Civic Intelligence

Dignity Health Insurance of Nevada Ltd

EIN 81-3800752 • 501(c)3 • San Francisco, CA

Profile

Administration of professional and captive insurance program for affiliated charitable healthcare organizations.

185 Berry Street No 200San Francisco, CA 94107-1777

n/A

Siviq Scores

Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.

Liabilities / Assets

Score unavailable

No value available

Liabilities-to-assets requires both liabilities and assets on the latest valid filing.

Source year 2021

Liabilities / Revenue

62nd percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

501(c)3 • <$500k nonprofits • Source year 2021

Net Margin

1st percentile

-568390%

Higher net margin than 1% of similar nonprofits.

501(c)3 • <$500k nonprofits • Source year 2021

Top Officer Pay

100th percentile

$5,416,775

Higher top officer pay than 100% of similar nonprofits.

Top officer pay equals 330291.2% of source-year revenue.

501(c)3 • <$500k nonprofits • Source year 2021

Asset Growth

10th percentile

-100%

Faster asset growth than 10% of similar nonprofits.

501(c)3 • <$500k nonprofits • Annualized from 2020 to 2021

Revenue Growth

5th percentile

-98%

Faster revenue growth than 5% of similar nonprofits.

501(c)3 • <$500k nonprofits • Annualized from 2020 to 2021

Assets

Down

$0

Down $14,962,190 (-100%) from 2020

Liabilities

Down

$0

Down $5,640,599 (-100%) from 2020

Net Assets

Down

$0

Down $9,321,591 (-100%) from 2020

Revenue

Down

$1,640

Down $70,650 (-98%) from 2020

Expenses

Up

$9,323,231

Up $9,274,261 (+18939%) from 2020

Net Income

Down

-$9,321,591

Down $9,344,911 (-40073%) from 2020

Trend Graphs

Balance Sheet Trend

Grouped bars show assets, liabilities, and net assets across loaded filings.

$15M$10M$5.0M$0Assets 2017: $200,000Liabilities 2017: $27,5002017Assets 2018: $270,917Liabilities 2018: $154,225Net Assets 2018: $116,6922018Assets 2019: $14,936,249Liabilities 2019: $5,227,623Net Assets 2019: $9,708,6262019Assets 2020: $14,962,190Liabilities 2020: $5,640,599Net Assets 2020: $9,321,5912020Assets 2021: $0Liabilities 2021: $0Net Assets 2021: $02021

Highlighted filing

2021

Assets$0
Liabilities$0
Net Assets$0

Operations Trend

Revenue, expenses, and net income by year, with the latest filing highlighted.

$10M$5.0M$0-$5.0M-$10MRevenue 2017: $0Expenses 2017: $27,500Net Income 2017: -$27,5002017Revenue 2018: $0Expenses 2018: $55,808Net Income 2018: -$55,8082018Revenue 2019: $423,075Expenses 2019: $71,141Net Income 2019: $351,9342019Revenue 2020: $72,290Expenses 2020: $48,970Net Income 2020: $23,3202020Revenue 2021: $1,640Expenses 2021: $9,323,231Net Income 2021: -$9,321,5912021

Highlighted filing

2021

Revenue$1,640
Expenses$9,323,231
Net Income-$9,321,591

Filings

Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jul 1, 2020 to Apr 7, 2021
Signed
Mar 15, 2022
Return Version
2020v4.2
Gross Receipts
$1,640
Mission and Program Overview

Mission

Administration of professional and captive insurance program for affiliated charitable healthcare organizations.

Administration of professional and captive affiliated charitable healthcare organizations.

Balance Sheet Detail
LineBeginningEndChange
Assets
Savings and Temporary Cash Investments$14,939,852$0▼ $14,939,852
Prepaid Expenses and Deferred Charges$22,338$0▼ $22,338
Cash and Non-Interest-Bearing Accounts-$0-
Accounts Receivable-$0-
Other Notes and Loans Receivable, Net-$0-
Pledges and Grants Receivable-$0-
Receivable From Disqualified Prsn-$0-
Receivables From Officers Etc-$0-
Investments Other Securities-$0-
Investments Program Related-$0-
Investments in Publicly Traded Securities-$0-
Land, Buildings, and Equipment, Net-$0-
Intangible Assets-$0-
Inventories for Sale or Use-$0-
Total Assets$14,962,190$0▼ $14,962,190
Other Assets Total-$0-
Liabilities
Other Liabilities$5,615,724$0▼ $5,615,724
Accounts Payable and Accrued Expenses$24,875--
Total Liabilities$5,640,599$0▼ $5,640,599
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$9,321,591$0▼ $9,321,591
Total Net Assets Fund Balance$9,321,591$0▼ $9,321,591
Total Liabilities and Net Assets / Fund Balance$14,962,190$0▼ $14,962,190
Compensation and Service Providers

Board Members and Trustees

NameTitle
Ellen CharnleyDirector
Julie Hyer OpDirector
MARVIN O'QUINNDirector
Robert Wiebe MdDirector/ Secretary
Daniel J Morissette CPADirector/ Treasurer
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$0
Investment Income
$1,640
Other Revenue
$0
Change in Net Assets
$-9,321,591
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Grants and Similar Amounts Paid$9,295,459
Other Expenses$27,772
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Grants to Domestic Orgs$9,295,459--$9,295,459
Fees for Services Other$13,445$1,939-$15,384
Other Expenses-$12,388-$12,388
Total Functional Expenses$9,308,904$14,327$0$9,323,231
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
Dignity Health Hospital & Professional Liability Self-insurance TrustSan Francisco, CA501(c)(3)Related Entity Support Due to Dissolution$9,295,459
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Receivables from Disqualified Persons-$0-
Receivables from Officers, Directors, Trustees, and Key Employees-$0-
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Business relationship with 35% controlled entity
No
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
No
Other officer compensation reviewed
No
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, Line 2

Sr. J. Hyer, d. Morissette, m. O'quinn, r. Wiebe, md business relationship d. Morissette, m. O'quinn - business relationship

Form 990, Part VI, Section A, Line 7A

Dignity health, the sole member of the organization, has the power to appoint and remove members of the board of trustees. On february 1, 2019, dignity health and catholic health initiatives ("chi"), a colorado nonprofit corporation, effected a business combination. On that date, chi changed its name to commonspirit health and became the sole corporate member of dignity health. Commonspirit health is a catholic healthcare system sponsored by the public juridic person, catholic health care federation ("chcf").

Form 990, Part VI, Section B, Line 11B

The supported organization's sole member's svp/chief risk officer worked closely with the accounting and tax departments. The final version of the form 990 was not provided to the filing organization before the return was filed.

Form 990, Part VI, Section B, Line 12C

The organization has adopted the related organization, commonspirit's conflicts of interest policy. The conflicts of interest ("coi") policy (the "policy") was put in place to protect the interests of commonspirit in circumstances that may result in a conflict between personal interests of a person and the interests of the organization and those it serves. The policy was last updated during the tax year ended 6/30/2021. Commonspirit's coi policy applies to commonspirit, its direct affiliates and subsidiaries and any related entity the governing documents of which require the entity to comply with commonspirit policy (collectively the "system entities"). The following persons are required to disclose actual or potential conflicts of interest at least annually (via a formal system-administered survey) if the person's affiliation with commonspirit continues: -members of corporate and community boards of system entities -members of committees of corporate and community boards of system entities -members of the executive leadership team ("elt") of commonspirit -corporate officers of system entities -employees of system entities at the vice president level and above -all individuals engaged in research at institutions owned or operated by a system entity. -select employees as determined from time to time by leadership (which includes key employees and highest compensated employees as specified by the internal revenue service for form 990 purposes who are not otherwise included in the categories above). Disclosure, review, and management of perceived, potential, or actual conflicts of interest are accomplished through a defined coi disclosure review process. Each person is required to promptly and fully disclose any situation or circumstance that may create a conflict of interest as soon as she/he becomes aware of it. In addition, at the inception of an individual's relationship with commonspirit (e.g. Hiring, board appointment), and for certain positions, annually thereafter, written conflict of interest disclosure forms must be completed. A failure to disclose may result in disciplinary or corrective actions. Reported potential or actual conflicts of interest are initially reviewed by legal, corporate responsibility or research integrity staff. If necessary, a conflict of interest management plan is developed, which plan shall be subject to acceptance by the appropriate direct manager, supervisor, medical staff office, board or board committee (for board, board committee, elt or corporate officer conflicts), or other appropriate individual or body. Once accepted, the conflict of interest management plan is communicated to the person with the actual or potential conflict and the individual must conduct themselves in conformity with the plan. In the event that a transactional conflict interest arises in connection with a system entity board meeting, the conflicted individual must disclose that conflict prior to or at the beginning of the meeting in which the matter is to be considered. The conflicted individual is excluded from voting on the transaction and is prohibited from using personal influence with respect to the matter, but is not prohibited from providing input if requested to do so.

Form 990, Part VI, Section B, Line 15

For 2020 compensation, compensation levels for the organization's top management official were established by the related organization, commonspirit. Commonspirit 's board of stewardship trustees appoints a human resources and compensation committee, comprised of exclusively independent directors, who are accountable for setting reasonable compensation packages for each officer and certain key executives (including the president/ceo). The human resources and compensation committee approves, consistent with the organization's philosophy and principles, the annual performance goals and criteria to be used in determining merit increases and variable compensation criteria for officers and key employees. The human resources and compensation committee also engages outside legal counsel as necessary and qualified independent compensation and benefits specialists (independent experts) to review, analyze and provide benchmarking data for the total compensation and benefits packages of officers and key executives. Appropriate comparable data is obtained from the independent experts, (e.g., total economic benefits paid by similarly situated organizations, both taxable and tax-exempt, for similar job responsibilities). Key deliberations of the committee are documented in meeting minutes which are approved at the next committee meeting and provided to the board of directors. The documentation of the deliberations includes (a) the terms of the agreement approved and the date approved; (b) the members of the committee who were present during discussion of the approved agreement and those who voted on it; and (c) the comparability data obtained and relied upon by the committee and how the data was obtained.

Form 990, Part VI, Section C, Line 19

Federal tax laws do not mandate that the organization's governing documents, conflict of interest policy and financial statements be made available for public inspection. The organization is included in commonspirit's consolidated financial statements which are available on commonspirit's website and upon request.

Filing and Contact Details

Filer

Filer Name
Dignity Health Insurance of Nevada Ltd
EIN
81-3800752
Phone
4154385500
Address
185 BERRY STREET NO 200, SAN FRANCISCO, CA 94107-1777

Signing Officer

Name
Daniel Morissette
Title
Treasurer
Phone
4154385500
Signed
2022-03-15
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Daniel Morissette
Formed
2016
Legal Domicile
Nv
Voting Board Members
5
Independent Board Members
2
Employees
0
Volunteers
5

Preparer

Firm
Commonspirit Health
Address
198 INVERNESS DRIVE WEST, ENGLEWOOD, CO 80112
Preparer
Angela Noel
Phone
3032989100
Supplemental Narrative

Additional Explanations

Form 990, Part III, Line 3

On february 1, 2019, dignity health and catholic health initiatives ("chi"), a colorado nonprofit corporation, effected a business combination. On that date, chi changed its name to commonspirit health ("commonspirit") and became the sole corporate member of dignity health. A review was conducted to integrate the insurance programs of the two legacy healthcare systems, commonspirit health and dignity health. The review was to determine the most cost effective and efficient utilization of commonspirit's captive insurance. The review concluded that the organization was surplus to the needs of commonspirit, therefore, the organization was to be dissolved. Effective april 7, 2021, the organization dissolved with the nevada secretary of state.

Form 990, Part V, Line 2A & 2B

The organization does not have employees. The organization operates as the administration company of the captive insurance program for the supported organization, dignity health, and its related entities.

Financial Statement Notes

PART X, LINE 2:

The organization reviews its tax positions quarterly and has determined that there are no material uncertain tax positions that require recognition in the accompanying consolidated financial statements.

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IRS990ScheduleA/Form990ScheduleAPartVIGrp/ExplanationTxt0DHIN PROVIDED OR PURCHASED FOR THE BENEFIT OF DIGNITY HEALTH, VARIOUS SERVICES, FACILITIES AND GOODS. SEE FORM 990, PART III FOR FURTHER DETAILS. EFFECTIVE APRIL 7, 2021, THE ORGANIZATION DISSOLVED WITH THE NEVADA SECRETARY OF STATE.
IRS990ScheduleA/Form990ScheduleAPartVIGrp/ExplanationTxt1DHIN, A NEVADA CAPTIVE, IS ORGANIZED AND OPERATED EXCLUSIVELY FOR THE BENEFIT OF, AND TO CARRY OUT THE PURPOSES OF, DIGNITY HEALTH AND ITS AFFILIATED CHARITABLE ORGANIZATIONS. THE CAPTIVE IS ORGANIZED EXCLUSIVELY FOR CHARITABLE PURPOSES AND IS INTENDED TO BE FOR THE BENEFIT OF AND SUPPORT OF DIGNITY HEALTH AND AFFILIATED ORGANIZATIONS, TO SERVE AS A REPOSITORY FOR FUNDS PAID IN BY DIGNITY HEALTH AND AFFILIATED ORGANIZATIONS, TO MAKE PAYMENTS ON BEHALF OF DIGNITY HEALTH AND AFFILIATED ORGANIZATIONS PURSUANT TO ARTICLE VI AND TO OPERATE AS AN INTEGRAL PART OF, AND IN SUPPORT OF THE OPERATIONS OF, DIGNITY HEALTH AND AFFILIATED ORGANIZATIONS.
IRS990ScheduleA/Form990ScheduleAPartVIGrp/FormAndLineReferenceDesc0SCHEDULE A, PART I, LINE 12G
IRS990ScheduleA/Form990ScheduleAPartVIGrp/FormAndLineReferenceDesc1PART IV, SECTION A, LINE 1:
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IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt0THE ORGANIZATION REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS.
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IRS990ScheduleI/RecipientTable/PurposeOfGrantTxt0RELATED ENTITY SUPPORT DUE TO DISSOLUTION
IRS990ScheduleI/RecipientTable/RecipientBusinessName/BusinessNameLine1Txt0DIGNITY HEALTH HOSPITAL & PROFESSIONAL LIABILITY SELF-INSURANCE TRUST
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IRS990ScheduleI/SupplementalInformationDetail/ExplanationTxt0GRANTS, IF ANY, ARE PROVIDED TO NOT-FOR-PROFIT ORGANIZATIONS THAT FURTHER DHIN'S EXEMPT PURPOSE. ALL ORGANIZATIONS THAT ARE PROVIDED GRANTS ARE REQUIRED TO BE A SECTION 501(C)(3) ORGANIZATION.
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm0MARVIN O'QUINN
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm1DANIEL J MORISSETTE CPA
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm2ROBERT WIEBE MD
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt0DIRECTOR
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt1DIRECTOR/ TREASURER
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt2DIRECTOR/ SECRETARY
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IRS990ScheduleJ/SeverancePaymentInd01
IRS990ScheduleJ/SupplementalInformationDetail/ExplanationTxt0THE ORGANIZATION RELIED ON A RELATED ORGANIZATION, COMMONSPIRIT, THAT USED A HUMAN RESOURCES AND COMPENSATION COMMITTEE OF THE COMMONSPIRIT BOARD OF STEWARDSHIP TRUSTEES; INDEPENDENT COMPENSATION CONSULTANT; COMPENSATION SURVEY OR STUDY; ANDAPPROVAL BY THE BOARD OR HUMAN RESOURCES AND COMPENSATION COMMITTEE TO ESTABLISH DIGNITY HEALTH MEDICAL FOUNDATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15A FOR ADDITIONAL INFORMATION.
IRS990ScheduleJ/SupplementalInformationDetail/ExplanationTxt1PART I, LINE 4A CERTAIN LISTED PERSONS PARTICIPATE IN A SEVERANCE PLAN THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 1 TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE PLAN. NO PAYMENTS PURSUANT TO THE PLAN ARRANGMENT OCCURRED DURING 2020. PART I, LINE 4B CERTAIN LISTED PERSONS ARE ELIGIBLE TO PARTICIPATE IN NON-QUALIFIED 457(F) PLANS THAT ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE, AS REQUIRED BY THE IRS. THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR EXECUTIVES PLANS THAT ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE, AS REQUIRED BY THE IRS. THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR EXECUTIVES HIRED PRIOR TO JUNE 30, 2006. THE BENEFIT IS INTENDED TO BRIDGE THE DIFFERENCE, IF ANY, BETWEEN THE BENEFIT PROVIDED UNDER THE DIGNITY HEALTH EXCESS BENEFIT PLAN HAD BENEFIT SERVICE NOT BEEN FROZEN AT JANUARY 1, 2008, AND THE BENEFITS PROVIDED FROM ALL OTHER QUALIFIED AND NON-QUALIFIED PLANS. BENEFITS VEST UNDER THIS 457(F) PLAN AT THE LATER OF THE DATE THE PARTICIPANT ATTAINS AGE 62 OR IS CREDITED WITH 15 YEARS OF SERVICE. THE 2010 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR CERTAIN OFFICERS AND KEY EMPLOYEES, PRIMARILY THOSE WHO ARE NOT ELIGIBLE TO PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN OR THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN DESCRIBED ABOVE. THIS BENEFIT PROVIDES AN ANNUAL ACCRUAL OF 10% OF TOTAL COMPENSATION AND IS PAYABLE ANNUALLY ON JULY 1 ONCE VESTED, WHICH IS AGE 62 WITH 5 YEARS OF SERVICE; THE PLAN ALSO ALLOWS FOR SPECIAL AWARDS. PAYMENTS PURSUANT TO THE PLAN ARRANGEMENTS OCCURRED DURING 2020 INCLUDE M. O'QUINN, $401,134 AND R. WIEBE, $229,580. COMPENSATION AMOUNTS FOR THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS DISCUSSED ABOVE ARE REPORTED AS DEFERRED COMPENSATION IN THE YEAR ACCRUED (SCHEDULE J, PART II, COLUMN C) AND ARE REFLECTED AGAIN AS OTHER REPORTABLE COMPENSATION IN THE YEAR PAID (SCHEDULE J, PART II, COLUMN B(III)).
IRS990ScheduleJ/SupplementalInformationDetail/ExplanationTxt2THE ORGANIZATION FOLLOWS COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY. COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST COMMONSPIRIT AND ITS RELATED ORGANIZATIONS IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE ORGANIZATION TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES IT SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND THE ORGANIZATION'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE, REVENUES AND COMPLEXITY. PAYMENTS PURSUANT TO A LONG-TERM FINANCIAL PERFORMANCE GOAL WERE PAID IN CALENDAR YEAR 2020.
IRS990ScheduleJ/SupplementalInformationDetail/FormAndLineReferenceDesc0PART I, LINE 3
IRS990ScheduleJ/SupplementalInformationDetail/FormAndLineReferenceDesc1PART I, LINES 4A-B
IRS990ScheduleJ/SupplementalInformationDetail/FormAndLineReferenceDesc2SCHEDULE J, PART II ADDITIONAL INFORMATION
IRS990ScheduleJ/SupplementalNonqualRtrPlanInd01
IRS990ScheduleN/AssetsDistributedInd01
IRS990ScheduleN/AttorneyGeneralNotifiedInd01
IRS990ScheduleN/BondsOutstandingInd00
IRS990ScheduleN/DirectorOfSuccessorInd00
IRS990ScheduleN/EmployeeOfSuccessorInd00
IRS990ScheduleN/LiabilitiesPaidInd01
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/AssetsDistriOrExpnssPaidDesc0CASH, AP PAYABLES, INTERCOMPANY PAYABLES
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/BusinessName/BusinessNameLine1Txt0DIGNITY HEALTH HOSPITAL & PROFESSIONAL LIABILITY SELF-INSURANCE TRUST
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/DistributionDt02021-04-07
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IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/FairMarketValueOfAssetAmt09295459
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/IRCSectionTxt0501(C)(3)
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/MethodOfFMVDeterminationTxt0BOOK VALUE
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/AddressLine1Txt0185 BERRY STREET SUITE 200
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/CityNm0SAN FRANCISCO
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IRS990ScheduleN/OwnerOfSuccessorInd00
IRS990ScheduleN/ReceiveCompensationInd00
IRS990ScheduleN/RequiredToNotifyAGInd01
IRS990/ScheduleORequiredInd01
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0ON FEBRUARY 1, 2019, DIGNITY HEALTH AND CATHOLIC HEALTH INITIATIVES ("CHI"), A COLORADO NONPROFIT CORPORATION, EFFECTED A BUSINESS COMBINATION. ON THAT DATE, CHI CHANGED ITS NAME TO COMMONSPIRIT HEALTH ("COMMONSPIRIT") AND BECAME THE SOLE CORPORATE MEMBER OF DIGNITY HEALTH. A REVIEW WAS CONDUCTED TO INTEGRATE THE INSURANCE PROGRAMS OF THE TWO LEGACY HEALTHCARE SYSTEMS, COMMONSPIRIT HEALTH AND DIGNITY HEALTH. THE REVIEW WAS TO DETERMINE THE MOST COST EFFECTIVE AND EFFICIENT UTILIZATION OF COMMONSPIRIT'S CAPTIVE INSURANCE. THE REVIEW CONCLUDED THAT THE ORGANIZATION WAS SURPLUS TO THE NEEDS OF COMMONSPIRIT, THEREFORE, THE ORGANIZATION WAS TO BE DISSOLVED. EFFECTIVE APRIL 7, 2021, THE ORGANIZATION DISSOLVED WITH THE NEVADA SECRETARY OF STATE.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1THE ORGANIZATION DOES NOT HAVE EMPLOYEES. THE ORGANIZATION OPERATES AS THE ADMINISTRATION COMPANY OF THE CAPTIVE INSURANCE PROGRAM FOR THE SUPPORTED ORGANIZATION, DIGNITY HEALTH, AND ITS RELATED ENTITIES.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2SR. J. HYER, D. MORISSETTE, M. O'QUINN, R. WIEBE, MD BUSINESS RELATIONSHIP D. MORISSETTE, M. O'QUINN - BUSINESS RELATIONSHIP
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3DIGNITY HEALTH, THE SOLE MEMBER OF THE ORGANIZATION, HAS THE POWER TO APPOINT AND REMOVE MEMBERS OF THE BOARD OF TRUSTEES. ON FEBRUARY 1, 2019, DIGNITY HEALTH AND CATHOLIC HEALTH INITIATIVES ("CHI"), A COLORADO NONPROFIT CORPORATION, EFFECTED A BUSINESS COMBINATION. ON THAT DATE, CHI CHANGED ITS NAME TO COMMONSPIRIT HEALTH AND BECAME THE SOLE CORPORATE MEMBER OF DIGNITY HEALTH. COMMONSPIRIT HEALTH IS A CATHOLIC HEALTHCARE SYSTEM SPONSORED BY THE PUBLIC JURIDIC PERSON, CATHOLIC HEALTH CARE FEDERATION ("CHCF").
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4THE SUPPORTED ORGANIZATION'S SOLE MEMBER'S SVP/CHIEF RISK OFFICER WORKED CLOSELY WITH THE ACCOUNTING AND TAX DEPARTMENTS. THE FINAL VERSION OF THE FORM 990 WAS NOT PROVIDED TO THE FILING ORGANIZATION BEFORE THE RETURN WAS FILED.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt5THE ORGANIZATION HAS ADOPTED THE RELATED ORGANIZATION, COMMONSPIRIT'S CONFLICTS OF INTEREST POLICY. THE CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") WAS PUT IN PLACE TO PROTECT THE INTERESTS OF COMMONSPIRIT IN CIRCUMSTANCES THAT MAY RESULT IN A CONFLICT BETWEEN PERSONAL INTERESTS OF A PERSON AND THE INTERESTS OF THE ORGANIZATION AND THOSE IT SERVES. THE POLICY WAS LAST UPDATED DURING THE TAX YEAR ENDED 6/30/2021. COMMONSPIRIT'S COI POLICY APPLIES TO COMMONSPIRIT, ITS DIRECT AFFILIATES AND SUBSIDIARIES AND ANY RELATED ENTITY THE GOVERNING DOCUMENTS OF WHICH REQUIRE THE ENTITY TO COMPLY WITH COMMONSPIRIT POLICY (COLLECTIVELY THE "SYSTEM ENTITIES"). THE FOLLOWING PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AT LEAST ANNUALLY (VIA A FORMAL SYSTEM-ADMINISTERED SURVEY) IF THE PERSON'S AFFILIATION WITH COMMONSPIRIT CONTINUES: -MEMBERS OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES -MEMBERS OF COMMITTEES OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES -MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM ("ELT") OF COMMONSPIRIT -CORPORATE OFFICERS OF SYSTEM ENTITIES -EMPLOYEES OF SYSTEM ENTITIES AT THE VICE PRESIDENT LEVEL AND ABOVE -ALL INDIVIDUALS ENGAGED IN RESEARCH AT INSTITUTIONS OWNED OR OPERATED BY A SYSTEM ENTITY. -SELECT EMPLOYEES AS DETERMINED FROM TIME TO TIME BY LEADERSHIP (WHICH INCLUDES KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES AS SPECIFIED BY THE INTERNAL REVENUE SERVICE FOR FORM 990 PURPOSES WHO ARE NOT OTHERWISE INCLUDED IN THE CATEGORIES ABOVE). DISCLOSURE, REVIEW, AND MANAGEMENT OF PERCEIVED, POTENTIAL, OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. EACH PERSON IS REQUIRED TO PROMPTLY AND FULLY DISCLOSE ANY SITUATION OR CIRCUMSTANCE THAT MAY CREATE A CONFLICT OF INTEREST AS SOON AS SHE/HE BECOMES AWARE OF IT. IN ADDITION, AT THE INCEPTION OF AN INDIVIDUAL'S RELATIONSHIP WITH COMMONSPIRIT (E.G. HIRING, BOARD APPOINTMENT), AND FOR CERTAIN POSITIONS, ANNUALLY THEREAFTER, WRITTEN CONFLICT OF INTEREST DISCLOSURE FORMS MUST BE COMPLETED. A FAILURE TO DISCLOSE MAY RESULT IN DISCIPLINARY OR CORRECTIVE ACTIONS. REPORTED POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE INITIALLY REVIEWED BY LEGAL, CORPORATE RESPONSIBILITY OR RESEARCH INTEGRITY STAFF. IF NECESSARY, A CONFLICT OF INTEREST MANAGEMENT PLAN IS DEVELOPED, WHICH PLAN SHALL BE SUBJECT TO ACCEPTANCE BY THE APPROPRIATE DIRECT MANAGER, SUPERVISOR, MEDICAL STAFF OFFICE, BOARD OR BOARD COMMITTEE (FOR BOARD, BOARD COMMITTEE, ELT OR CORPORATE OFFICER CONFLICTS), OR OTHER APPROPRIATE INDIVIDUAL OR BODY. ONCE ACCEPTED, THE CONFLICT OF INTEREST MANAGEMENT PLAN IS COMMUNICATED TO THE PERSON WITH THE ACTUAL OR POTENTIAL CONFLICT AND THE INDIVIDUAL MUST CONDUCT THEMSELVES IN CONFORMITY WITH THE PLAN. IN THE EVENT THAT A TRANSACTIONAL CONFLICT INTEREST ARISES IN CONNECTION WITH A SYSTEM ENTITY BOARD MEETING, THE CONFLICTED INDIVIDUAL MUST DISCLOSE THAT CONFLICT PRIOR TO OR AT THE BEGINNING OF THE MEETING IN WHICH THE MATTER IS TO BE CONSIDERED. THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE TRANSACTION AND IS PROHIBITED FROM USING PERSONAL INFLUENCE WITH RESPECT TO THE MATTER, BUT IS NOT PROHIBITED FROM PROVIDING INPUT IF REQUESTED TO DO SO.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt6FOR 2020 COMPENSATION, COMPENSATION LEVELS FOR THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL WERE ESTABLISHED BY THE RELATED ORGANIZATION, COMMONSPIRIT. COMMONSPIRIT 'S BOARD OF STEWARDSHIP TRUSTEES APPOINTS A HUMAN RESOURCES AND COMPENSATION COMMITTEE, COMPRISED OF EXCLUSIVELY INDEPENDENT DIRECTORS, WHO ARE ACCOUNTABLE FOR SETTING REASONABLE COMPENSATION PACKAGES FOR EACH OFFICER AND CERTAIN KEY EXECUTIVES (INCLUDING THE PRESIDENT/CEO). THE HUMAN RESOURCES AND COMPENSATION COMMITTEE APPROVES, CONSISTENT WITH THE ORGANIZATION'S PHILOSOPHY AND PRINCIPLES, THE ANNUAL PERFORMANCE GOALS AND CRITERIA TO BE USED IN DETERMINING MERIT INCREASES AND VARIABLE COMPENSATION CRITERIA FOR OFFICERS AND KEY EMPLOYEES. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ALSO ENGAGES OUTSIDE LEGAL COUNSEL AS NECESSARY AND QUALIFIED INDEPENDENT COMPENSATION AND BENEFITS SPECIALISTS (INDEPENDENT EXPERTS) TO REVIEW, ANALYZE AND PROVIDE BENCHMARKING DATA FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGES OF OFFICERS AND KEY EXECUTIVES. APPROPRIATE COMPARABLE DATA IS OBTAINED FROM THE INDEPENDENT EXPERTS, (E.G., TOTAL ECONOMIC BENEFITS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR SIMILAR JOB RESPONSIBILITIES). KEY DELIBERATIONS OF THE COMMITTEE ARE DOCUMENTED IN MEETING MINUTES WHICH ARE APPROVED AT THE NEXT COMMITTEE MEETING AND PROVIDED TO THE BOARD OF DIRECTORS. THE DOCUMENTATION OF THE DELIBERATIONS INCLUDES (A) THE TERMS OF THE AGREEMENT APPROVED AND THE DATE APPROVED; (B) THE MEMBERS OF THE COMMITTEE WHO WERE PRESENT DURING DISCUSSION OF THE APPROVED AGREEMENT AND THOSE WHO VOTED ON IT; AND (C) THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE COMMITTEE AND HOW THE DATA WAS OBTAINED.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt7FEDERAL TAX LAWS DO NOT MANDATE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS BE MADE AVAILABLE FOR PUBLIC INSPECTION. THE ORGANIZATION IS INCLUDED IN COMMONSPIRIT'S CONSOLIDATED FINANCIAL STATEMENTS WHICH ARE AVAILABLE ON COMMONSPIRIT'S WEBSITE AND UPON REQUEST.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PART III, LINE 3
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PART V, LINE 2A & 2B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PART VI, SECTION A, LINE 2
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3FORM 990, PART VI, SECTION A, LINE 7A
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4FORM 990, PART VI, SECTION B, LINE 11B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc5FORM 990, PART VI, SECTION B, LINE 12C
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc6FORM 990, PART VI, SECTION B, LINE 15
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc7FORM 990, PART VI, SECTION C, LINE 19
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