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
2019
Open to Public
Inspection
Name of the organization
St Joseph Ambulatory Care Inc
 
Employer identification number

22-2480373
Return Reference Explanation
Form 990, Part VI, Section A, line 6 St. Joseph Healthcare Foundation is the sole corporate member of the Organization.
Form 990, Part VI, Section A, line 7a As the sole corporate member of the Organization, St. Joseph Healthcare Foundation retains the ability to elect and remove the Organization's board of directors with or without cause.
Form 990, Part VI, Section A, line 7b As the sole corporate member of the Organization, St. Joseph Healthcare Foundation has the following powers and rights over the Organization and its subsidiaries as outlined in the Organizaton's bylaws: 1. To approve any change in the written statements of philosophy and mission; 2. To amend and to repeal the organizing and governing documents; 3. To approve all plans of merger, consolidation, reorganization, dissolution, or the sale, lease assignment, or transfer of substantially all of the assets, or the purchase or acquisition of an interest in any corporation, partnership, joint venture, or other entity; 4. To approve all long-range strategic plans before implementation; 5. To approve the acquisition, sale, or encumberance of any real estate valued in excess of an amount set by the Member in writing; 6. To approve all capital budgets and non-budgeted expeness in excess of an amount set by the Member in writing; 7. To approve all debt in excess of limits set by the Member in writing; 8. To appoint the auditors; 9. To approve the sale, assignment, or transfer of any equity interest or membership interest in any subsidiary; 10. To approve any reclassification or other change of any capital stock or other equity security; 11. To approve the issuance of, or the creation of any obligation to issue, an equity security; and, 12. To evaluate the performance of the Medical Center in preserving, furthering, and promoting the purposes of the Medical Center.
Form 990, Part VI, Section B, line 11b The Form 990 is provided to the governing body for their review and approval prior to filing.
Form 990, Part VI, Section B, line 12c This process is the responsibility of the Compliance Officer. A conflict of interest disclosure form is submitted to all leadership, board members, board committee members, employed physicians, medical directors and certain employees in key positions annually to be completed. Reminders are sent to all persons of interest to ensure that all conflict of interest disclosure forms are completed and collected.
Form 990, Part VI, Section B, line 15 Any compensation paid to the trustees, directors, officers or key employees of the Organization is subject to the oversight and decisions of Covenant Health, a related tax-exempt organization. Every two-to-three years the Compensation Committee of the Covenant Health Board of Directors engages an external consultant to provide competitive market data from various survey sources, which is then used to develop recommendations for changes to the compensation program. Since 2003, the Compensation Committee has engaged a human resources consultant to conduct this analysis. Objectives of the analysis are to assess the compositeness of the total cash compensation levels of the senior leadership team, develop market based competitive salary ranges for all executive positions, and ensure that the annual incentive opportunities, if there are any, are competitive and reasonable.
Form 990, Part VI, Section C, line 19 The Organization's Form 990, governing documents, conflict of interest policy, and financial statements are made available to the public upon request. The Organization's Form 990 is also made available on the website of its parent organization, Covenant Health, at the following web address: https://www.covenanthealth.net/financial-information/financial-information
Form 990, Part XII, Line 2c: The audit process has not changed from the previous year.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


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