2013-05-02T07:27:31-05:00 2012-06-30 450250958 EIDE BAILLY LLP 800 NICOLLET MALL STE 1300 MINNEAPOLIS MN 554027033 990 2011-07-01 410839343 DIVINE PROVIDENCE COMMUNITY HOME DIVI 5077943011 700 3RD AVENUE NW SLEEPY EYE MN 560851036 JAYNA GROEBNER 5077943011 2013-04-16 1 KIM HUNWARDSEN CPA P00484560 6122536500 2013-04-18 2011 2016-02-25 16:41:14Z JAYNA GROEBNER 700 3RD AVENUE NW SLEEPY EYE MN 560851036 3807218 0 0928 X N/A X 1960 MN RELIGIOUS ORGANIZATION WHOSE PURPOSE IS THE CARE OF THE AGED AND PHYSICALLY IMPAIRED BY PROVIDING PROFESSIONAL CARE AT THE HIGHEST LEVEL. 6 6 141 6 0 0 48058 21702 3853679 3747713 19456 16281 13341 13903 3934534 3799599 7710 4082 0 0 2147705 2195175 0 0 791 1371357 1322946 3526772 3522203 407762 277396 2111094 2379042 236359 230456 1874735 2148586 RELIGIOUS ORGANIZATION WHOSE PURPOSE IS THE CARE OF THE AGED AND PHYSICALLY IMPAIRED BY PROVIDING PROFESSIONAL CARE AT THE HIGHEST LEVEL. 0 0 3243060 4082 3747713 DIVINE 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. 3243060 1 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 4 0 1 141 1 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 1 0 1 0 0 0 1 1 1 1 0 0 0 0 0 MN X JAYNA GROEBNER 5077943011 700 THIRD AVENUE NW SLEEPY EYE MN 560851036 X SR RITA BUTLER 40.00 X X 0 0 0 SR BERNADINE UGOLINI 40.00 X X 0 0 0 SR PATRICIA MCCAFFERTY 40.00 X X 0 0 0 SR MARY WALKER 40.00 X X 0 0 0 SR MARTHA SCHEESSELE 40.00 X 0 0 0 SR MARY LYNN RAKOWSKI 40.00 X 0 0 0 0 0 0 0 0 0 0 ONR 1101 SOUTH CAPITAL OF TEXAS HWY AUSTIN TX 78746 THERAPY SERVICES 138518 SYSCO 1390 ENCLAVE PARKWAY HOUSTON TX 770772099 FOOD & SUPPLIES 133475 2 21702 21702 NURSING HOME CARE 623000 3454467 3454467 SENIOR LIVING APARTMEN 623000 231341 231341 OTHER REVENUE 900099 61905 61905 3747713 16281 16281 13510 1656 11854 11854 8012 5963 2049 2049 3799599 3747713 0 30184 4082 4082 1857691 1711996 145695 48268 48268 147961 147961 141255 141255 18082 18082 301508 295445 6063 1747 1747 271936 256769 15167 174 174 266874 266874 3345 3345 9777 9554 223 957 957 101145 101145 79124 79124 NURSING FACILITY SURCHA 149664 149664 MEDICAL SUPPLIES 88357 88357 MISCELLANEOUS 7790 6906 93 791 AUXILIARY 6923 6923 15543 6904 8639 3522203 3243060 278352 791 642071 665230 245644 239112 47789 44663 2040665 1433773 653996 606892 504958 805063 16636 18082 2111094 2379042 188711 174952 8610 19250 16636 18082 22402 18172 236359 230456 X 1874735 2148586 1874735 2148586 2111094 2379042 X 277396 -3545 X 0 1 0 X 0 X 49800 80192 57649 48058 21702 257401 49800 80192 57649 48058 21702 257401 4025 253376 11430 11719 19977 19456 16281 78863 336264 18662945 0.75350 0.78660 X 1 11671 19283 15738 15216 1 758487 444082 314405 1250705 959120 291585 31473 30571 902 606892 CAPITALIZED LEASE OBLIGATIONS 18172 18172 3799599 3522203 277396 -3545 -3545 273851 3789131 7159 7159 3781972 17627 17627 3799599 3515280 8815 8815 3506465 15738 15738 3522203 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. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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. PART XI, LINE 8 - OTHER ADJUSTMENTS: NET GAIN/LOSS ON AUXILIARY NOT INCLUDED IN FINANCIAL STATEMENTS -3,545. PART XII, LINE 2D - OTHER ADJUSTMENTS: DONATIONS FROM THE AUXILIARY. 7,159. PART XII, LINE 4B - OTHER ADJUSTMENTS: REVENUE FROM THE AUXILIARY. 19,283. FUNDRAISING EXPENSES FROM THE AUXILIARY. -1,656. PART XIII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES FROM THE AUXILIARY. 1,656. DONATIONS FROM THE AUXILIARY. 7,159. PART XIII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES FROM THE AUXILIARY. 15,738. 1 SCHOLARSHIP 2 4082 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE 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. FORM 990, PART VI, SECTION A, LINE 7A THE 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 8B THE ORGANIZATION DOES NOT HAVE A COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE 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 12C THE 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 19 THE 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. CHANGES IN NET ASSETS OR FUND BALANCES: 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. THE DAUGHTERS OF ST MARY PROVIDENCE 4200 N AUSTIN AVENUE CHICAGO IL 60634 510219736 CHARITY IL 501(C)(3) LINE 1 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0