Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
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Total |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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): |
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| 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 | ||||
| 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 2019 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-2019 |
(iii) Distributable Amount for 2019 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2019 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2019: | ||||
| a From 2014....... | ||||
| b From 2015....... | ||||
| c From 2016....... | ||||
| d From 2017....... | ||||
| e From 2018....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2019 distributable amount | ||||
|
i
Carryover from 2014 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2019 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2019 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2020. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2015..... | ||||
| b Excess from 2016..... | ||||
| c Excess from 2017..... | ||||
| d Excess from 2018..... | ||||
| e Excess from 2019..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART III, LINE 4A | PROGRAM SERVICE ACCOMPLISHMENTS MENTAL HEALTH CENTER - PROVIDED MENTAL HEALTH SERVICES TO 723 CLIENTS IN THE FORM OF PSYCHOTHERAPY. - RESOURCE BROKERING, AND/OR CASE MANAGEMENT PROVIDED TO 129 INDIVIDUALS. - OFFERED PSYCHOTHERAPEUTIC, PSYCHO EDUCATIONAL GROUPS AND COMMUNITY PRESENTATIONS RESULTING IN 805 ENCOUNTERS. - A SAMPLING OF THE TRAININGS OFFERED INCLUDED: ASSIST FOR SUICIDE ASSESSMENT AND INTERVENTION, ACES INTERFACE, NAMI PROVIDER TRAINING AND LAW AND ETHICS. THE NUMBER OF PROFESSIONALS TRAINED FOR CY19 WAS 1,511 - PROVIDED A SUPERVISED CLINICAL INTERNSHIP TRAINING PROGRAM FOR 8 MSW (MASTER OF SOCIAL WORK) STUDENTS. EACH INTERN WAS PROVIDED WITH WEEKLY ONE HOUR LONG SUPERVISION AND ONE AND A HALF HOUR LONG GROUP SUPERVISION COMMUNITY BENEFIT GRANTS PROGRAM - 82 GRANTS FUNDED TOTALING OVER $3M - PRIORITY FOCUS AREAS INCLUDED: ACCESS TO CARE, ECONOMIC SECURITY, MENTAL HEALTH, AND PREVENTION OF CHRONIC DISEASE AND MANAGEMENT HEALTH MINISTRIES PROGRAM THE FCN PROGRAM HOSTED MULTIPLE EVENTS AND WORKSHOPS IN CY19. ANNUAL CLINICAL SERVICES INCLUDE FLU VACCINE CLINICS, CPR TRAINING, BLOOD PRESSURE SCREENINGS AND BLOOD DRIVES. THE FCN NURSES ADMINISTERED AND HOSTED: - 9,047 FLU VACCINE DOSES TO FAITH MEMBERS AND THE COMMUNITY - 225 INDIVIDUALS WHO RECEIVED LIFE-SAVING AED/CPR TRAINING - 887 BLOOD PRESSURE SCREENINGS AND WELLNESS EDUCATION TO INDIVIDUALS - 441 UNITED OF DONATED BLOOD - SPIRITUALLY BASED ALZHEIMERS EDUCATION CLASSES THAT SERVED 123 INDIVIDUALS - FCN LED COURSES ATTENDED BY 2,117 INDIVIDUALS COVERING TOPICS THAT INCLUDED MENTAL HEALTH, TAI CHI, CHAIR EXERCISE, DEVOTIONS, DIABETES, SENIOR HOUSING, PARENTING, ETC. - SUPPORT GROUPS ON CAREGIVING AND GRIEF AND LOSS SERVED 1,040 INDIVIDUALS - 28 RNS COMPLETED 36 CEUS IN THE FOUNDATIONS OF FAITH COMMUNITY NURSING - FCNS COMPLETED 463 HOURS OF CONTINUING EDUCATION - HOSTED THE ANNUAL SPIRITUALITY CONFERENCE WITH 200 ATTENDEES - 85 RNS ATTENDED THE FAITH COMMUNITY NURSE REGIONAL SUMMIT - ESTABLISHED QUARTERLY CONFERENCE CALLS LINKING WEST COAST FAITH COMMUNITY LEADERS FROM AK, WA, OR, NV, AZ. PROJECT WIPEOUT - HOSTED THE 40TH ANNUAL LIFEGUARD EDUCATION SYMPOSIUM, WITH OVER 375 ATTENDEES, WHICH INCLUDED LIFEGUARDS AND FIRE PERSONNEL FROM ALL OVER ORANGE COUNTY. AN ADDITIONAL 125 LIFEGUARDS AND LIFE-SAVING PERSONNEL VIEWED THE LIVE STREAM AT VARIOUS LOCATIONS. - PROVIDED $35,000 IN MICRO-GRANT FUNDING FOR ORANGE COUNTY LIFEGUARD AGENCIES TO PROVIDE PROGRAMMATIC SUPPORT. - DURING CY2019, PROJECT WIPEOUT AND THE BEN CARLSON MEMORIAL AND SCHOLARSHIP FOUNDATION CO-HOSTED THE INAUGURAL SOUTHERN CALIFORNIA WATER SAFETY SUMMIT. THE SUMMIT CONSISTED OF A ONE-DAY CONFERENCE DESIGNED TO BE A FORUM FOR COLLABORATION ON PRACTICES, PROGRAMS, AND POLICY THAT REDUCE DROWNING AND AQUATIC INJURIES IN OUR COMMUNITY. OVER 140 WATER SAFETY ADVOCATES AND PROFESSIONALS ATTENDED, REPRESENTATIVE OF SEVERAL CA COUNTIES, AS WELL AS AZ, WA, ID, UT, AND NY. MELINDA HOAG SMITH CENTER FOR HEALTHY LIVING - 2,479 INDIVIDUALS AND/OR FAMILIES REGISTERED AS MEMBERS OR INQUIRED ABOUT SERVICES AND WERE LINKED TO APPROPRIATE AGENCIES THROUGH OUR CASE MANAGER SUPPORT TEAM. - 405 INDIVIDUALS WERE CPR CERTIFIED. THIS HELPED FOR JOB SECURITY AND JOB PLACEMENT FOR SEVERAL NANNIES, CHILD CARE WORKERS, AND PRESCHOOL TEACHERS - 698 ADULTS PARTICIPATED IN CIELO'S ENTREPRENEURSHIP/JOB READINESS CLASSES - 125 SINGLE PARENTS RECEIVED SERVICES WITH PROJECT SELF-SUFFICIENCY - 156 HOMELESS INDIVIDUALS AND/OR FAMILIES RECEIVED SERVICES THROUGH SPIN (SERVING PEOPLE IN NEED) - 1,722 ENCOUNTERS FOR GIRLS INCS AFTER SCHOOL HOMEWORK AND STEM ACTIVITIES (BOYS AND GIRLS) - 7,311 ENCOUNTERS FOR YOGA, ZUMBA AND OTHER FITNESS CLASSES - 297 ENCOUNTERS FOR CHILDREN PARTICIPATED IN BALLET CLASSES - 1,650 ENCOUNTERS FOR CHILDREN PARTICIPATED IN AMIGITOS/ZUMBINI - 199 CHOC PODER CLASSES - 896 ENCOUNTERS FOR YOUTH HIP HOP - 1,007 INDIVIDUALS PARTICIPATED IN A NAMI CLASS/SUPPORT GROUP - 462 INDIVIDUALS WERE EITHER VISITED AT HOME OR MET WITH A PROMOTORA ONSITE TO DISCUSS MENTAL HEALTH SERVICES - 419 INDIVIDUALS HAVE RECEIVED LEGAL CONSULTATION OR REPRESENTATION FROM THE PUBLIC LAW CENTER, FOCUSING ON FAMILY LAW DIVORCE, DV, CHILD CUSTODY ETC. - APPROXIMATELY 1,163 PROFESSIONALS PARTICIPATED IN TRAININGS HOSTED BY THE MHSCHL. |
| FORM 990, PART VI, LINE 2 | BUSINESS RELATIONSHIPS BOARD MEMBER GARY MCKITTERICK, OFFICER ROBERT BRAITHWAITE AND OFFICER ANDREW GUARNI HAVE A BUSINESS RELATIONSHIP. |
| FORM 990, PART VI, LINE 6 | MEMBERS OR STOCKHOLDERS THE MEMBERS OF THE CORPORATION CONSIST OF THE FOLLOWING: I. COVENANT HEALTH NETWORK INC. ("CHN") II. THE GEORGE HOAG FAMILY FOUNDATION ("GHF FOUNDATION") III. THE CONSTITUENT REFORMED PRESBYTERIAN CHURCHES LOCATED IN ORANGE COUNTY, CALIFORNIA WHICH INCLUDE DENOMINATIONS OF THE LOS RANCHOS PRESBYTERY OF THE PRESBYTERIAN CHURCH (USA) AND ECO: A COVENANT ORDER OF EVANGELICAL PRESBYTERIANS, AS REPRESENTED BY THE ASSOCIATION OF PRESBYTERIAN MEMBERS (THE "APM"), AND IV. SUCH INDIVIDUAL MEMBERS AS MAY BE APPOINTED BY THE GHF FOUNDATION OR THE APM UP TO A MAXIMUM OF FORTY-EIGHT (48) INDIVIDUAL MEMBERS TO BE DIVIDED EQUALLY BETWEEN THE GHF FOUNDATION AND THE APM. |
| FORM 990, PART VI, LINE 7A | POWER TO ELECT OR APPOINT DIRECTORS HOAG HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT DIRECTORS TO THE HOAG BOARD. ALL APPOINTMENTS THAT COME FROM THE GOVERNANCE COMMITTEE OF THE HOAG BOARD AS NOMINATIONS MUST BE APPROVED BY AFFIRMATIVE VOTE OF AT LEAST A MAJORITY OF THE VOTES ENTITLED TO BE CAST BY THE GHF FOUNDATION, THE APM, AND THE INDIVIDUAL MEMBERS (IF ANY), AT SUCH ANNUAL MEETING OF THE MEMBERS, PROVIDED THAT SUCH MAJORITY INCLUDES THE AFFIRMATIVE VOTE OF THE GHF FOUNDATION AND THE AFFIRMATIVE VOTE OF THE APM, SUBJECT TO FINAL APPROVAL BY REQUISITE VOTE OF THE CHN BOARD OF DIRECTORS. THE REQUISITE VOTE OF THE CHN BOARD OF DIRECTORS MEANS THE AFFIRMATIVE VOTE OF NOT LESS THAN FIVE (5) OF THE SEVEN (7) DIRECTORS OF CHN, INCLUDING THE VOTE OF AT LEAST THREE (3) OF THE FOUR (4) DIRECTORS DESIGNATED BY PROVIDENCE ST. JOSEPH HEALTH, AND THE VOTE OF AT LEAST TWO (2) OF THE THREE (3) DIRECTORS DESIGNATED BY THE GHF FOUNDATION AND THE APM. IF SUCH ANNUAL MEETING IS NOT HELD OR DIRECTORS ARE NOT ELECTED THEREAT, THE DIRECTORS MAY BE ELECTED AT ANY SPECIAL MEETING OF THE MEMBERS CALLED FOR THAT PURPOSE BY THE SAME VOTE AS IS REQUIRED AT ANY ANNUAL MEETING, BUT SUBJECT IN ALL INSTANCES TO FINAL APPROVAL BY THE REQUISITE VOTE OF THE CHN BOARD OF DIRECTORS. |
| FORM 990, PART VI, LINE 7B | DECISIONS RESERVED TO MEMBERS OR STOCKHOLDER THE ORGANIZATION IS SUBJECT TO THE COVENANT HEALTH NETWORK, INC. GOVERNANCE MATRIX THAT OUTLINES VARIOUS RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE. THE GOVERNANCE MATRIX PROVIDES FOR APPROVAL BY THE CHN BOARD AND, IN SOME CASES, FINAL APPROVAL BY THE ST. JOSEPH HEALTH SYSTEM ("SJHS") BOARD. EXAMPLES REQUIRING SJHS BOARD APPROVAL INCLUDE CHANGES TO THE STATEMENT OF COMMON VALUES, FINANCING, BUDGETS, UNBUDGETED EXPENDITURES OF DEFINED AMOUNTS, STRATEGIC PLANS, APPOINTMENT OR REMOVAL OF AUDITORS, CREATION OR INVESTMENT IN A LEGALLY RECOGNIZED ENTITY, AND JOINT VENTURES. A SUPERMAJORITY VOTE OF THE CHN BOARD IS REQUIRED TO APPROVE ANY MERGER OR SALE OF ALL OR SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF THE HOAG BOARD OF DIRECTORS, OR AMENDMENT OF BYLAWS AND ARTICLES. THE POWERS AND RESPONSIBILITIES OF THE MEMBERS OF THE CORPORATION INCLUDE, BUT ARE NOT LIMITED TO: (A) TO ASSURE THE BOARD OF DIRECTORS CARRIES OUT THE CORPORATION'S MISSION; (B) TO CONSIDER THE QUALIFICATIONS OF DIRECTORS TO BE ELECTED TO THE BOARD OF DIRECTORS; (C) TO APPROVE ANY AMENDMENT, MODIFICATION OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION; (D) TO APPROVE THE ELECTION, APPOINTMENT OR REMOVAL OF ANY DIRECTOR OF THE CORPORATION; AND (E) TO APPROVE ANY SALE, TRANSFER CONVEYANCE OR OTHER DISPOSITION OF ALL, SUBSTANTIALLY ALL OR A MATERIAL PORTION OF THE ASSETS OF THE CORPORATION, OR ANY MERGER, CONSOLIDATION, AFFILIATION OR DISSOLUTION OF THE CORPORATION. IN ADDITION, THE FOLLOWING ACTIONS ARE RESERVED TO THE GHF FOUNDATION AND THE APM: (A) ANY CHANGE IN THE NAME OF OR UTILIZED BY THE CORPORATION (OTHER THAN ANY CHANGE THAT WOULD REQUIRE AN AMENDMENT TO THE ARTICLES OR BYLAWS); AND (B) ANY CHANGES TO THE CORPORATIONS MISSION STATEMENT. |
| FORM 990, PART VI, LINE 11B | PROCESS USED TO REVIEW THE FORM 990 THE ORGANIZATION'S BOARD OF DIRECTORS HAS DELEGATED TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD THE REVIEW OF FORM 990 PRIOR TO ISSUANCE. THE FORM 990 WAS PREPARED BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION INCLUDING THE ACCOUNTING TEAM, HUMAN RESOURCES, CORPORATE COMPLIANCE AND GOVERNANCE. THE ORGANIZATION ENGAGED AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE RETURN. THE RETURN HAS BEEN REVIEWED BY MANAGEMENT, INCLUDING AN OFFICER OF THE ORGANIZATION. MANAGEMENT PRESENTED THE RETURNS TO THE AUDIT AND COMPLIANCE COMMITTEE, AND DISCUSSED KEY DISCLOSURES AND INFORMATION INCLUDED IN THE FORM 990. IN ADDITION, AN ELECTRONIC VERSION OF THE FORM 990 IS POSTED TO A SECURE WEBSITE AVAILABLE TO ALL OF THE BOARD OF DIRECTORS PRIOR TO FILING. |
| FORM 990, PART VI, LINE 12C | MONITORING & ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY THE ORGANIZATION HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY. OFFICERS, DIRECTORS, NON-DIRECTOR MEMBERS OF BOARD COMMITTEES, AND SENIOR EXECUTIVES AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE. RESPONSES TO THE QUESTIONNAIRE ARE SUBMITTED FOR REVIEW AND RECOMMENDATION TO THE CHIEF COMPLIANCE OFFICER PRIOR TO REVIEW AND CONSIDERATION BY THE AUDIT & COMPLIANCE OR THE GOVERNANCE COMMITTEES OF THE BOARD. THE RESPONSES TO THE ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE ARE ALSO PRESENTED TO THE BOARD OF DIRECTORS. IF, SUBSEQUENT TO COMPLETION OF THE ANNUAL QUESTIONNAIRE, ANY COVERED PERSON BECOMES AWARE OF AN INTEREST THAT COULD GIVE RISE TO A CONFLICT OF INTEREST WITH RESPECT TO A PROPOSED CONTRACT, TRANSACTION OR ARRANGEMENT INVOLVING THE ORGANIZATION OR AN AFFILIATE, THE COVERED PERSON SHALL PROMPTLY MAKE DISCLOSURE OF THE INTEREST TO THE BOARD OR THE GOVERNANCE COMMITTEE. THE AUDIT AND COMPLIANCE COMMITTEE OR THE GOVERNANCE COMMITTEE SHALL THEN DETERMINE IF A DISCLOSED INTEREST MAY RESULT IN A CONFLICT OF INTEREST BY MEETING, DISCUSSING AND VOTING ON THE MATTER. THE PERSON HOLDING THE INTEREST BEING CONSIDERED SHALL NOT BE PRESENT DURING ANY MEETING IN WHICH THE AUDIT AND COMPLIANCE OR GOVERNANCE COMMITTEE CONDUCTS ITS EVALUATION, EXCEPT TO ANSWER QUESTIONS AS MAY BE NECESSARY. THE AUDIT AND COMPLIANCE COMMITTEE OR GOVERNANCE COMMITTEE MAY REQUEST ADDITIONAL INFORMATION CONCENRING THE RELEVANT INTEREST FROM ALL REASONABLE SOURCES BEFORE REACHING A DETERMINATION. WHEN A CONFLICT OF INTEREST IS DETERMINED TO EXIST, ADDITIONAL PROCEDURES ARE FOLLOWED INCLUDING FURTHER REVIEW BY THE GOVERNANCE COMMITTEE AND THE BOARD OF DIRECTORS. ANY DIRECTOR WHO HAS A CONFLICT OF INTEREST WITH RESPECT TO A PROPOSED CONTRACT, TRANSACTION OR ARRANGEMENT SHALL REFRAIN FROM VOTING ON ANY MATTER RELATING TO THE CONTRACT, TRANSACTIONS OR ARRANGEMENT, OR BE EXCUSED FROM ANY MEETING WHERE THE PROPOSED CONTRACT IS DISCUSSED. |
| FORM 990, PART VI, LINE 15A | PROCESS FOR DETERMINING COMPENSATION OF CEO: THE COMPENSATION OF THE CEO IS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF HOAG'S BOARD OF DIRECTORS, COMPRISED SOLELY OF INDEPENDENT DIRECTORS. THE COMPENSATION COMMITTEE RECEIVES A STUDY PERFORMED BY AN INDEPENDENT CONSULTING FIRM THAT REVIEWS LEVELS OF COMPENSATION AT COMPARABLE ORGANIZATIONS FOR COMPARABLE POSITIONS WHEN SETTING COMPENSATION OF THE OFFICERS AND KEY EMPLOYEES. THIS PROCESS OF USING COMPARABLE DATA TO ESTABLISH LEVELS OF COMPENSATION HAS BEEN IN PLACE IN EXCESS OF 38 YEARS. THE COMPENSATION COMMITTEE DOCUMENTS THAT THE COMPENSATION IS REASONABLE IN ITS BOARD MINUTES DURING EXECUTIVE SESSION. THIS PROCESS WAS LAST COMPLETED IN 2019. IN ADDITION, THE INDEPENDENT CONSULTING FIRM PROVIDES THE BOARD WITH AN OPINION LETTER EACH YEAR CERTIFYING THAT THE COMPENSATION PROGRAM AND ALL PAY ELEMENTS (TOTAL REMUNERATION) APPROVED BY THE BOARD ARE DEEMED REASONABLE IN COMPLIANCE WITH IRC SECTION 4958. |
| FORM 990, PART VI, LINE 15B | PROCESS FOR DETERMINING COMPENSATION: THE COMPENSATION OF THE COO, CFO AND ALL SENIOR VICE PRESIDENTS (KEY EMPLOYEES) IS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF HOAG'S BOARD OF DIRECTORS, COMPRISED SOLELY OF INDEPENDENT DIRECTORS. THE COMPENSATION COMMITTEE RECEIVES A STUDY PERFORMED BY AN INDEPENDENT CONSULTING FIRM THAT REVIEWS LEVELS OF COMPENSATION AT COMPARABLE ORGANIZATIONS FOR COMPARABLE POSITIONS WHEN SETTING COMPENSATION OF THE OFFICERS AND KEY EMPLOYEES. THIS PROCESS OF USING COMPARABLE DATA TO ESTABLISH LEVELS OF COMPENSATION HAS BEEN IN PLACE IN EXCESS OF 37 YEARS. THE COMPENSATION COMMITTEE DOCUMENTS THAT THE COMPENSATION IS REASONABLE IN ITS BOARD MINUTES DURING EXECUTIVE SESSION. THIS PROCESS WAS LAST COMPLETED IN 2019. IN ADDITION, THE INDEPENDENT CONSULTING FIRM PROVIDES THE BOARD WITH AN OPINION LETTER EACH YEAR CERTIFYING THAT THE COMPENSATION PROGRAM AND ALL PAY ELEMENTS (TOTAL REMUNERATION) APPROVED BY THE BOARD ARE DEEMED REASONABLE IN COMPLIANCE WITH IRC SECTION 4958. |
| FORM 990, PART XI, LINE 9 | CHANGES IN NET ASSETS OR FUND BALANCE EQUITY TRANSFERS (11,146,271) UBI GAIN FROM PARTNERSHIP/LLC'S 14,793,857 FOUNDATION DONATED CAPITAL - TIMING DIFFERENCES 277,156 EXCLUDED SERVICES PER HERITAGE AFFILIATION 41,725 JV DISTRIBUTIONS RECEIVED 19,724,198 OTHER 2,804 ============= TOTAL 23,693,469 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PURCHASED SERVICES/CONSULTING TOTAL FEES:73985635 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:35356014 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:HMO PURCHASED SERVICES TOTAL FEES:19410629 |
| Software ID: | |
| Software Version: |