer identification number 75-2765566

Part II	Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 4


Name of organization Covenant Health System			Employer identification number 75-2765566
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Covenant Health System

Employer identification number

75-2765566

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2018

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ...............................
c	Total lobbying expenditures (add lines 1a and 1b) ...................................................................
d	Other exempt purpose expenditures ........................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2018

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

45,284

Total. Add lines 1c through 1i ....................................................................................................

45,284

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
SCHEDULE C, PART II-B, LINE 1I	PORTION OF DUES PAID TO HOSPITAL ASSOCIAITIONS FOR LOBBYING ACTIVITIES THE LOBBYING EXPENDITURES REPORTED REPRESENTS THE PORTION OF DUES ALLOCATED TO COVENANT HEALTH SYSTEM.

Schedule C (Form 990 or 990EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Covenant Health System

Employer identification number

75-2765566

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2018

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	18,817,059		18,817,059
b	Buildings ....	491,836,616	269,333,046	222,503,570
c	Leasehold improvements	20,656,196	18,518,587	2,137,609
d	Equipment ....	216,714,539	163,341,532	53,373,007
e	Other .....	111,941,478		111,941,478
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				408,772,723

Schedule D (Form 990) 2018

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) LT DUE FROM AFFILIATES				101,720,261
(2) OTHER RECEIVABLES				1,141,365
(3) ASSETS HELD IN TRUST				347,723
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				103,209,349

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
LONG-TERM DEBT - GRACE HEALTH	99,292,326
INTERCOMPANY LIABILITIES - BONDS	72,093,465
PAYABLE TO THIRD-PARTY PAYORS	29,154,546
OTHER NON CURRENT LIABILITIES	3,638,045
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	204,178,382
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2018

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation

Schedule D (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Covenant Health System

Employer identification number

75-2765566

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 175 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	44,491,812		44,491,812	6.160 %
b	Medicaid (from Worksheet 3, column a) . . . . .	50,064,585	33,950,178	16,114,407	2.230 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	812,410	35,550	776,860	0.110 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	95,368,807	33,985,728	61,383,079	8.500 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	634,053	230	633,823	0.090 %
f	Health professions education (from Worksheet 5) . . .	13,553,540	5,452,924	8,100,616	1.120 %
g	Subsidized health services (from Worksheet 6) . . . .	267,421	4,436	262,985	0.040 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	538,838		538,838	0.070 %
j	Total. Other Benefits . .	14,993,852	5,457,590	9,536,262	1.320 %
k	Total. Add lines 7d and 7j .	110,362,659	39,443,318	70,919,341	9.820 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018

Schedule H (Form 990) 2018

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

10,425,890

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

107,008,429

Enter Medicare allowable costs of care relating to payments on line 5.....

166,040,188

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-59,031,759

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1METHODIST DIAGNOSTIC	HEALTHCARE	60 %	40 %
2COVENANT L-T CARE LP	HEALTHCARE	82.76 %	17.24 %
3COVENANT HP SURG CTR	HEALTHCARE	35.3 %	64.7 %
4COVENANT REHAB HOSP	HEALTHCARE	49 %	51 %
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2018

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?2Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)						Facility reporting group
1	COVENANT MEDICAL CENTER 3615 19TH STREET LUBBOCK,TX794101203 WWW.COVENANTHEALTH.ORG 465	X	X	X	X	A
2	GRACE MEDICAL CENTER 2412 50TH STREET LUBBOCK,TX794122504 WWW.GRACEHEALTHSYSTEM.COM 465	X	X		X	B

Schedule H (Form 990) 2018

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	A
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 16

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SCHEDULE H, PART V, SECTION C

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 17

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SCHEDULE H, PART V, SECTION C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 175.% and FPG family income limit for eligibility for discounted care of 300.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE PART V, SECTION C

The FAP application form was widely available on a website (list url):

SEE PART V, SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE SECTION C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	A
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	B
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Yes

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url):

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Indicate the tax year the hospital facility last adopted an implementation strategy: 20

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

If "Yes" (list url):

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	B
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 175.% and FPG family income limit for eligibility for discounted care of 300.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE PART V, SECTION C

The FAP application form was widely available on a website (list url):

SEE PART V, SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE SECTION C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	B
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	B
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
SCHEDULE H, PART V, SECTION B, LINE 2	(B, 2) COVENANT HEALTH SYSTEM ACQUIRED GRACE MEDICAL SYSTEM, INCLUDING GRACE MEDICAL CENTER, ON FEBRUARY 1, 2018. GRACE MEDICAL CENTER WAS NOT A TAX-EXEMPT HOSPITAL PRIOR TO THE ACQUISITION AND PLANS TO COMPLETE THEIR FIRST CHNA BY 12/31/2020 IN ACCORDANCE WITH TREAS. REG SECTION 1.501(R)-3(D). SCHEDULE H, PART V, SECTION B, LINE 3E (A, 1) THE SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED THROUGH THE CHNA PROCESS AND ARE LISTED IN RANK ORDER (PRIORITIZED). SCHEDULE H, PART V, SECTION B, LINE 5 (A, 1) INPUT FROM COMMUNITY REPRESENTATIVES THE PROCESS OF COLLECTING QUALITATIVE COMMUNITY INPUT TOOK THREE MAIN FORMS: COMMUNITY RESIDENT FOCUS GROUPS, A NONPROFIT AND GOVERNMENT STAKEHOLDER FOCUS GROUP, AND A COMMUNITY FORUM. EACH GROUP WAS DESIGNED TO CAPTURE THE COLLECTED KNOWLEDGE AND OPINIONS OF PEOPLE WHO LIVE AND WORK IN THE COMMUNITIES SERVED BY COVENANT HEALTH. WE DEVELOPED A PROTOCOL (NOTED IN CHNA APPENDIX 3B, POSTED ON THE COVENANT WEBSITE) FOR EACH GROUP TO ENSURE CONSISTENCY ACROSS INDIVIDUAL FOCUS GROUPS, ALTHOUGH THE FACILITATORS HAD SOME DISCRETION ON ASKING FOLLOW-UP QUESTIONS OR PROBES AS THEY SAW FIT. INVITATION AND RECRUITMENT PROCEDURES VARIED FOR EACH TYPE OF GROUP. CHNA APPENDIX 3, AVAILABLE ONLINE, ON COVENANT HEALTH WEBSITE, INCLUDES A FULL REPORT OF THE COMMUNITY INPUT PROCESS AND FINDINGS ALONG WITH DESCRIPTIONS OF THE PARTICIPANTS. SPRING 2017 - RESIDENT FOCUS GROUPS: FOR COMMUNITY RESIDENT GROUPS, COMMUNITY BENEFIT STAFF, IN COLLABORATION WITH THEIR COMMITTEES AND THE SYSTEM OFFICE, IDENTIFIED GEOGRAPHIC AREAS WHERE DATA SUGGESTED THERE WERE SIGNIFICANT HEALTH, PHYSICAL ENVIRONMENT, AND SOCIOECONOMIC CONCERNS. THIS PROCESS ALSO IDENTIFIED THE LANGUAGE NEEDS OF THE COMMUNITY, WHICH DETERMINED THE LANGUAGE IN WHICH EACH FOCUS GROUP WAS CONDUCTED. COMMUNITY BENEFIT STAFF THEN PARTNERED WITH COMMUNITY-BASED ORGANIZATIONS THAT SERVE THOSE AREAS TO RECRUIT FOR AND HOST THE FOCUS GROUPS. THE COMMUNITY-BASED ORGANIZATION DEVELOPED AN INVITATION LIST USING THEIR CONTACTS AND KNOWLEDGE OF THE AREA, AND PARTICIPANTS WERE PROMISED A SMALL INCENTIVE FOR THEIR TIME. DESCRIPTION OF MEDICALLY UNDERSERVED, LOW INCOME AND/OR MINORITY POPULATIONS REPRESENTED IN COMMUNITY INPUT PROCESS: TWO CONSULTANTS STAFFED EACH FOCUS GROUP, SERVING AS FACILITATORS AND NOTE TAKERS. THESE CONSULTANTS WERE NOT DIRECTLY AFFILIATED WITH THE MINISTRY TO ENSURE CANDOR FROM THE PARTICIPANTS. THE DEMOGRAPHICS OF THE RESIDENT FOCUS GROUPS ARE AS FOLLOWS: FEMALE - 81% MALE - 19% RACE/ETHNICITY: HISPANIC/LATINO - 69% NON-LATINO WHITE - 15% BLACK/AFRICAN-AMERICAN - 12% NATIVE AMERICAN 4% CHRONIC CONDITIONS: PERSON WITH CHRONIC CONDITIONS OR A LEADER OR REPRESENTATIVE OF INDIVIDUALS WITH CHRONIC CONDITIONS - 58% INCOME: TOTAL HOUSEHOLD INCOME BEFORE TAXES LESS THAN $20,000 - 68%. SPRING 2017 NONPROFIT & GOVERNMENT STAKEHOLDER FOCUS GROUP: FOR THE NONPROFIT AND GOVERNMENT STAKEHOLDER FOCUS GROUP, COMMUNITY BENEFIT STAFF DEVELOPED A LIST OF LEADERS FROM ORGANIZATIONS THAT SERVE DIVERSE CONSTITUENCIES WITHIN THE HOSPITAL'S SERVICE AREA. MINISTRY STAFF SOUGHT TO INVITE ORGANIZATIONS WITH WHICH THEY HAD EXISTING RELATIONSHIPS, BUT ALSO USED THE FOCUS GROUP AS AN OPPORTUNITY TO BUILD NEW RELATIONSHIPS WITH STAKEHOLDERS. PARTICIPANTS WERE NOT GIVEN A MONETARY INCENTIVE FOR ATTENDANCE. AS WITH THE RESIDENT FOCUS GROUPS, THIS GROUP WAS FACILITATED BY OUTSIDE CONSULTANTS WITHOUT A DIRECT LINK TO ST. JOSEPH HEALTH. SPRING 2017 - RESIDENT COMMUNITY FORUM: RECRUITMENT FOR THE COMMUNITY RESIDENT FORUM WAS MUCH BROADER TO ENCOURAGE AS MANY PEOPLE AS POSSIBLE TO ATTEND THE SESSION. COMMUNITY BENEFIT STAFF PUBLICIZED THE EVENT THROUGH FLYERS AND EMAILS USING THEIR EXISTING OUTREACH NETWORKS, AND ALSO ASKED THEIR PARTNER ORGANIZATIONS TO INVITE AND RECRUIT PARTICIPANTS. NO FORMAL INVITATION LIST WAS USED FOR THE FORUMS AND ANYONE WHO WISHED TO ATTEND WAS WELCOMED. THE FORUM WAS CONDUCTED BY AN OUTSIDE CONSULTANT IN ENGLISH, WITH SIMULTANEOUS SPANISH LANGUAGE TRANSLATION FOR ANYONE WHO REQUESTED IT. WHILE THE FOCUS GROUPS FOLLOWED A SIMILAR PROTOCOL TO EACH OTHER IN WHICH FIVE TO SIX QUESTIONS WERE ASKED OF THE GROUP, THE FORUM FOLLOWED A DIFFERENT PROCESS. THE LEAD FACILITATOR SHARED THE HEALTH NEEDS THAT HAD EMERGED FROM THE CHNA PROCESS SO FAR AND ASKED THE PARTICIPANTS TO COMMENT ON THEM AND ADD ANY OTHER CONCERNS. ONCE THE DISCUSSION WAS COMPLETE, THE PARTICIPANTS ENGAGED IN A CUMULATIVE VOTING PROCESS USING DOTS TO INDICATE THEIR GREATEST CONCERNS. THROUGH THIS PROCESS, THE FORUM SERVED AS SOMETHING OF A "CAPSTONE" TO THE COMMUNITY INPUT PROCESS. COMPLETE, THE PARTICIPANTS ENGAGED IN A CUMULATIVE VOTING PROCESS USING DOTS TO INDICATE THEIR GREATEST CONCERNS. THROUGH THIS PROCESS, THE FORUM SERVED AS SOMETHING OF A "CAPSTONE" TO THE COMMUNITY INPUT PROCESS.
SCHEDULE H, PART V, SECTION B, LINE 6	(A, 1) CHNA HOSPITAL FACILITIES THE NEEDS ASSESSMENT WAS CONDUCTED AS A COLLABORATIVE EFFORT BETWEEN THE FOLLOWING COVENANT HEALTH ENTITIES: COVENANT HEALTH MEDICAL CENTER, COVENANT HEALTH CHILDREN'S, COVENANT HEALTH PLAINVIEW, COVENANT HEALTH LEVELLAND AND COVENANT SPECIALTY HOSPITAL (JOINT VENTURE). THESE FACILITIES ARE REFERRED TO COLLECTIVELY AS COVENANT HEALTH AND ALL SERVE THE SAME GEOGRAPHIC SERVICE AREA OF WEST TEXAS AND EASTERN NEW MEXICO.
SCHEDULE H, PART V, SECTION B, LINE 7A	(A, 1) THE CHNA FOR COVENANT HEALTH SYSTEM CAN BE FOUND ON ITS WEBSITE AT HTTPS://WWW.COVENANTHEALTH.ORG/DOCUMENTS/CMC-CC-CSH-CHNA-FY17.PDF
SCHEDULE H, PART V, SECTION B, LINE 10A	(A, 1) HTTPS://WWW.COVENANTHEALTH.ORG/DOCUMENTS/CMC-CC-CSH-CBPLAN-ISREPORT-FY18-2 0.PDF
SCHEDULE H, PART V, SECTION B, LINE 11	(A, 1) COVENANT HEALTH IS WORKING BOTH INTERNALLY AND WITH COMMUNITY PARTNERS TO ADDRESS SIGNIFICANT HEALTH NEEDS IDENTIFY BY THE FY17 COMMUNITY HEALTH NEEDS ASSESSMENT. COVENANT HEALTH'S FY18-FY20 COMMUNITY BENEFIT PLAN/IMPLEMENTATION STRATEGY REPORT FOCUSES ON THREE AREAS, MENTAL/BEHAVIORAL HEALTH, DIABETES PREVENTION AND INTERVENTION, AND DENTAL HEALTH. BELOW IS A HIGH-LEVEL SUMMARY OF THE FY18-FY20 CB PLAN/IMPLEMENTATION STRATEGY REPORT: MENTAL/BEHAVIORAL HEALTH - WORK WITH COMMUNITY PARTNERS TO EXPAND AND INVESTIGATE CREATIVE SOLUTIONS ACCESS TO CARE, TO CREATE COMMUNITY RESILIENCE, REDUCE DEPRESSION AND ANXIETY, AND EXPAND SUBSTANCE ABUSE (INCLUDING ALCOHOL) PREVENTION/INTERVENTION INITIATIVES THROUGH EITHER DIRECT PROGRAMMING OR FINANCIAL SUPPORT OF PARTNER AGENCIES. DIABETES PREVENTION AND INTERVENTION - EXPAND CURRENT OUTREACH TO INCLUDE MORE INNOVATIVE APPROACHES TO PREVENTION WITH EMPHASIS ON EARLY INTERVENTIONS WITH CHILDREN AND FAMILIES, COLLABORATE WITH INTERNAL AND EXTERNAL PARTNERS TO IMPLEMENT EVIDENCE BASED PRACTICES, AND INCREASE ACCESS TO MEDICATION. INCLUDING FOCUS ON PREVENTIVE LIFESTYLE ISSUES SUCH AS OBESITY REDUCTION, UNHEALTHY LIFESTYLES, FOOD CHOICES AND EXERCISE. DENTAL HEALTH - ENHANCE CURRENT OUTREACH PRACTICES TO INCLUDE MORE EARLY INTERVENTION WITH CHILDREN AND NEW PARENTS, INCREASE SCHOOL PARTNERSHIPS AND EXPLORE WAYS TO CONTINUE TO IMPROVE ACCESS TO SERVICES NEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAM THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MINISTRY CHNA ARE NOT ADDRESSED THROUGH DIRECT ONGOING HOSPITAL PROGRAMMING HOWEVER THEY ARE ADDRESSED BY COVENANT HEALTH COMMUNITY PARTNERSHIPS: RESOURCE AWARENESS, POVERTY, TEEN PREGNANCY, CRIME AND FOOD INSECURITY COVENANT HEALTH PARTNERS WITH AND PROVIDES FUNDING TO SEVERAL ORGANIZATIONS THAT PROVIDE SERVICES IN THESE AREAS, INCLUDING BUT NOT LIMITED TO CATHOLIC CHARITIES, LOCAL FQHC'S, THE SOUTH PLAINS FOOD BANK, YWCA, WOMEN'S PROTECTIVE SERVICES, MEALS ON WHEELS, AND FAMILY GUIDANCE AND OUTREACH CENTER. WE ALSO HAVE BEGUN HOSTING AN ANNUAL CHILD ABUSE PREVENTION SUMMIT AND HAVE AN INTERNAL FOOD PANTRY FOR PATIENT'S FAMILIES IN NEED. WE ARE COMMITTED TO CONTINUE OUR MISSION THROUGH COMMUNITY BENEFIT PROGRAM AND BY FUNDING OTHER LOCAL NON-PROFITS THROUGH OUR WELLNESS AND PREVENTION GRANTS FUNDED THROUGH OUR CARE FOR THE POOR DOLLARS AND MANAGED BY COVENANT HEALTH COMMUNITY OUTREACH. IN ADDITION, WE COLLABORATE WITH LOCAL ORGANIZATION(S) AND LOCAL FEDERALLY QUALIFIED HEALTH CLINICS THAT ADDRESS AFOREMENTIONED COMMUNITY NEEDS TO COORDINATE CARE. FOR MORE INFORMATION ON THE KEY STRATEGIES FOR ADDRESSING THIS HEALTH NEEDS GO TO THE COVENANT HEALTH FY18-FY20 CB PLAN LOCATED AVAILABLE ONLINE AT HTTPS://WWW.COVENANTHEALTH.ORG/DOCUMENTS/CMC-CC-CSH-CBPLAN-ISREPORT-FY18-2 0.PDF
SCHEDULE H, PART V, SECTION B, LINE 13H	(A, 1) & (B,2) 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 16A	(A, 1) & (B, 2) HTTPS://WWW.COVENANTHEALTH.ORG/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING- AND-PAYMENTS/PATIENT-FINANCIAL-ASSISTANCE/ HTTPS://GRACEHEALTHSYSTEM.COM/FOR-PATIENTS/FINANCIAL-ASSISTANCE-PROGRAM/
SCHEDULE H, PART V, SECTION B, LINE 16B	(A, 1) & (B, 2) HTTPS://WWW.COVENANTHEALTH.ORG/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING- AND-PAYMENTS/PATIENT-FINANCIAL-ASSISTANCE/ HTTPS://GRACEHEALTHSYSTEM.COM/FOR-PATIENTS/FINANCIAL-ASSISTANCE-PROGRAM/
SCHEDULE H, PART V, SECTION B, LINE 16C	(A, 1) & (B, 2) HTTPS://WWW.COVENANTHEALTH.ORG/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING- AND-PAYMENTS/PATIENT-FINANCIAL-ASSISTANCE/ HTTPS://GRACEHEALTHSYSTEM.COM/FOR-PATIENTS/FINANCIAL-ASSISTANCE-PROGRAM/
SCHEDULE H, PART V, SECTION B, LINE 16J	(A, 1) & (B, 2) THE ORGANIZATION ADHERES TO STATE REGULATIONS IN PUBLICIZING ITS FINANCIAL ASSISTANCE POLICY. THESE REGULATIONS INCLUDE THE POSTING OF THE FULL POLICY ON THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) WEBSITE. IN ADDITION, POLICY NOTICES ARE POSTED IN CONSPICUOUS AREAS SUCH AS EMERGENCY DEPARTMENTS, BILLING OFFICES, ADMISSIONS OFFICES AND OTHER OUTPATIENT SETTINGS. INDIVIDUAL NOTICES OF FINANCIAL ASSISTANCE ARE INCLUDED WITH BILLINGS TO PATIENTS WHO HAVE NOT PROVIDED PROOF OF THIRD-PARTY COVERAGE ALONG WITH CONTACT INFORMATION IN THE EVENT OF ADDITIONAL INQUIRIES. NOTICES OF FINANCIAL ASSISTANCE ARE ALSO PROVIDED UPON REQUEST. WRITTEN NOTICES ARE PROVIDED IN ALL LANGUAGES SPOKEN BY 5% OR MORE OF THE HOSPITAL'S SERVICE AREA.

Schedule H (Form 990) 2018

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?10
Name and address		Type of Facility (describe)
1	COVENANT LT CARE LP DBA COVENANT SP HOSP 4000 24TH STREET LUBBOCK,TX79410	LONG TERM CARE
2	COVENANT HEART & VASCULAR 3615 19TH STREET LUBBOCK,TX79410	GENERAL MEDICAL & SURGICAL
3	COVENANT HIGH PLAINS SURGERY CENTER LLC 10000 MEMORIAL DR STE 540 HOUSTON,TX77024	SURGERY CENTER
4	METHODIST DIAGNOSTIC IMAGING 4005 24TH STREET LUBBOCK,TX79410	DIAGNOSTIC CENTER
5	FAMILY HEALTHCARE CENTER 7601 QUAKER LUBBOCK,TX79424	MEDICAL CLINIC
6	SOUTHWEST MEDICAL PARK 9812 SLIDE ROAD LUBBOCK,TX79424	GENERAL MEDICAL & SURGICAL
7	NORTHWEST CLINIC 611 N FRANKFORD LUBBOCK,TX79416	MEDICAL CLINIC
8	COVENANT REHAB HOSPITAL OF LUBBOCK 7770 JEFFERSON ST NE SUITE 320 ALBUQUERQUE,NM87109	REHAB HOSPITAL
9	COVENANT HEALTH EMERGENCY CENTER 7905 MILWAUKEE AVE LUBBOCK,TX79424	EMERGENCY
10	COVENANT HEALTH EMERGENCY CENTER 10205 QUAKER AVE LUBBOCK,TX79424	EMERGENCY

Schedule H (Form 990) 2018

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
SCHEDULE H, PART I, LINE 3C	IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, FPG IS A KEY FACTOR. 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 6A	COVENANT HEALTH PREPARES AN ANNUAL REPORT AS A SYSTEM WHICH INCLUDES COVENANT MEDICAL CENTER, COVENANT CHILDREN'S HOSPITAL AND COVENANT SPECIALTY HOPSITAL (JOINT VENTURE), AND IT IS PUBLICLY AVAILABLE AT HTTPS://WWW.COVENANTHEALTH.ORG/DOCUMENTS/CH-CBR-FY17.PDF
SCHEDULE H, PART I, LINE 7A-I	THE AMOUNTS REPORTED IN THE TABLE WERE DERIVED FROM THE COST ACCOUNTING SYSTEM AND GENERAL LEDGER. THE ORGANIZATION'S COST ACCOUNTING SYSTEM ADDRESSED ALL PATIENT SEGMENTS.
SCHEDULE H, PART I, LINE 7G	NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED.
SCHEDULE H, PART III, SECTION A, LINE 2	THE ORGANIZATION ANALYZES ITS HISTORICAL EXPERIENCE AND TRENDS TO ESTIMATE THE APPOPRIATE 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 WERE GRANTED 100 PERCENT FINANCIAL ASSISTANCE (FREE CARE). 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	FINANCIAL STATEMENT FOOTNOTE DESCRIBING BAD DEBT FOOTNOTE FROM THE PROVIDENCE ST. JOSEPH COMBINED FINANCIAL STATEMENTS FOR THE YEAR ENDED 12/31/2018. THE HEALTH SYSTEM PROVIDES FOR AN ALLOWANCE AGAINST PATIENT ACCOUNTS RECEIVABLE FOR AMOUNTS THAT COULD BECOME UNCOLLECTIBLE. THE HEALTH SYSTEM ESTIMATES THIS ALLOWANCE BASED ON THE AGING OF ACCOUNTS RECEIVABLE, HISTORICAL COLLECTION EXPERIENCE BY PAYOR, AND OTHER RELEVANT FACTORS. THERE ARE VARIOUS FACTORS THAT CAN IMPACT THE COLLECTION TRENDS, SUCH AS CHANGES IN THE ECONOMY, WHICH IN TURN HAVE AN IMPACT ON UNEMPLOYMENT RATES AND THE NUMBER OF UNINSURED AND UNDERINSURED PATIENTS, THE INCREASED BURDEN OF COPAYMENTS TO BE MADE BY PATIENTS WITH INSURANCE COVERAGE AND BUSINESS PRACTICES RELATED TO COLLECTION EFFORTS. THESE FACTORS CONTINUOUSLY CHANGE AND CAN HAVE AN IMPACT ON COLLECTION TRENDS AND THE ESTIMATION PROCESS USED BY THE HEALTH SYSTEM. THE HEALTH SYSTEM RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICES ON THE BASIS OF PAST EXPERIENCE, WHICH HAS HISTORICALLY INDICATED THAT MANY PATIENTS ARE UNRESPONSIVE OR ARE OTHERWISE UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE.
SCHEDULE H, PART III, SECTION B, LINE 8	THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT.
SCHEDULE H, PART III, SECTION C, LINE 9B	COVENANT HEALTH SYSTEM 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 ASSESSMENT COVENANT HEALTH AS PART OF ITS STRATEGIC PLANNING PROCESS DEVELOPS A FIVE-YEAR STRATEGIC PLAN WHICH ESTABLISHES A VISION FOR THE ORGANIZATION WHILE SETTING A GUIDE FOR THE ANNUAL STRATEGIC PLAN. AS PART OF THE PLANNING PROCESS, WE ANALYZE EXTERNAL MARKET INFORMATION (INCLUDING BUT NOT LIMITED TO POPULATION ESTIMATES, DEMOGRAPHIC AND SOCIOECONOMIC INFORMATION, REGIONAL USE RATES AND MARKET UTILIZATION TREND ANALYSES) AND INTERNAL INFORMATION (INCLUDING BUT NOT LIMITED TO INPATIENT, OUTPATIENT/SAME DAY, AND EMERGENCY VISIT DATA BY PATIENT ORIGIN, BY AGE COHORTS, BY RACE AND ETHNICITY AND INCOME STRATA) TO BETTER UNDERSTAND THE NEEDS OF OUR PATIENTS AND COMMUNITY. THIS WORK IS USED TO DEVELOP SERVICE AND PHYSICIAN/PROVIDER NEED PROJECTIONS TO DETERMINE GAPS IN OUR COMMUNITY. AS A FAITH-BASED PROVIDER THIS INFORMATION ALSO IS USED TO DETERMINE NEEDS FOR THE UNDERSERVED AND VULNERABLE IN OUR COMMUNITY AND REGION.
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 ANDOUT PATIENT 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 HEALTH'S TOTAL HOSPITAL SERVICE AREA (TSA) INCLUDES 25 COUNTIES. THE MOST DENSE POPULATION OF THE TSA IS IN LUBBOCK COUNTY, AND APPROXIMATELY 100 PERCENT OF LUBBOCK COUNTY'S POPULATION IS WITHIN THE TSA. THE TOTAL HOSPITAL SERVICE AREA POPULATION IS 750,000 WITH A MEDIAN HOUSHOLD INCOME OF $45,365. THE TOTAL SERVICE HAS 34.6 PERCENT OF THE POPULATION WITH A HOUSEHOLD INCOME BELOW 200% FPL AND 24.5 PERCENT OF CHILDREN AND 10.8 PERCENT OF OLDER ADULTS LIVE BELOW 100% OF POVERTY LEVEL. WHEN LOOKING AT THE PRIMARY SERVICE AREA, 25.4 PERCENT OF THE POPULATION IS UNDER THE AGE OF 18 13.2 PERCENT OF THE POPULATION IS OVER THE AGE OF 65. LUBBOCK COUNTY DEMOGRAPHICS INCLUDE: 54% WHITE NON-HISPANIC, 35% HISPANIC/LATINO, 2.4% ASIAN/PACIFIC ISLANDER, 7.8% AFRICAN AMERICAN, 1% NATIVE AMERICAN. COVENANT HEALTH'S TOTAL SERVICE AREA INCLUDES: 43.9% HISPANIC/LATION, 47.8 % WHITE NON-HISPANIC, 5% AFRICAN AMERICAN, 1.4 % ASIAN/PACIFIC ISLANDER, .5% NATIVE AMERICAN. THE FOLLOWING ZIP CODE HAVE HIGH LEVELS OF POVERTY 79401,79411,79404,79415,79403,79412,79064,79041,79357,79410,79339,79316,79 414,79072,79241 OTHER HOSPITALS IN THE TSA INCLUDE: COCHRAN MEMORIAL HOSPITAL CROSBYTON CLINIC HOSPITAL MEDICAL ARTS HOSPITAL W.J. MANGOLD MEMORIAL HOSPITAL MEMORIAL HOSPITAL YOAKUM COUNTY HOSPITAL COVENANT HEALTH - PLAINVIEW COVENANT HEALTH - LEVELLAND LAMB HEALTHCARE CENTER COVENANT CHILDREN'S HOSPITAL LUBBOCK HEART HOSPITAL LYNN COUNTY HOSPITAL DISTRICT BROWNFIELD REGIONAL MEDICAL CENTER YOAKUM COUNTY HOSPITAL COGDELL MEMORIAL HOSPITAL PLAINS REGIONAL MEDICAL CENTER LEA REGIONAL MEDICAL CENTER NOR-LEA GENERAL HOSPITAL HEALTH PROFESSIONS SHORTAGE AREA - MENTAL, DENTAL, OTHER THE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION DESIGNATES HEALTH PROFESSIONAL SHORTAGE AREAS AS AREAS WITH A SHORTAGE OF PRIMARY MEDICAL CARE, DENTAL CARE, OR MENTAL HEALTH PROVIDERS. THEY ARE DESIGNATED ACCORDING TO GEOGRAPHY (I.E., SERVICE AREA), DEMOGRAPHICS (I.E., LOW-INCOME POPULATION), OR INSTITUTIONS (I.E., COMPREHENSIVE HEALTH CENTERS). COVENANT HEALTH IS LOCATED IN A SHORTAGE AREA, THE MAJORITY OF THE TOTAL SERVICE AREA IS DESIGNATED AS SHORTAGE AREAS. MEDICAL UNDERSERVED AREA/MEDICAL PROFESSIONAL SHORTAGE AREA MEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ARE DEFINED BY THE FEDERAL GOVERNMENT TO INCLUDE AREAS OR POPULATION GROUPS THAT DEMONSTRATE A SHORTAGE OF HEALTHCARE SERVICES. THIS DESIGNATION PROCESS WAS ORIGINALLY ESTABLISHED TO ASSIST THE GOVERNMENT IN ALLOCATING COMMUNITY HEALTH CENTER GRANT FUNDS TO THE AREAS OF GREATEST NEED. MEDICALLY UNDERSERVED AREAS ARE IDENTIFIED BY CALCULATING A COMPOSITE INDEX OF NEED INDICATORS COMPILED AND COMPARED WITH NATIONAL AVERAGES TO DETERMINE AN AREA'S LEVEL OF MEDICAL "UNDER SERVICE." MEDICALLY UNDERSERVED POPULATIONS ARE IDENTIFIED BASED ON DOCUMENTATION OF UNUSUAL LOCAL CONDITIONS THAT RESULT IN ACCESS BARRIERS TO MEDICAL SERVICES. MEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ARE PERMANENTLY SET, AND NO RENEWAL PROCESS IS NECESSARY. THE MAJORITY OF THE COVENANT HEALH SERVICE AREA, IS LOCATED IN A MEDICALLY UNDERSERVED AREA/MEDICALLY UNDERSERVED POPULATIONS AREA, SIGNIFYING THE IMPORTANCE OF COVENANT MEDICAL CENTER TO THE COMMUNITY IT SERVES. FOR MORE INFORMATION, GO TO THE COVENANT HEALTH'S FY17 COMMUNITY BENEFIT REPORT POSTED AT HTTPS://WWW.COVENANTHEALTH.ORG/DOCUMENTS/CH-CBR-FY17.PDF.
SCHEDULE H, PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH COVENANT MEDICAL CENTER, COVENANT CHILDREN'S, COVENANT HEALTH LEVELLAND AND COVENANT HEALTH PLAINVIEW ALL PROVIDE VITAL COMMUNITY HEALTH SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERSINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTED CARE. COVENANT HEALTH IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE IN ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS: 1) A COMMUNITY BENEFIT COMMITTEE THAT HAS COMMUNITY REPRESENTATION AND IS A SUBCOMMITTEE OF THE BOARD OF TRUSTEES 2) OPEN MEDICAL STAFF 3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS. SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS.
SCHEDULE H, PART VI, LINE 6	AFFILIATED HEALTH CARE SYSTEM ON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (LEGACY PHS) AND ST. JOSEPH HEALTH SYSTEM (LEGACY SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT. BY COMING TOGETHER, PROVIDENCE ST. JOSEPH HEALTH SEEKS TO BETTER SERVE ITS COMMUNITIES THROUGH GREATER PATIENT AFFORDABILITY, OUTSTANDING CLINICAL CARE, IMPROVEMENTS TO THE PATIENT EXPERIENCE AND INTRODUCTION OF NEW SERVICES WHERE THEY ARE NEEDED MOST. TOGETHER, OUR CAREGIVERS SERVE IN 51 HOSPITALS AND OVER 829 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. EFFECTIVE FEBRUARY 1, 2018, COVENANT HEALTH SYSTEM ACQUIRED GRACE HEALTH SYSTEM TO CREATE THE MOST CLINICALLY-INTEGRATED HEALTH NETWORK IN LUBBOCK, WEST TEXAS AND EASTERN NEW MEXICO. TOGETHER, COVENANT HEALTH SYSTEM IS ABLE TO DELIVER MORE EFFECTIVE CARE TO ITS COMMUNITY BY PROVIDING GREATER ACCESS TO SERVICES, PHYSICIANS AND INNOVATION IN THE DELIVERY OF HEALTH CARE. GRACE HEALTH SYSTEM INCLUDES GRACE CLINIC AND GRACE MEDICAL CENTER. GRACE HEALTH SYSTEM IS AN INNOVATIVE HEALTHCARE PROVIDER DEDICATED TO CLINICAL EXCELLENCE, DELIVERING AN ENJOYABLE PATIENT EXPERIENCE AND PROVIDING BEST VALUE. GRACE IS COMMITTED TO DELIVERING THE POSITIVE EFFECTS OF PREVENTIVE MEDICINE AND BELIEVES IN THE IMPORTANCE OF A STRONG PATIENT/DOCTOR RELATIONSHIP. GRACE WAS BUILT ON THE MISSION OF DELIVERING THE KIND OF CARE EACH OF US WANTS FOR OUR OWN FAMILY.
SCHEDULE H, PART VI, LINE 7	STATE FILING OF COMMUNITY BENEFIT REPORT TEXAS

Schedule H (Form 990) 2018

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
Covenant Health System

Employer identification number
75-2765566

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(h) Purpose of grant or assistance
(1) ST JOSEPH HEALTH SYSTEM FOUNDATION 1801 LIND AVE SW RENTON,CA980579016	33-0143024	501(c)(3)	4,728,100		CARE FOR THE POOR GENERAL SUPPORT GENERAL SUPPORT CAMPAIGN FACILITY WELLNESS & PREVENTION GRANT WELLNESS & PREVENTION GRANT WELLNESS & PREVENTION GRANT SNACK PAK 4 KIDS WELLNESS & PREVENTION GRANT GENERAL SUPPORT WELLNESS & PREVENTION GRANT WELLNESS AND HEALTHIEST COMM
(2) DIOCESE OF LUBBOCK PO BOX 98700 LUBBOCK,TX794998700	75-1889213	501(c)(3)	50,000	0	GENERAL SUPPORT
(3) LUBBOCK ENTERTAINMENT PERFORMING ARTS ASSC 1500 BROADWAY STREET 1254 LUBBOCK,TX79401	46-1912406	501(c)(3)	100,000	0	GENERAL SUPPORT
(4) TEXAS TECH FOUNDATION PO BOX 41081 LUBBOCK,TX79409	75-6043842	501(c)(3)	50,000	0	COMMUNITY WELLNESS
(5) LUBBOCK DREAM CENTER 1111 30TH STREET LUBBOCK,TX79424	45-3991946	501(c)(3)	53,625		WELLNESS & PREVENTION GRANT
(6) CARPENTER'S CHURCH 1918 13TH STREET LUBBOCK,TX79401		501(c)(3)	25,000	0	WELLNESS & PREVENTION GRANT
(7) LUBBOCK FAMILY GUIDANCE CENTER INC 5 BRIERCROFT OFFICE PARK LUBBOCK,TX79412	75-1890384	501(c)(3)	30,000	0
(8) BAPTIST COMMUNITY SERVICES 6110 W 34TH AVENUE AMARILLO,TX791094004	75-2206268	501(c)(3)	20,000	0	SNACK PACK 4 KIDS
(9) SOUTH PLAINS COMMUNITY ACTION ASSOCIATION 411 AUSTIN LEVELLAND,TX79336	75-1230219	501(c)(3)	35,000	0
(10) HALE CENTER SENIOR CITIZENS ASSC INC PO BOX 205 HALE CENTER,TX79041	75-1865523	501(c)(3)	10,000	0
(11) FAIR FOOD NETWORK 205 E WASHINGTON ST NO B ANN ARBOR,MI48104	26-4143394	501(c)(3)	15,000	0
(12) TEXAS TECH UNIVERSITY BOX 41105 LUBBOCK,TX79409	75-2668014	GOVT	234,590	0

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2018

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
SCHEDULE I, PART I, LINE 2	DESCR OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS DONATIONS MADE TO OTHER ORGANIZATIONS ARE APPROVED BY MANAGEMENT TO ENSURE THEY SUPPORT THE MISSION ON COVENANT HEALTH SYSTEM. NO ADDITIONAL MONITORING IS DONE.

Schedule I (Form 990) 2018

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Covenant Health System

Employer identification number

75-2765566

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2018

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1JACK L COX MD BOARD MEMBER (PART YEAR)	(i) (ii)	0 ------------- 512,129	0 ------------- 299,564	0 ------------- 90,123	0 ------------- 11,000	0 ------------- 22,238	0 ------------- 935,054	0 ------------- 0
2JEREMY DALTON MD BOARD MBR/CHIEF OF STAFF CCH	(i) (ii)	0 ------------- 322,117	0 ------------- 12,195	0 ------------- 42,304	0 ------------- 8,000	0 ------------- 15,720	0 ------------- 400,336	0 ------------- 0
3KERRY HENDERSHOT MD BOARD MEMBER	(i) (ii)	0 ------------- 354,815	0 ------------- 165,797	0 ------------- 5,181	0 ------------- 10,000	0 ------------- 25,613	0 ------------- 561,406	0 ------------- 0
4BRIAN NICHOLSON MD BOARD MEMBER	(i) (ii)	0 ------------- 412,533	0 ------------- 214,539	0 ------------- 4,790	0 ------------- 0	0 ------------- 23,966	0 ------------- 655,828	0 ------------- 0
5RICHARD PARKS BOARD MBR/REGIONAL CEO - PSJH	(i) (ii)	0 ------------- 773,840	0 ------------- 521,737	0 ------------- 102,604	0 ------------- 13,750	0 ------------- 24,258	0 ------------- 1,436,189	0 ------------- 0
6DONALD QUICK MD BOARD MBR/CHIEF OF STAFF CMC	(i) (ii)	0 ------------- 433,320	0 ------------- 89,115	0 ------------- 120,756	0 ------------- 10,000	0 ------------- 20,025	0 ------------- 673,216	0 ------------- 58,502
7WALTER CATHEY PRES CH OPERATIONS	(i) (ii)	379,664 ------------- 0	244,911 ------------- 0	51,718 ------------- 0	21,635 ------------- 0	29,516 ------------- 0	727,444 ------------- 0	0 ------------- 0
8JOHN GRIGSON REGIONAL CFO	(i) (ii)	445,847 ------------- 0	71,702 ------------- 0	74,099 ------------- 0	19,250 ------------- 0	22,530 ------------- 0	633,428 ------------- 0	0 ------------- 0
9JAMES KELLY SECRETARY	(i) (ii)	0 ------------- 313,533	0 ------------- 47,481	0 ------------- 27,603	0 ------------- 11,000	0 ------------- 28,870	0 ------------- 428,487	0 ------------- 0
10ROBERT TURNER VP MISSION INGEGRATION	(i) (ii)	219,693 ------------- 0	33,699 ------------- 0	22,562 ------------- 0	9,205 ------------- 0	28,840 ------------- 0	313,999 ------------- 0	0 ------------- 0
11KAREN BAGGERLY VP CHIEF NURSING EXEC	(i) (ii)	308,053 ------------- 0	45,883 ------------- 0	43,861 ------------- 0	24,750 ------------- 0	11,582 ------------- 0	434,129 ------------- 0	0 ------------- 0
12DYANA KERR CFO - SERVICE AREA COVANENT	(i) (ii)	188,130 ------------- 0	29,050 ------------- 0	52,210 ------------- 0	13,841 ------------- 0	32,861 ------------- 0	316,092 ------------- 0	0 ------------- 0
13SHARON PRATHER CHIEF GOVERNANCE OFFICER	(i) (ii)	255,153 ------------- 0	38,131 ------------- 0	37,239 ------------- 0	23,690 ------------- 0	21,085 ------------- 0	375,298 ------------- 0	0 ------------- 0
14CRAIG RHYNE MD REG CHIEF MEDICAL OFFICER	(i) (ii)	546,328 ------------- 0	87,994 ------------- 0	97,123 ------------- 0	22,000 ------------- 0	25,182 ------------- 0	778,627 ------------- 0	0 ------------- 0
15BRIAN SCHROEDER MD CHIEF MEDICAL OFFICER - CMC	(i) (ii)	369,225 ------------- 0	66,226 ------------- 0	7,798 ------------- 0	11,000 ------------- 0	27,571 ------------- 0	481,820 ------------- 0	0 ------------- 0
16CHRISTINE SHAVER VP CHIEF HUMAN RESOURCES	(i) (ii)	229,761 ------------- 0	34,445 ------------- 0	28,047 ------------- 0	20,989 ------------- 0	19,634 ------------- 0	332,876 ------------- 0	0 ------------- 0
17STEVEN BECK CHIEF ADMIN OFFICER-LB	(i) (ii)	306,404 ------------- 0	42,438 ------------- 0	38,415 ------------- 0	24,750 ------------- 0	20,958 ------------- 0	432,965 ------------- 0	0 ------------- 0
18RUEBAN LACY CHIEF REVENUE CYCLE - TEXAS	(i) (ii)	198,348 ------------- 0	30,493 ------------- 0	23,925 ------------- 0	7,352 ------------- 0	20,423 ------------- 0	280,541 ------------- 0	0 ------------- 0
19KELLY MCDANIEL EXECUTIVE DIR SUPPORT SERVICES	(i) (ii)	209,001 ------------- 0	28,963 ------------- 0	24,766 ------------- 0	19,443 ------------- 0	20,392 ------------- 0	302,565 ------------- 0	0 ------------- 0
20ROBERT SALEM MD EXEC MEDICAL DIRECTOR EMERITUS	(i) (ii)	306,404 ------------- 0	42,438 ------------- 0	38,415 ------------- 0	24,750 ------------- 0	20,958 ------------- 0	432,965 ------------- 0	0 ------------- 0
21DAVID SHAW VP NM HOSPITAL ADMINISTRATOR	(i) (ii)	237,652 ------------- 0	37 ------------- 0	28,526 ------------- 0	19,827 ------------- 0	31,210 ------------- 0	317,252 ------------- 0	0 ------------- 0
22STEVEN MCCAMY PRES/CEO CMG (FORMER KEY EMPL)	(i) (ii)	0 ------------- 7,989	0 ------------- 82,564	0 ------------- 410,268	0 ------------- 559	0 ------------- 0	0 ------------- 501,380	0 ------------- 0

Schedule J (Form 990) 2018

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
SCHEDULE J, PART I, LINE 3	ALTHOUGH THE CHIEF EXECUTIVE OFFICER IS PAID BY THE FILING ORGANIZATION, THE PROCESS TO DETERMINE COMPENSATION IS COMPLETED BY ITS TAX EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY ST. JOSEPH HEALTH SYSTEM.
SCHEDULE J, PART I, LINE 4A	STEVE MCCAMY RECEIVED SEVERANCE PAYMENTS IN THE AMOUNT OF $15,978.
SCHEDULE J, PART I, LINE 4B	NONQUALIFIED RETIREMENT PLAN ENTITIES WITHIN THE PSJH SYSTEM SPONSOR NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS FOR CERTAIN EXECUTIVES. THE PLANS PROVIDE FOR EMPLOYER CONTRIBUTIONS BASED ON A PERCENTAGE OF EXECUTIVE BASE SALARY AND, DEPENDING ON THE PLAN, ARE SUBJECT TO EITHER A THREE YEAR, AGE 59 OR A FIVE YEAR, AGE 65 VESTING SCHEDULE. CERTAIN EXECUTIVES PARTICIPATE IN A NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN PROVIDED BY A RELATED ENTITY. THE AMOUNTS SHOWN IN COLUMN F OF PART II REFLECT CURRENT YEAR PAYOUTS FROM THESE PLANS DONALD QUICK - $58,502
SCHEDULE J, PART I, LINE 7	A PORTION OF EXECUTIVE 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 STRATEGIC OBJECTIVES AS WELL AS FISCAL STEWARDSHIP. EACH OF THESE FACTORS IS TAKEN INTO CONSIDERATION WHEN DETERMINING THE PERCENTAGE OF AT-RISK PAY.

Schedule J (Form 990) 2018

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SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Covenant Health System

Employer identification number

75-2765566

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( MEDICAL EQUIPMENT )	X	33	678,080	COST/SELLING PRICE
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which is not required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 51227J

Schedule M (Form 990) (2018)

Page 2

Part II

Supplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
SCHEDULE M, PART I, LINE 25, COLUMN (B)	THE NUMBER IN COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED, NOT THE NUMBER OF ITEMS RECEIVED.

Schedule M (Form 990) (2018)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

Covenant Health System

Employer identification number

75-2765566

Return Reference	Explanation
FORM 990, PART III, LINE 4A	PROVIDENCE ST. JOSEPH HEALTH SYSTEM ON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT. BY COMING TOGETHER, PROVIDENCE ST. JOSEPH HEALTH SEEKS TO BETTER SERVE ITS COMMUNITIES THROUGH GREATER PATIENT AFFORDABILITY, OUTSTANDING CLINICAL CARE, IMPROVEMENTS TO THE PATIENT EXPERIENCE AND INTRODUCTION OF NEW SERVICES WHERE THEY ARE NEEDED MOST. TOGETHER, OUR CAREGIVERS SERVE IN 51 HOSPITALS, 829 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE FOUNDERS OF BOTH ORGANIZATIONS WERE COURAGEOUS WOMEN AHEAD OF THEIR TIME. THE SISTERS OF PROVIDENCE AND THE SISTERS OF ST. JOSEPH OF ORANGE BROUGHT HEALTH CARE AND OTHER SOCIAL SERVICES TO THE AMERICAN WEST WHEN IT WAS STILL A RUGGED, UNTAMED FRONTIER. NOW, AS WE FACE A DIFFERENT LANDSCAPE - A CHANGING HEALTH CARE ENVIRONMENT - WE DRAW UPON THEIR PIONEERING AND COMPASSIONATE SPIRIT TO PLAN FOR THE NEXT CENTURY OF HEALTH CARE. PROVIDENCE HEALTH & SERVICES IN 1856, MOTHER JOSEPH AND FOUR SISTERS OF PROVIDENCE ESTABLISHED HOSPITALS, SCHOOLS AND ORPHANAGES ACROSS THE NORTHWEST. OVER THE YEARS, OTHER CATHOLIC SISTERS TRANSFERRED SPONSORSHIP OF THEIR MINISTRIES TO PROVIDENCE, INCLUDING THE LITTLE COMPANY OF MARY, DOMINICANS AND CHARITY OF LEAVENWORTH. RECENTLY, SWEDISH HEALTH SERVICES, KADLEC REGIONAL MEDICAL CENTER AND PACIFIC MEDICAL CENTERS HAVE JOINED PROVIDENCE AS SECULAR PARTNERS WITH A COMMON COMMITMENT TO SERVING ALL MEMBERS OF THE COMMUNITY. TODAY, PROVIDENCE SERVES ALASKA, CALIFORNIA, MONTANA, OREGON AND WASHINGTON. ST. JOSEPH HEALTH SYSTEM IN 1912, A SMALL GROUP OF SISTERS OF ST. JOSEPH LANDED ON THE RUGGED SHORES OF EUREKA, CALIFORNIA TO PROVIDE EDUCATION AND HEALTH CARE. THEY LATER ESTABLISHED ROOTS IN ORANGE, CALIFORNIA, AND EXPANDED TO SERVE SOUTHERN CALIFORNIA, NORTHERN CALIFORNIA AND TEXAS. THE HEALTH SYSTEM ESTABLISHED MANY KEY PARTNERSHIPS, INCLUDING A MERGER BETWEEN LUBBOCK METHODIST HOSPITAL SYSTEM AND ST. MARY HOSPITAL TO FORM COVENANT HEALTH IN LUBBOCK TEXAS. RECENTLY, AN AFFILIATION WAS ESTABLISHED WITH HOAG HEALTH TO INCREASE ACCESS TO SERVICES IN ORANGE COUNTY, CALIFORNIA. REALIZING OUR MISSION COVENANT MEDICAL CENTER, IS PART OF NEWLY FORMED PROVIDENCE ST. JOSEPH HEALTH. COVENANT MEDICAL CENTER IS ONE OF SIX COVENANT HEALTH HOSPITALS. COVENANT HEALTH IS THE LARGEST AND MOST CLINICALLY INTEGRATED HEALTH NETWORK SERVING THE WEST TEXAS/EASTERN NEW MEXICO REGION. COVENANTS CHRISTIAN MINISTRY OF HEALING SERVES A TWENTY ONE COUNTY SERVICE AREA COVERING MORE THAN 30,000 SQUARE MILES AND 750,000 PEOPLE. OUR MISSION OF HEALING INCLUDES SEVEN HOSPITALS, MORE THAN 1,100 LICENSED BEDS, 5,000 CAREGIVERS, 350 OWNED OR ALIGNED PROVIDERS, AND MORE THAN 600 ADMITTING PHYSICIANS. COVENANT HEALTH DELIVERS ANNUALLY AN AVERAGE DAILY CENSUS OF MORE THAN 400 AT ITS HOSPITALS, MORE THAN 28,000 PATIENT DISCHARGES, AND MORE THAN 85,000 EMERGENCY ROOM VISITS. COVENANT IS THE MOST AWARDED HEALTH PROVIDER IN THE REGION BASED ON ANNUAL QUALITY AND SAFETY AWARDS FROM HEALTHGRADES AND US NEWS. MORE THAN A HEALTH SYSTEM, COVENANT IS THE LARGEST PRIVATE EMPLOYER IN LUBBOCK AND THE SOUTH PLAINS PROVIDING MORE THAN $1.1 BILLION IN ANNUAL ECONOMIC IMPACT TO THE COMMUNITIES IT SERVES AND IS CONSISTENTLY RATED AS ONE OF THE BEST PLACES TO WORK IN LUBBOCK. COVENANT IS COMMITTED TO OFFERING ACCESSIBLE, AFFORDABLE CARE TO LUBBOCKS SURROUNDING AREAS WITH HOSPITALS AND SERVICES OFFERED BY COVENANT HOSPITAL LEVELLAND AND COVENANT HOSPITAL PLAINVIEW, AND COVENANT MEDICAL GROUP, A LARGE EMPLOYED PHYSICIAN GROUP COMPRISED OF APPROXIMATELY 200 PRIMARY CARE AND SPECIALIST PHYSICIANS ACROSS WEST TEXAS AND EASTERN NEW MEXICO PROGRAM SERVICE ACCOMPLISHMENTS MENTAL/BEHAVIORAL HEALTH - COVENANT COMMUNITY OUTREACH COUNSELING CENTER PROVIDES COUNSELING SERVICES TO UNDERSERVED AND LOW-INCOME PERSONS IN OUR COMMUNITY OFFERING INDIVIDUAL, COUPLES AND FAMILY THERAPY TO PEOPLE OF ALL AGES. DURING 2018, A PARTNERSHIP WAS FORMED WITH TEXAS TECH UNIVERSITYS CENTER FOR ADOLESCENT RESILIENCY TO IMPLEMENT AND CO-FUND A PROGRAM WITHIN LUBBOCK INDEPENDENT SCHOOL DISTRICT TO PROVIDE FREE COUNSELING SERVICES AND IN-SCHOOL ADVOCATES FOR IDENTIFIED AT-RISK MIDDLE AND HIGH SCHOOL STUDENTS. A FREE MENTAL HEALTH FIRST AID COURSE WAS HOSTED BY COVENANT HEALTH FOR LOCAL SCHOOL POLICE OFFICERS. ADDITIONALLY, A COUNSELOR WAS ASSIGNED TO THE COVENANT LEVELLAND TO PROVIDE FREE COMMUNITY COUNSELING SERVICES WITH AN EMPHASIS ON SUICIDE PREVENTION. DIABETES WELLNESS AND PREVENTION COVENANT HEALTH OFFERS A FREE DIABETIC AND PREVENTION EDUCATION PROGRAM TO THE COMMUNITY. THIS INCLUDES A FULL TIME REGISTERED DIETITIAN AND CERTIFIED DIABETES EDUCATOR WHO IS DEDICATED TO DIABETES EDUCATION/PREVENTION AND GENERAL HEALTH /NUTRITION EDUCATION FOR ALL AGES. WE ALSO PARTNER WITH COVENANT MEDICAL GROUP WHICH PROVIDES A FULL-TIME REGISTERED NURSE AND A SECOND CERTIFIED DIABETES EDUCATOR WHO ALSO PROVIDE FREE EDUCATION. IN 2018 EDUCATION AND INTERVENTION PROGRAMMING WAS OFFERED MONTHLY AT CATHOLIC CHARITIES, LUBBOCK CHILDRENS CLINIC AND AT THE COVENANT DIABETES EDUCATION CLINIC. THE HEALTH EDUCATION TEAM ALSO PARTICIPATED LOCAL IN HEALTH SCREENINGS AND HEALTH FAIRS THROUGH THE YEAR. COVENANT HEALTH ALSO FUNDED GO NOODLE PLUS DURING THE 2017-18 ACADEMIC BRINING PROGRAMING TO 83 SCHOOLS, 1,892 TEACHERS AND 34,500 STUDENTS IN LUBBOCK, HALE AND HOCKLEY COUNTIES IN WEST TEXAS. ADDITIOANLLY COVENANT HEALTH PROVIDES SUBSTANCIAL FUNDING TO COMMUNITY PARTNER AGENCIES THROUGH THE WELLNESS AND PRVENTION GRANT PROGRAM ANNUALLY. DENTAL HEALTH - COMMUNITY OUTREACH DENTAL CLINIC SERVES LOW-INCOME FAMILIES OFFERING COMPREHENSIVE DENTAL CARE TO PATIENTS AGED 5 AND UP AND INCLUDES MOBILE DENTAL UNIT THAT SERVES PATIENTS IN A 75-MILE RADIUS OF LUBBOCK. IN 2018, COVENANT DENTAL PROVIDED DENTAL SEALANTS AND ORAL HEALTH SCREENINGS TO THIRD GRADERS IN THREE AREA SCHOOL DISTRICTS INCLUDING LEVELLAND, SUNDOWN AND LUBBOCK. 107 STUDENTS WERE SCREENED AND 105 SEALANT TREATMENTS WERE COMPLETED. THE DENTAL TEAM PARTICIPATED IN MULTIPLE HEALTH EDUCATION EVENTS AND EDUCATED OVER 500 CHILDREN ON ORAL HYGIENE. COVENANT HEALTH ALSO PROVIDED FUNDING TO THE SOUTH PLAINS COMMUNITY ACTION ASSOCIATION TO PROVIDE DENTAL SERVICES FOR LOW-INCOME CHILDREN IN THEIR HEAD START PROGRAM. EFFECTIVE FEBRUARY 1, 2018, COVENANT HEALTH SYSTEM ACQUIRED GRACE HEALTH SYSTEM TO CREATE THE MOST CLINICALLY-INTEGRATED HEALTH NETWORK IN LUBBOCK, WEST TEXAS AND EASTERN NEW MEXICO. TOGETHER, COVENANT HEALTH SYSTEM IS ABLE TO DELIVER MORE EFFECTIVE CARE TO ITS COMMUNITY BY PROVIDING GREATER ACCESS TO SERVICES, PHYSICIANS AND INNOVATION IN THE DELIVERY OF HEALTH CARE. GRACE HEALTH SYSTEM INCLUDES GRACE CLINIC AND GRACE MEDICAL CENTER. GRACE HEALTH SYSTEM IS AN INNOVATIVE HEALTHCARE PROVIDER DEDICATED TO CLINICAL EXCELLENCE, DELIVERING AN ENJOYABLE PATIENT EXPERIENCE AND PROVIDING BEST VALUE. GRACE IS COMMITTED TO DELIVERING THE POSITIVE EFFECTS OF PREVENTIVE MEDICINE AND BELIEVES IN THE IMPORTANCE OF A STRONG PATIENT/DOCTOR RELATIONSHIP. GRACE WAS BUILT ON THE MISSION OF DELIVERING THE KIND OF CARE EACH OF US WANTS FOR OUR OWN FAMILY. FOR MORE INFORMATION ABOUT COVENANT MEDICAL CENTER, PLEASE VISIT HTTPS://WWW.COVENANTHEALTH.ORG/ FOR MORE INFORMATION ABOUT GRACE MEDICAL CENTER, PLEASE VISIT HTTPS://GRACEHEALTHSYSTEM.COM/ FOR MORE INFORMATION ABOUT PROVIDENCE ST. JOSEPH HEALTH, PLEASE VISIT HTTPS://WWW.PSJHEALTH.ORG/ FOR MORE INFORMATION ABOUT ST. JOSEPH HEALTH, PLEASE VISIT WWW.STJHS.ORG.
FORM 990, PART V, LINE 1A	ST. JOSEPH HEALTH SYSTEM PAYS ALL VENDORS FOR COVENANT HEALTH SYSTEM FROM ITS SHARED SERVICES. ST. JOSEPH HEALTH SYSTEM ISSUES FORM 1099-MISC UNDER ITS TAX ID NUMBER AND COMPLIES WITH BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS.
FORM 990, PART VI, LINE 6	CLASSES OF MEMBERS OR STOCKHOLDERS ST. JOSEPH HEALTH SYSTEM AND LUBBOCK METHODIST HOSPITAL SYSTEM ARE THE CORPORATE MEMBERS OF COVENANT HEALTH SYSTEM.
FORM 990, PART VI, LINE 7A	CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS COVENANT HEALTH SYSTEM HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE COVENANT HEALTH SYSTEM BOARD. ALL TRUSTEE APPOINTMENTS THAT COME FROM THE COVENANT HEALTH SYSTEM BOARD AS NOMINATIONS MUST BE APPROVED BY THE ST. JOSEPH HEALTH SYSTEM, AS THE CORPROATE MEMBER, AND THE ST. JOSEPH HEALTH MINISTRY, AS THE ORGANIZATIONAL SPONSOR. THE ST. JOSEPH HEALTH SYSTEM MEMBER APPROVES 50% OF THE BOARD NOMINATIONS, PLUS THE VOTING CEO. THE LUBBOCK METHODIST HEALTH SYSTEM APPROVES THE OTHER 50% OF BOARD NOMINATIONS.
FORM 990, PART VI, LINE 7B	CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & 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. THE CORPORATE MEMBER, ST. JOSEPH HEALTH SYSTEM MEMBER, RESERVES THE RIGHT TO APPROVE THE 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	PROCESS TO REVIEW 990 THE FORM 990 WAS PREPARED BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION INCLUDING THE FINANCE TEAM, HUMAN RESOURCES, PAYROLL, COMPLIANCE AND THE GENERAL COUNSEL'S OFFICE. THE ORGANIZATION ENGAGED AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE RETURN. THE RETURN HAS BEEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. MANAGEMENT PRESENTED THE RETURNS TO THE FINANCE COMMITTEE, AND DISCUSSED KEY DISCLOSURES AND INFORMATION INCLUDED IN THE FORM 990. IN ADDITION, A COPY OF THE FORM 990 WAS DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING.
FORM 990, PART VI, LINE 12C	PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST BOARD MEMBERS, SPONSORS, SENIOR LEADERS AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANY REAL OR POTENTIAL CONFLICT OF INTEREST (COI) IN ACCORDANCE WITH THE PSJH COI POLICY AND IN CONNECTION WITH THAT INDIVIDUAL SATISFYING HIS OR HER FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES ARE MADE ANNUALLY AND/OR IF AT ANY TIME AN ACTUAL, REAL OR POTENTIAL CONFLICT OF INTEREST ARISES. PSJH CHIEF LEGAL OFFICER AND/OR THE PSJH CHIEF RISK OFFICER, REVIEW ALL DISCLOSURES. WHERE APPROPRIATE, THE CEO AND/OR THE BOARD CHAIR CONSIDER MATTERS THAT INVOLVE SENIOR LEADERSHIP OR A BOARD MEMBER. PSJH CHIEF LEGAL OFFICER AND/OR CHIEF RISK OFFICER REVIEW MATTERS WHERE CONFLICT IS DIFFICULT OR CANNOT BE RESOLVED AND PRESENT RECOMMENDATIONS TO THE APPROPRIATE BOARD COMMITTEE OR THE CEO, FOR DISCUSSION AND RESOLUTION. WHEN APPROPRIATE, THE INDIVIDUAL WITH THE REAL/POTENTIAL CONFLICT THAT IS BEING REVIEWED MAY PARTICIPATE IN THE DISCUSSION BUT IS EXCUSED FROM THE MEETING WHEN ACTION IS DECIDED. WHERE APPROPRIATE, THE CHIEF RISK OFFICER OR CHIEF LEGAL OFFICER WILL PROVIDE PLAN TO MANAGE CONFLICTS. AUDITING AND MONITORING OF THIS PROCESS IS DONE PERIODICALLY. ALL DOCUMENTATION OF COI DISCLOSURES IS RETAINED PER ORGANIZATION RETENTION POLICY.
FORM 990, PART VI, LINES 15A & 15B	IT IS PROVIDENCE ST. JOSEPH HEALTH'S INTENTION TO MAKE FINANCIAL INFORMATION ACCESSIBLE AND TRANSPARENT. ALTHOUGH THE FILING OF FORM 990 PROVIDES INSIGHT INTO HOW PROVIDENCE ST. JOSEPH HEALTH ACHIEVES ITS MISSION, DELIVERS ITS PROGRAMS AND STEWARDS ITS FINANCES, DECIPHERING THE INFORMATION DIRECTLY FROM FORM 990 CAN BE CHALLENGING. THE FOLLOWING PARAGRAPHS PROVIDE FURTHER INFORMATION ABOUT THE PROCESS WE USE TO DETERMINE COMPENSATION FOR TOP MANAGEMENT, OFFICERS AND KEY EMPLOYEES. PROVIDENCE ST. JOSEPH HEALTH HAS A SINGLE FIDUCIARY BOARD, WITH RESPONSIBILITY FOR FINANCIAL OVERSIGHT ASSOCIATED WITH FULFILLMENT OF THE PROVIDENCE ST. JOSEPH HEALTH MISSION, DEVELOPING SYSTEM POLICIES, PROTECTING THE ASSETS ENTRUSTED TO THE ORGANIZATION AND OVERSEEING THE STRATEGIC AND OPERATIONAL AFFAIRS OF PROVIDENCE ST. JOSEPH HEALTH'S LEGAL ENTITIES. PROVIDENCE ST. JOSEPH HEALTH ALSO MAINTAINS A NETWORK OF COMMUNITY ENTITY BOARDS WITH RESPONSIBILITY FOR QUALITY OF CARE OVERSIGHT, COMMUNITY RELATIONS, ADVOCACY AND COMMUNITY NEEDS ASSESSMENTS. PROVIDENCE ST. JOSEPH HEALTH HAS A CONSISTENT COMPENSATION PHILOSOPHY FOR ALL OF ITS OFFICERS, INCLUDING OUR SENIOR EXECUTIVES. SALARIES FOR SENIOR EXECUTIVES ARE REVIEWED BY THE PROVIDENCE ST. JOSEPH HEALTH COMMITTEE. THE BOARD RETAINS AN INDEPENDENT CONSULTANT EACH YEAR TO REVIEW SALARIES OF THOSE IN THE MOST SIGNIFICANT LEADERSHIP ROLES IN THE ORGANIZATION. PART OF THE CONSULTANT'S ROLE IS TO REVIEW AN EXTENSIVE ARRAY OF COMPENSATION SURVEYS OF LARGE, NOT-FOR-PROFIT HEALTH CARE SYSTEMS IN THE UNITED STATES. PROVIDENCE ST. JOSEPH HEALTH IS ONE OF THE LARGER HEALTH SYSTEMS IN THE COUNTRY, AND AS SUCH, THE BOARD BENCHMARKS EXECUTIVE COMPENSATION AGAINST OTHER LARGE, NOT-FOR-PROFIT HEALTH SYSTEMS WHOSE REVENUE IS SIMILAR TO THAT OF PROVIDENCE ST. JOSEPH HEALTH. ADDITIONALLY, PROVIDENCE ST. JOSEPH HEALTHS LABOR MARKET CONTINUES TO SPREAD ACROSS HEALTH CARE AND INTO GENERAL INDUSTRY. BECAUSE OF THIS, PROVIDENCE ST. JOSEPH HEALTH ALSO TAKES INTO CONSIDERATION GENERAL INDUSTRY FOR-PROFIT MARKET DATA, WHERE APPLICABLE. BASE SALARIES FOR PROVIDENCE ST. JOSEPH HEALTH EXECUTIVES ARE GENERALLY TARGETED TO THE MEDIAN LEVEL OF THE MARKET, AS IDENTIFIED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE EXECUTIVE COMPENSATION COMMITTEE. THE PRESIDENT/CEO UTILIZES THE MARKET INFORMATION PROVIDED BY THE CONSULTANT ALONG WITH FORMAL PERFORMANCE EVALUATIONS, TO DETERMINE SALARY RECOMMENDATIONS FOR OTHER SENIOR EXECUTIVES. THIS PROCESS INCLUDES A RIGOROUS ANALYSIS OF THOSE RECOMMENDATIONS WITH THE EXECUTIVE COMPENSATION COMMITTEE AS A PART OF THE REVIEW AND APPROVAL PROCESS. PERFORMANCE INCENTIVES ALLOW EXECUTIVES TO EARN ADDITIONAL COMPENSATION IF THEY ACHIEVE SPECIFIC ORGANIZATIONAL GOALS FOR FURTHERING PROVIDENCE ST. JOSEPH HEALTH OPERATING COMMITMENTS AND STRATEGIC OBJECTIVES. THE BOARD OF DIRECTORS CONDUCTS A THOROUGH REVIEW PROCESS TO ENSURE PERFORMANCE INCENTIVES ARE ALIGNED WITH APPROPRIATE MARKET PRACTICES. THE BOARD'S PROCESS FOR EXECUTIVE COMPENSATION FULLY COMPLIES WITH IRS STANDARDS AND MIRRORS BEST PRACTICES. THE PROCESS TO REVIEW COMPENSATION WAS LAST COMPLETED MARCH 5, 2019.
FORM 990, PART VI, LINE 19	GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE PSJH COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE SJHS INTERNET SITE. AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FORM 990.
FORM 990, PART X, LINES 13 & 14	THE BEGINNING BALANCE OF INVESTMENTS - PROGRAM RELATED WAS UPDATED FROM $29,801,454 IN THE PRIOR YEAR TO $7,301,454. $22,500,000 OF INTANGIBLE ASSETS WERE INADVERTENTLY INCLUDED IN INVESTMENTS - PROGRAM RELATED IN THE PRIOR YEAR.
FORM 990, PART XI, LINE 9	OTHER CHANGES IN NET ASSETS CONTRIBUTED CAPITAL $ 2,071,119 INVESTMENT IN SUBS $ (47,669,428) EQUITY TRANSFERS $ (15,610,558) GRACE UNRESTRICTED FND BAL $ (9,262) -------------- TOTAL $ (61,218,129)
FORM 990 PART IX LINE 11G	DESCRIPTION:Other fees TOTAL FEES:97013055

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Covenant Health System

Employer identification number

75-2765566

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) COVENANT LTC-GP LLC 4000 24TH STREET LUBBOCK,TX79410 20-5477333	HEALTHCARE	TX	0	0	CHS
(2) CHS HOLDING GP LLC 4000 24TH STREET LUBBOCK,TX79410 20-5477307	HEALTHCARE	TX	0	0	CHS
(3) GRACE CLINIC HOLDINGS LLC 4515 MARSHA SHARP FREEWAY LUBBOCK,TX79047	HEALTHCARE	TX	4,942,442	32,130,423	CHS
(4) GRACE FINANCE LLC 4515 MARSHA SHARP FREEWAY LUBBOCK,TX79047	HEALTHCARE	TX	0	0	CHS
(5) LUBBOCK HERITAGE HOSPITAL LLC 4515 MARSHA SHARP FREEWAY LUBBOCK,TX79047	HEALTHCARE	TX	75,681,161	129,482,103	CHS

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)COVENANT ACO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 61-1573313	HEALTHCARE	TX	501(C)(3)	12, I	CHS	Yes
(2)COVENANT HEALTH NETWORK INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 46-1259908	HEALTHCARE	CA	501(C)(3)	12, III	SJHS	Yes
(3)COVENANT HEALTH PARTNERS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 46-3516417	HEALTHCARE	TX	501(C)(3)	12, I	CHS	Yes
(4)COVENANT HEALTH SYSTEM FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 75-2897026	HEALTHCARE	TX	501(C)(3)	7	CHS	Yes
(5)COVENANT MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 82-2913146	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes
(6)COVENANT MEDICAL GROUP 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 75-2743883	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes
(7)E WA & MT UNEMPLOYMENT COMP INSR TRUST 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1082119	UNEMPLOYMENT	WA	501(C)(3)	12, I	PHS WA	Yes
(8)EVERETT TRANSITIONAL CARE SERVICES PO BOX 5128 EVERETT,WA982065128 94-3264605	TRANS. CARE	WA	501(C)(3)	10	NA		No
(9)FACEY MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-4322584	SUPPORT	CA	501(C)(3)	7	PHS SOCAL	Yes
(10)GAMELIN WASHINGTON ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 20-1910170	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes
(11)GLOBAL TO LOCAL HEALTH INITIATIVE 2800 SOUTH 192ND ST 104 SEATAC,WA98188 27-3133200	HEALTHCARE	WA	501(C)(3)	7	SHS	Yes
(12)HMTS INC 1 HOAG DRIVE PO BOX 6100 NEWPORT BEACH,CA92658 45-3583707	HEALTHCARE	CA	501(C)(3)	12, I	HMHP	Yes
(13)HOAG CHARITY SPORTS 2081 BUSINESS CTR DR STE 195 IRVINE,CA92612 45-2982422	SUPPORT	CA	501(C)(3)	7	HHF	Yes
(14)HOAG CLINIC (FKA COASTAL MGMT SVCS ORG) 1 HOAG DRIVE PO BOX 6100 NEWPORT BEACH,CA92658 33-0676831	HEALTHCARE	CA	501(C)(3)	10	HMHP	Yes
(15)HOAG HOSPITAL FOUNDATION 330 PLACENTIA AVE NEWPORT BEACH,CA92663 95-3222343	FUNDRAISING	CA	501(C)(3)	7	HMHP	Yes
(16)HOAG MEMORIAL HOSPITAL PRESBYTERIAN 1 HOAG DRIVE PO BOX 6100 NEWPORT BEACH,CA92658 95-1643327	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes
(17)HOSPICE OF LUBBOCK 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 75-2133781	HEALTHCARE	TX	501(C)(3)	10	CHS	Yes
(18)INLAND NORTHWEST HEALTH SERVICES 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1307555	HEALTHCARE	WA	501(C)(3)	3	PHS WA	Yes
(19)INSTITUTE FOR MENTAL HEALTH & WELLNESS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-4260130	HEALTHCARE	WA	501(C)(3)	7	PHSSJHS	Yes
(20)INSTITUTE FOR SYSTEMS BIOLOGY 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-2003593	HEALTHCARE	WA	501(C)(3)	7	WHC	Yes
(21)JOHN WAYNE CANCER INSTITUTE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-4291515	HEALTHCARE	CA	501(C)(3)	4	PSJHC	Yes
(22)KADLEC AUXILIARY INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-6033089	SUPPORT	WA	501(C)(3)	12, III	KRMC	Yes
(23)KADLEC FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 23-7005501	SUPPORT	WA	501(C)(3)	12, I	KRMC	Yes
(24)KADLEC REGIONAL MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-0655392	HEALTHCARE	WA	501(C)(3)	3	WHC	Yes
(25)LITTLE COMPANY OF MARY ANCILLARY SVCS CO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 33-0844408	IMAGING SVCS	CA	501(C)(3)	10	PHS SOCAL	Yes
(26)LUBBOCK METHODIST HOSPITAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 75-2220963	HEALTHCARE	TX	501(C)(3)	7	CHS	Yes
(27)LUNDBERG ASSOCIATIONPROVIDENCE HOUSE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1562797	SUPPORT	OR	501(C)(3)	7	PHS OR	Yes
(28)MARSHA RIVKIN CTR FOR OVARIAN CANCER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-2054035	RESEARCH	WA	501(C)(3)	7	SHS	Yes
(29)METHODIST CHILDREN'S HOSPITAL 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 75-2428911	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes
(30)METHODIST HOSPITAL LEVELLAND 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 75-2246348	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes
(31)METHODIST HOSPITAL PLAINVIEW 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 75-2426010	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes
(32)MISSION HOSPITAL REGIONAL MEDICAL CTR 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-1643360	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes
(33)NORTHWEST HOPE & HEALING FOUNDATION PO BOX 16069 SEATTLE,WA98116 20-0799737	SUPPORT	WA	501(C)(3)	12,I	SHS	Yes
(34)PACMED CLINICS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 56-2290878	HEALTHCARE	WA	501(C)(3)	10	WHC	Yes
(35)PH&S FOUNDATIONSFVSA & SCVSA 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-3544877	HEALTHCARE	CA	501(C)(3)	7	PHS SOCAL	Yes
(36)PROVIDENCE ALASKA FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 92-0093565	HEALTHCARE	AK	501(C)(3)	12, I	PHS WA	Yes
(37)PROVIDENCE BENEDICTINE NURSING CTR FNDN 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1940286	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes
(38)PROVIDENCE BLANCHET ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1789266	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes
(39)PROVIDENCE CHILDREN'S HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 93-0800140	SUPPORT	OR	501(C)(3)	7	PHS OR	Yes
(40)PROVIDENCE COMMUNITY HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 93-0692907	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes
(41)PROVIDENCE DETHMAN HOUSE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-3385506	SUPPORT	WA	501(C)(3)	7	NA		No
(42)PROVIDENCE GAMELIN HOUSE ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 31-1744654	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes
(43)PROVIDENCE HEALTH & SERVICES 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1549796	HEALTHCARE	WA	501(C)(3)	12, II	PSJH		No
(44)PROVIDENCE HEALTH & SERVICES - MONTANA 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-0231793	HEALTHCARE	MT	501(C)(3)	3	PHS WA	Yes
(45)PROVIDENCE HEALTH & SERVICES - OREGON 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 51-0216587	HEALTHCARE	OR	501(C)(3)	3	PHS	Yes
(46)PROVIDENCE HEALTH & SERVICES - WA 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 51-0216586	HEALTHCARE	WA	501(C)(3)	3	PHS	Yes
(47)PROVIDENCE HEALTH & SERVICES - WEST WA 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1303277	HEALTHCARE	WA	501(C)(3)	3	PMWHC	Yes
(48)PROVIDENCE HEALTH ASSURANCE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 55-0828701	MEDICAID	OR	501(C)(4)	N/A	PHP	Yes
(49)PROVIDENCE HEALTH CARE FNDN - E WA 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 32-0014330	HEALTHCARE	WA	501(C)(3)	7	PHS WA	Yes
(50)PROVIDENCE HEALTH CARE FNDN (CENTRALIA) 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1433382	HEALTHCARE	WA	501(C)(3)	7	PHS W WA	Yes
(51)PROVIDENCE HEALTH PLAN 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 93-0863097	HEALTHCARE	OR	501(C)(4)	N/A	PPP	Yes
(52)PROVIDENCE HEALTH SYSTEM - SO CAL 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 51-0216589	HEALTHCARE	CA	501(C)(3)	3	PHS	Yes
(53)PROVIDENCE HOOD RIVER MEM HOSP FNDN 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 93-0921990	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes
(54)PROVIDENCE HOSPICE AND HOME CARE FNDN 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 27-2552749	HEALTHCARE	WA	501(C)(3)	7	PHS W WA	Yes
(55)PROVIDENCE HOSPICE OF SEATTLE FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-2077378	HEALTHCARE	WA	501(C)(3)	7	PHS W WA	Yes
(56)PROVIDENCE LITTLE COMPANY OF MARY FNDN 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 51-0224944	HEALTHCARE	CA	501(C)(3)	7	PHS SOCAL	Yes
(57)PROVIDENCE MARIANWOOD FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 93-1554288	HEALTHCARE	WA	501(C)(3)	12, I	PHS W WA	Yes
(58)PROVIDENCE MEDICAL INSTITUTE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 33-0283773	HEALTHCARE	CA	501(C)(3)	12, I	PHS SOCAL	Yes
(59)PROVIDENCE MILWAUKIE FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 94-3079515	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes
(60)PROVIDENCE MINISTRIES 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016	RELIGIOUS ORG	WA	501(C)(3)	1	NA		No
(61)PROVIDENCE MOUNT ST VINCENT FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1188119	HEALTHCARE	WA	501(C)(3)	7	PHS WA	Yes
(62)PROVIDENCE NEWBERG HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 93-0889144	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes
(63)PROVIDENCE PETER CLAVER ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 31-1629656	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes
(64)PROVIDENCE PLAN PARTNERS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1861964	HEALTHCARE	WA	501(C)(4)	N/A	PHS OR	Yes
(65)PROVIDENCE PORTLAND MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 93-1231494	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes
(66)PROVIDENCE ROSSI ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 31-1584166	SUPPORT	WA	501(C)(3)	10	PHS WA	Yes
(67)PROVIDENCE SAINT JOHN'S HEALTH CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-1684082	HEALTHCARE	CA	501(C)(3)	3	PHS SOCAL	Yes
(68)PROVIDENCE SAINT JOHN'S MEDICAL FNDN 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-4542216	HEALTHCARE	CA	501(C)(3)	3	PHS SOCAL	Yes
(69)PROVIDENCE SEASIDE HOSPITAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 93-0927320	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes
(70)PROVIDENCE ST ELIZABETH HOUSE ASSOC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-2171539	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes
(71)PROVIDENCE ST FRANCIS ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 94-3244854	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes
(72)PROVIDENCE ST JOSEPH HEALTH 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-1244422	HEALTHCARE	WA	501(C)(3)	12, III	NA		No
(73)PROVIDENCE ST JOSEPH HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 94-3078543	HEALTHCARE	WA	501(C)(3)	12, I	PHS WA	Yes
(74)PROVIDENCE ST JOSEPH MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-0463482	HEALTHCARE	MT	501(C)(3)	3	PHS WA	Yes
(75)PROVIDENCE ST MARY FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 45-2841492	HEALTHCARE	WA	501(C)(3)	7	PHS WA	Yes
(76)PROVIDENCE ST PETER FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1097056	SUPPORT	WA	501(C)(3)	7	PHS W WA	Yes
(77)PROVIDENCE ST VINCENT MEDICAL FNDN 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 93-0575982	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes
(78)PROVIDENCE TRINITYCARE HOSPICE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-3264139	HEALTHCARE	CA	501(C)(3)	10	PHS SOCAL	Yes
(79)PROVIDENCE TRINITYCARE HOSPICE FNDN 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 33-0261016	HEALTHCARE	CA	501(C)(3)	7	PTCH	Yes
(80)PROVIDENCE WILLAMETTE FALLS MEDICAL FNDN 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 93-1003750	HEALTHCARE	OR	501(C)(3)	12, I	PHS OR	Yes
(81)QUEEN OF THE VALLEY MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 94-1243669	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes
(82)REDWOOD MEMORIAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 94-2779313	HEALTHCARE	CA	501(C)(3)	7	RMH	Yes
(83)REDWOOD MEMORIAL HOSPITAL 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 94-1384665	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes
(84)SAINT JOHN'S HOSPITALHEALTH CENTER FNDN 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-6100079	SUPPORT	CA	501(C)(3)	7	PSJHC	Yes
(85)SANTA ROSA MEMORIAL HOSPITAL 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 94-1231005	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes
(86)SEATTLE SCIENCE FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 61-1502822	PHYSN COLLAB	WA	501(C)(3)	7	WHC	Yes
(87)SISTERS OF PROVIDENCE OF MONTANA CORP 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 26-2612415	SHELL CORP	MT	501(C)(3)	1	PHS WA		No
(88)SISTERS OF ST JOSEPH OF ORANGE 480 S BATAVIA ORANGE,CA92868 95-1643383	RELIGIOUS ORG	CA	501(C)(3)	1	NA		No
(89)SRM ALLIANCE HOSPITAL SERVICES (PVH) 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 68-0395200	HEALTHCARE	CA	501(C)(3)	3	SRMH	Yes
(90)ST JOSEPH HEALTH MINISTRY 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 27-1666576	RELIGIOUS ORG	CA	501(C)(3)	1	SSJO		No
(91)ST JOSEPH HEALTH N CALIFORNIA LLC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-4791043	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes
(92)ST JOSEPH HEALTH SYSTEM 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-3589356	HEALTHCARE	CA	501(C)(3)	12, I	PSJH		No
(93)ST JOSEPH HEALTH SYSTEM FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 33-0143024	HEALTHCARE	CA	501(C)(3)	7	SJHS	Yes
(94)ST JOSEPH HERITAGE HEALTHCARE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 33-0185031	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes
(95)ST JOSEPH HOME CARE NETWORK 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 68-0331084	HEALTHCARE	CA	501(C)(3)	10	SJHS	Yes
(96)ST JOSEPH HOSPITAL OF EUREKA 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 94-1156596	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes
(97)ST JOSEPH HOSPITAL OF ORANGE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-1643359	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes
(98)ST JUDE HOSPITAL INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-1643324	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes
(99)ST LUKE ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 94-3176618	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes
(100)ST MARY MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-1914489	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes
(101)ST MARY OF THE PLAINS HOSPITAL FDN 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 75-1653181	HEALTHCARE	TX	501(C)(3)	7	CHS	Yes
(102)ST PATRICK HOSPITAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 23-7056976	HEALTHCARE	MT	501(C)(3)	7	PHS WA	Yes
(103)ST THOMAS CHILD AND FAMILY CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-0233495	EDUCATION	MT	501(C)(3)	10	PHS WA	Yes
(104)SWEDISH EDMONDS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 27-2305304	HEALTHCARE	WA	501(C)(3)	3	WHC	Yes
(105)SWEDISH HEALTH SERVICES 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-0433740	HEALTHCARE	WA	501(C)(3)	3	WHC	Yes
(106)SWEDISH MEDICAL CENTER FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-0983214	HEALTHCARE	WA	501(C)(3)	7	SHS	Yes
(107)SWEDISH MJM HOLDINGS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 27-3139262	HOLDING CO	WA	501(C)(3)	12, I	SHS	Yes
(108)THE GAMELIN ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1180824	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes
(109)THE GAMELIN CALIFORNIA ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1293869	SUPPORT	CA	501(C)(3)	10	PHS SOCAL	Yes
(110)THE GAMELIN OREGON ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 91-1214491	SUPPORT	OR	501(C)(3)	10	PHS OR	Yes
(111)UNIVERSITY OF PROVIDENCE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-0231777	EDUCATION	MT	501(C)(3)	2	PHS	Yes
(112)WESTERN HEALTHCONNECT 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 45-4171900	SHELL CORP	WA	501(C)(3)	12, II	PHS W WA	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2018

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) 20TH STREET SURGERY LLC 1301 20TH STREET STE 140 SANTA MONICA,CA90404 73-1735618	AMBULATORY SURG	CA	NA	N/A
(2) BROADWAY IMAGING LLC 500 W BROADWAY MISSOULA,MT59802 52-2405971	MEDICAL IMAGING	MT	NA	N/A
(3) CENTER FOR SPECIALTY SURGERY LLC 11782 SW BARNES RD PORTLAND,OR97225 26-3638838	AMBULATORY SURG	OR	NA	N/A
(4) CLACKAMAS RADIATION ONCOLOGY CENTER LLC 4400 NE HALSEY ST BLDG II 495 PORTLAND,OR97213 26-0381897	RADIATION ONCOL	OR	NA	N/A
(5) COASTAL ASC HOLDINGS LLC ONE HOAG DRIVE PO BOX 6100 NEWPORT BEACH,CA926586100 81-0986844	HEALTHCARE	CA	NA	N/A
(6) COVENANT LONG-TERM CARE LP 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 20-5033419	HEALTHCARE	TX	CHS	RELATED				No	0	Yes		82.760 %
(7) CTR FOR MED IMAGING-BRIDGEPORT LLC 4400 NE HALSEY 495 PORTLAND,OR97213 26-0796953	IMAGING DIAG.	OR	NA	N/A
(8) CTR FOR MED IMAGING-TANASBOURNE LLC 4400 NE HALSEY 495 PORTLAND,OR97213 20-0477972	IMAGING DIAG.	OR	NA	N/A
(9) FULLERTON SURGICAL CENTER LP 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-0927394	AMBULATORY SURG	CA	NA	N/A
(10) GREATER VALLEY MEDICAL BUILDING LP 501 S BUENA VISTA ST BURBANK,CA91505 95-4570858	REAL ESTATE - MOB	CA	NA	N/A
(11) HCSA PROPERTIES LLC 1600 M STREET NW AUBURN,WA98001 46-0620892	REAL ESTATE RENT	WA	NA	N/A
(12) HERITAGE INVESTMENT GROUP I LLC 500 S MAIN STREET STE 1000 ORANGE,CA92868 27-1000061	INVESTMENTS	CA	NA	N/A
(13) HOAG ORTHOPEDIC INSTITUTE ONE HOAG DRIVE PO BOX 6100 NEWPORT BEACH,CA926586100 61-1588294	HEALTHCARE	CA	NA	N/A
(14) HOAG OUTPATIENT CENTERS LLC 27271 LAS RAMBLAS 350 MISSION VIEJO,CA92691 45-3587572	HEALTHCARE	CA	NA	N/A
(15) INLAND IMAGING LLC 801 S STEVENS ST SPOKANE,WA99204 91-1855796	MEDICAL IMAGING	WA	NA	N/A
(16) LSC REAL PROPERTY LLC 2301 QUAKER AVENUE LUBBOCK,TX79410 47-4646059	REAL ESTATE	TX	CHS	EXCLUDED	276,199	863,974		No	0	Yes		60.500 %
(17) METHODIST DIAGNOSTIC IMAGING 4005 24TH STREET LUBBOCK,TX79410 75-2343261	HEALTHCARE	TX	NA	N/A
(18) NEWPORT BAY SURGERY CENTER LLC 3333 W PACIFIC COAST HWY 100 NEWPORT BEACH,CA92663 56-2518360	HEALTHCARE	CA	NA	N/A
(19) NEWPORT BEACH ENDOSCOPY CENTER LLC 27271 LAS RAMBLAS 350 MISSION VIEJO,CA92691 77-0368744	HEALTHCARE	CA	NA	N/A
(20) NEWPORT IMAGING CENTER 360 SN MIGUEL NEWPORT BEACH,CA92660 33-0191776	HEALTHCARE	CA	NA	N/A
(21) NEWPORT SURGICAL PARTNERS LLC 27271 LAS RAMBLAS 350 MISSION VIEJO,CA92691 39-2060266	HEALTHCARE	CA	NA	N/A
(22) NORTH BAY ENDOSCOPY CENTER 1383 N MCDOWELL BLVD STE 110 PETALUMA,CA94954 61-1559876	HEALTHCARE	CA	NA	N/A
(23) OREGON ADVANCED IMAGING LLC 881 OHARE PARKWAY MEDFORD,OR97504 45-0471748	MEDICAL IMAGING	OR	NA	N/A
(24) OREGON OUTPATIENT SURGERY CENTER 7300 SW CHILDS RD TIGARD,OR97224 22-3883387	AMBULATORY SURG	OR	NA	N/A
(25) PETCT IMAGING AT SWEDISH CANCER INSTITU 1221 MADISON STREET SEATTLE,WA98104 20-3132044	MEDICAL IMAGING	WA	NA	N/A
(26) PHS INVESTMENT TRANSITION PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2279711	INVESTMENTS	WA	NA	N/A
(27) PHS INVESTMENT TRUST 2015 PRIVATE ASSETS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-3393740	INVESTMENTS	WA	NA	N/A
(28) PHS INVESTMENT TRUST 2016 PRIVATE ASSETS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-1532735	INVESTMENTS	WA	NA	N/A
(29) PHS INVESTMENT TRUST 2016 PRIVATE REAL E 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-2960145	INVESTMENTS	WA	NA	N/A
(30) PHS INVESTMENT TRUST BANK LOANS PORTFOLI 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2357735	INVESTMENTS	WA	NA	N/A
(31) PHS INVESTMENT TRUST COMMODITIES PORTFOL 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2269004	INVESTMENTS	WA	NA	N/A
(32) PHS INVESTMENT TRUST HEDGE FUND PORTFOLI 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2293255	INVESTMENTS	WA	NA	N/A
(33) PHS INVESTMENT TRUST LDI PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2392060	INVESTMENTS	WA	NA	N/A
(34) PHS INVESTMENT TRUST LONG TREASURIES POR 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2385238	INVESTMENTS	WA	NA	N/A
(35) PHS INVESTMENT TRUST MLP PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2367538	INVESTMENTS	WA	NA	N/A
(36) PHS INVESTMENT TRUST PUBLIC DEBT PORTFOL 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2353569	INVESTMENTS	WA	NA	N/A
(37) PHS INVESTMENT TRUST PUBLIC EQUITY PORTF 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2283974	INVESTMENTS	WA	NA	N/A
(38) PHS INVESTMENT TRUST RELATIVE VALUE PORT 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2314743	INVESTMENTS	WA	NA	N/A
(39) PHS INVESTMENT TRUST RISK PARITY PORTFOL 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2336377	INVESTMENTS	WA	NA	N/A
(40) PHS INVESTMENT TRUST SHORT TERM INVESTME 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-2701056	INVESTMENTS	WA	NA	N/A
(41) PHS INVESTMENT TRUST TACTICAL TRADING PO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2327491	INVESTMENTS	WA	NA	N/A
(42) PHS INVESTMENT TRUST TIPS PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-2402609	INVESTMENTS	WA	NA	N/A
(43) PORTLAND MEDICAL IMAGING LLC 4400 NE HALSEY 495 PORTLAND,OR97213 20-1054971	IMAGING DIAG.	OR	NA	N/A
(44) PROV RADIATION ONCOLOGY DEVELOP ASSN 4400 NE HALSEY 495 PORTLAND,OR97213 26-0682491	REAL ESTATE - MOB	OR	NA	N/A
(45) PROVIDENCE CHILDREN'S NEONATAL SERVICES 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 47-0918549	NEONATAL CARE	WA	NA	N/A
(46) PROVIDENCE IMAGING CENTER JOINT VENTURE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 92-0118807	MEDICAL IMAGING	AK	NA	N/A
(47) PROVIDENCE PARTNERS FOR HEALTH LLC 501 S BUENA VISTA ST BURBANK,CA91505 45-4041798	CLIN QUALITY/INT	CA	NA	N/A
(48) PROVIDENCE ST JOSEPH HEALTH LONG TERM P 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 82-3190634	INVESTMENTS	WA	NA	N/A
(49) PROVIDENCE SURGERY CENTER LLC 902 N ORANGE ST MISSOULA,MT59802 84-1401625	AMBULATORY SURG	MT	NA	N/A
(50) PROVIDENCESILVERTON REHAB LLC 4400 NE HALSEY 425 PORTLAND,OR97213 48-1287267	REHAB SERVICES	OR	NA	N/A
(51) PROVIDENCEUSP SANTA CLARITA GP LLC 11550 INDIAN HILLS ROAD 160 MISSION HILLS,CA91345 20-2829660	AMBULATORY SURG	CA	NA	N/A
(52) PROVIDENCEUSP SURGERY CTRS LLC 11550 INDIAN HILLS ROAD 160 MISSION HILLS,CA91345 20-0905938	AMBULATORY SURG	CA	NA	N/A
(53) SHA LLC 12940 NORTH HIGHWAY 183 AUSTIN,TX78750 75-2569094	HEALTHCARE	TX	NA	N/A
(54) SJO ASC HOLDINGS LLC 1140 W LA VETA AVE ORANGE,CA92868 82-1655501	HEALTHCARE	CA	NA	N/A
(55) ST JOSEPH PHYSICIAN VENTURES I LLC 1100 WEST STEWART DRIVE ORANGE,CA92868 45-4521884	REAL ESTATE	CA	NA	N/A
(56) ST JOSEPHSATELLITE DIALYSIS CENTERS L 300 SANTANA ROW SUITE 300 SAN JOSE,CA95128 81-4657391	HEALTHCARE	CA	NA	N/A
(57) ST JUDE SURGICAL CENTERS LLC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 82-3352570	AMBULATORY SURG	CA	NA	N/A
(58) SURGERY CENTER AT TANASBOURNE LLC 11221 ROE AVE STE 300 LEAWOOD,KS66211 20-8187971	AMBULATORY SURG	KS	NA	N/A
(59) TARZANA PEDIATRIC VENTURES LLC 18321 CLARK ST TARZANA CA 91356 TARZANA,CA91356 82-1308306	HEALTHCARE	CA	NA	N/A
(60) THE MADISON SPOKANE INN LLC 15 WEST ROCKWOOD BLVD SPOKANE,WA99204 84-1606484	HOTEL SERVICES	WA	NA	N/A

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) AMERICAN UNITY GROUP LTD 90 PITTS BAY ROAD PEMBROKE HM08 BD	CAPTIVE INSURANCE	BD	NA	C-CORP
(2) 1221 MADISON STREET OWNERS ASSOC 747 BROADWAY SEATTLE,WA98122 20-1954319	OWNERS' ASSOC.	WA	NA	C-CORP
(3) AYIN HEALTH SOLUTIONS INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 83-3037172	HEALTHCARE	DE	NA	C-CORP
(4) BOURGET HEALTH SERVICES INC PO BOX 2687 SPOKANE,WA99220 91-1354431	CLIN/MED LAB	WA	NA	C-CORP
(5) CARON HEALTH CORPORATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 81-0486082	MED PHYS SVCS	MT	NA	C-CORP
(6) DATU HEALTH INC AND SUBSIDIARIES 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 46-3070062	IT SVCS	DE	NA	C-CORP
(7) GRACE CLINIC OF LUBBOCK 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 20-3856995	HEALTHCARE	TX	CHS	C-CORP	32,737,543	3,958,295	100.000 %	Yes
(8) GRACE CLINIC SERVICES INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 20-3857067	HEALTHCARE	TX	CHS	C-CORP	2,638,214	0	100.000 %	Yes
(9) HOAG CLINIC (FKA COASTAL MGM SVS ORG) 1 HOAG DRIVE PO BOX 6100 NEWPORT BEACH,CA926586100 33-0676831	HEALTHCARE	CA	NA	C-CORP
(10) HOAG MANAGEMENT SERVICES INC 1 HOAG DRIVE PO BOX 6100 NEWPORT BEACH,CA926586100 33-0731587	HEALTHCARE	CA	NA	C-CORP
(11) LUBBOCK METHODIST HOSP PRACTICE MGMT 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 75-2578995	INACTIVE	TX	CHS	C-CORP	0	531,170	100.000 %	Yes
(12) LUBBOCK METHODIST HOSPITAL SVCS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 75-2118585	HEALTHCARE	TX	CHS	C-CORP	249,155	111,498,722	100.000 %	Yes
(13) LUMEDIC ACQUISITION CO INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 83-3881097	HEALTHCARE	WA	NA	C-CORP
(14) MISSION VIEJO MEDICAL VENTURES 27800 MEDICAL CENTER RD 354 MISSION VIEJO,CA92691 33-0212905	HEALTHCARE	CA	NA	C-CORP
(15) PHN HOLDINGS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 46-1814184	STRAT PLAN SVCS	CA	NA	C-CORP
(16) PIONEER INNOVATIONS INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 36-4818191	HEALTH INNOVATNS	WA	NA	C-CORP
(17) PROVIDENCE ASSURANCE INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 20-8194071	CAPTIVE INSURANCE	AZ	NA	C-CORP
(18) PROVIDENCE HEALTH CARE VENTURES INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 90-0155714	CLIN/MED LAB	WA	NA	C-CORP
(19) PROVIDENCE HEALTH NETWORK 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 80-0886966	PREPAID HEALTH	CA	NA	C-CORP
(20) PROVIDENCE HEALTH VENTURES INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 33-0122216	INVESTMENT	CA	NA	C-CORP
(21) ST JOSEPH HEALTH 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 46-2340232	HOLDING COMPANY	CA	NA	C-CORP
(22) ST JOSEPH HEALTH SOURCE INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 46-1900168	HEALTHCARE	CA	NA	C-CORP
(23) ST JOSEPH PROF SVCS ENTERPRSES INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 33-0155323	HEALTHCARE	CA	NA	C-CORP
(24) VINSERRA INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 95-3943315	INVESTMENT	CA	NA	C-CORP
(25) WESTERN HEALTHCONNECT VENTURES INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA980579016 80-0953654	INVESTMENT	WA	NA	C-CORP
(26) YAKIMA MEDICAL ARTS INC 611 N PERRY 100 SPOKANE,WA99202 91-0787963	RENT REAL ESTATE	WA	NA	C-CORP

Schedule R (Form 990) 2018

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) COVENANT CHILDREN'S HOSPITAL	l	12,684,587	ACCRUAL
(2) COVENANT CHILDREN'S HOSPITAL	m	1,267,338	ACCRUAL
(3) COVENANT CHILDREN'S HOSPITAL	o	448,190	ACCRUAL
(4) COVENANT CHILDREN'S HOSPITAL	p	2,946,060	ACCRUAL
(5) COVENANT CHILDREN'S HOSPITAL	q	65,077,793	ACCRUAL
(6) COVENANT CHILDREN'S HOSPITAL	r	199,937,012	ACCRUAL
(7) COVENANT CHILDREN'S HOSPITAL	s	297,255,404	ACCRUAL
(8) COVENANT HOSPITAL LEVELLAND	l	111,255	ACCRUAL
(9) COVENANT HOSPITAL LEVELLAND	p	922,002	ACCRUAL
(10) COVENANT HOSPITAL LEVELLAND	q	5,617,268	ACCRUAL
(11) COVENANT HOSPITAL LEVELLAND	r	11,135,964	ACCRUAL
(12) COVENANT HOSPITAL LEVELLAND	s	15,624,619	ACCRUAL
(13) COVENANT HOSPITAL PLAINVIEW	l	139,024	ACCRUAL
(14) COVENANT HOSPITAL PLAINVIEW	m	81,074	ACCRUAL
(15) COVENANT HOSPITAL PLAINVIEW	o	26,953	ACCRUAL
(16) COVENANT HOSPITAL PLAINVIEW	p	975,837	ACCRUAL
(17) COVENANT HOSPITAL PLAINVIEW	q	9,435,545	ACCRUAL
(18) COVENANT HOSPITAL PLAINVIEW	r	23,779,997	ACCRUAL
(19) COVENANT HOSPITAL PLAINVIEW	s	30,709,834	ACCRUAL
(20) COVENANT MEDICAL GROUP	j	7,923,343	ACCRUAL
(21) COVENANT MEDICAL GROUP	l	6,370,571	ACCRUAL
(22) COVENANT MEDICAL GROUP	m	38,328,939	ACCRUAL
(23) COVENANT MEDICAL GROUP	p	5,299,027	ACCRUAL
(24) COVENANT MEDICAL GROUP	q	51,482,529	ACCRUAL
(25) COVENANT MEDICAL GROUP	r	117,487,765	ACCRUAL
(26) COVENANT MEDICAL GROUP	s	156,256,973	ACCRUAL
(27) HOSPICE OF LUBBOCK	l	304,748	ACCRUAL
(28) HOSPICE OF LUBBOCK	p	159,636	ACCRUAL
(29) HOSPICE OF LUBBOCK	q	2,129,207	ACCRUAL
(30) HOSPICE OF LUBBOCK	r	3,162,810	ACCRUAL
(31) HOSPICE OF LUBBOCK	s	5,505,967	ACCRUAL
(32) COVENANT ACO	m	500,000	ACCRUAL
(33) COVENANT HEALTH PARTNERS	l	3,574,441	ACCRUAL
(34) COVENANT HEALTH PARTNERS	m	20,777,362	ACCRUAL
(35) COVENANT HEALTH PARTNERS	p	835,491	ACCRUAL
(36) COVENANT HEALTH PARTNERS	q	6,425,423	ACCRUAL
(37) COVENANT HEALTH PARTNERS	r	24,505,076	ACCRUAL
(38) COVENANT HEALTH PARTNERS	s	14,416,514	ACCRUAL
(39) COVENANT HEALTH SYSTEM FOUNDATION	c	2,178,080	ACCRUAL
(40) COVENANT HEALTH SYSTEM FOUNDATION	l	431,267	ACCRUAL
(41) COVENANT HEALTH SYSTEM FOUNDATION	m	1,559,662	ACCRUAL
(42) COVENANT HEALTH SYSTEM FOUNDATION	p	50,073	ACCRUAL
(43) COVENANT HEALTH SYSTEM FOUNDATION	q	871,268	ACCRUAL
(44) COVENANT HEALTH SYSTEM FOUNDATION	r	4,044,810	ACCRUAL
(45) COVENANT HEALTH SYSTEM FOUNDATION	s	4,827,598	ACCRUAL
(46) ST JOSEPH HEALTH SYSTEM FOUNDATION	c	2,297,718	ACCRUAL
(47) ST JOSEPH HEALTH SYSTEM FOUNDATION	b	4,728,100	ACCRUAL

Schedule R (Form 990) 2018

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2018

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference

Explanation

SCHEDULE R, PART III

IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP 20TH STREET SURGERY LLC EIN: 73-1735618 ADDRESS: 1301 20TH STREET, STE 140, SANTA MONICA, CA 90404 BROADWAY IMAGING, LLC EIN: 52-2405971 ADDRESS: 500 W. BROADWAY MISSOULA, MT 59802 CENTER FOR SPECIALTY SURGERY, LLC EIN: 26-3638838 ADDRESS: 11782 SW BARNES RD. PORTLAND, OR 97225 CLACKAMAS RADIATION ONCOLOGY CENTER, LLC EIN: 26-0381897 ADDRESS: 4400 NE HALSEY ST., BLDG. II, #495 PORTLAND, OR 97213 COASTAL ASC HOLDINGS LLC EIN: 81-0986844 ADDRESS: ONE HOAG DRIVE, PO BOX 6100, NEWPORT BEACH, CA 92658 COVENANT LONG-TERM CARE, LP EIN: 20-5033419 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 CTR. FOR MED. IMAGING-BRIDGEPORT, LLC EIN: 26-0796953 ADDRESS: 4400 NE HALSEY, #495 PORTLAND, OR 97213 CTR. FOR MED. IMAGING-TANASBOURNE, LLC EIN: 20-0477972 ADDRESS: 4400 NE HALSEY, #495 PORTLAND, OR 97213 FULLERTON SURGICAL CENTER LP EIN: 47-0927394 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 GREATER VALLEY MEDICAL BUILDING, L.P. EIN: 95-4570858 ADDRESS: 501 S. BUENA VISTA ST. BURBANK, CA 91505 HCSA PROPERTIES LLC EIN: 46-0620892 ADDRESS: 1600 M STREET NW AUBURN, WA 98001 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, PO BOX 6100, NEWPORT BEACH, CA 92658 HOAG OUTPATIENT CENTERS, LLC EIN: 45-3587572 ADDRESS: 27271 LAS RAMBLAS #350, MISSION VIEJO, CA 92691 INLAND IMAGING, LLC EIN: 91-1855796 ADDRESS: 801 S. STEVENS ST., SPOKANE, WA 99204 LSC REAL PROPERTY, LLC EIN: 47-4646059 ADDRESS: 2301 QUAKER AVENUE, LUBBOCK, TX, 79410 METHODIST DIAGNOSTIC IMAGING EIN: 75-2343261 ADDRESS: 4005 24TH STREET, LUBBOCK, TX 79410 NEWPORT BAY SURGERY CENTER, LLC EIN: 56-2518360 ADDRESS: 3333 W. PACIFIC COAST HWY, #100 NEWPORT BEACH, CA 92663 NEWPORT BEACH ENDOSCOPY CENTER, LLC EIN: 77-0368744 ADDRESS: 27271 LAS RAMBLAS #350 MISSION VIEJO, CA 92691 NEWPORT IMAGING CENTER EIN: 33-0191776 ADDRESS: 360 SN MIGUEL, NEWPORT BEACH, CA 92660 NEWPORT SURGICAL PARTNERS, LLC EIN: 39-2060266 ADDRESS: 27271 LAS RAMBLAS #350 MISSION VIEJO, CA 92691 NORTH BAY ENDOSCOPY CENTER EIN: 61-1559876 ADDRESS: 1383 N. MCDOWELL BLVD, SUITE 110, PETALUMA, CA 94954 OREGON ADVANCED IMAGING, LLC EIN: 45-0471748 ADDRESS: 881 O'HARE PARKWAY, MEDFORD, OR 97504 OREGON OUTPATIENT SURGERY CENTER EIN: 22-3883387 ADDRESS: 7300 SW CHILDS ROAD, TIGARD, OR 97224 PET/CT IMAGING AT SWEDISH CANCER INSTITUTE, LLC EIN: 20-3132044 ADDRESS: 1221 MADISON STREET SEATTLE, WA 98104 PHS INVESTMENT TRANSITION PORTFOLIO EIN: 47-2279711 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST 2015 PRIVATE ASSETS PORTFOLIO EIN: 47-3393740 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST 2016 PRIVATE ASSETS PORTFOLIO EIN: 81-1532735 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST 2016 PRIVATE REAL ESTATE PORTFOLIO EIN: 81-2960145 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST BANK LOANS PORTFOLIO EIN: 47-2357735 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST COMMODITIES PORTFOLIO EIN: 47-2269004 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST HEDGE FUND PORTFOLIO EIN: 47-2293255 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST LDI PORTFOLIO EIN: 47-2392060 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST LONG TREASURIES PORTFOLIO EIN: 47-2385238 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST MLP PORTFOLIO EIN: 47-2367538 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST PUBLIC DEBT PORTFOLIO EIN: 47-2353569 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST PUBLIC EQUITY PORTFOLIO EIN: 47-2283974 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST RELATIVE VALUE PORTFOLIO EIN: 47-2314743 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST RISK PARITY PORTFOLIO EIN: 47-2336377 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST SHORT TERM INVESTMENT PORTFOLIO EIN: 81-2701056 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST TACTICAL TRADING PORTFOLIO EIN: 47-2327491 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST TIPS PORTFOLIO EIN: 47-2402609 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PORTLAND MEDICAL IMAGING, LLC EIN: 20-1054971 ADDRESS: 4400 NE HALSEY, #495 PORTLAND, OR 97213 PROV. RADIATION ONCOLOGY DEVELOP. ASSN., LLC EIN: 26-0682491 ADDRESS: 4400 NE HALSEY, #495 PORTLAND, OR 97213 PROVIDENCE CHILDREN'S NEONATAL SERVICES EIN: 47-0918549 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PROVIDENCE IMAGING CENTER JOINT VENTURE EIN: 92-0118807 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PROVIDENCE PARTNERS FOR HEALTH, LLC EIN: 45-4041798 ADDRESS: 501 S. BUENA VISTA ST. BURBANK, CA 91505 PROVIDENCE ST. JOSEPH HEALTH LONG TERM PORTFOLIO EIN: 82-3190634 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PROVIDENCE SURGERY CENTER, LLC EIN: 84-1401625 ADDRESS: 902 N. ORANGE ST MISSOULA, MT 59802 PROVIDENCE/SILVERTON REHAB, LLC EIN: 48-1287267 ADDRESS: 4400 NE HALSEY #425, PORTLAND, OR 97213 PROVIDENCE/USP SANTA CLARITA GP, LLC EIN: 20-2829660 ADDRESS: 11550 INDIAN HILLS ROAD #160, MISSION HILLS, CA 91345 PROVIDENCE/USP SURGERY CENTERS, LLC EIN: 20-0905938 ADDRESS: 11550 INDIAN HILLS ROAD #160, MISSION HILLS, CA 91345 SHA, LLC EIN: 75-2569094 ADDRESS: 12940 NORTH HIGHWAY 183, AUSTIN, TX 78750 SJO ASC HOLDINGS LLC EIN: 82-1655501 ADDRESS: 1140 W. LA VETA AVE ORANGE, CA 92868 ST JOSEPH PHYSICIAN VENTURES I, LLC EIN: 45-4521884 ADDRESS: 1100 WEST STEWART DRIVE, ORANGE, CA 92868 ST. JOSEPH/SATELLITE DIALYSIS CENTERS, LLC EIN: 81-4657391 ADDRESS: 300 SANTANA ROW, SUITE 300 SAN JOSE, CA 95128 ST. JUDE SURGICAL CENTERS, LLC EIN: 82-3352570 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 SURGERY CENTER AT TANASBOURNE, LLC EIN: 20-8187971 ADDRESS: 11221 ROE AVE., STE 300, LEAWOOD, KS 66211 TARZANA PEDIATRIC VENTURES LLC EIN: 82-1308306 ADDRESS: 18321 CLARK ST, TARZANA, CA 91356 THE MADISON SPOKANE INN, LLC EIN: 84-1606484 ADDRESS: 15 WEST ROCKWOOD BLVD. SPOKANE, WA 99204

Schedule R (Form 990) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	17
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	12
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	3,712
6	Total number of volunteers (estimate if necessary) .............	6	75
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	5,110,630
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	5,470,772	7,068,430
9	Program service revenue (Part VIII, line 2g) .........	292,599,949	687,735,842
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	45,739	1,345,255
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	0	0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	298,116,460	696,149,527
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	2,980,686	5,356,435
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	100,763,672	214,581,900
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	190,848,547	466,486,741
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	294,592,905	686,425,076
19	Revenue less expenses. Subtract line 18 from line 12.......	3,523,555	9,724,451
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	646,659,894	716,587,857
21	Total liabilities (Part X, line 26).............	131,057,100	254,415,449
22	Net assets or fund balances. Subtract line 21 from line 20.....	515,602,794	462,172,408

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 627,622,110 including grants of $ 5,356,435 ) (Revenue $ 688,980,623 )
	SEE SCHEDULE O

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses627,622,110

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	5,564,777	5,366,897	820,223

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	4,475,798
e	Government grants (contributions)		1e	2,592,632

f	All other contributions, gifts, grants, and similar amounts not included above		1f	0

g	Noncash contributions included in lines 1a - 1f:$ 678,080
h Total. Add lines 1a-1f.......		7,068,430

		Business Code
2a	PATIENT SERVICES REVENUE	622110	522,162,130	522,162,130	0	0
b	MOB RENTAL REVENUE	531120	11,977,065	11,977,065	0	0
c	OUTREACH LAB SERVICES	621511	2,981,601	0	2,981,601	0
d	CAFETERIA REVENUE	722310	3,232,359	3,232,359	0	0
e	BILLING/MANAGEMENT FEE	541611	2,129,029	0	2,129,029	0
f	All other program service revenue.		145,253,658	145,253,658		0
g	Total. Add lines 2a–2f ....		687,735,842

3 Investment income (including dividends, interest, and othersimilar amounts) ......			100,474			100,474
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)	0	0
d	Net rental income or (loss)......			0
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	9,342,918
b	Less: cost or other basis and sales expenses	8,098,137
c	Gain or (loss)	1,244,781
d	Net gain or (loss).....			1,244,781			1,244,781
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a		0
b	Less: direct expenses ...b		0
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a		0
b	Less: direct expenses ...b		0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
	a		0
b	Less: cost of goods sold ..b		0
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			0
12	Total revenue. See Instructions......			696,149,527	682,625,212	5,110,630	1,345,255

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	5,356,435	5,356,435
2	Grants and other assistance to domestic individuals. See Part IV, line 22	0	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.	0	0
4	Benefits paid to or for members	0	0
5	Compensation of current officers, directors, trustees, and key employees ....	4,008,450	0	4,008,450	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0	0	0	0
7	Other salaries and wages	169,081,433	157,170,359	11,911,074	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	8,509,269	7,220,223	1,289,046	0
9	Other employee benefits .......	21,555,549	21,359,320	196,229	0
10	Payroll taxes ...........	11,427,199	10,630,764	796,435	0
11	Fees for services (non-employees):
a	Management ......	141,788,722	139,447,788	2,340,934	0
b	Legal .........	3,598,336	3,598,336	0	0
c	Accounting ...........	0	0	0	0
d	Lobbying ...........	45,284	45,284	0	0
e	Professional fundraising services. See Part IV, line 17	0			0
f	Investment management fees ......	0	0	0	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	97,013,055	71,576,857	25,436,198	0
12	Advertising and promotion ....	3,655,965	2,942,065	713,900	0
13	Office expenses .......	2,472,094	2,157,055	315,039	0
14	Information technology ......	3,093,234	3,093,234	0	0
15	Royalties ..	0	0	0	0
16	Occupancy ...........	19,183,636	16,141,619	3,042,017	0
17	Travel ............	899,420	712,294	187,126	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0	0	0	0
19	Conferences, conventions, and meetings ....	160,113	82,642	77,471	0
20	Interest ...........	10,116,815	3,938,365	6,178,450	0
21	Payments to affiliates .......	0	0	0	0
22	Depreciation, depletion, and amortization ..	42,470,559	42,470,559	0	0
23	Insurance ...	2,347,518	2,292,868	54,650	0
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	129,124,412	127,709,375	1,415,037	0
b	EQUIPMENT RENTALS	2,719,414	2,717,584	1,830	0
c	ALL OTHER EXPENSES	7,798,164	6,959,084	839,080	0
d
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	686,425,076	627,622,110	58,802,966	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			11,329,887	1	42,108,107
2	Savings and temporary cash investments .........			14,691,860	2	11,490,191
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			59,027,353	4	67,580,247
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
				0	6	0
7	Notes and loans receivable, net ....			0	7	0
8	Inventories for sale or use ........			7,618,302	8	9,250,120
9	Prepaid expenses and deferred charges ......			1,807,269	9	2,038,240
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	859,965,888
b	Less: accumulated depreciation	10b	451,193,165	342,279,179	10c	408,772,723
11	Investments—publicly traded securities .			43,329,390	11	46,168,365
12	Investments—other securities. See Part IV, line 11 .....			3,305,959	12	3,363,590
13	Investments—program-related. See Part IV, line 11 ..			7,301,454	13	106,925
14	Intangible assets ...............			22,500,000	14	22,500,000
15	Other assets. See Part IV, line 11 ...........			133,469,241	15	103,209,349
16	Total assets. Add lines 1 through 15 (must equal line 34)...			646,659,894	16	716,587,857

17	Accounts payable and accrued expenses .....	33,540,031	17	50,237,067
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	97,517,069	25	204,178,382
26	Total liabilities. Add lines 17 through 25..	131,057,100	26	254,415,449

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	515,602,794	27	462,172,408
28	Temporarily restricted net assets ...........	0	28	0
29	Permanently restricted net assets	0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	515,602,794	33	462,172,408
34	Total liabilities and net assets/fund balances ........	646,659,894	34	716,587,857