Unknown Organization

990 • Fiscal year 2013 • EIN 48-0925688

Jan 01, 2013 to Dec 31, 2013 • Filed on Nov 11, 2014

Organization Profile www.providence-health.org

2480 w 26th aveSuite 200b80211

(913) 596-4000

Siviq Scores

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

0.01x

Higher debt load relative to assets than 20% of similar nonprofits.

2013 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2013

0.02x

Higher debt load relative to revenue than 27% of similar nonprofits.

2013 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2013

59%

Higher net margin than 93% of similar nonprofits.

2013 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2013

No value available

This filing does not contain officer compensation rows.

Source year 2013

22%

Faster asset growth than 84% of similar nonprofits.

2013 filings • 501(c)3 • $1M-$5M nonprofits • Annualized from 2012 to 2013

No value available

No earlier valid filing was available within the previous three public years.

Source year 2013

Balance Sheet

Liabilities / Assets20th percentile

Assets

$3,152,555

Up $561,712 (+22%) from 2012

Net Assets

$3,134,965

Up $592,767 (+23%) from 2012

Liabilities

Down

$17,590

Down $31,055 (-64%) from 2012

Revenue And Expenses

Liabilities / Revenue27th percentile Net Margin93rd percentile

Revenue

$800,965

No earlier filing loaded for comparison.

Expenses

Down

$326,393

Down $360,530 (-52%) from 2012

Net Income

$474,572

No earlier filing loaded for comparison.

Historical Trend

Balance Sheet Trend

Asset Growth84th percentile

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

Highlighted filing

2013

Assets$3,152,555

Liabilities$17,590

Net Assets$3,134,965

Open 2013 Filing

Operations Trend

Revenue GrowthScore unavailable

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

Highlighted filing

2013

Revenue$800,965

Expenses$326,393

Net Income$474,572

Open 2013 Filing

Jump To

Filing Snapshot

Filing Period: Jan 1, 2013 to Dec 31, 2013
Signed: Nov 11, 2014
Return Version: 2013v3.1
Gross Receipts: $831,014

Mission and Program Overview

Mission

We will, in the spirit of the sisters of charity, reveal god's healing love by improving the health of the individuals and communities we serve, especially those who are poor or vulnerable.

We will, in the spirit of the sisters of charity, reveal god's healing love by improving health of individuals and communites we serve, especially those who are poor or vulnerable.

Balance Sheet Detail

Line	Beginning	End	Change
Assets
Investments Other Securities	$2,149,460	$2,381,065	▲ $231,605
Cash and Non-Interest-Bearing Accounts	$125,570	$509,054	▲ $383,484
Pledges and Grants Receivable	$260,221	$258,343	▼ $1,878
Inventories for Sale or Use	$44,829	$0	▼ $44,829
Land, Buildings, and Equipment, Net	$7,044	$4,093	▼ $2,951
Prepaid Expenses and Deferred Charges	$3,719	$0	▼ $3,719
Savings and Temporary Cash Investments	$0	$0	→ $0
Accounts Receivable	$0	$0	→ $0
Other Notes and Loans Receivable, Net	$0	$0	→ $0
Receivable From Disqualified Prsn	$0	$0	→ $0
Receivables From Officers Etc	$0	$0	→ $0
Investments Program Related	$0	$0	→ $0
Investments in Publicly Traded Securities	$0	$0	→ $0
Intangible Assets	$0	$0	→ $0
Loans From Officers Directors	$0	$0	→ $0
Total Assets	$2,590,843	$3,152,555	▲ $561,712
Other Assets Total	$0	$0	→ $0
Liabilities
Accounts Payable and Accrued Expenses	$48,645	$17,590	▼ $31,055
Grants Payable	$0	$0	→ $0
Mortgage Notes Payable Secured by Investment Property	$0	$0	→ $0
Unsecured Notes Loans Payable	$0	$0	→ $0
Other Liabilities	$0	$0	→ $0
Deferred Revenue	$0	$0	→ $0
Escrow Account Liability	$0	$0	→ $0
Tax Exempt Bond Liabilities	$0	$0	→ $0
Total Liabilities	$48,645	$17,590	▼ $31,055
Net Assets / Fund Balance
Temporarily Rstr Net Assets	$1,581,337	$2,055,213	▲ $473,876
Unrestricted Net Assets	$-94,226	$754,035	▲ $848,261
Permanently Rstr Net Assets	$1,055,087	$325,717	▼ $729,370
Total Net Assets Fund Balance	$2,542,198	$3,134,965	▲ $592,767
Total Liabilities and Net Assets / Fund Balance	$2,590,843	$3,152,555	▲ $561,712

Asset Categories

Asset	Book Value	Depreciation	Basis
Equipment	$2,195	$15,542	$17,737
Leasehold Improvements	$1,498	$12,015	$13,513
Other Land Buildings	$400	$1,205	$1,605
Other Securities	$2,381,065	-	-

Endowment Activity

Period	Beginning	Contrib.	Gain/Loss	Other Uses	End
2013	$1,055,087	$25	▲ $54,333	$770,151	$328,679
2012	$948,384	$1,600	▲ $108,103	-	$1,055,087
2011	$926,607	$-47,868	▲ $69,645	-	$948,384
2010	$871,512	$3,900	▲ $88,300	$37,105	$926,607
2009	$736,128	$1,250	▲ $138,884	$4,750	$871,512

Compensation and Service Providers

Top Officer PayScore unavailable

Employees

Name	Title	Other	Total
Jimmy Lopez	Bd Member	$358,852	$358,852
Reverend Jimmie Banks	bd member	$125,383	$125,383

Board Members and Trustees

Name	Title
John Southard	Chair
Randy Nyp	President/CEO- Pmc
Greg Cotton	Vice Chair
Karla Kimerer	Executive Director
Adriana Martinez	bd member
Ann M Hoins	bd member
Bill Dunn III	bd member
Cynthia Caruthers	bd member
Diane Hentges	Bd Member
Irene Caudillo	bd member
Jane Sieve - Wilson	Bd Member
John N Vani MD	bd member
Leon Roberts	Bd Member
Lisa R Gonzales DDS	bd member
Manu Rattan	Bd Member
Sister Marianna Bauder	bd member
Steve Beaumont	bd member
Steve Kaaz	Bd Member
Vernon Mills Md	bd member
Mike Graft	Secretary
Adam Ehlert	Treasurer

Revenue and Support

Revenue Composition

Contributions and Grants: $675,420
Program Service Revenue: $0
Investment Income: $100,444
Other Revenue: $25,101
All Other Contributions: $662,920
Change in Net Assets: $474,572

Expenses and Functional Allocation

Major Expense Lines

Line Item	Amount
Other Expenses	$152,372
Grants and Similar Amounts Paid	$103,631
Total Fundraising Expense	$79,201
Salaries, Compensation, and Employee Benefits	$70,390
Professional Fundraising Fees	$0

Functional Expense Allocation

Line Item	Program	Management	Fundraising	Total
Office Expenses	$33,792	$50,688	$50,688	$135,168
Other Salaries and Wages	$14,434	$21,650	$21,650	$57,734
Grants to Domestic Individuals	$55,226	-	-	$55,226
Grants to Domestic Orgs	$48,405	-	-	$48,405
Other Employee Benefits	$3,164	$4,746	$4,746	$12,656
Fees for Services Other	$1,411	$2,117	$2,117	$5,645
Fees for Services Accounting	-	$4,810	-	$4,810
Depreciation Depletion	-	$2,951	-	$2,951
Travel	-	$1,912	-	$1,912
Other Expenses	$683	$683	-	$1,366
Conferences and Meetings	-	$520	-	$520
Total Functional Expenses	$157,115	$90,077	$79,201	$326,393

International Activity

Grant and Assistance Recipients

Recipient	Location	Category	Purpose	Amount
26-0810345	-	501(c)(3)	Support Medical Care for Trainer	$39,294

Fundraising, Events, and Gaming

Fundraising activities: No
Gaming activities: No
Professional fundraiser used: No

Fundraising and Gaming Totals

Line Item	Amount
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 Item	Beginning	End	Change
Loans from Officers, Directors, Trustees, and Key Employees	$0	$0	→ $0
Receivables from Disqualified Persons	$0	$0	→ $0
Receivables from Officers, Directors, Trustees, and Key Employees	$0	$0	→ $0

Related Organizations and Partnerships

Related Tax-Exempt Organizations

Organization	Location	Activity	Code	Public Charity	Controlled
23-7379161	-	Management	501(c)(3)	11b-type Ii	No
48-1009910	-	Clinic Svcs	501(c)(3)	3	Yes
48-1046905	-	Clinic Svcs	501(c)(3)	3	Yes
84-1085822	-	Clinic Svcs	501(c)(3)	3	Yes
48-0784446	-	Hospital Svcs	501(c)(3)	3	Yes
48-0543768	-	Hospital Svcs	501(c)(3)	3	Yes
48-0547719	-	Hospital Svcs	501(c)(3)	3	Yes
48-1092520	-	Support Organ	501(c)(3)	11a-type I	Yes
84-0425720	-	Hospital Svcs	501(c)(3)	3	Yes
23-7001007	-	Support Organ	501(c)(3)	11a-type I	Yes
84-0735096	-	Support Organ	501(c)(3)	11a-type I	Yes
81-0231792	-	Hospital Svcs	501(c)(3)	3	Yes
20-2270238	-	Support Organ	501(c)(3)	11a-type I	Yes
81-0232124	-	Hospital Svcs	501(c)(3)	3	Yes
81-0468034	-	Support 501c3	501(c)(3)	7	Yes
81-0231785	-	Hospital Svcs	501(c)(3)	3	Yes
65-1202190	-	Support 501c3	501(c)(3)	11a-type I	Yes
95-1684082	-	Hospital Svcs	501(c)(3)	3	Yes
95-4291515	-	Cancer R&d	501(c)(3)	4	Yes
95-6100079	-	Support 501c3	501(c)(3)	7	Yes
84-1103606	-	Hospital Svcs	501(c)(3)	3	Yes
20-8846152	-	Support 501c3	501(c)(3)	7	Yes
84-1649162	-	Support 501c3	501(c)(3)	7	Yes
74-2571584	-	Insurance	501(c)(3)	11a-type I	Yes
84-0405260	-	Res Care	501(c)(3)	11a-type I	Yes
84-0417134	-	Hospital Svcs	501(c)(3)	3	Yes
48-1207407	-	Healthcare	501(c)(3)	3	Yes

Related Partnerships and Joint Ventures

Organization	Location	Activity	Income	Assets	Ownership	Managing Partner
03-0516198	-	Radiology	$0	$0	0%	-
84-1238904	-	Mgmt Service	$0	$0	0%	-
20-2856331	-	Op Cancer	$0	$0	0%	-
81-0491356	-	Rental Real Estat	$0	$0	0%	-
02-0749532	-	Op Surgery	$0	$0	0%	-
20-8038915	-	Op Surgery	$0	$0	0%	-
20-8038977	-	Op Surgery	$0	$0	0%	-
46-0788218	-	Op Endoscopy	$0	$0	0%	-
72-1519467	-	Op Surgery	$0	$0	0%	-
27-2270640	-	Physical Therapy	$0	$0	0%	-
95-3974903	-	Rental Real Estat	$0	$0	0%	-
95-3983096	-	Rental Real Estat	$0	$0	0%	-
46-2418729	-	Home Care	$0	$0	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 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

Filing and Contact Details

Filer

EIN: 48-0925688
In Care Of: % SHARON OWENS
Phone: 9135964000

Signing Officer

Name: Lydia Jumonville
Title: CFO/SVP
Phone: 9135964835
Signed: 2014-11-11
Discuss with paid preparer: Yes

Organization Details

Principal Officer: Lydia Jumonville
Formed: 1981
Legal Domicile: Ks
Voting Board Members: 21
Independent Board Members: 21
Employees: 0
Volunteers: 207

Preparer

Preparer: Bruce E Bernstien
Phone: 9135964835

Supplemental Narrative

Additional Explanations

Governing Body and Managment

“Form 990, part vi, lines 6, 7a-b providence medical center is the sole corporate member of the foundation. Providence medical center has the power to elect board members and approve decisions of the governing body.”

Review of Form 990

“FORM 990 PART VI, SECTION B, LINE 11b THE FORM 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. IT IS THEN REVIEWED BY THE FINANCIAL SERVICES GROUP AT THE SISTERS OF CHARITY LEAVENWORTH HEALTH SYSTEM. THE BOARD OF DIRECTORS OF THE FOUNDATION IS NOT AVAILABLE IN 2014 TO BE PROVIDED THE FORM 990 AS THE FOUNDATION WAS DISSOLVED IN 2014.”

Conflict of Interest Policy

“Form 990, part vi, section b, line 12c conflict of interest enforcement: conflict of interest forms are sent out annually to all board members and key employees. Receipt of the signed forms are tracked and provided to the ceo for review.”

Policy on Making Governing Doc & Financial Stmt Avaliable to the Public

“FORM 990, PART VI, SECTION C, LINE 19 SCLHS' governance manual for board members and its affiliate board members is available to the Public on the website, www.GreatBoards.org. The manual sets forth the standards and expectations of each board member including the fiduciary duty of loyalty which requires that each member abide by SCLHS' conflict of interest policy, disclose any issues which may present a conflict, complete the annual disclosure statement, review policies and procedures pertaining to conflicts of interest, and provide oversight of SCLHS' responsibility program. Providence Saint John Foundation's unaudited financial statements are not available to the public.”

FORM 990, PART XI, LINE 9:

“Uncollectiable fundraising revenue ($4,642) net assets released from restriction ($4,873) unristicted funding ($3,493) misc changes in grants $43 total ($12,965)”

Financial Statement Notes

Intended uses of the organization'S endowment funds

“Retained endowment funds are intended to support indigent care, provide nursing scholarships, and to be used for the general support of the hospital at the discretion of the board.”

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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/Desc	0	IT IS THE PHILOSOPHY OF THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. AND AFFILIATED HOSPITALS TO TREAT PATIENTS IN A NON-DISCRIMINATORY MANNER, MINIMIZE HUMAN SUFFERING AS MUCH AS POSSIBLE, CREATE A PREFERENTIAL OPTION FOR THE POOR AND PROVIDE ASSISTANCE TO THOSE PATIENTS WHO HAVE LIMITED FINANCIAL RESOURCES. THE HOSPITAL PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMS AND AS SUCH PROVIDES CARE AT REIMBURSEMENT LEVELS LOWER THAN CHARGES. PROVIDENCE/SAINT JOHN FOUNDATION, INC. PROVIDES FUNDS FOR HEALTH-RELATED SERVICES THROUGH RELATED NON-PROFIT HOSPITALS INCLUDED IN THE HOSPITAL MISSION IS SERVICE TO the COMMUNITY in WHICH IT OPERATES. TO THAT END, THE HOSPITAL HAS INSTITUTED AND PARTICIPATES IN THE FOLLOWING COMMUNITY BENEFIT ACTIVITIES; PROVIDES LABORATORY, RADIOLOGICAL, AND PHARMACEUTICAL SERVICE AT DUCHESNE CLINIC. DUCHESNE CLINIC IS A CLINIC FOR THE CARE OF THE MEDICALLY INDIGENT. COMMUNITY HEALTH SERVICES PROVIDED AT MINIMAL OR NO CHARGE: CHOLESTERAL SCREENING, BLOOD SUGAR SCREENING, SIBLING PREPARATION, LAMAZE CHILDBIRTH CLASSES, CANcER SUPPORT GROUP, STROKE SUPPORT GROUP, BREAST FEEDING SUPPORT, HEARING SCREENING, CESAREAN BIRTH CLASSES, FREEDOM FROM SMOKING, COLORECTAL SCREENING, NUTRITIONAL COUNSELING, HOSPITAL CARE, INPATIENT DAYS OF CARE, INPATIENT ADMISSIONS, NEWBORN DELIVERIES, OUTPATIENT REGISTRATIONS, EMERGENCY ROOM VISITS, CLINIC VISITS.
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Filings

Displayed year

2013 • Form 990Detailed filing. Detailed filing data is available for this year.

Open filing

Assets: $3,152,555
Liabilities: $17,590
Net assets: $3,134,965
Revenue: $800,965
Expenses: $326,393
Net income: $474,572

	Balance Sheet			Operations
Year	Assets	Liabilities	Net Assets	Revenue	Expenses	Net Income
2013Detailed filing. Detailed filing data is available for this year.	$3.15	$0.02	$3.13	$0.80	$0.33	$0.47
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.	$2.59	$0.05	$2.54		$0.69
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.	$2.49	$0.06	$2.43		$0.77
2010Facts available. Structured filing facts are available, but richer extracted sections are limited.	$2.98	$0.05	$2.92		$0.67