2011-10-27T08:25:47-04:00 2010-12-31 KPMG LLP 191 West Nationwide Blvd Ste 500 Columbus OH 432152568 990 2010-01-01 371127787 PROVENA SENIOR SERVICES PROV 7084787900 19065 HICKORY CREEK DRIVE MOKENA IL 60448 Anthony J Filer 2011-10-26 true KPMG LLP 6142492300 2010 2016-03-07 17:11:31Z CONNIE MARCH-CURTIS 19065 HICKORY CREEK DRIVE Mokena IL 60448 88716184 false X http://www.provena.org/seniors X 1997 IL PROVENA SENIOR SERVICES PROVIDES CARE TO THE ELDERLY in communities primarily in Northern and Central Illinois through long-term care and senior residential properties it owns and operates. 15 13 1379 110 151474 93526 3398988 977833 89740324 84007773 216410 352631 3326785 3308070 96682507 88646307 0 0 0 0 61911124 57926500 0 0 45771 29423151 28258693 91334275 86185193 5348232 2461114 87910592 89614158 13400838 15258542 74509754 74355616 X OUTPATIENT PHARMACY IN NORTHERN AND CENTRAL ILLINOIS AND INDIANA. PROVIDES CARE TO THE ELDERLY AND OWNS AND OPERATES 10 NURSING HOMES, FOUR INDEPENDENT LIVING FACILITIES, TWO ASSISTED LIVING FACILITIES, FOUR ADULT DAYCARE CENTERS, TWO COMMUNITY SERVICE FACILITIES, AND ONE OUTPATIENT PHARMACY IN NORTHERN AND CENTRAL ILLINOIS AND INDIANA. false false 75803018 70390979 PROVENA SENIOR SERVICES PROVIDES NURSING CARE FOR LONG-TERM RESIDENTS WHO NEED ASSISTANCE WITH ACTIVITIES OF DAILY LIVING. 5665066 6875106 PROVENA SENIOR SERVICES OPERATES 17 LONG-TERM CARE SENIOR RESIDENTIAL AND COMMUNITY-BASED SERVICE CAMPUSES. FACILITIES ARE LOCATED IN NORTHERN ILLINOIS WITH ONE LOCATION IN INDIANA. 3015188 5953442 Provena Senior Services operates a Pharmacy in Kankakee, IL That IS ONLY AVAILABLE TO ITS RESIDENTS. 1452037 1379700 85935309 true true false false false false false false false true false false false true true false true false false false false false false true false false false false true false false false false false false false false false false false false true true false false false false true 173 0 1379 true true true false false false false false false false false false false false false X 15 13 false false false false false true true true true false true true true true true true true true true true false IL X X PATRICK QUINN 8158062328 9223 WEST ST FRANCIS ROAD Frankfort IL 604238334 BARRY C HUEBNER 1.0 X X DENNIS SONNENBERG 1.0 X DEBRA Y CYBORSKI 1.0 X X CHERYL L LOWNEY 1.0 X X TIM PHILLIPpE 1.0 X X PATRICIA GOMEZ 1.0 X CONNIE S MARCH 1.0 X X 419349 71112 THERESA KWIATKOWSKI 1.0 X JUDY MARWICK 1.0 X TERRY SOLEM 1.0 X 377149 64086 Nancy T Dowd 1.0 X Florida Freeman 1.0 X Sr Margaret Mary Hinz 1.0 X Sheila Sorrentino PhD RN 1.0 X Sr Marie Mason 1.0 X Sallie Miller 1.0 X Phyllis Nichols 1.0 X CRAIG CULVER 40.0 X 145152 33672 DAVID HOWARD 40.0 X 206601 19247 KATHY DENNIS 40.0 X 163356 19509 WENDELL PROVOST 40.0 X 197747 28431 NANCY SIEKIERKA 40.0 X 112533 14049 mike gordon 40.0 X 240906 31842 Susan Enright 40.0 X 139293 12634 Marge Gleason 40.0 X 184292 35349 MICHAEL BORN 40.0 X 154760 32005 CRAIG PROKUPEK 40.0 X 136617 17353 mark fedyk 40.0 X 116635 11955 lynda olinski 40.0 X 115972 7842 Ann Dodge 40.0 X 121116 17984 1470489 1360989 417070 20 false true false ROCHE DIETITIANS 51 E BURLINGTON ST RIVERSIDE IL 605462124 CONSULTING 116732 Shawnee Construction Engineering 7701 Opportunity Drive FORT WAYNE IN 46825 Construction 937739 Mid-America Roofing Inc 1304 Enterprise Drive ROMEOVILLE IL 60446 Construction 178123 Select Rehabilitation PO Box 809056 CHICAGO IL 60678 Therapy Services 9242309 Alverno Clinical Laboratories 2434 Interstate Plaza Drive HAMMOND IN 46324 LAB services 250502 5 977833 977833 NET PATIENT REV. 900099 24589675 24589675 MEDICARE/MEDICAID PAYMENTS 900099 59418098 59418098 84007773 361048 361048 0 0 15689 24106 -8417 -8417 -8417 115762 45771 69991 69991 0 0 MANAGEMENT SERVICE 541610 438630 151474 287156 CHILD CARE 900099 614147 614147 PURCHASE REBATES 900099 516342 516342 1668960 1668960 3238079 88646307 84007773 151474 3509227 0 0 0 0 1481177 1481177 0 44953321 44840428 112893 1487557 1482952 4605 6243979 6235391 8588 3760466 3737867 22599 466411 463521 2890 -175505 -175505 130524 127405 3119 0 0 0 2284193 2274726 9467 0 0 0 0 4035744 4025773 9971 0 0 0 3000051 3000051 2773894 2773894 4008091 4006940 1151 1653703 1653703 ILLINOIS/INDIANA BED TAX 888073 888073 REAL ESTATE TAXES 599610 599610 SUPPLIES & DRUGS 3289130 3287122 2008 PROVISION FOR BAD DEBT 859860 859860 FOOD 3498805 3497879 926 946109 874442 25896 45771 86185193 85935309 204113 45771 12496354 13137926 11676479 11368039 682337 704078 173512 214949 115723820 60063987 54741839 55659833 6917083 7577039 1222988 952294 87910592 89614158 10292866 11120835 493887 347243 45859 1164939 2568226 2625525 13400838 15258542 X 72743610 72596758 1522880 1515594 243264 243264 74509754 74355616 87910592 89614158 X 2461114 -2615252 X false true true X false X false false false 1825290 1621364 1609410 3398988 977833 9432885 1825290 1621364 1609410 3398988 977833 9432885 9432885 1094517 1089676 433325 278232 361048 3256798 38775 83384 65134 43561 93526 324380 2672593 2963776 3535297 3427862 2917773 15517301 28531364 715001070 0.33061 0.33441 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4796124 4796124 88112143 45768245 42343898 2084665 1638514 446151 20359968 12657228 7702740 370920 370920 55659833 0 RESIDENT DEPOSITS 451550 DUE TO AFFILIATES 1099900 DEFERRED COMPENSATION 442616 OTHER CURRENT LIABILITIES 192715 CONDITIONAL ASSET RETIREMENT 438744 2625525 Supplemental Information On January 1, 2008, Provena adopted ASC Subtopic 740-10 Income Taxes- Overall, which addresses the determination of how tax benefits claimed or expected to be claimed on a tax return should be recorded in the consolidated financial statements. Under ASC Subtopic 740-10, Provena may recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. The tax benefits recognized in the consolidated financial statements from such a position are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. ASC Subtopic 740-10 also provides guidance on derecognition, classification, interest and penalties on income taxes, and accounting in interim periods and requires increased disclosures. At the date of adoption, and as of December 31, 2010, Provena does not have any liabilities for any unrecognized tax benefits. Dancing w/Stars 42785 42785 14558 Golf Outing 61351 61351 27083 2 11626 11626 4130 115762 115762 45771 45771 69991 X X X X X X false false false false false false false false false CONNIE S MARCH 271471 54549 93329 48639 22473 490461 TERRY SOLEM 287046 33615 56488 48969 15117 441235 MICHAEL BORN 122476 22555 9729 9135 22870 186765 CRAIG CULVER 110481 29594 5077 9852 23820 178824 DAVID HOWARD 159164 41057 6380 15266 3981 225848 KATHY DENNIS 126870 31060 5426 12259 7250 182865 WENDELL PROVOST 147591 35903 14253 13307 15124 226178 mike gordon 183841 33938 23127 14244 18334 273484 CRAIG PROKUPEK 108297 19689 8631 9209 8144 153970 Susan Enright 124349 10738 4206 8955 3679 151927 Marge Gleason 155776 9072 19444 18892 17074 220258 FORM 990 PART VI SECTION A, QUESTIONS 7A & 7B The member body consisting of 2 members appointed by the leadership teams of each sponsoring congregation that are Franciscan Sisters of the Sacred Heart, Servants of the Holy Heart of Mary, USA Province and Sisters of Mercy, West, Mid-West Region has the authority to appoint Board members and approve the recommendations of the Board FORM 990 PART VI SECTION A, QUESTION 11A the board reviews the form 990 and supporting schedules at a meeting before submission to the IRS. the return is submitted with the board package and is also placed on a board member website. annual education sessions on the 990 are also given to the board. FORM 990 PART VI SECTION B, QUESTIONS 12A, 12B, & 12C THE ORGANIZATION HAS ADOPTED A POLICY THAT REQUIRES BOARD MEMBERS TO COMPLETE A STATEMENT THAT DISCLOSES ALL ACTIVITIES AND PROHIBITS VOTING ON ANY MATTERS INVOLVING ANY CONFLICTS. EVERY AGENDA HAS A STATEMENT THAT PROHIBITS VOTING ON AGENDA ITEMS WHERE BOARD MEMBERS HAVE CONFLICTS. VENDOR FILES ARE MATCHED WITH COMPANIES THAT BOARD MEMBERS HAVE AFFILIATIONS WITH TO DETERMINE IF CONFLICTS EXIST. FORM 990 PART VI SECTION B, QUESTIONS 15A & 15B AN INDEPENDENT HUMAN RESOURCES COMPANY REVIEWS SALARY SURVEYS FOR CEO'S AND KEY EMPLOYEES DURING THE YEAR AND MAKES RECOMMENDATIONS TO THE BOARD OF DIRECTORS. FORM 990 PART VI SECTION C, QUESTION 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST AND ARE ON THE ORGANIZATION'S WEBSITE. form 990 Part XI, Line 5 Change in net assets Transfers to Affiliates (2,072,160) Unrealized Gain 373,587 Net Fundraising Income (69,991) Net Assets Adjustment forProvena Laverna Terrace (740,297) Goodwill Impairment (106,391) ------------ Total Changes in Net Assets (2,615,252) Alverno Provena Hospitals Laboratory 2434 Interstate Plaza Drive Hammond IN 46324 203238867 Healthcare IN NA PROVENA HOSPITALS 9223 WEST ST FRANCIS ROAD FRANKFORT IL 60423 364195126 HEALTHCARE IL 501(c)(3) 3 N/A PROVENA CARE HOME 19065 Hickory Creek Drive Mokena IL 60448 460483587 HEALTHCARE IL 501(c)(3) 9 N/A PROVENA HOME HEALTH INC 19065 Hickory Creek Drive Mokena IL 60448 460483581 HEALTHCARE IL 501(c)(3) 9 N/A PROVENA HEALTH 9223 WEST ST FRANCIS ROAD FRANKFORT IL 60423 363366652 HEALTHCARE IL 501(c)(3) 11 N/A PROVENA LAVERNA TERRACE 19065 Hickory Creek Drive Mokena IL 60448 363438977 HEALTHCARE IL 501(c)(3) 9 NA PROVENA VENTURES 9223 WEST ST FRANCIS ROAD FRANKFORT IL 60423 371168085 MEDICAL IL N/A C CORP PROVENA SERVICE CORPORATION 9223 WEST ST FRANCIS ROAD FRANKFORT IL 60423 364314354 MEDICAL IL PROVENA HOSPITA C CORP PROVENA PROPERTIES 9223 WEST ST FRANCIS ROAD FRANKFORT IL 60423 363520630 MEDICAL IL N/A C CORP PROVENA ASSURANCE CORPORATION 9223 WEST ST FRANCIS ROAD FRANKFORT IL 60423 980420054 MEDICAL IL N/A C CORP PROVENA SELF-INSURANCE TRUST 9223 WEST ST FRANCIS ROAD FRANKFORT IL 60423 362987310 INSURANCE IL PROVENA HEALTH TRUST false false false false false false false false false false false false false true true false true false