FURP.ORG / PUBLIC DATA EXPLORER

DIVINE PROVIDENCE COMMUNITY HOME: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
DIVINE PROVIDENCE COMMUNITY HOME (EIN 41-0839343)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-02
IRS object ID
201321229349300702
Schema version
2011v1.5
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-05-02T07:27:31-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN450250958EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1800 NICOLLET MALL STE 1300AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code554027033ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN410839343EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1DIVINE PROVIDENCE COMMUNITY HOMEBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlDIVINameControl
Phone5077943011Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1700 3RD AVENUE NWAddressLine1
CitySLEEPY EYECity
StateMNState
ZIP Code560851036ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJAYNA GROEBNERName
TitleADMINISTRATORTitle
Phone5077943011Phone
Date Signed2013-04-16DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKIM HUNWARDSEN CPAName
PTINP00484560PTIN
Phone6122536500Phone
Date Prepared2013-04-18DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJAYNA GROEBNERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1700 3RD AVENUE NWAddressLine1
CitySLEEPY EYECity
StateMNState
ZIP Code560851036ZIPCode
FieldValueIRS element (for citing)
Gross Receipts3807218GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1960YearFormation
State Legal DomicileMNStateLegalDomicile
Activity Or Mission DescriptionRELIGIOUS ORGANIZATION WHOSE PURPOSE IS THE CARE OF THE AGED AND PHYSICALLY IMPAIRED BY PROVIDING PROFESSIONAL CARE AT THE HIGHEST LEVEL.ActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees141TotalNbrEmployees
Total Nbr Volunteers6TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year48058ContributionsGrantsPriorYear
Contributions Grants Current Year21702ContributionsGrantsCurrentYear
Program Service Revenue Prior Year3853679ProgramServiceRevenuePriorYear
Program Service Revenue CY3747713ProgramServiceRevenueCY
Investment Income Prior Year19456InvestmentIncomePriorYear
Investment Income Current Year16281InvestmentIncomeCurrentYear
Other Revenue Prior Year13341OtherRevenuePriorYear
Other Revenue Current Year13903OtherRevenueCurrentYear
Total Revenue Prior Year3934534TotalRevenuePriorYear
Total Revenue Current Year3799599TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year7710GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY4082GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year2147705SalariesEtcPriorYear
Salaries Etc Current Year2195175SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year791TotalFundrsngExpCurrentYear
Other Expense Prior Year1371357OtherExpensePriorYear
Other Expenses Current Year1322946OtherExpensesCurrentYear
Total Expenses Prior Year3526772TotalExpensesPriorYear
Total Expenses Current Year3522203TotalExpensesCurrentYear
Revenues Less Expenses Prior Year407762RevenuesLessExpensesPriorYear
Revenues Less Expenses CY277396RevenuesLessExpensesCY
Total Assets BOY2111094TotalAssetsBOY
Total Assets EOY2379042TotalAssetsEOY
Total Liabilities BOY236359TotalLiabilitiesBOY
Total Liabilities EOY230456TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1874735NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2148586NetAssetsOrFundBalancesEOY
Mission DescriptionRELIGIOUS ORGANIZATION WHOSE PURPOSE IS THE CARE OF THE AGED AND PHYSICALLY IMPAIRED BY PROVIDING PROFESSIONAL CARE AT THE HIGHEST LEVEL.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense3243060Expense
Grants4082Grants
Revenue3747713Revenue
DescriptionDIVINE PROVIDENCE PROVIDES SERVICES TO SENIORS BY CREATING A HAVEN OF CHRISTIAN LOVE AND COMMITMENT THAT SPEAKS LOUDLY OF THE DIGNITY OF LIFE. THE 58 BED NURSING HOME PROVIDED 20,775 DAYS OF RESIDENT CARE. THIS INCLUDES PROFESSIONAL NURSING CARE, COORDINATED REHABILITATION SERVICES, DAILY MASS AND ROSARY, WEEKLY PROTESTANT SERVICES, NUTRITIOUS MEALS, AND ENGAGING ACTIVITIES. THE 21 SENIOR LIVING APARTMENTS PROVIDED HOUSING SERVICES FOR 25 TENANTS. THE PURPOSE IS TO HELP SENIORS WHO ARE CONTINUING LIFE'S JOURNEY WITH THE HELP OF FAMILY, FRIENDS, AND PROFESSIONALS IN ALL AREAS OF LONG TERM CARE.Description
Total Program Service Expense3243060TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling1CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10964NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees141NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMNStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JAYNA GROEBNERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5077943011TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1700 THIRD AVENUE NWAddressLine1
CitySLEEPY EYECity
StateMNState
ZIP Code560851036ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (6 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
SR RITA BUTLER
PRESIDENT40.00XX000
SR BERNADINE UGOLINI
VICE PRESIDENT40.00XX000
SR PATRICIA MCCAFFERTY
TREASURER40.00XX000
SR MARY WALKER
SECRETARY40.00XX000
SR MARTHA SCHEESSELE
DIRECTOR40.00X000
SR MARY LYNN RAKOWSKI
DIRECTOR40.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ONR
1101 SOUTH CAPITAL OF TEXAS HWYAUSTINTX78746THERAPY SERVICES138518
SYSCO
1390 ENCLAVE PARKWAYHOUSTONTX770772099FOOD & SUPPLIES133475
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
All Other Contributions21702AllOtherContributions
Total Contributions21702TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NURSING HOME CARE62300034544673454467
SENIOR LIVING APARTMEN623000231341231341
OTHER REVENUE9000996190561905
FieldValueIRS element (for citing)
Total Program Service Revenue3747713TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column16281TotalRevenueColumn
Exclusion$16,281ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events13510GrossIncomeFundraisingEvents
Fundraising Direct Expenses1656FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column11854TotalRevenueColumn
Exclusion$11,854ExclusionAmount
FieldValueIRS element (for citing)
Gross Sales Of Inventory8012GrossSalesOfInventory
Cost Of Goods Sold5963CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column2049TotalRevenueColumn
Exclusion$2,049ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column3799599TotalRevenueColumn
Related Or Exempt Function Income3747713RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$30,184ExclusionAmount

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total4082Total
Program Services4082ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1857691Total
Program Services1711996ProgramServices
Management And General145695ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total48268Total
Program Services48268ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total147961Total
Program Services147961ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total141255Total
Program Services141255ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total18082Total
Management And General18082ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total301508Total
Program Services295445ProgramServices
Management And General6063ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1747Total
Management And General1747ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total271936Total
Program Services256769ProgramServices
Management And General15167ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total174Total
Management And General174ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total266874Total
Program Services266874ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total3345Total
Management And General3345ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total9777Total
Program Services9554ProgramServices
Management And General223ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total957Total
Program Services957ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total101145Total
Program Services101145ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total79124Total
Management And General79124ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
NURSING FACILITY SURCHA149664149664
MEDICAL SUPPLIES8835788357
MISCELLANEOUS7790690693791
AUXILIARY69236923

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total15543Total
Program Services6904ProgramServices
Management And General8639ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total3522203Total
Program Services3243060ProgramServices
Management And General278352ManagementAndGeneral
Fundraising791Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY642071BOY
EOY665230EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY245644BOY
EOY239112EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY47789BOY
EOY44663EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis2040665LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1433773LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY653996BOY
EOY606892EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY504958BOY
EOY805063EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY16636BOY
EOY18082EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2111094BOY
EOY2379042EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY188711BOY
EOY174952EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY8610BOY
EOY19250EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY16636BOY
EOY18082EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY22402BOY
EOY18172EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY236359BOY
EOY230456EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1874735BOY
EOY2148586EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1874735BOY
EOY2148586EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2111094BOY
EOY2379042EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses277396ReconcilationRevenueExpenses
Reconcilation Other Changes-3545ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee0AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years49800CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years80192CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years57649CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year48058CurrentTaxYearMinus1Year
Current Tax Year21702CurrentTaxYear
Total257401Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years49800CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years80192CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years57649CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year48058CurrentTaxYearMinus1Year
Current Tax Year21702CurrentTaxYear
Total257401Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total4025AmountsSubstContributorsTotal
Public Support Total170253376PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11430CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11719CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years19977CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year19456CurrentTaxYearMinus1Year
Current Tax Year16281CurrentTaxYear
Total78863Total
FieldValueIRS element (for citing)
Total Support336264TotalSupport
Gross Receipts From Admissions Etc18662945GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.75350PublicSupportPertcentage170
Public Support Pertcent Prior Year0.78660PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc1AgentTrusteeEtc
Beginning Balance11671BeginningBalance
Additions During Year19283AdditionsDuringYear
Distributions During Year15738DistributionsDuringYear
Ending Balance15216EndingBalance
Included On FS1IncludedOnFS

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis758487OtherCostOrOtherBasis
Depreciation444082Depreciation
Book Value314405BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1250705OtherCostOrOtherBasis
Depreciation959120Depreciation
Book Value291585BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis31473OtherCostOrOtherBasis
Depreciation30571Depreciation
Book Value902BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings606892TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionCAPITALIZED LEASE OBLIGATIONSDescription
Amount$18,172Amount
FieldValueIRS element (for citing)
Total Of Amounts18172TotalOfAmounts
Total Revenue3799599TotalRevenue
Total Expenses3522203TotalExpenses
Excess Or Deficit For Year277396ExcessOrDeficitForYear
Other-$3,545OtherAmount
Total Adjustments-3545TotalAdjustments
Excess Or Deficit Per FS273851ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt3789131TotRevenueEtcAuditedFinclStmt
Other Revenues7159OtherRevenues
Revenue Not Rptd F9907159RevenueNotRptdF990
Revenue Subtotal3781972RevenueSubtotal
Other Revenues Not Included17627OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt17627RevenueNotRptdOnFinStmt
Total Revenue Per Form9903799599TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt3515280TotExpensesEtcAuditedFinclStmt
Other Expenses Included8815OtherExpensesIncluded
Expenses Not Rptd F9908815ExpensesNotRptdF990
Expenses Subtotal3506465ExpensesSubtotal
Other Expenses Not Included15738OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt15738ExpensesNotRptdOnFinStmt
Total Expenses Per Form9903522203TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART IV, LINE 1B:THE ORGANIZATION HOLDS ASSETS FOR THE AUXILIARY.
PART IV, LINE 2B:THE HOME ACTS AS CUSTODIAN FOR THE FUNDS OF THE RESIDENTS AND HOLDS TENANT SECURITY DEPOSITS.
PART X:THE HOME BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND, AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE HOME WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE, IF SUCH INTEREST AND PENALTIES ARE INCURRED.DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:
NET GAIN/LOSS ON AUXILIARY NOT INCLUDED IN FINANCIAL STATEMENTS -3,545.PART XI, LINE 8 - OTHER ADJUSTMENTS:
DONATIONS FROM THE AUXILIARY. 7,159.PART XII, LINE 2D - OTHER ADJUSTMENTS:
REVENUE FROM THE AUXILIARY. 19,283. FUNDRAISING EXPENSES FROM THE AUXILIARY. -1,656.PART XII, LINE 4B - OTHER ADJUSTMENTS:
FUNDRAISING EXPENSES FROM THE AUXILIARY. 1,656. DONATIONS FROM THE AUXILIARY. 7,159.PART XIII, LINE 2D - OTHER ADJUSTMENTS:
EXPENSES FROM THE AUXILIARY. 15,738.PART XIII, LINE 4B - OTHER ADJUSTMENTS:

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantSCHOLARSHIPTypeOfGrant
Number Of Recipients2NumberOfRecipients
Amount Of Cash Grant4082AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: EMPLOYEES WHO RECEIVE A SCHOLARSHIP MUST PROVIDE RECEIPTS FOR TUITION AND BOOK EXPENSE. RECIPIENT MUST BE EMPLOYED AT DIVINE PROVIDENCE FOR AT LEAST ONE YEAR AND CONTINUE WORKING AT LEAST 20 HOURS PER WEEK. THE INDIVIDUAL MUST SEEK CAREER ADVANCEMENT IN NURSING, MEDICAL CARE, INTERPRETER SERVICES, SOCIAL WORK, JOB RELATED ENGLISH AS A SECOND LANGUAGE, OR CAREER ADVANCEMENT WITHIN THE FACILITY OR WITHIN THE FIELD OF LONG-TERM CARE.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 7ATHE BOARD OF DIRECTORS ARE APPOINTED BY THE PROVINCIAL OF THE U.S.A. PROVINCE OF THE DAUGHTERS OF ST. MARY OF PROVIDENCE.
FORM 990, PART VI, SECTION A, LINE 8BTHE ORGANIZATION DOES NOT HAVE A COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11THE REQUIRED ANNUAL FORM 990 FILING IS COMPLETED FROM THE FINANCIAL RECORDS PROVIDED BY THE NON-PROFIT ORGANIZATION UPON COMPLETION OF AN ANNUAL AUDIT BY AN INDEPENDENT CPA. AFTER THE REVIEW BY THE BOARD, THE INFORMATION TAX RETURN FORMS ARE THEN SUBMITTED TO AN OFFICER FOR SIGNATURE AND SUBMISSION.
FORM 990, PART VI, SECTION B, LINE 12CTHE POLICY COVERS THE BOARD OF DIRECTORS AND PROHIBITS CONTRACTING SERVICES WITH AGENCIES OWNED IN PART OR ENTIRELY BY PERSONS EMPLOYED BY DIVINE PROVIDENCE AND/OR RELATED TO MANAGERIAL EMPLOYEES. HOWEVER, SINCE DIVINE IS LOCATED IN THE SMALL TOWN OF SLEEPY EYE, AND SINCE THE CHOICE OF PROVIDERS IS LIMITED IN THIS RURAL SETTING, SUCH CONTRACTS MAY BE NECESSARY. THE BOARD OF DIRECTORS WOULD DETERMINE IF A CONFLICT EXISTS AND MAKE REVIEWS.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ALL ITS GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AS WELL AS ALL FINANCIAL DATA REGARDING THE FILING OF ALL REQUIRED FORMS.
FORM 990, PART XI, LINE 5:NET GAIN/LOSS ON AUXILIARY NOT INCLUDED IN FINANCIAL STATEMENTS -3,545. TOTAL TO FORM 990, PART XI, LINE 5: -3,545.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1THE DAUGHTERS OF ST MARY PROVIDENCEBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14200 N AUSTIN AVENUEAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60634ZIPCode
FieldValueIRS element (for citing)
EIN510219736EIN
Primary ActivitiesCHARITYPrimaryActivities
Legal Domicile StateILLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity StatusLINE 1PublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg