2022-07-15T14:31:32-05:00 2021-08-31 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2020-09-01 351947580 PROVIDENCE SELF SUFFICIENCY MINISTRIES PROV 8129511878 8037 UNRUH DR GEORGETOWN IN 47122 SUSAN GERNERT PRESIDENT 8129511878 2022-07-15 1 SUSAN GERNERT 999009999 NATHAN A RODGERS CPA P01568275 3176334705 2022-07-15 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z SUSAN GERNERT 8037 UNRUH DR GEORGETOWN IN 47122 8401809 0 X WWW.GUERININC.ORG X 1994 IN PROVIDENCE SELF SUFFICIENCY MINISTRIES, INC. OPERATES VARIOUS RESIDENTIAL PROGRAMS, INCLUDING (1) AFFORDABLE RENTAL HOUSING FOR VERY LOW AND LOW-INCOME SENIORS, (2) A SENIOR CENTER, (3) AN ASSISTED LIVING/SKILLED NURSING/MEMORY CARE FACILITY FOR SENIORS, AND (4) A TREATMENT PROGRAM THAT PROVIDES CLINICAL AND SOCIAL SERVICES, SELF-SUFFICIENCY PROGRAMING, AND CASE MANAGEMENT FOR FAMILIES AT RISK OF SEPARATION BECAUSE OF CHILD NEGLECT OR ABUSE. 13 13 195 5 0 0 37515 1013655 7941553 7372700 2547 1180 73300 14274 8054915 8401809 0 0 0 0 4962349 5266928 0 0 0 3345700 4044137 8308049 9311065 -253134 -909256 2559848 1706729 2218131 2367356 341717 -660627 TO PROVIDE ASSISTANCE - BY WAY OF RESIDENTIAL TREATMENT FACILITIES AND VARIOUS CLINICAL, SOCIAL, AND LIFE SKILLS SERVICES - TO PERSONS OF ALL AGES WHO ARE IN NEED. 0 0 8172829 6559766 ENRICHING THE BODIES, HEARTS, AND MINDS OF ELDERS IN NEED OF DAILY ASSISTANCE OR NURSING CARE BY PROVIDING A NURTURING, PERSON-CENTERED HOME. 498752 827208 PROVIDING FAMILIES AT RISK OF SEPARATION BECAUSE OF CHILD NEGLECT OR ABUSE BOTH A SUPPORTING-PERSON-CENTERED HOME AND SERVICES DESIGNED TO SUSTAIN THE FAMILY UNIT THROUGH SELF-SUFFICIENCY AND A HEALTH, PRODUCTIVE LIFESTYLE. 8671581 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 11 0 1 195 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 IN X X THE ORGANIZATION 8129511878 8037 UNRUH DR GEORGETOWN IN 47122 SISTER LISA STALLINGS CHAIRPERSON 1.00 1.00 X X 0 0 0 DIANE MURPHY TREASURER 1.00 1.00 X X 0 0 0 GEORGE GESENHUES SECRETARY 1.00 2.00 X X 0 0 0 ALLYSON BRADOW DIRECTOR 1.00 0.00 X 0 0 0 NEIL BYRNE DIRECTOR 1.00 0.00 X 0 0 0 ANN CURRUTHERS DIRECTOR-TERM BEGAN 12/20 1.00 0.00 X 0 0 0 DR CARLA HERMAN DIRECTOR 1.00 0.00 X 0 0 0 JAN HEFFERNAN DIRECTOR-TERM BEGAN 12/20 1.00 0.00 X 0 0 0 JEFF MCCAFFREY DIRECTOR-TERM BEGAN 12/20 1.00 1.00 X 0 0 0 SISTER NANCY REYNOLDS DIRECTOR-TERM BEGAN 11/20 1.00 0.00 X 0 0 0 JO RUSSELL DIRECTOR 1.00 0.00 X 0 0 0 JEANNIE UNRUH DIRECTOR 1.00 1.00 X 0 0 0 BRYAN WICKENS DIRECTOR-TERM BEGAN 01/21 1.00 0.00 X 0 0 0 MARIA PRICE DIRECTOR-TERM ENDED 11/20 1.00 0.00 X 0 0 0 SUSAN GERNERT PRESIDENT/CEO 35.00 5.00 X 150000 0 0 LYNDA ALEXANDER CFO 40.00 0.00 X 105000 0 0 255000 0 0 2 0 0 0 0 993905 19750 1013655 MANAGEMENT SERVICE REV 900099 4886905 4886905 CLIENT SERVICE REVENUE 623000 1066498 1066498 MANAGEMENT FEES 900099 1009500 1009500 SERVICE REVENUE - IGT 900099 409797 409797 7372700 1180 1180 14274 14274 14274 8401809 7386974 0 1180 255000 237150 17850 4398145 4090275 307870 613783 570818 42965 909972 846274 63698 111992 104153 7839 802059 745915 56144 6566 6106 460 407840 379291 28549 25793 23987 1806 531054 493880 37174 13341 12407 934 455 423 32 62187 57834 4353 80055 74451 5604 MEDICAL EXPENSES 890543 828205 62338 IGT EXPENSES 160800 160800 LICENSES/DUES 26664 24798 1866 PROGRAM EXPENSES 14787 14787 29 27 2 9311065 8671581 639484 0 1718330 942989 718377 575919 8950 20674 490831 365408 114141 125423 50 41724 2559848 1706729 328968 193788 240258 195142 993905 983300 655000 995126 2218131 2367356 X 341717 -1660627 1000000 341717 -660627 2559848 1706729 -909256 -93088 0 X 0 0 0 X 39546 35253 120663 37515 1013655 1246632 6795110 6717458 7321162 7941553 7372700 36147983 6834656 6752711 7441825 7979068 8386355 37394615 0 0 0 37394615 16993 259 390 15172 1180 33994 16993 259 390 15172 1180 33994 35472 53618 352677 60675 14274 516716 6887121 6806588 7794892 8054915 8401809 37945325 0.98550 0.98360 0.00090 0.00150 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2016 AMOUNT: $ 35,472. 2017 AMOUNT: $ 53,618. 2018 AMOUNT: $ 352,677. 2019 AMOUNT: $ 117. 2020 AMOUNT: $ 14,274. INSURANCE PROCEEDS - 2019 AMOUNT: $ 60,558. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7087 182 6905 463116 347690 115426 20628 17536 3092 125423 DUE TO GUERIN, INC. 995126 995126 FORM 990, PART VI, SECTION A, LINE 2 NEIL BYRNE, A DIRECTOR OF PROVIDENCE SELF SUFFICIENCY MINISTRIES, INC., HAS A FAMILY RELATIONSHIP WITH PAT BYRNE, A DIRECTOR OF A RELATED ORGANIZATION (GUERIN, INC.). FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT REVIEWS THE FORM 990 PREPARED BY ITS OUTSIDE ACCOUNTING FIRM. THE ORGANIZATION'S FINANCE COMMITTEE THEN REVIEWS AND APPROVES THE FORM 990 FOR FILING. THE 990 IS MADE AVAILABLE TO BOARD MEMBERS VIA EMAIL. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS ARE REQUIRED TO SIGN AND COMPLY WITH A CONFLICT OF INTEREST STATEMENT, WHICH READS IN RELEVANT PART: "NO BOARD MEMBER OR BOARD COMMITTEE MEMBER, OR ANY MEMBER OF HIS OR HER FAMILY (COLLECTIVELY "DIRECTOR") SHOULD ACCEPT ANY GIFT, ENTERTAINMENT, SERVICE, LOAN, OR PROMISE OF FUTURE BENEFITS FROM ANY PERSON WHO EITHER PERSONALLY OR WHOSE EMPLOYEES MIGHT BENEFIT OR APPEAR TO BENEFIT FROM SUCH DIRECTOR'S CONNECTION WITH [THE ORGANIZATION], UNLESS THE FACTS OF SUCH BENEFIT, GIFT, SERVICE, OR LOAN ARE DISCLOSED IN GOOD FAITH AND ARE AUTHORIZED BY THE BOARD. DIRECTORS SHOULD NOT PROVIDE, FOR ANY PERSONAL GAIN, SERVICES TO ANY SUPPLIER OF GOODS OR SERVICES, AS EMPLOYEE, CONSULTANT, OR IN ANY OTHER CAPACITY WHICH PROMISES COMPENSATION OF ANY KIND, UNLESS THE FACT OF SUCH TRANSACTION OR CONTRACTS ARE DISCLOSED IN GOOD FAITH, AND THE BOARD OR COMMITTEE AUTHORIZES SUCH A TRANSACTION. NO DIRECTOR SHOULD HAVE ANY BENEFICIAL INTEREST IN, OR SUBSTANTIAL OBLIGATION TO ANY [ORGANIZATION] SUPPLIER OF GOODS OR SERVICES OR ANY OTHER ORGANIZATION THAT IS ENGAGED IN DOING BUSINESS WITH OR SERVING [THE ORGANIZATION] UNLESS IT HAS BEEN DETERMINED BY THE BOARD, ON THE BASIS OF FULL DISCLOSURE OF FACTS, THAT SUCH INTEREST DOES NOT GIVE RISE TO A CONFLICT OF INTEREST." IN ADDITION, IF A DIRECTOR WERE TO ABSTAIN FROM VOTING DUE TO A CONFLICT OF INTEREST, IT WOULD BE REFLECTED IN THE BOARD MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 15A THE PRESIDENT/CEO'S COMPENSATION WAS DETERMINED BY AN INDEPENDENT COMPENSATION CONSULTANT BASED ON A COMPENSATION SURVEY OF OTHER NOT-FOR-PROFIT ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. ALSO, THE ORGANIZATION'S 990 IS AVAILABLE AT WWW.GUIDESTAR.ORG. THE MEADOWS OF GUERIN INC 8037 UNRUH DRIVE GEORGETOWN IN 47122 261642548 OPERATES AN AFFORDABLE APARTMENT RENTAL COMMUNITY FOR SENIORS IN 501(C)(3) LINE 10 GUERIN INC 0 GUERIN INC 8037 UNRUH DRIVE GEORGETOWN IN 47122 352061759 PROVIDE RESIDENTIAL FACILITIES TO SERVE PERSONS IN NEED IN 501(C)(3) LINE 10 N/A 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 1 0 1 0 0 GUERIN INC E 995126 COST GUERIN INC K 200000 COST GUERIN INC L 83364 COST GUERIN INC O 83364 COST GUERIN INC Q 83364 COST