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 | |||||
|
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.") . | 7,832 | 0 | 500 | 0 | 1,515,562 | 1,523,894 |
| 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 | 212,017,780 | 196,431,376 | 195,674,699 | 135,581,043 | 74,090,942 | 813,795,840 |
| 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 | 212,025,612 | 196,431,376 | 195,675,199 | 135,581,043 | 75,606,504 | 815,319,734 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | |||||
| 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. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 815,319,734 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 212,025,612 | 196,431,376 | 195,675,199 | 135,581,043 | 75,606,504 | 815,319,734 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 41,107 | 73,335 | 63,131 | 76,955 | 97,642 | 352,170 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 41,107 | 73,335 | 63,131 | 76,955 | 97,642 | 352,170 |
| 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.) .. | 2,164,058 | 5,460,860 | 4,684,910 | 3,148,374 | 3,154,084 | 18,612,286 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 214,230,777 | 201,965,571 | 200,423,240 | 138,806,372 | 78,858,230 | 834,284,190 |
| 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) |
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| 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) |
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| 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 |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | MISCELLANEOUS REVENUE - 2015 AMOUNT: $ 2,164,058. 2016 AMOUNT: $ 5,460,860. 2017 AMOUNT: $ 4,684,910. 2018 AMOUNT: $ 3,148,374. 2019 AMOUNT: $ 3,154,084. |
| 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 VI, SECTION A, LINE 6 | ACCORDING TO THE BYLAWS OF KENTUCKYONE HEALTH MEDICAL GROUP, INC., THE ENTITY'S SOLE MEMBER IS KENTUCKYONE HEALTH INC., A KENTUCKY NONPROFIT CORPORATION (THE "CORPORATE MEMBER"). |
| FORM 990, PART VI, SECTION A, LINE 7A | ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY THE CORPORATE MEMBER. THE CORPORATE MEMBER MAY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS, AND MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS OF THE CORPORATION SHALL BE APPOINTED BY THE CORPORATE MEMBER NO LATER THAN JUNE 30 OF EACH YEAR. THE NAMES AND QUALIFICATIONS OF EACH INDIVIDUAL ACCEPTED BY THE BOARD OF DIRECTORS SHALL BE SUBMITTED TO THE CORPORATE MEMBER, WHO SHALL APPOINT OR REFUSE EACH NOMINEE IN ACCORDANCE WITH THE CORPORATE MEMBER'S BYLAWS AND WITH ENDORSEMENT OF THE SENIOR VICE PRESIDENT OF OPERATIONS. THE CORPORATE MEMBER MAY UNILATERALLY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS SHOULD THE BOARD FAIL TO FURNISH THE CORPORATE MEMBER WITH A LIST OF INDIVIDUALS QUALIFIED TO SERVE ON THE BOARD OF DIRECTORS OF THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE CORPORATE MEMBER SHALL HAVE THE RIGHT TO APPROVE ANY OF THE ACTIONS SET FORTH BELOW: (A) ANY CHANGE IN THE MISSION OR PHILOSOPHY OF THE CORPORATION; (B) ANY AMENDMENT TO THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION; (C) THE REMOVAL, WITH OR WITHOUT CAUSE, OF ANY MEMBER OF THE BOARD OF DIRECTORS OF THE CORPORATION; (D) THE INCURRENCE OF DEBT, INCLUDING WITHOUT LIMITATION, BORROWINGS, GUARANTEES, LOANS, ENCUMBRANCES, OPERATING LEASES, AND CAPITAL LEASES, IN EXCESS OF THRESHOLDS AND WITHIN THE LIMITS ESTABLISHED FROM TIME TO TIME BY THE CORPORATE MEMBER; (E) ANY JOINT VENTURE TO WHICH THE CORPORATION IS A PARTY; (F) THE CREATION OF A NEW CORPORATION, PARTNERSHIP OR LIMITED LIABILITY COMPANY BY THE CORPORATION; (G) ANY MERGER OR CONSOLIDATION TO WHICH THE CORPORATION IS A PARTY; (H) DISSOLUTION OR LIQUIDATION OF, OR THE SALE OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF, THE ASSETS OF THE CORPORATION; (I) THE ADOPTION OF LONG RANGE AND STRATEGIC PLANS; (J) THE ADOPTION OF OPERATING AND CAPITAL BUDGETS AND AMENDMENTS THERETO; AND, (K) ANY VARIATIONS FROM PREVIOUSLY APPROVED OPERATING AND/OR CAPITAL BUDGETS, IN EXCESS OF THRESHOLDS ESTABLISHED BY THE CORPORATE MEMBER. 4.4.2 IN ADDITION, THE CORPORATE MEMBER SHALL HAVE THE POWER TO TRANSFER ASSETS OF THE CORPORATION OR TO REQUIRE THE CORPORATION TO TRANSFER ASSETS TO THE CORPORATE MEMBER, TO THE EXTENT NECESSARY TO ACCOMPLISH THE CORPORATE MEMBER'S GOALS AND OBJECTIVES, AND TO PROVIDE FOR THE PAYMENT OF ALL INDEBTEDNESS OF THE CORPORATE MEMBER OR AN ENTITY CONTROLLED BY, CONTROLLING, OR UNDER COMMON CONTROL WITH THE CORPORATE MEMBER (FOR PURPOSES OF THIS SECTION, A "CORPORATE MEMBER AFFILIATE"), ISSUED OR INCURRED BY OR ON BEHALF OF THE CORPORATE MEMBER OR A CORPORATE MEMBER AFFILIATE IN FURTHERANCE OF THE CORPORATE MEMBER'S GOALS AND OBJECTIVES. THE CORPORATION SHALL NOT BE REQUIRED TO VIOLATE ITS CHARITABLE PURPOSES, THE TERMS OF ANY RESTRICTED GIFTS, OR THE COVENANTS OF ITS DEBT INSTRUMENTS AS A RESULT OF ANY ASSET TRANSFERS MADE OR DIRECTED BY THE CORPORATE MEMBER. EXCEPT FOR TRANSFERS PREVIOUSLY APPROVED BY THE CORPORATE MEMBER, EITHER INDIVIDUALLY OR AS PART OF THE CHI HEALTHCARE SYSTEM BUDGET PROCESS, AND EXCEPT FOR TRANSFERS TO AN AFFILIATE OR SUBSIDIARY OF THE CORPORATION, THE CORPORATION SHALL NOT TRANSFER ASSETS TO ENTITIES OTHER THAN THE CORPORATE MEMBER OR CORPORATE MEMBER AFFILIATES WITHOUT THE APPROVAL OF THE CORPORATE MEMBER. |
| FORM 990, PART VI, SECTION B, LINE 11B | ONCE THE RETURN IS PREPARED, THE RETURN IS REVIEWED BY THE KENTUCKYONE MEDICAL GROUP EXECUTIVES AND THE KENTUCKYONE HEALTH, INC. FINANCE EXECUTIVES. SUBSEQUENT TO THE REVIEW, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") IN PLACE TO MAINTAIN THE INTEGRITY OF ITS ACTIVITIES. THE POLICY APPLIES TO THE FOLLOWING PERSONS ("COVERED PERSONS"): MEMBERS OF THE COMMONSPIRIT HEALTH ("COMMONSPIRIT") BOARD OF STEWARDSHIP TRUSTEES AND ITS COMMITTEES; COMMONSPIRIT HEALTH CORPORATE OFFICERS; MEMBERS OF THE DIGNITY HEALTH BOARD OF STEWARDSHIP TRUSTEES AND ITS COMMITTEES. IN ADDITION, THE POLICY APPLIES TO ORGANIZATIONS THAT WERE AFFILIATES AND SUBSIDIARIES OF COMMONSPIRIT HEALTH PRIOR TO ITS AFFILIATION WITH DIGNITY HEALTH ("CHI ENTITIES"). COVERED PERSONS OF CHI ENTITIES INCLUDE: MEMBERS OF ANY CHI ENTITY DIRECT AFFILIATE OR SUBSIDIARY BOARD AND THEIR COMMITTEES; EMPLOYEES OF CHI ENTITIES; AND CHI ENTITY RESEARCHERS (AS DEFINED BY THE POLICY). DISCLOSURE, REVIEW AND MANAGEMENT OF PERCEIVED, POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. ALL COVERED PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS AND MUST DISCLOSE THAT CONFLICT TO HIS/HER DIRECT MANAGER (OR OTHER PERSON AS IS APPROPRIATE PER POLICY). SUCH DISCLOSURE IS REQUIRED ON A TRANSACTIONAL BASIS AT THE TIME SUCH CONFLICTS ARISE, WHEN AN INDIVIDUAL BECOMES A COVERED PERSON (E.G. UPON HIRING OR BOARD APPOINTMENT), AND ANNUALLY THEREAFTER. DISCLOSURES OF PERCEIVED, POTENTIAL OR ACTUAL CONFLICTS ARE INITIALLY REVIEWED BY NATIONAL OR REGIONAL LEGAL OR CORPORATE RESPONSIBILITY TEAM MEMBERS TO DETERMINE WHETHER AN ACTUAL OR POTENTIAL CONFLICT MAY EXIST. IF IT IS DETERMINED THAT A POTENTIAL OR ACTUAL CONFLICT EXISTS, ISSUES ARE ELEVATED TO THE BOARD EXECUTIVE COMMITTEE OR BOARD CHAIR (FOR BOARD OR OFFICER CONFLICTS), OR THE CONFLICTS OF INTEREST REVIEW COMMITTEE (FOR ANY OTHER CONFLICT). THE PROCEDURES FOR ADDRESSING A CONFLICT RELATED TO A PROPOSED TRANSACTION IN THE CASE OF GOVERNING BODIES OR A CORPORATE OFFICER INCLUDE, BUT ARE NOT LIMITED TO 1) DISCLOSURE TO THE BOARD, 2) THE TRUSTEE OR CORPORATE OFFICER BEING EXCUSED FROM THE MEETING DURING DISCUSSION AND VOTE ON THE CONFLICT OF INTEREST (ALTHOUGH HE OR SHE MAY RESPOND TO PERTINENT QUESTIONS IF THE KNOWLEDGE IS RELEVANT), AND 3) BOARD APPROVAL OF THE TRANSACTION BY A MAJORITY OF DISINTERESTED MEMBERS. IN ADDITION, BOARDS CAREFULLY REVIEW AND SCRUTINIZE ANY NON-TRANSACTIONAL CONFLICTS OF INTEREST. IN SUCH CIRCUMSTANCES, BY A MAJORITY VOTE OF THE DISINTERESTED TRUSTEES, THE BOARD TAKES WHATEVER ACTION IS DEEMED APPROPRIATE. FOR CONFLICTS NOT INVOLVING A BOARD MEMBER OR OFFICER, THE CONFLICTS OF INTEREST REVIEW COMMITTEE ("C-CIRC") WILL FACILITATE A COI MANAGEMENT PLAN TO MITIGATE THE CONFLICT IF ADEQUATE CONTROLS AREN'T ALREADY IN PLACE. NOTWITHSTANDING THE FOREGOING, AT ITS SOLE DISCRETION, AN ENTITY MAY REJECT A PERSON'S REQUEST TO ENTER INTO THE RELATIONSHIP IN QUESTION, OR REQUIRE THE RELATIONSHIP BE SUFFICIENTLY ALTERED TO AVOID A POTENTIAL CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | FORM 990, PART VI, LINE 15A - PROCESS USED TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL KENTUCKYONE HEALTH MEDICAL GROUP'S TOP MANAGEMENT OFFICIAL IS COMPENSATED BY KENTUCKYONE HEALTH MEDICAL GROUP, INC. (KHMG). KHMG'S MANAGEMENT REVIEW COMMITTEE IS RESPONSIBLE FOR REVIEW AND APPROVAL OF MANAGEMENT COMPENSATION. THE FULL COMMITTEE ADDRESSED THE OVERALL COMPENSATION PHILOSOPHY AND HOW THE ORGANIZATION'S GOALS CAN BE FURTHERED BY THE STRUCTURE OF COMPENSATION. THE INDEPENDENT MANAGEMENT REVIEW COMMITTEE AND ALL INDEPENDENT MEMBERS OF THE FULL BOARD APPROVED MAXIMUM COMPENSATION LEVELS FOR ALL DISQUALIFIED PERSONS. NONINDEPENDENT DIRECTORS DID NOT PARTICIPATE IN THE DISCUSSION OR VOTE ON COMPENSATION LEVELS FOR INDIVIDUALS. THE MANAGEMENT REVIEW COMMITTEE RETAINED AN OUTSIDE COMPENSATION CONSULTANT FROM A NATIONAL FIRM TO ADVISE IT REGARDING REASONABLE COMPENSATION LEVELS, AND RELIED ON THE CONSULTANT'S OPINION THAT COMPENSATION LEVELS ARE REASONABLE. THE COMMITTEE RECEIVES A MARKET REVIEW ON EACH DISQUALIFIED PERSON FROM THE COMPENSATION CONSULTANT. THE MANAGEMENT REVIEW COMMITTEE APPROVED THE PEER GROUP OF SIMILAR ENTITIES USED TO MEASURE COMPARABLE COMPENSATION LEVELS. THE MANAGEMENT REVIEW COMMITTEE FOLLOWS THE PROCESS NECESSARY TO OBTAIN THE REBUTTABLE PRESUMPTION THAT COMPENSATION LEVELS ARE REASONABLE, INCLUDING CONTEMPORANEOUS DOCUMENTATION OF DECISIONS. VIREN BAVISHI REPLACED RON WALDRIDGE AS A PRESIDENT OF KENTUCKYONE HEALTH MEDICAL GROUP, INC. IN MAY 2019 AND WAS PAID BY KENTUCKYONE HEALTH MEDICAL GROUP, INC. FORM 990, PART VI, LINE 15B - PROCESS TO ESTABLISH COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES CHI PHYSICIAN SERVICES, THROUGH ITS MEDICAL GROUP LEADERSHIP COUNCIL (MGLC) ESTABLISHES THE STANDARDS FOR PHYSICIAN COMPENSATION STANDARDS. CHI PHYSICIAN SERVICES IS CHARGED WITH REVIEWING TRANSACTIONS (INCLUDING AN MGLC PANEL REVIEW, WHERE REQUIRED) AND THAT REVIEW IS CONDUCTED PRIOR TO ANY LOCAL REVIEW AND APPROVAL. AN EXTERNAL COMMERCIAL REASONABLENESS AND FAIR MARKET VALUE OPINION IS REQUIRED IN CERTAIN CIRCUMSTANCES (FOR EXAMPLE, WHEN TOTAL COMPENSATION IS PROJECTED TO EXCEED THE RELEVANT 90TH PERCENTILE BLENDED COMPENSATION BENCHMARK). LOCALLY, AT MINIMUM, THE PROVIDER COMPENSATION GOVERNANCE STRUCTURE FOR OVERSIGHT OF COMPENSATION ARRANGEMENTS INCLUDES A PHYSICIAN TRANSACTION REVIEW COMMITTEE (PTRC) AND A PHYSICIAN ENTERPRISE (PE) PROVIDER COMPENSATION COMMITTEE (AS WELL AS SUPPORT STAFF FOR COMPENSATION ANALYSIS). THE PURPOSE OF THE PE PROVIDER COMPENSATION COMMITTEE IS TO REVIEW, ADVISE, AND RECOMMEND (TO THE PTRC REVISIONS TO PROVIDER COMPENSATION PRINCIPLES, COMPENSATION MODELS, DISTRIBUTION METHODS, COMPENSATION GUIDELINES, AND PROVIDER BENEFIT PACKAGES IN COMPLIANCE WITH THE EMPLOYED PROVIDER COMPENSATION PRINCIPLES. THE PTRC IS THE COMMITTEE THAT HAS BEEN DELEGATED RESPONSIBILITY BY THE CONTRACTING ENTITY'S GOVERNING BOARD FOR REVIEWING AND APPROVING PHYSICIAN TRANSACTIONS. THE PRIMARY PURPOSE OF PTRC REVIEW AND APPROVAL IS TO EVALUATE THE FAIR MARKET VALUE AND COMMERCIAL REASONABLENESS OF A PHYSICIAN TRANSACTION IN THE CONTEXT OF ACHIEVING THE REBUTTABLE PRESUMPTION OF REASONABLENESS, AS WELL AS TO ENSURE THAT TRANSACTIONS ADVANCE THE CHARITABLE AND BUSINESS PURPOSES OF THE CONTRACTING ENTITY AND ARE DESIGNED TO COMPLY WITH APPLICABLE LEGAL AND REGULATORY REQUIREMENTS, INCLUDING WITHOUT LIMITATION, THE STARK LAW AND THE ANTI-KICKBACK STATUTE. THE ORGANIZATION'S NON-PHYSICIAN OFFICER'S COMPENSATION WAS PAID BY KENTUCKYONE HEALTH MEDICAL GROUP, INC.. KHMG'S MANAGEMENT REVIEW COMMITTEE IS RESPONSIBLE FOR REVIEW AND APPROVAL OF MANAGEMENT COMPENSATION. THE FULL COMMITTEE ADDRESSED THE OVERALL COMPENSATION PHILOSOPHY AND HOW THE ORGANIZATION'S GOALS CAN BE FURTHERED BY THE STRUCTURE OF COMPENSATION. THE INDEPENDENT MANAGEMENT REVIEW COMMITTEE AND ALL INDEPENDENT MEMBERS OF THE FULL BOARD APPROVED MAXIMUM COMPENSATION LEVELS FOR ALL DISQUALIFIED PERSONS. NON-INDEPENDENT DIRECTORS DID NOT PARTICIPATE IN THE DISCUSSION OR VOTE ON COMPENSATION LEVELS FOR INDIVIDUALS. KHMG'S MANAGEMENT REVIEW COMMITTEE RETAINED AN OUTSIDE COMPENSATION CONSULTANT FROM A NATIONAL FIRM TO ADVISE IT REGARDING REASONABLE COMPENSATION LEVELS, AND RELIED ON THE CONSULTANT'S OPINION THAT COMPENSATION LEVELS ARE REASONABLE. THE COMMITTEE RECEIVES A MARKET REVIEW ON EACH DISQUALIFIED PERSON FROM THE COMPENSATION CONSULTANT. THE MANAGEMENT REVIEW COMMITTEE APPROVED THE PEER GROUP OF SIMILAR ENTITLES USED TO MEASURE COMPARABLE COMPENSATION LEVELS. KHMG'S MANAGEMENT REVIEW COMMITTEE FOLLOWS THE PROCESS NECESSARY TO OBTAIN THE REBUTTABLE PRESUMPTION THAT COMPENSATION LEVELS ARE REASONABLE, INCLUDING CONTEMPORANEOUS DOCUMENTATION OF DECISIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.COMMONSPIRIT.ORG. |
| FORM 990, PART XI, LINE 9: | TRANSFERS FROM AFFILIATES 970,586,732. LEASE ACCOUNTING CHANGES DUE TO ASC 842 9,136. |
| Software ID: | |
| Software Version: |