COVENANT HEALTH INVESTMENT TRUST: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- COVENANT HEALTH INVESTMENT TRUST (EIN 04-6835128)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-06-24
- IRS object ID
- 201311759349300816
- Schema version
- 2012v2.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-06-24T14:51:21-05:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020383073 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WILLIAM STEELE & ASSOCIATES PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 40 STARK STREET | AddressLine1 |
| City | MANCHESTER | City |
| State | NH | State |
| ZIP Code | 03101 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 046835128 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROVIDENTIA PRIMA TRUST | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PROV | NameControl |
| Phone | 9786546363 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 AMES POND DRIVE | AddressLine1 |
| City | TEWKSBURY | City |
| State | MA | State |
| ZIP Code | 01876 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN AHLE | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 9786546363 | Phone |
| Date Signed | 2013-06-20 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WILLIAM G STEELE JR CPA | Name |
| PTIN | P00233103 | PTIN |
| Phone | 6036228881 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JOHN AHLE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 AMES POND DRIVE | AddressLine1 |
| City | TEWKSBURY | City |
| State | MA | State |
| ZIP Code | 01876 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 9501273 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | COVENANTHS.ORG | WebSite |
| Type Of Organization Trust | X | TypeOfOrganizationTrust |
| Year Formation | 1996 | YearFormation |
| State Legal Domicile | MA | StateLegalDomicile |
| Activity Or Mission Description | PROVIDENTIA PRIMA WAS ESTABLISHED TO HOLD AND MANAGE POOLED INVESTMENTS OF VARIOUS ORGANIZATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501 (C) (3) | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 4 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 6887078 | InvestmentIncomePriorYear |
| Investment Income Current Year | 9484818 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 30591 | OtherRevenuePriorYear |
| Other Revenue Current Year | 16455 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 6917669 | TotalRevenuePriorYear |
| Total Revenue Current Year | 9501273 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 793693 | OtherExpensePriorYear |
| Other Expenses Current Year | 851295 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 793693 | TotalExpensesPriorYear |
| Total Expenses Current Year | 851295 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 6123976 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 8649978 | RevenuesLessExpensesCY |
| Total Assets BOY | 147469529 | TotalAssetsBOY |
| Total Assets EOY | 179178125 | TotalAssetsEOY |
| Total Liabilities BOY | 2173965 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2638875 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 145295564 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 176539250 | NetAssetsOrFundBalancesEOY |
| Mission Description | PROVIDENTIA PRIMA WAS ESTABLISHED TO HOLD AND MANAGE POOLED INVESTMENTS OF VARIOUS ORGANIZATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501 (C) (3). | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Description | N/A | Description |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 4 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHN AHLE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9786546363 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 AMES POND DRIVE | AddressLine1 |
| City | TEWKSBURY | City |
| State | MA | State |
| ZIP Code | 01876 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (9 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| JOHN AHLE | ||||||
| TREASURER/SECRETARY | 1.00 | X | X | 0 | 491296 | 161726 |
| CAROLYN KASABIAN | ||||||
| TRUSTEE | 1.00 | X | 0 | 254744 | 26328 | |
| DONALD M DEHART | ||||||
| CHAIR/PRESIDENT | 3.00 | X | X | 0 | 0 | 0 |
| RICHARD J PLAMONDON | ||||||
| VICE PRESIDENT | 1.00 | X | X | 0 | 286455 | 49899 |
| WILLIAM ADAMS | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| PAUL ERCOLINI | ||||||
| TRUSTEE | 1.00 | X | 0 | 164149 | 32910 | |
| KEVIN HALLORAN | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| WILLIAM DEMASO | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| SR CATHERINE O'CONNOR | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1196644 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 270863 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| STATE STREET BANK & TRUST | |||||
| 200 CLARENDON STREET | BOSTON | MA | 02116 | CUSTODIAN FEES | 131949 |
| SILCHESTER INTERNATIONAL INVESTORS | |||||
| 780 3RD AVENUE 42ND FLOOR | NEW YORK | NY | 10017 | INVESTMENT MANAGER | 130310 |
| NEPC LLC | |||||
| ONE MAIN STREET 8TH FLLOR | CAMBRIDGE | MA | 02142 | INVESTMENT MANAGER | 124259 |
| IRONBRIDGE CAPITAL MANAGEMENT LP | |||||
| ONE PARKVIEW PLAZA SUITE 600 | OAKBROOK TERRACE | IL | 60181 | INVESTMENT MANAGER | 103326 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3959307 | TotalRevenueColumn |
| Exclusion | $3,959,307 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 5525511 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 5525511 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5525511 | TotalRevenueColumn |
| Exclusion | $5,525,511 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 16455 | TotalRevenueColumn |
| Exclusion | $16,455 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 16455 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9501273 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $9,501,273 | ExclusionAmount |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35000 | Total |
| Management And General | 35000 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 753998 | Total |
| Management And General | 753998 | ManagementAndGeneral |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral |
|---|---|---|
| ADMINISTRATION EXPENSE | 40000 | 40000 |
| MISCELLANEOUS EXPENSES | 22297 | 22297 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 851295 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 851295 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5904476 | BOY |
| EOY | 3258411 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100868488 | BOY |
| EOY | 128325437 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40629611 | BOY |
| EOY | 45377110 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66954 | BOY |
| EOY | 2217167 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 147469529 | BOY |
| EOY | 179178125 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2173965 | BOY |
| EOY | 2638875 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2173965 | BOY |
| EOY | 2638875 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Do Not Follow SFAS117 | X | DoNotFollowSFAS117 |
Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 145295564 | BOY |
| EOY | 176539250 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 145295564 | BOY |
| EOY | 176539250 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 147469529 | BOY |
| EOY | 179178125 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 8649978 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 6717055 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 15876653 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation (18 entries)
| EINEIN | Type Of OrganizationTypeOfOrganization | Listed In Governing DocListedInGoverningDoc | Supported Organization NotifiedSupportedOrganizationNotified | Organized In USOrganizedInUS | AmountAmount |
|---|---|---|---|---|---|
| COVENANT HEALTH SYSTEMS | |||||
| 222484505 | 9 | 1 | 1 | 1 | $0 |
| ST MARY'S HEALTH SYSTEM INC | |||||
| 222504349 | 9 | 1 | 1 | 1 | $0 |
| FANNY ALLEN CORPORATION | |||||
| 222495808 | 9 | 1 | 1 | 1 | $0 |
| CHS OF WALTHAM INC | |||||
| 043333609 | 9 | 1 | 1 | 1 | $0 |
| ST JOSEPH HOSPITAL | |||||
| 020222215 | 3 | 1 | 1 | 1 | $0 |
| YOUVILLE HOSPITAL | |||||
| 043239563 | 3 | 1 | 1 | 1 | $0 |
| YOUVILLE PLACE INC | |||||
| 043297834 | 9 | 1 | 1 | 1 | $0 |
| ST ANDRE HEALTH CARE FACILITY | |||||
| 010342399 | 9 | 1 | 1 | 1 | $0 |
| MI NURSINGRESTORATIVE CENTER INC | |||||
| 042104851 | 9 | 1 | 1 | 1 | $0 |
| ST MARY'S VILLA NURSING HOME INC | |||||
| 232057177 | 9 | 1 | 1 | 1 | $0 |
| MI MANAGEMENT INC | |||||
| 042857794 | 9 | 1 | 1 | 1 | $0 |
| MI ADULT DAY HEALTH CENTER INC | |||||
| 042921888 | 9 | 1 | 1 | 1 | $0 |
| MI TRANSPORTATION INC | |||||
| 042921889 | 9 | 1 | 1 | 1 | $0 |
| YOUVILLE HOUSE INC | |||||
| 043239593 | 9 | 1 | 1 | 1 | $0 |
| ST MARY'S REGIONAL MEDICAL CTR | |||||
| 010211551 | 9 | 1 | 1 | 1 | $0 |
| ST MARY'S D'YOUVILLE PAVILION | |||||
| 012011558 | 9 | 1 | 1 | 1 | $0 |
| ST JOSEPH HOSPITAL | |||||
| 010212435 | 9 | 1 | 1 | 1 | $0 |
| ST JOSEPH AMBULATORY CARE INC | |||||
| 010422885 | 9 | 1 | 1 | 1 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 18 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ALTERNATIVE INVESTMENTS | Description |
| Book Value | 45377110 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 45377110 | TotalOfBookValueSecurities |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 15367034 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 6717056 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 6717056 | RevenueNotRptdF990 |
| Revenue Subtotal | 8649978 | RevenueSubtotal |
| Other Revenues Not Included | 851295 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 851295 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 9501273 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 0 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 0 | ExpensesSubtotal |
| Other Expenses Not Included | 851295 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 851295 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 851295 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS IS THE FOLLOWING "TAX EXEMPT ORGANIZATIONS COULD BE REQUIRED TO RECORD AN OBLIGATION FOR INCOME TAXES AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS TAX EXPOSURE ITEMS INCLUDING UNRELATED BUSINESS INCOME OR TAX STATUS. THE SYSTEM HAS EVALUATED THE POSITIONS TAKEN ON ITS FILED TAX RETURNS, AND HAS CONCLUDED NO UNCERTAIN INCOME TAX POSITIONS EXIST AT DECEMBER 31, 2012." |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | INVESTMENT EXPENSES INCLUDED IN REVENUE 851,295. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | INVESTMENT EXPENSES INCLUDED IN REVENUE 851,295. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN AHLE | ||||||||||||||
| TREASURER/SECRETARY | 0 | 327760 | 0 | 118124 | 0 | 45412 | 0 | 130000 | 0 | 31726 | 0 | 653022 | 0 | 118124 |
| CAROLYN KASABIAN | ||||||||||||||
| TRUSTEE | 0 | 233889 | 0 | 0 | 0 | 20855 | 0 | 7184 | 0 | 19144 | 0 | 281072 | 0 | 0 |
| RICHARD J PLAMONDON | ||||||||||||||
| VICE PRESIDENT | 0 | 261479 | 0 | 0 | 0 | 24976 | 0 | 24453 | 0 | 25446 | 0 | 336354 | 0 | 0 |
| PAUL ERCOLINI | ||||||||||||||
| TRUSTEE | 0 | 140093 | 0 | 0 | 0 | 24056 | 0 | 6669 | 0 | 26241 | 0 | 197059 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE BOARD OF TRUSTEES DELEGATED MANAGEMENT DUTIES TO CARDINAL INVESTMENT MANAGEMENT, INC. (EIN 04-3391257). | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 IS PRESENTED TO, AND REVIEWED BY, THE BOARD PRIOR TO FILING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE MONITORING AND ENFORCEMENT OF COMPLIANCE WITH THE POLICY IS COMPLETED AT THE INDIVIDUAL BOARD LEVELS OF THE ENTITIES THAT ARE SHAREHOLDERS OF PROVIDENTIA PRIMA. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. | |
| FORM 990, PART XI, LINE 9: | NET TRANSFER FROM AFFILIATES 15,876,653. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2C | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (19 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| COVENANT HEALTH SYSTEM INC | |||||||||||
| 100 AMES POND DRIVE | TEWKSBURY | MA | 01876 | 222484505 | MANAGEMENT AND HEALTH RESOURCE ORGANIZATION | MA | 501(C)(3) | LINE 9 | N/A | 0 | |
| ST MARY'S HEALTH SYSTEM | |||||||||||
| PO BOX 7291 | LEWISTON | ME | 04243 | 222504349 | PARENT COMPANY | ME | 501(C)(3) | LINE 9 | 0 | COVENANT HEALTH SYSTEMS | |
| FANNY ALLEN CORPORATION | |||||||||||
| 790 COLLEGE PARKWAY | COLCHESTER | VT | 05446 | 222495808 | HEALTH CARE SERVICES | VT | 501(C)(3) | LINE 9 | 0 | COVENANT HEALTH SYSTEMS | |
| CHS WALTHAM | |||||||||||
| 66 NEWTON STREET | WALTHAM | MA | 02453 | 043333609 | SKILLED NURSING FACILITY | MA | 501(C)(3) | LINE 9 | 0 | COVENANT HEALTH SYSTEMS | |
| ST JOSEPH HOSPITAL | |||||||||||
| 172 KINSLEY ST | NASHUA | NH | 03061 | 020222215 | ACUTE CARE HOSPITAL | NH | 501(C)(3) | LINE 3 | 0 | COVENANT HEALTH SYSTEMS | |
| YOUVILLE HOSPITAL | |||||||||||
| 100 AMES POND DRIVE | TEWKSBURY | MA | 01876 | 023239563 | FORMER REHAB HOSPITAL | MA | 501(C)(3) | LINE 3 | 0 | COVENANT HEALTH SYSTEMS | |
| YOUVILLE PLACE | |||||||||||
| 10 PELHAM RD | LEXINGTON | MA | 02421 | 043297834 | ASSISTED LIVING FACILITY | MA | 501(C)(3) | LINE 9 | 0 | COVENANT HEALTH SYSTEMS | |
| ST ANDRE SKILLED NURSING AND REHAB FACILITY | |||||||||||
| 407 POOL ST | BIDDEFORD | ME | 04005 | 010342399 | SKILLED NURSING FACILITY | ME | 501(C)(3) | LINE 9 | 0 | COVENANT HEALTH SYSTEMS | |
| MI NURSING RESTORATIVE CENTER | |||||||||||
| 172 LAWRENCE ST | LAWRENCE | MA | 01841 | 042104851 | SKILLED NURSING FACILITY | MA | 501(C)(3) | LINE 9 | 0 | COVENANT HEALTH SYSTEMS | |
| ST MARY'S VILLA NURSING HOME | |||||||||||
| 675 ST MARYS VILLA ROAD | MOSCOW | PA | 18444 | 232057177 | SKILLED NURSING FACILITY | PA | 501(C)(3) | LINE 9 | 0 | COVENANT HEALTH SYSTEMS | |
| MI MANAGEMENT INC | |||||||||||
| 172 LAWRENCE ST | LAWRENCE | MA | 01841 | 042857794 | SKILLED NURSING FACILITY | MA | 501(C)(3) | LINE 9 | 0 | COVENANT HEALTH SYSTEMS | |
| MI ADULT DAY HEALTH CENTER | |||||||||||
| 172 LAWRENCE ST | LAWRENCE | MA | 01841 | 042921888 | SKILLED NURSING FACILITY | MA | 501(C)(3) | LINE 9 | 0 | COVENANT HEALTH SYSTEMS | |
| MI TRANSPORTATION | |||||||||||
| 172 LAWRENCE ST | LAWRENCE | MA | 01841 | 042921889 | SKILLED NURSING FACILITY | MA | 501(C)(3) | LINE 9 | 0 | COVENANT HEALTH SYSTEMS | |
| YOUVILLE HOUSE | |||||||||||
| 1575 CAMBRIDGE ST | CAMBRIDGE | MA | 02138 | 043239593 | ASSISTED LIVING FACILITY | MA | 501(C)(3) | LINE 9 | 0 | COVENANT HEALTH SYSTEMS | |
| YOUVILLE LIFECARE | |||||||||||
| 100 AMES POND DRIVE | TEWKSBURY | MA | 01876 | 042103582 | MANAGEMENT SERVICES | MA | 501(C)(3) | LINE 11A, I | 0 | COVENANT HEALTH SYSTEMS | |
| ST MARY'S REGIONAL MEDICAL CENTER | |||||||||||
| PO BOX 7291 | LEWISTON | ME | 04243 | 010211551 | HOSPITAL | ME | 501(C)(3) | LINE 9 | 0 | ST MARY'S HEALTH SYSTEM | |
| ST MARY'S D'YOUVILLE PAVILION | |||||||||||
| PO BOX 7291 | LEWISTON | ME | 04243 | 010211558 | NURSING HOME | ME | 501(C)(3) | LINE 9 | 0 | ST MARY'S HEALTH SYSTEM | |
| ST JOSEPH HOSPITAL | |||||||||||
| 360 BROADWAY | BANGOR | ME | 04402 | 010212435 | HOSPITAL | ME | 501(C)(3) | LINE 1 | 0 | ST JOSEPH HEALTHCARE FOUNDATION | |
| ST JOSEPH AMBULATORY CARE INC | |||||||||||
| 360 BROADWAY | BANGOR | ME | 04402 | 222480373 | PHYSICIAN PRATICE | ME | 501(C)(3) | LINE 3 | 0 | ST JOSEPH HEALTHCARE FOUNDATION | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (14 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| COVENANT HEALTH SYSTEMS INC | ||
| R | 21564389 | CASH |
| YOUVILLE HOUSE INC | ||
| R | 180771 | CASH |
| ST MARY'S HEALTH SYSTEM INC | ||
| R | 6000000 | CASH |
| ST MARY'S REGIONAL MEDICAL CENTER | ||
| R | 2840000 | CASH |
| FANNY ALLEN CORPORATION INC | ||
| R | 250000 | CASH |
| COVENANT HEALTH SYSTEMS INC | ||
| S | 16387390 | CASH |
| ST JOSEPH'S HOSPITAL OF NASHUA NH | ||
| S | 16932000 | CASH |
| YOUVILLE HOUSE INC | ||
| S | 1145770 | CASH |
| ST JOSEPH HOSPITAL | ||
| S | 297687 | CASH |
| ST MARY'S HEALTH SYSTEM INC | ||
| S | 563846 | CASH |
| ST MARY'S D'YOUVILLE PAVILION | ||
| S | 19313 | CASH |
| ST MARY'S REGIONAL MEDICAL CENTER | ||
| S | 8739306 | CASH |
| ST JOSEPH AMBULATORY CARE INC | ||
| S | 441500 | CASH |
| YOUVILLE PLACE | ||
| S | 1285000 | CASH |