Civic Intelligence

Jane Phillips Health Care Foundation Inc

990 • Fiscal year 2014 • EIN 73-1250611

Jul 01, 2013 to Jun 30, 2014 • Filed on May 13, 2015

3500 E Frank Phillips Blvd74006

(918) 333-7200

Siviq Scores

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

Liabilities / Assets

96th percentile

1.65x

Higher debt load relative to assets than 96% of similar nonprofits.

2014 filings • 501(c)3 • <$500k nonprofits • Source year 2014

Liabilities / Revenue

92nd percentile

0.50x

Higher debt load relative to revenue than 92% of similar nonprofits.

2014 filings • 501(c)3 • <$500k nonprofits • Source year 2014

Net Margin

6th percentile

-72%

Higher net margin than 6% of similar nonprofits.

2014 filings • 501(c)3 • <$500k nonprofits • Source year 2014

Top Officer Pay

Score unavailable

No value available

This filing does not contain officer compensation rows.

Source year 2014

Asset Growth

5th percentile

-66%

Faster asset growth than 5% of similar nonprofits.

2014 filings • 501(c)3 • <$500k nonprofits • Annualized from 2013 to 2014

Revenue Growth

56th percentile

5.5%

Faster revenue growth than 56% of similar nonprofits.

2014 filings • 501(c)3 • <$500k nonprofits • Annualized from 2013 to 2014

Assets

Down

$143,118

Down $281,690 (-66%) from 2013

Net Assets

Down

-$93,166

Down $446,819 (-126%) from 2013

Liabilities

Up

$236,284

Up $165,129 (+232%) from 2013

Revenue

Up

$470,188

Up $24,567 (+5.5%) from 2013

Expenses

Down

$807,383

Down $511 (-0.1%) from 2013

Net Income

Up

-$337,195

Up $25,078 (+6.9%) from 2013

Historical Trend

Balance Sheet Trend

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

$800K$600K$400K$200K$0-$200KAssets 2011: $636,681Liabilities 2011: $409,058Net Assets 2011: $227,6232011Assets 2012: $488,146Liabilities 2012: $162,105Net Assets 2012: $326,0412012Assets 2013: $424,808Liabilities 2013: $71,155Net Assets 2013: $353,6532013Assets 2014: $143,118Liabilities 2014: $236,284Net Assets 2014: -$93,1662014

Highlighted filing

2014

Assets$143,118
Liabilities$236,284
Net Assets-$93,166

Operations Trend

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

$1.5M$1.0M$500K$0-$500K-$1.0MRevenue 2011: $821,838Expenses 2011: $1,353,571Net Income 2011: -$531,7332011Revenue 2012: $607,783Expenses 2012: $1,243,886Net Income 2012: -$636,1032012Revenue 2013: $445,621Expenses 2013: $807,894Net Income 2013: -$362,2732013Revenue 2014: $470,188Expenses 2014: $807,383Net Income 2014: -$337,1952014

Highlighted filing

2014

Revenue$470,188
Expenses$807,383
Net Income-$337,195
Jump To
Filing Snapshot
Filing Period
Jul 1, 2013 to Jun 30, 2014
Signed
May 13, 2015
Return Version
2013v4.0
Gross Receipts
$470,188
Mission and Program Overview

Mission

To provide medical excellence and compassionate care to all who need it.

Balance Sheet Detail
LineBeginningEndChange
Assets
Land, Buildings, and Equipment, Net$282,102--
Accounts Receivable$79,025$45,547▼ $33,478
Cash and Non-Interest-Bearing Accounts$10,404$42,982▲ $32,578
Other Notes and Loans Receivable, Net$32,617--
Inventories for Sale or Use$10,656--
Prepaid Expenses and Deferred Charges$10,004--
Total Assets$424,808$143,118▼ $281,690
Other Assets Total$0$54,589▲ $54,589
Liabilities
Other Liabilities$0$177,870▲ $177,870
Accounts Payable and Accrued Expenses$71,155$58,414▼ $12,741
Total Liabilities$71,155$236,284▲ $165,129
Net Assets / Fund Balance
Permanently Rstr Net Assets-$0-
Temporarily Rstr Net Assets-$0-
Unrestricted Net Assets$353,653$-93,166▼ $446,819
Total Net Assets Fund Balance$353,653$-93,166▼ $446,819
Total Liabilities and Net Assets / Fund Balance$424,808$143,118▼ $281,690

Asset Categories

AssetBook ValueDepreciationBasis
Other Assets Org$54,589--
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseOtherTotal
Janice ShippyNurse PractitionerFT$127,630$39,878$167,508

Board Members and Trustees

NameTitle
John B KaneChairperson
David StirePresident & COO
Charles BowermanVice Chairperson
Bill BeierschmittDirector
David SigmonDirector
Glenn BonnerDirector
H Michael MayDirector
Jean BloomfieldDirector
Joseph LeBlanc MDDirector
Robert BaughmanDirector
Robert KaneDirector
Stan DeFehr MDDirector
Charles AndersonDirector/VP OP
Kevin SteckSecretary/Corp. Resp. Off.
Lex AndersonTreasurer/Sr. VP & SJHS CFO
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$470,188
Investment Income
$0
Other Revenue
$0
Change in Net Assets
$-337,195
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$496,216
Other Expenses$311,167
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$400,712$3,632-$404,344
Occupancy$60,775--$60,775
Other Employee Benefits$45,513$1,053-$46,566
Office Expenses$41,908--$41,908
Fees for Services Other$22,388$18,824-$41,212
Insurance$27,679$8,913-$36,592
Depreciation Depletion$32,617--$32,617
Payroll Taxes$25,437$262-$25,699
All Other Expenses$21,214$208-$21,422
Information Technology$19,869--$19,869
Pension Plan Contributions$18,667$940-$19,607
Advertising$10,714--$10,714
Conferences and Meetings$2,584--$2,584
Travel$1,764--$1,764
Fees for Services Legal$554$31-$585
Other Expenses$124$0$0$124
Total Functional Expenses$773,520$33,863$0$807,383
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
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Other Liabilities$177,870
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 2

Many of the persons listed on Part VII have a "business relationship" with each other by virtue of employment by St. John Health System, Inc. related entities. John B. Kane, Officer and Director, and Robert Kane, Director, have a family relationship.

Form 990, Part VI, Section A, line 6

Jane Phillips Health Care Foundation, Inc. has a single corporate member, Jane Phillips Memorial Medical Center.

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

Jane Phillips Health Care Foundation, Inc. has a single corporate member, Jane Phillips Memorial Medical Center, who has the ability to elect members to the governing body of Jane Phillips Health Care Foundation, Inc.

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

All decisions that have a material impact to Jane Phillips Health Care Foundation, Inc.'s financial information or corporation as a whole are subject to approval by its sole corporate member, Jane Phillips Memorial Medical Center. Ascension Health, the sole corporate member of St. John Health System, Inc., has designated a system authority matrix which assigns authority for key decisions that are necessary in the operation of the System. Specific areas that are identified in the authority matrix are: new organizations and major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic and financial plans; assets; system policies and procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix.

Form 990, Part VI, Section B, line 11

Jane Phillips Health Care Foundation, Inc. (JPHCF) is an affiliate of St. John Health System, Inc. (SJHS). SJHS has hired a third party preparer experienced in the preparation of Form 990 to assist in the preparation of the return. The Executive Vice President/Chief Financial Officer and Controller of SJHS will work closely with the paid preparer in gathering the information for the return and will perform the initial detailed review of the return. The return will then be reviewed by the SJHS Audit Committee (as delegated by the Board of the filing organization). A copy of the return will be provided to all voting Board Members of the filing Organization prior to filing.

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

At every fiscal year end, St. John Health System, Inc. ("SJHS") distributes a copy of the current Conflict of Interest Policy and Procedure Bulletin, together with an explanation and questionnaire to the members of the Board of Directors, administrative officers and key employees of SJHS, its subsidiaries and affiliates, including Craig County Medical Services Corp. The Board Members, administrative officers and key employees of SJHS, its subsidiaries and affiliates must complete the questionnaire and return it to the designated SJHS official within two weeks of receipt. Completed questionnaires are reviewed and summarized by the Vice President, Corporate Compliance and Integrity, or his/her designee. That individual then presents the questionnaire results to the heads of each hospital for further provision to the various boards' Audit and Compliance Committees. The Audit and Compliance Committees, as appropriate, submit a confidential report to their Board Chairman summarizing the questionnaire results. The Board Chairman, as appropriate, may review with the Executive Committee the responses to the questionnaire results. Members of a committee with governing board delegated powers annually sign a statement which affirms such person has received a copy of the Conflict of Interest Policy, has read and understands the Policy, has agreed to comply with the Policy, and understands that the Organization is charitable and, in order to maintain its federal tax exemption, it must engage primarily in activities which accomplish its tax-exempt purpose.

Form 990, Part VI, Section B, line 15

Compensation for all executives in St. John Health System, Inc. (SJHS) of which Jane Phillips Health Care Foundation, Inc. is a part, is analyzed by an independent health care consulting firm. The analysis includes a fair market value assessment and establishment of a range for each position based on research of comparable health care systems of similar size. The report and recommended compensation levels for each executive management position is reviewed and approved by the Executive Compensation Committee of the SJHS Board of Directors.

Form 990, Part VI, Section C, line 19

The Organization will provide any documents open to public inspection upon request.

Form 990, Part VII, Section B:

Independent Contractor Reporting: Compensation of independent contractors is paid by and reported on the Form 1096, Annual Summary and Transmittal of U.S. Information Returns, of Jane Phillips Memorial Medical Center EIN 73-0606129. Expenses are allocated to and reimbursed by the filing organization to Jane Phillips Memorial Medical Center. As such, the organization has not reported independent contractors paid on Form 990, Part VII, Section B.

Filing and Contact Details

Filer

EIN
73-1250611
Phone
9183337200

Signing Officer

Name
Lex Anderson
Title
CFO
Phone
9183337200
Signed
2015-05-13
Discuss with paid preparer
Yes

Organization Details

Principal Officer
David Stire
Formed
1985
Legal Domicile
Ok
Voting Board Members
13
Independent Board Members
11
Employees
13
Volunteers
11

Preparer

Preparer
Alicia Janisch
Phone
5137847100
Supplemental Narrative

Additional Explanations

Form 990, Part I, Item C

DBA: Coffeyville Clinic

Form 990, Part III, line 3

Ownership of all assets, excluding accounts receiveable, has been 100% transferred to St. John Physicians, Inc.

Form 990, Part V, Line 2A:

Statements Regarding Other IRS Filings and Tax Compliance The salaries reflected on Form 990 were all reported on the Form 941 Employer's Quarterly Federal Tax Return of Jane Phillips Memorial Medical Center (JPMMC). These salaries were reimbursed to JPMMC by the filing organization and were included in the number of employees on JPMMC's calendar year 2013 Form W-3. The number of employees reported on Part V, Line 2a of Form 990 by the filing organization represents the number of employees providing services to the filing organization during calendar year 2013.

Form 990, Part XI, line 9:

Transfer to Affiliates -109,624.

Financial Statement Notes

Part X, Line 2:

From the consolidated audited financial statements of St. John Health System, Inc., which includes the activity of Jane Phillips Health Care Foundation, Inc.: The Health Ministry accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return.

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IRS990/Desc0Jane Phillips Health Care Foundation, Inc. ("the Clinic") operates an outpatient clinic providing medical care to the citizens of Southeastern Kansas and Northeastern Oklahoma. The Clinic is part of St. John Health System, Inc.St. John Health System, Inc. ("St. John"), and affiliates, own and operate a comprehensive tertiary health care delivery system which provides a full spectrum of health-related services throughout Northeastern Oklahoma. St. John, headquartered in Tulsa, Oklahoma, is a wholly-owned subsidiary of Ascension Health. St. John conducts its operations through several wholly-owned or wholly-controlled subsidiaries, including: St. John Medical Center, Inc. (the "Medical Center"), St. John Sapulpa, Inc. ("St. John Sapulpa"), Jane Phillips Memorial Medical Center ("Jane Phillips"), Utica Services, Inc. ("Utica"), St. John Villas, Inc. ("St. John Villas"), Owasso Medical Facility, Inc. ("St. John Owasso"), St. John Health System Foundation, Inc. ("St. John Foundation"), St. John Building Corporation ("SJBC"), and St. John Broken Arrow, Inc. ("St. John Broken Arrow"). St. John, these subsidiaries, and all other subsidiaries under St. John's direct or indirect control or ownership are referred to herein as "the St. John System."Mission and Values:As a Catholic healthcare organization, St. John carries on the mission of its sponsors, through Ascension Health, of continuing the healing ministry of Jesus Christ. It aspires to provide health care that works, health care that is safe, and health care that leaves no one behind, with a promise to our patients and the communities we serve of providing medical excellence and compassionate care. It operates in conformance with "the ethical and religious directives for Catholic health facilities." Faithful to the sponsorship mission, philosophy and values, St. John's mission is to provide healthcare and related ministries for the people served, especially the sick, the poor and the powerless. The board of directors, management and employees of St. John are guided in their day-to-day actions and interactions with those who serve and who are served by the values of service to the poor, wisdom, reverence, creativity, dedication and integrity.St. John and the Clinic collaborate with other individuals and institutions in the various communities it serves to ascertain community needs and provide a broad range of services along the healthcare continuum to help meet those needs. Programs and services include preventive, diagnostic, therapeutic and rehabilitative programs, including emphasis on health promotion and disease prevention. St. John also advocates for public policies which advance a healthy and just society. St. John works with local, state and national leaders and organizations to bring about a healthcare delivery system that provides dignified access to and affordable, high quality healthcare for all persons.Governance:The administrative powers of the Clinic are vested in its Board of Directors, which controls and manages the properties, affairs and funds of the Hospital, subject to reservation of certain powers by St. John. The Board meets when needed and it works in concert with and when appropriate under the direction of the St. John Health System, Inc. board.Community Benefit:In measuring and reporting quantifiable community benefit, St. John follows guidelines promulgated by the Catholic Health Association of the United States and endorsed by other organizations. Uncompensated care and other elements of community benefit are measured at the unreimbursed estimated cost of services or resources provided.The St. John System serves as an important safety net provider of a broad continuum of health care services to the citizens of Northeastern Oklahoma and the surrounding region. Each of its six main hospitals operates a full-service, 24-hour, 365-day emergency room providing both urgent and emergency care to all individuals, regardless of their ability to pay. The Medical C
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IRS990/Form990PartVIISectionAGrp/TitleTxt4Director
IRS990/Form990PartVIISectionAGrp/TitleTxt5Director
IRS990/Form990PartVIISectionAGrp/TitleTxt6Director
IRS990/Form990PartVIISectionAGrp/TitleTxt7Director
IRS990/Form990PartVIISectionAGrp/TitleTxt8Director
IRS990/Form990PartVIISectionAGrp/TitleTxt9Director
IRS990/Form990PartVIISectionAGrp/TitleTxt10Director
IRS990/Form990PartVIISectionAGrp/TitleTxt11Director
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IRS990/MissionDesc0Jane Phillips Health Care Foundation, Inc. is part of the Jane Phillips Health System. It is the mission of Jane Phillips Health System to provide healthcare and related ministries for the people served, especially the sick, the poor, and the powerless. Jane Phillips Health Care Foundation, Inc. is also part of the St. John Health System, Inc. St. John Health System, Inc.'s mission is to continue the healing ministry of Jesus Christ by providing medical excellence and compassionate care to all who need it with a special emphasis for the poor and powerless.
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IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt0From the consolidated audited financial statements of St. John Health System, Inc., which includes the activity of Jane Phillips Health Care Foundation, Inc.: The Health Ministry accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return.
IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc0Part X, Line 2:
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