Civic Intelligence

Providence Trinitycare Hospice Foundation

990 • Fiscal year 2016 • EIN 33-0261016

Jan 01, 2016 to Dec 31, 2016 • Filed on Nov 10, 2017

5315 Torrance Blvd No B1Torrance, CA 90503

(310) 543-3440

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

18th percentile

0.02x

Higher debt load relative to assets than 18% of similar nonprofits.

2016 filings • 501(c)3 • $10M-$25M nonprofits • Source year 2016

Liabilities / Revenue

23rd percentile

0.08x

Higher debt load relative to revenue than 23% of similar nonprofits.

2016 filings • 501(c)3 • $10M-$25M nonprofits • Source year 2016

Net Margin

9th percentile

-31%

Higher net margin than 9% of similar nonprofits.

2016 filings • 501(c)3 • $10M-$25M nonprofits • Source year 2016

Top Officer Pay

96th percentile

$928,908

Higher top officer pay than 96% of similar nonprofits.

Top officer pay equals 32.6% of source-year revenue.

2016 filings • 501(c)3 • $10M-$25M nonprofits • Source year 2016

Asset Growth

16th percentile

-5.5%

Faster asset growth than 16% of similar nonprofits.

2016 filings • 501(c)3 • $10M-$25M nonprofits • Annualized from 2015 to 2016

Revenue Growth

7th percentile

-42%

Faster revenue growth than 7% of similar nonprofits.

2016 filings • 501(c)3 • $10M-$25M nonprofits • Annualized from 2015 to 2016

Assets

Down

$10,070,416

Down $581,430 (-5.5%) from 2015

Net Assets

Down

$9,845,749

Down $610,851 (-5.8%) from 2015

Liabilities

Up

$224,667

Up $29,421 (+15%) from 2015

Revenue

Down

$2,851,472

Down $2,027,826 (-42%) from 2015

Expenses

Up

$3,741,570

Up $1,118,001 (+43%) from 2015

Net Income

Down

-$890,098

Down $3,145,827 (-139%) from 2015

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$20M$15M$10M$5.0M$0Assets 2011: $5,852,714Liabilities 2011: $342,203Net Assets 2011: $5,510,5112011Assets 2012: $6,837,777Liabilities 2012: $517,151Net Assets 2012: $6,320,6262012Assets 2014: $8,743,417Liabilities 2014: $153,558Net Assets 2014: $8,589,8592014Assets 2015: $10,651,846Liabilities 2015: $195,246Net Assets 2015: $10,456,6002015Assets 2016: $10,070,416Liabilities 2016: $224,667Net Assets 2016: $9,845,7492016Assets 2018: $11,856,924Liabilities 2018: $4,280Net Assets 2018: $11,852,6442018Assets 2021: $15,729,740Liabilities 2021: $19,070Net Assets 2021: $15,710,6702021Assets 2022: $15,448,892Liabilities 2022: $25,329Net Assets 2022: $15,423,5632022Assets 2024: $17,692,583Liabilities 2024: $30,522Net Assets 2024: $17,662,0612024

Highlighted filing

2016

Assets$10,070,416
Liabilities$224,667
Net Assets$9,845,749

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$10M$5.0M$0-$5.0MExpenses 2011: $1,699,6832011Expenses 2012: $1,323,7432012Revenue 2014: $3,479,888Expenses 2014: $1,550,965Net Income 2014: $1,928,9232014Revenue 2015: $4,879,298Expenses 2015: $2,623,569Net Income 2015: $2,255,7292015Revenue 2016: $2,851,472Expenses 2016: $3,741,570Net Income 2016: -$890,0982016Revenue 2018: $3,122,743Expenses 2018: $3,795,569Net Income 2018: -$672,8262018Revenue 2021: $2,314,489Expenses 2021: $3,713,418Net Income 2021: -$1,398,9292021Revenue 2022: $4,542,665Expenses 2022: $3,279,701Net Income 2022: $1,262,9642022Revenue 2024: $6,810,071Expenses 2024: $6,095,999Net Income 2024: $714,0722024

Highlighted filing

2016

Revenue$2,851,472
Expenses$3,741,570
Net Income-$890,098
Jump To
Filing Snapshot
Filing Period
Jan 1, 2016 to Dec 31, 2016
Signed
Nov 10, 2017
Return Version
2016v3.0
Gross Receipts
$9,664,345
Mission and Program Overview

Mission

As People of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.Support Providence TrinityCare Hospice in Torrance, CA.

Support Providence TrinityCare Hospice in Torrance, CA.

Balance Sheet Detail
LineBeginningEndChange
Assets
Investments in Publicly Traded Securities$7,603,552$8,852,946▲ $1,249,394
Pledges and Grants Receivable$1,462,578$723,958▼ $738,620
Savings and Temporary Cash Investments$1,251,716$434,512▼ $817,204
Accounts Receivable$334,000$59,000▼ $275,000
Land, Buildings, and Equipment, Net$0$0→ $0
Total Assets$10,651,846$10,070,416▼ $581,430
Liabilities
Other Liabilities$183,830$202,450▲ $18,620
Accounts Payable and Accrued Expenses$11,416$22,217▲ $10,801
Total Liabilities$195,246$224,667▲ $29,421
Net Assets / Fund Balance
Unrestricted Net Assets$4,434,009$4,039,593▼ $394,416
Temporarily Rstr Net Assets$4,487,790$3,828,986▼ $658,804
Permanently Rstr Net Assets$1,534,801$1,977,170▲ $442,369
Total Net Assets Fund Balance$10,456,600$9,845,749▼ $610,851
Total Liabilities and Net Assets / Fund Balance$10,651,846$10,070,416▼ $581,430

Asset Categories

AssetBook ValueDepreciationBasis
Equipment$0$10,510$10,510

Endowment Activity

PeriodBeginningContrib.Gain/LossOther UsesEnd
2016$4,044,739$1,462,782▲ $512,134-$4,781,271
2015$2,264,739$2,062,000▼ $280,000-$4,044,739
2014$1,965,932$133,176▲ $165,631-$2,264,739
2013$1,664,338$50,000▲ $290,626-$1,965,932
2012$1,328,772$55,000▲ $280,566-$1,664,338
Compensation and Service Providers

Board Members and Trustees

NameTitle
James A ZappChair
Patricia Modrzejewski-Thru 716President
Susan Dolbert - Eff 816President
John KirkVice Chair
Scott SharpeVice President
Jim SalaDirector
Lynn TaylorDirector
Michael ClarkDirector
Suzi GulcherDirector
Tom SullivanDirector
Barbara Roberts - Thru 116Executive Director
Ben Chandler - Eff 216Executive Director
Robert HellrigelCorporate Member
Marcia PotterSecretary
Gary KuwaharaTreasurer
Revenue and Support

Revenue Composition

Contributions and Grants
$2,618,586
Program Service Revenue
$0
Investment Income
$232,886
Other Revenue
$0
All Other Contributions
$1,473,275
Change in Net Assets
$-890,098
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Grants and Similar Amounts Paid$2,434,011
Salaries, Compensation, and Employee Benefits$944,468
Total Fundraising Expense$795,627
Other Expenses$344,316
Professional Fundraising Fees$18,775

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Grants to Domestic Orgs$2,432,322--$2,432,322
Other Salaries and Wages-$226,397$348,596$574,993
Current Officers, Directors, Trustees, and Key Employees-$91,705$128,556$220,261
Other Employee Benefits-$38,171$57,256$95,427
Fees for Service Investment Mgmnt Fees-$87,598-$87,598
Payroll Taxes-$21,515$32,272$53,787
Fees for Services Other-$3,883$46,288$50,171
Conferences and Meetings-$3,304$37,609$40,913
Office Expenses-$12,402$18,603$31,005
Fees for Services Professional Fundraising--$18,775$18,775
Information Technology--$17,833$17,833
Travel--$17,535$17,535
Fees for Services Legal-$10,510$1,161$11,671
Other Expenses-$866$909$1,775
Grants to Domestic Individuals$1,689--$1,689
Total Functional Expenses$2,434,011$511,932$795,627$3,741,570
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
Providence TrinityCare HospiceTorrance, CA501(c)(3)Support Operations$2,432,322
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
Yes

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$18,775
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Due to Affiliates$202,450
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
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
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, line 6

Providence TrinityCare Hospice is the sole Corporate Member.

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

The powers of the Corporate Member include the provision to approve the number of Trustees if less than 7 or greater than 20, appoint Board of Trustees of the Foundation, and to remove such Trustees at any time with or without cause.

Form 990, Part VI, Section A, line 7B

The following powers are reserved exclusively to the Corporate Member: A) To adopt and amend the Articles of Incorporation and the By laws of the Foundation after consultation with the Foundation Board of Trustees. B) To approve the merger, consolidation, or affiliation of the Foundation with another corporation, organization or program, or the dissolution of the Foundation. C) To approve any strategic plan of the Foundation. D) To approve the annual fundraising plan including special events, annual, capital and planned giving activities. E) To approve the acceptance of any gift that carries conditions or limitations or any gift restricted to services, programs or facilities not currently offered or approved to be offered by the Corporate Member's Board of Directors.

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

The Form 990 is prepared internally by experienced Providence Health & Services staff and reviewed by the internal PH&S Director of Taxes and external tax advisors. The Board of Directors reviewed the Form 990 prior to filing with the IRS.

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

All employees and Trustees are required to review and sign the Providence Health & Services Conflict of Interest Disclosure statement. This statement indicates that they have received a copy of Providence's policies on confidentiality and conflict of interest. This form is re-reviewed and re-signed each year and the forms are kept on file in the Foundation's offices. Questions about conflict of interest are first brought to the Corporate Member of the Board of Trustees. Further questions would be brought to the Hospice Operating Board of Directors for resolution.

Form 990, Part VI, Section B, line 15

It is Providence's intention to make financial information accessible and transparent. Although the filing of Form 990 provides insight into how Providence 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 has a single fiduciary Board, with responsibility for financial oversight associated with fulfillment of the Providence Mission, developing system policies, protecting the assets entrusted to the organization and overseeing the strategic and operational affairs of Providence's legal entities. Providence also maintains a network of community ministry boards with responsibility for quality of care oversight, community relations, advocacy and community needs assessments. Providence 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 and approved by the full Board of Directors, none of whom is a Providence employee. 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 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. Additionally, Providence's labor market continues to spread across health care and into general industry. Because of this, Providence also takes into consideration general industry for-profit market data, where applicable. Base salaries for Providence executives are generally targeted to the median level of the market, as identified by the independent consultant and reviewed with the Executive Compensation Committee. Performance incentives allow executives to earn additional compensation if they achieve specific organizational goals for furthering Providence operating commitments and strategic objectives. The Board of Directors conducts a thorough 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 Foundation Executive Director is compensated by a related organization which uses a market based compensation program utilizing several independent third party compensation market surveys to establish pay ranges for the position. The related organization then establishes the individual rate of pay within the range based on relevant experience, skills and competencies. The rate offered to the Executive Director at the time of hire was determined through discussion between the Regional CEO, Regional Director of HR and the Administrative Director of HR. The ranges and rate of pay are reviewed on an annual basis by Regional HR.

Form 990, Part VI, Section C, line 19

Public disclosure of governing documents, conflict of interest policy and 990 filings are made available to the public upon request. The consolidated financial statements are available on our public Internet site www2.providence.org. All governing policies including the conflict of interest policy, as well as 990 filings are available to employees on the Intranet site.

Form 990, Part VII Contact Addresses for Officers, Directors, Etc

Robert Hellrigel - 1801 Lind Avenue SW, #9016, Renton, WA 98057.

Filing and Contact Details

Filer

Filer Name
Providence TrinityCare Hospice
EIN
33-0261016
Phone
3105433440
Address
5315 Torrance Blvd No B1, Torrance, CA 90503

Signing Officer

Name
Susan Dolbert
Title
President
Phone
8188473024
Signed
2017-11-10
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Ben Chandler
Formed
1987
Legal Domicile
CA
Voting Board Members
12
Independent Board Members
10
Employees
0
Volunteers
100

Preparer

Firm
Clark Nuber PS
Address
10900 NE 4th Suite 1400, Bellevue, WA 98004
Preparer
Sara Elizabeth J Hyre CPA
Phone
4254544919
Supplemental Narrative

Additional Explanations

Form 990, Part XI, line 9:

Rounding -2.

Form 990, Part XII, Line 2C - Audit & Compliance

The Providence Health & Services Audit and Compliance Committee assists the Board of Directors with the oversight of the integrity of the financial statements and reporting, the audit process and the internal financial controls and policies; compliance with ethical, legal and regulatory standards and requirements; the independence, qualifications and performance of the internal and external auditors; and informs the Board of Directors of critical risk areas and recommended mitigation.

Form 990, Part I, Line 5 & Part V, Line 2A - Employee Compensation

The employees working at the Foundation are paid by Providence Health System - Southern California - EIN# 51-0216589. Therefore, no W-2s are issued by the reporting organization.

Form 990, Part I, Line 6 - Volunteers

The volunteers for Providence TrinityCare Hospice Foundation provide an array of services and are involved in all aspects of planning and executing our special events, as well as assisting in day-to-day office projects. These services include: paper product preparation and coordination; mailing coordination; event registration, event set-up; event break-down and clean-up; auction item procurement and preparation; auction coordination and execution at special events; office filing and information packet assembly.

Form 990, Schedule R - Related Organizations

AFFILIATION AGREEMENTS Effective April 1, 2016, the Health System (Providence Health & Services) entered into a business combination agreement with the Institute for Systems Biology (ISB). The transaction was accounted for as an acquisition under ASC 958-805. On July 1, 2016, Providence Health & Services (PHS) and St. Joseph Health System (SJHS) entered into a business combination agreement, the purpose of which was to better serve both organizations' communities, maintain strong traditions of Catholic healthcare, and provide greater affordability and access to healthcare services. As part of the business combination, PHS and SJHS aligned under a single parent corporation, Providence St. Joseph Health, with a consolidated board of directors and cosponsorship from the public juridic persons Providence Ministries and St. Joseph Health Ministry. SJHS provides a full range of care facilities including 16 acute care hospitals, home health agencies, hospice care, outpatient services, skilled nursing facilities, community clinics, and physician groups spanning California, west Texas, and eastern New Mexico. The results of operations of these entities have been included in the combined statements of operations of the Health System since July 1, 2016, the effective date of the business combination.

Financial Statement Notes

Part V, Line 4:

The quasi-endowment funds are to be used for any purpose the Board designates within the charitable purposes of the organization. Investment income from the two permanently restricted funds have been restricted by the donors to be used towards The Gathering Place and for areas the Foundation deems to have the greatest need.

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This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

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IRS990/Form990PartVIISectionAGrp/PersonNm10Scott Sharpe
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IRS990/Form990PartVIISectionAGrp/PersonNm12Lynn Taylor
IRS990/Form990PartVIISectionAGrp/PersonNm13Barbara Roberts - Thru 116
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IRS990/MissionDesc0As People of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.Support Providence TrinityCare Hospice in Torrance, CA.
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IRS990/ProgSrvcAccomActy2Grp/Desc0Providence Institute for Human Caring - In 2014 Providence Institute for Human Caring was established as a program of Providence TrinityCare Hospice. The focus is on making Whole Person Care the new normal by, 1) Sharing expertise and best practices among our clinicians, 2) Offering educational programs for our clinicians and those from other health care providers, 3) Increasing training and support services among community organizations, 4) Supporting and accelerating community-based care through educational forums, 5) Elevating the importance of this issue nationally through news media, academic publications, and live presentations before both professional and public audiences, 6) Improving patient satisfaction, and 7) Improving family, caregiver and clinician well-being and satisfaction. Funding from the Foundation supports the operation of this program through the ministry.
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IRS990/ProgSrvcAccomActy3Grp/Desc0Palliative Care Program The outpatient and in-home palliative care programs offer care from an interdisciplinary palliative care-trained team from the time of diagnosis to cure and survivorship or to hospice and death. The team includes a physician, nurse practitioner, RN, social worker and chaplain working in close collaboration with the patient's curative medical team (medical oncologist, radiation oncologist, surgeon, primary care physician etc.) Not only does the team provide services as described by established national guidelines and standards, but their paradigm of care is broadened by embracing a richer scope of care entitled "Whole Person Care." This practice results in patients and families feeling like collaborative partners in their illness experience; with aligned goals, more support and caring, and health care providers experiencing greater job satisfaction while providing higher quality care.Funding from the Foundation supports the operation of this program through the ministry.
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IRS990/ProgSrvcAccomActyOtherGrp/Desc0Call Center Development - Funds provided by the Foundation supported developing a 24/7 Call Center process enabling Providence TrinityCare to grow in both breadth of services and volume by centralizing calls from patients, families, referral sources and physicians for hospice and outpatient palliative care programs. The funds for this one-year transfer were used to create a plan under the management of a project manager, train staff on the Electronic Health Record systems and test and implement the processes to assure the highest quality, compassionate care at the point of service for even more patients and families.
IRS990/ProgSrvcAccomActyOtherGrp/Desc1Patient Care Assistance (Charity Care), Necessities of Life, Bereavement and Volunteer Services - No one is ever turned away from TrinityCare Hospice due to an inability to pay or lack of insurance. For these patients, and for those who are underinsured, the Foundation provides assistance to make any and all of our hospice services available. 26 individuals were provided complete charity care support through the provision of hospice care and bereavement follow-up for their bereaved loved ones. Another 135 patients and families were assisted through Necessities of Life philanthropic support for needs such as groceries, diapers, and household supplies. 2,907 families were followed for 13 months through bereavement support and education provided by social workers, social work interns and highly trained volunteers. More than 100 individuals volunteered in 2016 with patients and families to provide companionship; run errands; lead Legacy Art projects; play and write music; transport families in the TrinityKids Care van; serve as "standardized patients; and deliver special Veterans' Day cupcakes to cheer and thank veterans for their service. During the holidays, 46 families received gifts, clothing, and household goods donated by caring community members.
IRS990/ProgSrvcAccomActyOtherGrp/Desc2The Gathering Place A center for loss of life and life transitions, offering counseling to those in the community who have suffered the death of a loved one from any cause. It is staffed by licensed professionals, graduate-level mental health interns and trained volunteers. The Gathering Place serves children ages 5 through adults - whether or not their loved one was on our hospice service. In 2016, the program provided services to 245 bereaved community members, who received services that included one-on-one supportive education, and participation in 14 nine-week long support groups to help these individuals through the grieving process. Additionally, The Gathering Place assists at times of tragic loss in the local South Bay community as requested by schools, police and fire departments. Funding from the Foundation supports the oepration of this program through the ministry.
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