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SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC (EIN 23-7379161)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-15
IRS object ID
201113199349300801
Schema version
2010v3.4
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)
Timestamp2011-11-15T02:00:52-05:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1190 CARONDELET PLAZA SUITE 1300AddressLine1
CityCLAYTONCity
StateMOState
ZIP Code63105ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN237379161EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SISTERS OF CHARITY OF LEAVENWORTHBusinessNameLine1
Business Name Line2HEALTH SYSTEM INCBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlSISTNameControl
Phone9138952800Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line19801 RENNER BOULEVARDAddressLine1
CityLENEXACity
StateKSState
ZIP Code662199745ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLYDIA JUMONVILLEName
TitleSR VP/CFOTitle
Date Signed2011-11-14DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3142901000Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonLYDIA W JUMONVILLENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12420 WEST 26TH AVE STE 100-DAddressLine1
CityDENVERCity
StateCOState
ZIP Code80211ZIPCode
FieldValueIRS element (for citing)
Gross Receipts101242709GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.sclhealthsystem.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1972YearFormation
State Legal DomicileKSStateLegalDomicile
Activity Or Mission DescriptionWE WILL, IN THE SPIRIT OF THE SISTERS OF CHARITY, REVEAL GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR OR VULNERABLE.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees271TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI-8577TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1093ContributionsGrantsPriorYear
Contributions Grants Current Year3100ContributionsGrantsCurrentYear
Program Service Revenue Prior Year59732749ProgramServiceRevenuePriorYear
Program Service Revenue CY72582296ProgramServiceRevenueCY
Investment Income Prior Year4240595InvestmentIncomePriorYear
Investment Income Current Year22559296InvestmentIncomeCurrentYear
Other Revenue Prior Year5456923OtherRevenuePriorYear
Other Revenue Current Year6098017OtherRevenueCurrentYear
Total Revenue Prior Year69431360TotalRevenuePriorYear
Total Revenue Current Year101242709TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year289461GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY379320GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year37882714SalariesEtcPriorYear
Salaries Etc Current Year40263716SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year65038561OtherExpensePriorYear
Other Expenses Current Year131032929OtherExpensesCurrentYear
Total Expenses Prior Year103210736TotalExpensesPriorYear
Total Expenses Current Year171675965TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-33779376RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-70433256RevenuesLessExpensesCY
Total Assets BOY825765094TotalAssetsBOY
Total Assets EOY1480585187TotalAssetsEOY
Total Liabilities BOY776716176TotalLiabilitiesBOY
Total Liabilities EOY1477109961TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY49048918NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY3475226NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionWE WILL, IN THE SPIRIT OF THE SISTERS OF CHARITY, REVEAL GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR OR VULNERABLE.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense59025230Expense
Grants0Grants
Revenue15175016Revenue
DescriptionFINANCE, AUDIT AND DEBT SERVICES - ADMINISTERS FINANCING PROGRAM AND REVIEWS THE CAPITAL FORMATION PROGRAM (FOR ELEVEN HOSPITALS AND FOUR CLINICS). IT ALSO OVERSEES THE AUDITS OF ITS RELATED AFFILIATES TO PROVIDE ASSURANCE REGARDING THE EFFECTIVENESS AND EFFICIENCY OF OPERATIONS AND THE RELIABILITY OF FINANCIAL REPORTING.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense3668129Expense
Grants0Grants
Revenue0Revenue
DescriptionHUMAN RESOURCES - ADMINISTERS PROGRAMS AND OTHER SERVICES TO THE ELEVEN HOSPITALS, FOUR CLINICS AND VARIOUS FOR-PROFIT ENTITIES WHICH ARE AFFILIATES OF SCLHS. PROGRAMS ADMINISTERED INCLUDE EMPLOYEE WELFARE BENEFIT PLANS, RETIREMENT PLANS, AND CERTAIN EXECUTIVE RECRUITING FUNCTIONS.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense52827400Expense
Grants0Grants
Revenue16551049Revenue
DescriptionINFORMATION SYSTEMS - COORDINATES THE CENTRALIZATION OF MANY OF THE INFORMATION SYSTEMS OF THE HEALTH SYSTEM. CURRENTLY, AN ENTERPRISE RESOURCE PLANNING (ERP) SYSTEM AND A RADIOLOGY INFORMATION SYSTEM (RIS) ARE INSTALLED AND BEING OPERATED. IN ADDITION, A CLINICAL AND PATIENT ADMINISTRATIVE SYSTEM IS BEING INSTALLED THROUGHOUT THE HEALTH SYSTEM.Description

Activity Other ActivityOther (4 entries)

ExpenseExpenseRevenueRevenueDescriptionDescriptionGrantsGrants
2663027838486684Quality, Risk Management, Communications:
74024122465822Medical Office Building, Denver, CO:
185108Depreciation:
379320Grants Related to SCLHS Mission:379320
FieldValueIRS element (for citing)
Total Of Other Program Service Exp34597118TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt379320TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev40952506TotalOfOtherProgramServiceRev
Total Program Service Expense150117877TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiestrueReportInvestOthSecurities
Report Prog Rel InvesttrueReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiestrueForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096262NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees271NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccounttrueForeignFinancialAccount
Name Of Foreign CountryCJNameOfForeignCountry
Name Of Foreign CountryUKNameOfForeignCountry
Name Of Foreign CountryCANameOfForeignCountry
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChapterstrueLocalChapters
Policies Reference ChapterstruePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSHARON OWENSSCL HEALTH SYSNamePerson
Telephone Number3038135190TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12420 W 26TH AVE STE 100-DAddressLine1
CityDENVERCity
StateCOState
ZIP Code80211ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (33 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
SISTER LYNN CASEY SCL
BOARD MEMBER-PARTIAL YEAR3.0X000
MICHAEL T DEFREECE
VICE CHAIRPERSON-PARTIAL YEAR3.0X38000X
SISTER KATHERINE FRANCHETT SCL
BOARD MEMBER-PARTIAL YEAR3.0X000
SISTER MAUREEN HALL SCL
VICE PRESIDENT-PARTIAL YEAR3.0X000X
TERRY HEATH
BOARD MEMBER3.0X000
GORDON HOWIE
CHAIRPERSON3.0X000X
SISTER EILEEN HURLEY SCL
BOARD MEMBER-PARTIAL YEAR3.0X000
KNUTE KNUDSON
BOARD MEMBER3.0X000
MATTHEW J LAMBERT III MD
VICE CHAIRPERSON-PARTIAL YEAR3.0X000X
SISTER JOAN SUE MILLER SCL
VICE PRESIDENT-PARTIAL YEAR3.0X000X
MARLON PRIEST MD
BOARD MEMBER3.0X62600
DENNIS PURTELL
BOARD MEMBER3.0X38600
SISTER LINDA ROTH SCL
BOARD MEMBER3.0X000
KENT RUSSELL
BOARD MEMBER-PARTIAL YEAR3.0X000
CAROLYN SMELTZER
BOARD MEMBER-PARTIAL YEAR3.0X78400
RON SPERLING
BOARD MEMBER3.0X33800
WILLIAM M MURRAY
PRESIDENT/CHIEF EXECUTIVE OFFI40.0X17064570169086X
LYDIA W JUMONVILLE
INTERIM TREASURER/SVP FIN/CFO40.02941900278X
MICHAEL D ROWE
TREASURER/SVP FIN/CFO40.0635455021368X
EDWARD L BARKER
SECRETARY/SVP GENERAL COUNSEL40.0967328068938X
MARK A WILKINSON
ASSISTANT TREASURER40.0136753025841X
PAMELA G LOGAN
ASSISTANT SECRETARY40.087763017132X
MARY JO GREGORY
EVP CHIEF OPERATING OFFICER40.013520590116263X
ROBERT A BOYSEN
VP CHIEF INFO OFFICER-PARTIAL40.0788947085811X
MARGARET J BREEN
SVP HUMAN RESOURCES40.05740960612685X
RICHARD T LOPES
SVP CHIEF TRANSFORMATION OFFIC40.0588276017185X
JILL WILLEN KENNELLY
VP CHIEF STRATEGY OFFICER40.0485416072262X
DAVID PECORARO
VP CHIEF INFO OFFICER-PARTIAL40.07934333299835001X
ROBERT W LADENBURGER
CEO EXEMPLA INC DENVER CO0.01224099063373X
JAMES T PAQUETTE
CEO ST VINCENT BILLINGS MT0.0768909097940X
LOURDES J LAZATIN
CEO SAINT JOHN'S SANTA MONICA0.0846020027143X
IRMA C NAPOLI
VP HUMAN RESOURCES40.0542838040337X
BAIN J FARRIS
CEO SAINT JOSEPH DENVER CO0.0525916073804X
FieldValueIRS element (for citing)
Total Reportable Comp From Org11606379TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs332998TotalReportableCompFrmRltdOrgs
Total Other Compensation1544447TotalOtherCompensation
Number Individuals GT100 K100NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
BROADLANE INC
13727 NOEL RDDALLASTX75240PROF/ADMIN PERSONNEL5139210
ERNST AND YOUNG LLP
PO BOX 660401DALLASTX75260AUDIT & TAX SERVICES1792983
CATHOLIC HEALTHCARE AUDIT NETWORK
231 SOUTH BEMISTONST LOUISMO63105INT AUDIT SERVICES1757895
HUSCH BLACKWELL SANDERS LLP
PO Box 802765KANSAS CITYMO641802765LEGAL CONSULTING1007747
MCKINSEY COMPANY INC
PO BOX 7247-7255PHILADELPHIAPA191707255CONSULTING9832750
FieldValueIRS element (for citing)
Number Of Contractors GT100 K23NumberOfContractorsGT100K
All Other Contributions3100AllOtherContributions
Total Contributions3100TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
AFFILIATE MANAGEMENT FEES541900548729545484295430000
PROGRAM RENTAL INCOME53200024905892490589
NET ASSETS RELEASED FROM RESTRICTIONS900099140000140000
INTEREST INCOME FROM NOTES RECEIVABLE5230001507875315078753
FieldValueIRS element (for citing)
Total Program Service Revenue72582296TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column10804603TotalRevenueColumn
Unrelated Business Revenue-38577UnrelatedBusinessRevenue
Exclusion$10,843,180ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column56292TotalRevenueColumn
Exclusion$56,292ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities11491341Securities
Other207060Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities11491341Securities
Other207060Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column11698401TotalRevenueColumn
Exclusion$11,698,401ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
VENDOR ADMINISTRATION REBATE9000996001742$6,001,742
DEBT GUARANTEE FEES9000999626396263
MISCELLANEOUS REVENUE9000991212
FieldValueIRS element (for citing)
Total Other Revenue6098017TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column101242709TotalRevenueColumn
Related Or Exempt Function Income72648571RelatedOrExemptFunctionIncome
Unrelated Business Revenue-8577UnrelatedBusinessRevenue
Exclusion$28,599,615ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total315667Total
Program Services315667ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total63653Total
Program Services63653ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total8897768Total
Program Services8897768ProgramServices

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total23955388Total
Program Services11921995ProgramServices
Management And General12033393ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4407633Total
Program Services2215397ProgramServices
Management And General2192236ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1460101Total
Program Services942253ProgramServices
Management And General517848ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1542826Total
Program Services1072190ProgramServices
Management And General470636ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total7277Total
Management And General7277ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total2793882Total
Management And General2793882ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total182470Total
Program Services182470ProgramServices

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total1155479Total
Management And General1155479ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total16271071Total
Program Services15646494ProgramServices
Management And General624577ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total669396Total
Program Services568987ProgramServices
Management And General100409ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total9660496Total
Program Services8211422ProgramServices
Management And General1449074ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1248218Total
Program Services1060985ProgramServices
Management And General187233ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total1616690Total
Program Services1616690ProgramServices

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total786666Total
Program Services786666ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total51997308Total
Program Services51997308ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total41852129Total
Program Services41852129ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total173624Total
Program Services147580ProgramServices
Management And General26044ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
SYSTEM DUES12740091274009
RENTAL LESS DEPRECIATION11662301166230
PRINTING173684173684
SCHOLARSHIP ADMIN EXPENSE43004300

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total171675965Total
Program Services150117877ProgramServices
Management And General21558088ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY443BOY
EOY988EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY6456749BOY
EOY22615441EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY60000BOY
EOY60000EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1750802BOY
EOY2714583EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis176910046LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec98980472LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY68918349BOY
EOY77929574EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY37384542BOY
EOY481273610EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY394290942BOY
EOY340800910EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY273145468BOY
EOY511801418EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY43757799BOY
EOY43388663EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY825765094BOY
EOY1480585187EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY17917000BOY
EOY48238199EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY630903678BOY
EOY1395010059EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY100000000BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY27895498BOY
EOY33861703EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY776716176BOY
EOY1477109961EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY11043137BOY
EOY-32798405EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY36005781BOY
EOY34273631EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2000000BOY
EOY2000000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY49048918BOY
EOY3475226EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY825765094BOY
EOY1480585187EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-70433256ReconcilationRevenueExpenses
Reconcilation Other Changes24859564ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type3 Func IntXSupportingOrg509a3Type3FuncInt
Certification CheckboxXCertificationCheckbox
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (14 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
PROVIDENCE MEDICAL CENTER INC
48078444603falsetruetrue$0
ST FRANCIS HEALTH CENTER INC
48054771903falsetruetrue$0
ST JAMES HEALTHCARE
81023178503falsetruetrue$0
SAINT JOHN HOSPITAL INC
48054376803falsetruetrue$0
SAINT JOHN'S HEALTH CENTER
95168408203falsetruetrue$0
SAINT JOSEPH HOSPITAL INC
84041713403falsetruetrue$0
EXEMPLA INC
84110360603falsetruetrue$0
ST MARY'S HOSPITAL AND MEDICAL CENTER INC
84042572003falsetruetrue$0
ST VINCENT HEALTHCARE
81023212403falsetruetrue$0
HOLY ROSARY HEALTHCARE
81023179203falsetruetrue$0
BETHANY COMMUNITY PLAZA INC
48120740703falsetruetrue$0
CARITAS CLINICS INC
48100991003falsetruetrue$0
MARIAN CLINIC INC
48104690503falsetruetrue$0
MARILLAC CLINIC INC
84108582203falsetruetrue$0
FieldValueIRS element (for citing)
Total Number Of Supported Orgs14TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteerstrueVolunteers
Paid Staff Or ManagementtruePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MemberstrueMailingsMembers
Mailings Members$35,412MailingsMembersAmount
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorstrueDirectContactLegislators
Direct Contact Legislators$56,539DirectContactLegislatorsAmount
Rallies DemonstrationstrueRalliesDemonstrations
Rallies Demonstrations$284,975RalliesDemonstrationsAmount
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB376926TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance3502137BeginningOfYearBalance
Contributions60804Contributions
Investment Earnings Or Losses277272InvestmentEarningsOrLosses
Other Expenditures200235OtherExpenditures
End Of Year Balance3639978EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance3435586BeginningOfYearBalance
Investment Earnings Or Losses261551InvestmentEarningsOrLosses
Other Expenditures195000OtherExpenditures
End Of Year Balance3502137EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance4177114BeginningOfYearBalance
Investment Earnings Or Losses-620022InvestmentEarningsOrLosses
Other Expenditures121506OtherExpenditures
End Of Year Balance3435586EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.54950PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.45050TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis36793483OtherCostOrOtherBasis
Book Value36793483BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis23931206OtherCostOrOtherBasis
Depreciation23559505Depreciation
Book Value371701BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1602195OtherCostOrOtherBasis
Depreciation1531681Depreciation
Book Value70514BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis114583162OtherCostOrOtherBasis
Depreciation73889286Depreciation
Book Value40693876BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value0BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings77929574TotalOfBookValueLandBuildings
Financial DerivativesFinancialDerivatives
Closely Held Equity InterestsCloselyHeldEquityInterests

Other Securities OtherSecurities (4 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
REAL ESTATE183070740F
ABSOLUTE RETURN FUNDS92242505F
CORE HEDGE FUNDS46873467F
PRIVATE EQUITY18614198F
FieldValueIRS element (for citing)
Total Of Book Value Securities340800910TotalOfBookValueSecurities

Investments Program Related InvestmentsProgramRelated (6 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
PROVIDENCE MEDICAL CENTER15663471F
ST. JOHN HOSPITAL, INC.1605816F
ST. JAMES HEALTHCARE14399438F
ST. MARY'S HOSPITAL & MEDICAL44092693F
SAINT JOHN'S HEALTH CENTER105000000F
SAINT JOSEPH HOSPITAL331040000F
FieldValueIRS element (for citing)
Total Of Book Value Program Related511801418TotalOfBookValueProgramRelated
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
DEFERRED COMP 457 PLAN LIAB$7,428,054
INTEREST RATE SWAP LIABILITY$13,348,330
FROZEN DB PLAN$13,085,319
FieldValueIRS element (for citing)
Total Of Amounts33861703TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierExplanationExplanation
FORM 990, SCHEDULE D, PART V, LINE 4 (ENDOWMENT FUNDS)SCLHS HAS A PERMANENT ENDOWMENT IN THE AMOUNT OF $2,000,000. THE EARNINGS FROM THE PERMANENT ENDOWMENT ARE A TERM ENDOWMENT TO BE USED FOR EDUCATION PURPOSES AS DETERMINED BY SCLHS MANAGEMENT.
FORM 990, SCHEDULE D, PART X (ASC 740-10 FOOTNOTE DISCLOSURE)SCLHS DID NOT HAVE A DISCLOSURE OF ASC 740-10 - INCOME TAXES IN ITS DECEMBER 31, 2010 AUDITED FINANCIAL STATEMENTS AS IT WAS NOT MATERIAL.

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable (4 entries)

RegionRegionNumber Of OfficesNumberOfOfficesNumber Of EmployeesNumberOfEmployeesType Of Activities ConductedTypeOfActivitiesConductedSpecific Services ProvidedSpecificServicesProvidedTotal ExpendituresTotalExpenditures
Central America and the Caribbean00Program ServicesCAPTIVE INSURANCE PREM19006085
Central America and the CaribbeanInvestments123267000
Europe (Including Iceland and Greenland)Investments2843000
North AmericaInvestments0
FieldValueIRS element (for citing)
Subtotal Number Of Offices0SubtotalNumberOfOffices
Subtotal Number Of Employees0SubtotalNumberOfEmployees
Total Number Of Offices0TotalNumberOfOffices
Total Number Of Employees0TotalNumberOfEmployees
Subtotal Amount Spent145116085SubtotalAmountSpent
Total Amount Spent145116085TotalAmountSpent
Transfer To Foreign CorptrueTransferToForeignCorp
Interest In Foreign TrustfalseInterestInForeignTrust
Own Foreign CorptrueOwnForeignCorp
Passive Foreign Invest CotruePassiveForeignInvestCo
Foreign PartnershiptrueForeignPartnership
Boycott CountriesfalseBoycottCountries

Form990 Schedule F Part V Form990ScheduleFPartV

FieldValueIRS element (for citing)
IdentifierSchedule F, Part I, Line 3Identifier
ExplanationSCLHS' expenditures (premiums paid) for its captive insurance premiums was $19,006,085 net of premium discounts.Explanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (11 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
CRISTO REY KANSAS CITY SCHOOL
211 W LINWOOD BLVDKANSAS CITYMO64111436033728501(c)(3)32416SCHOOL SUPPORT
ST VINCENT HEALTHCARE FOUNDATION
1106 N 30TH STBILLINGSMT59101481092520501(c)(3)10000FUNDRAISER SPONSOR
ST FRANCIS HEALTH CENTER FOUNDATION
1700 SW 7TH STTOPEKAKS66606480925688501(c)(3)10000FUNDRAISER SPONSOR
PROVIDENCE SAINT JOHN FOUNDATION
8929 PARALLEL PARKWAYKANSAS CITYKS66112956100079501(c)(3)10000FUNDRAISER SPONSOR
SAINT JOHNS HOSPITAL AND HEALTH CENTER FOUNDATION
2121 SANTA MONICA BLVDSANTA MONICACA90404481046905501(c)(3)65000FUNDRAISER SPONSOR AND MOTHER XAVIER ROSS AWARD
ST MARYS HOSPITAL FOUNDATION
2635 N 7TH STREETGRAND JUNCTIONCO81502651202190501(c)(3)10000FUNDRAISER SPONSOR
UNIVERSITY OF ST MARY
4100 SOUTH 4TH STREETLEAVENWORTHKS66048480547846501(C)(3)29500FUNDRAISER SPONSOR AND SUPPORT
LEGENDS OF GRAND VALLEY
248 S 4TH STGRAND JUNCTIONCO81501234338654501(C)(3)10000FUNDRAISER SPONSOR
AMERICAN RED CROSS
2025 EAST ST NWWASHINGTONDC20001530196605501(C)(3)33333HAITI RELIEF SUPPORT
CATHOLIC CHARITIES USA
PO BOX 17090BALTIMOREMD212037090530196620501(C)(3)33333HAITI RELIEF SUPPORT
PARTNERS IN PROGRESS
329 N FAIRFIELD STREETLIGONIERPA15658252896636501(C)(3)33333HAITI RELIEF SUPPORT
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants11TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantSECONDARY EDUCATION SCHOLARSHIPSTypeOfGrant
Number Of Recipients35NumberOfRecipients
Amount Of Cash Grant63653AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierForm 990, SCHEDULE I, PART I, LINE 2 (MONITORING OF GRANTS)Identifier
ExplanationSCLHS' MISSION DEPARTMENT REQUIRES WRITTEN STATEMENTS THREE TIMES A YEAR REGARDING THE PROGRESS AND STATUS OF THE GRANT.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
First Class Or Charter TravelXFirstClassOrCharterTravel
Travel For CompanionsXTravelForCompanions
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (16 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
WILLIAM M MURRAY
91018004893280306949015781601127001875543000
LYDIA W JUMONVILLE
270273000239170002780294468000
MICHAEL D ROWE
3283240250906056225018300030680656823000
EDWARD L BARKER
4537160245899026771305325401568401036266000
MARK A WILKINSON
13266400040890119410139000162594000
MARY JO GREGORY
71779803081710326090010534601091701468322000
ROBERT A BOYSEN
376494015906602533870747780110330874758000
MARGARET J BREEN
27289200030120406075430514201186781000
RICHARD T LOPES
1997210350775037780014673025120605461000
JILL WILLEN KENNELLY
3334450665310854400567500155120557678000
DAVID PECORARO
764502295470830442893204073977161052010129098533036201200
ROBERT W LADENBURGER
5764080268750037894105261301076001287472000
JAMES T PAQUETTE
41692006646202855270870720108680866849000
LOURDES J LAZATIN
501230010018902446010196000754308731630565300
IRMA C NAPOLI
28927101200670133500033986063510583175000
BAIN J FARRIS
4250340831640177180631050106990599720000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSCHEDULE J SUPPLEMENTAL DISCLOSURESIdentifier
ExplanationSCHEDULE J, PART I, LINE 1a (CHARTER TRAVEL) DURING 2010, SCLHS UTILIZED A CHARTER AIRCRAFT TO TRANSPORT AN EXECUTIVE TO A MEETING AT ITS AFFILIATE HOSPITAL IN BUTTE, MT. DUE TO SCHEDULE REQUIREMENTS THIS WAS THE ONLY TRANSPORTATION OPTION. ---------------------------------------------------------------------- SCHEDULE J, PART I, LINE 1a (TRAVEL FOR COMPANION) SCLHS AND ITS AFFILIATES HAVE ANNUAL RETREATS FOR THEIR BOARDS OF DIRECTORS. THE BOARD MEMBERS AND MANAGEMENT ARE ALLOWED TO BE REIMBURSED IF THEY BRING A SPOUSE OR GUEST TO THESE RETREATS. THESE AMOUNTS ARE TREATED AS TAXABLE COMPENSATION. THE INDIVIDUALS LISTED THAT WERE TAXED FOR 2010 WERE: MICHAEL T DEFREECE MARLON PRIEST MD DENNIS PURTELL CAROLYN SMELTZER RON SPERLING LYDIA W JUMONVILLE MARY JO GREGORY ROBERT W LADENBURGER BAIN J FARRIS ---------------------------------------------------------------------- SCHEDULE J, PART I, LINE 1a (TAX INDEMNIFICATION AND GROSS-UP PAYMENTS) SCLHS ALLOWS FOR CERTAIN TAX INDEMNIFICATION AND GROSS-UP PAYMENTS IN THE INSTANCES OF RELOCATION AND TEMPORARY HOUSING. THESE AMOUNTS ARE TREATED AS TAXABLE COMPENSATION. THE INDIVIDUALS LISTED THAT WERE TAXED FOR 2010 WERE: LYDIA W JUMONVILLE MARY JO GREGORY MARGARET J BREEN ROBERT W LADENBURGER ---------------------------------------------------------------------- SCHEDULE J, PART I, LINE 1a (HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE) SCLHS ALLOWS FOR CERTAIN HOUSING PAYMENTS IN THE INSTANCES OF RELOCATION AND TEMPORARY HOUSING. THESE AMOUNTS ARE TREATED AS TAXABLE COMPENSATION. THE INDIVIDUALS LISTED THAT WERE TAXED FOR 2010 WERE: LYDIA W JUMONVILLE MARY JO GREGORY MARGARET J BREEN ---------------------------------------------------------------------- SCHEDULE J, PART I, LINE 1a (CLUB MEMBERSHIPS) SCLHS HAS CERTAIN CORPORATE CLUB MEMBERSHIPS. PERSONAL USE IS TREATED AS TAXABLE COMENSATION TO THE INDIVIDUAL FOR IRS PURPOSES. THE INDIVIDUALS LISTED THAT WERE TAXED FOR 2010 WERE: LOURDES J LAZATIN ---------------------------------------------------------------------- SCHEDULE J, PART I, LINE 4a (SEVERANCE PAYMENTS) SCLHS PERIODICALLY INCURS SEVERANCE PAYMENTS RELATED TO FORMER EMPLOYEES. THE AMOUNTS PAID TO LISTED INDIVIDUALS FOR SEVERANCE IN 2010 WERE: MARGARET J BREEN-$43,317 ---------------------------------------------------------------------- SCHEDULE J, PART I, LINE 4b (PAYMENTS FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN) OTHER REPORTABLE COMPENSATION SHOWN IN SCHEDULE J PART II COLUMN (B) (III) CONTAINS AN ANNUAL REPORTING ADJUSTMENT FOR CERTAIN EMPLOYEES WHO PARTICIPATE IN THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS. SCLHS PROVIDES NONQUALIFIED RETIREMENT PLANS FOR EXECUTIVES TO COMPENSATE FOR REGULATORY IMPOSED LIMITATIONS IN QUALIFIED RETIREMENT PLANS AND TO PROVIDE A BENEFIT CONSISTENT WITH OTHER NOT FOR PROFIT HEALTH SYSTEMS. THESE PLANS ENABLE THE EXECUTIVE TO EARN BENEFITS DURING EACH YEAR THAT THEY PARTICIPATE. ON THE ADVICE OF COUNSEL, SCLHS HAS DETERMINED THAT THESE BENEFITS SHOULD BE SUBJECT TO TAXATION AS THEY ARE EARNED AND VESTED RATHER THAN WHEN THEY ARE RECEIVED. AS A RESULT, THE TOTAL NONQUALIFIED RETIREMENT PLAN BENEFITS, WHICH WERE ACCRUED AND VESTED IN THE CURRENT YEAR, ARE NOW CONSIDERED TAXABLE AND THUS WERE TAXED TO THE PARTICIPANTS. AN AMOUNT EQUAL TO THE PARTICIPANT'S EXPECTED INCOME TAX LIABILITY WAS WITHDRAWN FROM THE PARTICIPANT'S ACCOUNT AND REMITTED TO THE IRS AS WITHHOLDING ON THE TAXABLE BENEFIT. THE AMOUNTS WITHDRAWN FROM THE PLAN FOR TAXES IN 2010 WERE: WILLIAM M MURRAY-$113,244 EDWARD L BARKER-$106,552 ROBERT A BOYSEN-$96,080 ROBERT W LADENBURGER-$111,377 JAMES T PAQUETTE-$108,797 LOURDS J LAZATIN-$101,512 IRMA C NAPOLI-$45,489 IN ADDITION, VESTED AMOUNTS ARE PAYABLE UPON END OF EMPLOYMENT. THE AMOUNTS WITHDRAWN FOR THIS TYPE OF PAYMENT IN 2010 WERE: MICHAEL D ROWE-$128,351 RICHARD T LOPES-$152,565 ---------------------------------------------------------------------- SCHEDULE J (ADDITIONAL OFFICER AND BOARD DISCLOSURES) THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) CONSISTS OF ELEVEN HOSPITALS AND FOUR CLINICS (AFFILIATES) IN FOUR STATES. SCLHS AND ITS AFFILIATES ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING TRANSPARENCY AND ACCOUNTABILITY. IN KEEPING WITH SCLHS' CORE VALUE OF STEWARDSHIP, NO BOARD MEMBER SERVING ON SCLHS' BOARD OF DIRECTORS (BOARD) IS COMPENSATED FOR THAT SERVICE. SCLHS' BOARD COMPENSATION COMMITTEE (COMMITTEE) HAS RETAINED THE SERVICES OF SULLIVAN, COTTER AND ASSOCIATES, INC. (SULLIVAN COTTER), AS INDEPENDENT COMPENSATION ADVISORS. SULLIVAN COTTER IS RESPONSIBLE FOR ADVISING THE COMMITTEE ON ALL MATTERS RELATING TO EXECUTIVE COMPENSATION INCLUDING SUPPORTING THE COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED OFFICERS IS CONSISTENT WITH MARKET VALUE AND THE PAY PHILOSOPHY SET BY THE BOARD. THE PAY PHILOSOPHY SET BY THE BOARD IS TO PAY AT THE MIDDLE OF THE MARKET FOR EXECUTIVES OF SIMILAR SIZED ORGANIZATIONS OVERALL. SCLHS' EXECUTIVE COMPENSATION IS COMPARABLE TO THAT PROVIDED BY SIMILAR, NOT-FOR-PROFIT HEALTHCARE SYSTEMS AND HOSPITALS. THE SISTERS WHO SERVE AS OFFICERS AND / OR BOARD MEMBERS OF THIS HEALTH SYSTEM ARE MEMBERS OF THE SISTERS OF CHARITY OF LEAVENWORTH (A RELIGIOUS ORDER OF WOMEN). AS MEMBERS OF THIS ORDER, THEY HAVE TAKEN VOWS OF POVERTY AND RECEIVE NO COMPENSATION, EXPENSE ACCOUNT ALLOWANCE, OR CONTRIBUTIONS TO BENEFIT PLANS FOR THEIR SERVICES TO THE HEALTH SYSTEM. HOWEVER, PAYMENT IS MADE DIRECTLY TO THE SISTERS OF CHARITY OF LEAVENWORTH FOR THE SERVICES OF THOSE WHO PERFORM PROFESSIONAL, ADMINISTRATIVE, AND OTHER SUCH SERVICES. ----------------------------------------------------------------------Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
MONTANA FACILITY FINANCE AUTHORITY
81030240261204KBB62003-12-05392100002/2/1994 REFINANCE+BLDGS+EQUIPMENTfalsefalsefalse
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
52164382813033FQU72003-12-05497550002/2/1994 REFINANCEfalsefalsefalse
COLORADO HEALTH FACILITIES AUTHORITY
840752932196474K582003-12-051030350002/2/1994&9/9/1992 REFINANCE+BLDGS+falsefalsefalse
MONTANA FACILITY FINANCE AUTHORITY
81030240261204KBC42006-03-0735000000CONSTRUCT/REMODEL HOSPITAL FACILITfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Amount RetiredAmountRetiredAmount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapitalized InterestCapitalizedInterestRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsAmount UnspentAmountUnspentYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
0039210022000270531007630591002003truefalsetruetrue
00497550550003462000055002003truefalsetruetrue
001030354330007144380022369995002003truefalsetruetrue
00350289970003252990034703698002006falsefalsetruetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsetruetruefalsetrue0.000000.000740.00074true
falsetruetruefalsetrue0.000000.000000.00000true
falsetruetruefalsetrue0.000000.029370.02937true
falsetruetruefalsetrue0.000550.030930.03148true

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsTerm Of HedgeTermOfHedgeSuperintegrated HedgeSuperintegratedHedgeHedge TerminatedHedgeTerminatedGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
MERRILL LYNCH
truetruetrue20.falsefalsefalsefalsefalse
MERRILL LYNCH
truetruetrue20.falsefalsefalsefalsefalse
MERRILL LYNCH
truetruetrue20.falsefalsefalsefalsefalse
DEUTSCHE BANK
truetruetrue25.falsefalsefalsefalsefalse

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
IdentifierFORM 990, SCHEDULE K, PART I, COLUMN (C), CUSIP #Identifier
ExplanationSCHEDULE K DISCLOSES THE COLORADO HEALTH FACILITIES AUTHORITY BONDS, ISSUED 12/05/2003, WITH AN ISSUE PRICE OF $103,035,000. THIS IS DISCLOSED AS ONE LINE ON SCHEDULE K DUE TO ONLY ONE FORM 8038 BEING ISSUED. THAT SAID, THERE ARE ACTUALLY TWO CUSIP NUMBERS, AS FOLLOWS: PER FORM 8038: CUSIP - 196474 K58 / K41 ACTUAL: CUSIP - 196474 K58 and CUSIP - 196474 K41Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990 GENERAL EXPLANATIONS_1FORM 990 (DEFINITION) SCLHS = SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. ------------------------------------------------------------------------- FORM 990, PART VI (GOVERNANCE, MANAGEMENT, & DISCLOSURE) SECTION A. GOVERNING BODY AND MANAGEMENT 6., 7(A)., AND 7(B). SCLHS DOES HAVE MEMBERS WHO APPOINT THE BOARD OF DIRECTORS OF SCLHS. THE MEMBERS OF SCLHS ARE THE COMMUNITY DIRECTOR AND THOSE PERSONS WHO ARE MEMBERS OF THE COMMUNITY COUNCIL OF THE SISTERS OF CHARITY OF LEAVENWORTH RELIGIOUS COMMUNITY. SECTION B. POLICIES 11(B). SCLHS' GOVERNING BODY, A BOARD OF DIRECTORS, REVIEWS THE FORM 990 BEFORE IT IS FILED WITH THE IRS. THIS PROCESS INVOLVES EACH BOARD MEMBER RECEIVING A DRAFT OF THE FORM 990 AND THE OPPORTUNITY TO REVIEW AND ASK QUESTIONS BEFORE IT IS FILED, THUS ENSURING THAT THE INFORMATION ACCURATELY REFLECTS SCLHS' MISSION, OPERATIONS, COMMUNITY BENEFITS, GOVERNANCE OVERSIGHT, ETC. FURTHER, AND BEFORE THE FORM 990 IS FILED, IT IS REFLECTED IN THE MINUTES OF THE BOARD OF DIRECTORS THAT THEY HAVE REVIEWED THE DOCUMENTS AND INFORMATION, AND THAT THIS REVIEW WAS IN FACT MEANINGFUL. 12(C). SCLHS REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES ITS CONFLICT OF INTEREST POLICY BY PROVIDING EDUCATION AND TRAINING FOR EACH OF ITS EMPLOYEES, STAFF, OFFICERS AND DIRECTORS, AS WELL AS HAVING EACH OF THESE INDIVIDUALS COMPLETE A CONFLICT OF INTEREST STATEMENT ON AN ANNUAL BASIS TO DISCLOSE ANY POTENTIAL CONFLICT ISSUES. THESE STATEMENTS ARE CAREFULLY REVIEWED AND A REPORT PROVIDED TO SCLHS' PRESIDENT/CEO REGARDING EMPLOYEES AND OFFICERS, AND TO THE CHAIR OF THE BOARD AND CHAIR OF THE GOVERNANCE COMMITTEE REGARDING BOARD MEMBERS. IN THE EVENT OF A CONFLICT OF INTEREST WITH AN SCLHS BOARD MEMBER, THE CONFLICT SHALL PROMPTLY BE REPORTED TO THE SCLHS BOARD CHAIR WHO WILL PRESENT THE FACTS TO THE SCLHS GOVERNANCE COMMITTEE FOR EVALUATION AND PRESENTATION TO THE SCLHS BOARD OF DIRECTORS FOR ITS ACTION. 15(A) & 15(B). SCLHS' PROCESS FOR DETERMINING COMPENSATION FOR THE TOP MANAGEMENT, SENIOR LEADERSHIP, IS THE RESPONSIBILITY OF THE SCLHS COMPENSATION COMMITTEE. THIS COMMITTEE IS COMPOSED OF THREE OR MORE MEMBERS WHO ARE NOT CURRENT EMPLOYEES OF SCLHS, OR FORMER EMPLOYEES WITH NO ACTIVE INTEREST IN THE SCLHS' COMPENSATION PROGRAM, INCLUDING AT LEAST TWO MEMBERS OF THE SCLHS BOARD. SCLHS BELIEVES THAT THE INDEPENDENCE OF THESE MEMBERS IS VITAL TO THE INTEGRITY OF THE PROCESS. THE WORK OF THIS COMMITTEE INCLUDES BEING CONSTANTLY AWARE OF THE CURRENT COMPETITIVE MARKET FOR MANAGEMENT AND SENIOR LEADERS, AS WELL AS COMPILING AND MAINTAINING RECORDS OF COMPARABLE COMPENSATION AND BENEFITS DATA, INCLUDING SURVEYS AND OTHER ANALYSES, TO SUPPORT SCLHS' TOTAL COMPENSATION TO EACH INDIVIDUAL. MINUTES ARE KEPT CONTEMPORANEOUSLY FOR EACH MEETING OF THE COMMITTEE. LIKEWISE, THE COMMITTEE IS RESPONSIBLE FOR ENSURING THAT NO "EXCESS BENEFIT" IS CONFERRED ON AN INDIVIDUAL, OR THAT SUCH COMPENSATION DOES NOT CONSTITUTE PROHIBITED INUREMENT. THIS PROCESS IS COMPLETED FOR ALL SENIOR LEADERSHIP, AT THE AFFILIATE AND SYSTEM LEVEL, AND THE COMMITTEE'S RECOMMENDATION IS THEN SUBMITTED TO THE SCLHS BOARD FOR APPROVAL. THE CHARGE OF THIS COMMITTEE ADHERES TO SCLHS' CORE VALUE OF STEWARDSHIP, ENSURING THAT THE MINISTRY'S RESOURCES HELD IN TRUST ARE NOT WASTED OR MISUSED, AND ARE DEPLOYED TO EFFECTIVELY AND EFFICIENTLY ADVANCE THE MISSION. SECTION C. DISCLOSURE 19. SCLHS' GOVERNANCE MANUAL FOR BOARD MEMBERS IS AVAILABLE TO THE PUBLIC ON THE WEBSITE, WWW.GREATBOARDS.ORG. THE MANUAL SETS FORTH THE STANDARDS AND EXPECTATIONS OF EACH BOARD MEMBER INCLUDING THE FIDUCIARY DUTY OF LOYALTY WHICH REQUIRES THAT EACH MEMBER ABIDE BY SCLHS' CONFLICT OF INTEREST POLICY, DISCLOSE ANY ISSUES WHICH MAY PRESENT A CONFLICT, COMPLETE THE ANNUAL DISCLOSURE STATEMENT, REVIEW POLICIES AND PROCEDURES PERTAINING TO CONFLICTS OF INTEREST, AND PROVIDE OVERSIGHT OF SCLHS' RESPONSIBILITY PROGRAM. FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. ------------------------------------------------------------------------- FORM 990, PART XI (RECONCILIATION OF NET ASSETS) LINE 5: OTHER CHANGES IN NET ASSETS: UNREALIZED GAIN ON INVESTMENTS $26,753,038 UNREALIZED LOSS ON SWAPS (2,421,851) FROZEN DEFINED BENEFIT RETIREMENT PLAN GAIN 5,873,419 EQUITY TRANSFERS FROM RELATED 5,621,780 FAS 158 LOSS ON DEFINED BENEFIT PLANS (9,176,059) SELF-INSURED LIABILITY REDUCTION (1,651,332) RESTRICTED NET ASSET ACTIVITY (139,431) ----------- TOTAL $24,859,564 =========== ------------------------------------------------------------------------- FORM 990, PART XII, LINE 2 (FINANCIAL STATEMENTS & REPORTING) SCLHS HAS AN INDEPENDENT AUDIT COMPLETED AND REPORTED UPON ANNUALLY ON ITS CONSOLIDATED ORGANIZATION. THERE IS NO SEPARATE AUDIT REPORT FOR SCLHS. IN ADDITION, SCLHS' BOARD HAS AN AUDIT COMMITTEE WHICH HAS OVERSIGHT OF THE EXTERNAL AUDIT PROCESS AND RESULTS AS WELL AS SELECTION OF THE INDEPENDENT AUDITORS. CURRENT INDEPENDENT AUDITORS ARE ERNST & YOUNG, LLP. -------------------------------------------------------------------------
FORM 990 GENERAL EXPLANATIONS_2FORM 926, STATEMENT PURSUANT TO TREASURY REG. SEC. 1.6038B-1(C): APPLICABLE TO ALL IRS FORMS 926 FILED WITH THIS RETURN. 1. TRANSFEROR NAME: SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. AND U.S. TAXPAYER IDENTIFICATION NUMBER: 23-7379161. 2. TRANSFEREE: A. NAME: VARIOUS, SEE IRS FORMS 926, PART II, LINE 3; TAXPAYER IDENTIFICATION NUMBER: VARIOUS, SEE IRS FORMS 926, PART II, LINE 4; ADDRESS: VARIOUS, SEE IRS FORMS 926, PART II, LINE 5; COUNTRY OF INCORPORATION: VARIOUS, SEE IRS FORMS 926, PART II, LINE 6. B. GENERAL DESCRIPTION OF THE TRANSFER: VARIOUS, GENERALLY CASH, SEE IRS FORMS 926, PART III. 3. CONSIDERATION RECEIVED: SEE AMOUNT ON IRS FORMS 926, PART III. 4. PROPERTY TRANSFERRED, INCLUDING THE ESTIMATED FAIR MARKET VALUE AND ADJUSTED BASIS OF THE PROPERTY: A. ACTIVE BUSINESS PROPERTY: SEE AMOUNT ON IRS FORMS 926, PART III. B. STOCK OR SECURITIES: SEE AMOUNT ON IRS FORMS 926, PART III. I. ACTIVE TRADE OR BUSINESS STOCK. II. APPLICATION OF SPECIAL RULES. C. DEPRECIATED PROPERTY: SEE AMOUNT ON IRS FORMS 926, PART III. D. PROPERTY TO BE LEASED: N/A E. PROPERTY TO BE SOLD: N/A F. TRANSFERS TO FSCS: N/A G. TAINTED PROPERTY: N/A I. INVENTORY, ETC.: PROPERTY DESCRIBED IN SEC. 1.367(A)-5T(B); II. INSTALLMENT OBLIGATIONS, ETC.: PROPERTY DESCRIBED IN SEC. 1.367(A)-5T(C); III. FOREIGN CURRENCY, ETC: PROPERTY DESCRIBED IN SEC. 1.367(A)-5T(D); IV. INTANGIBLE PROPERTY: PROPERTY DESCRIBED IN SEC. 1.367(A)-5T(E); V. LEASED PROPERTY: PROPERTY DESCRIBED IN SEC. 1.367(A)-5T(F). H. FOREIGN LOSS BRANCH: N/A I. OTHER INTANGIBLES: SEE AMOUNT ON IRS FORMS 926, PART III. 5. TRANSFER OF FOREIGN BRANCH WITH PREVIOUSLY DEDUCTED LOSSES: N/A A. BRANCH OPERATION. B. BRANCH PROPERTY. C. PREVIOUSLY DEDUCTED LOSSES. D. CHARACTER OF GAIN IN ACCORDANCE WITH SEC. 1.367(A)-6T(C)(1). N/A ------------------------------------------------------------------------- FORM 926, STATEMENT PURSUANT TO TREASURY REGS. SEC. 1.351-3T(A) AND SEC. 1.351-3T(B): APPLICABLE TO ALL IRS FORMS 926 WHERE SCLHS IS A SIGNIFICANT TRANSFEROR. BY: SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. EIN: 23-7379161 YEAR ENDED DECEMBER 31, 2010. 1. NAME AND EIN (IF ANY) OF TRANSFEREE CORPORATION(S): SEE FORMS 926, PART II, LINES 3 AND 4. 2. DATE(S) OF THE TRANSFER(S) OF ASSETS: VARIOUS DATES. SEE FORMS 926, PART III. 3. IMMEDIATELY BEFORE THE EXCHANGE, THE PROPERTY TRANSFERRED BY THE TRANSFEROR IN EXCHANGE HAD AN: (A) AGGREGATE FAIR MARKET VALUE OF: SEE FORMS 926, PART III WHERE CASH VALUE EXCHANGED WAS REPORTED. (B) AGGREGATE BASIS OF: SINCE CASH WAS EXCHANGED, BASIS IS EQUAL TO FAIR MARKET VALUE ABOVE. 4. DATE AND CONTROL NUMBER OF ANY PRIVATE LETTER RULING(S) ISSUED BY THE INTERNAL REVENUE SERVICE IN CONNECTION WITH THE SECTION 351 EXCHANGE: NOT APPLICABLE. ------------------------------------------------------------------------- FORM 5471, STATEMENT PURSUANT TO TREASURY REG. SEC. 1.351-3T(B): APPLICABLE TO ALL IRS FORMS 5471 FILED WITH THIS RETURN. BY: VARIOUS, SEE ALL FORMS 5471 FILED WITH THIS RETURN. EIN: VARIOUS, SEE ALL FORMS 5471 FILED WITH THIS RETURN. YEAR ENDED DECEMBER 31, 2010. 1. NAME AND EIN (IF ANY) OF TRANSFEREE CORPORATION(S): SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC.; 23-7379161. 2. DATE(S) OF THE TRANSFER(S) OF ASSETS: VARIOUS DATES. SEE FORMS 5471. 3. IMMEDIATELY BEFORE THE EXCHANGE, THE PROPERTY TRANSFERRED BY THE TRANSFEROR IN EXCHANGE HAD AN: (A) AGGREGATE FAIR MARKET VALUE OF: SEE FORMS 5471 WHERE CASH VALUE EXCHANGED WAS REPORTED. (B) AGGREGATE BASIS OF: SINCE CASH WAS EXCHANGED, BASIS IS EQUAL TO FAIR MARKET VALUE ABOVE. 4. DATE AND CONTROL NUMBER OF ANY PRIVATE LETTER RULING(S) ISSUED BY THE INTERNAL REVENUE SERVICE IN CONNECTION WITH THE SECTION 351 EXCHANGE: NOT APPLICABLE. ------------------------------------------------------------------------- FORM 5471, STATEMENT OF REASONABLE CAUSE PURSUANT TO TREASURY REG. SEC. 301.6679-1(A)(3): SCLHS, A SHAREHOLDER OF THE RIVERVIEW MULTI-SERIES FUND SPC, LTD., IS NOT IN POSSESSION OF CERTAIN INFORMATION REQUESTED BY THE IRS ON FORM 5471 AND IS UNABLE TO OBTAIN SUCH INFORMATION FROM RIVERVIEW MULTI-SERIES FUND SPC, LTD. SPECIFICALLY, SCLHS IS NOT IN POSSESSION OF THE FOLLOWING INFORMATION REQUESTED IN FORM 5471: SCHEDULE B: THE IDENTITY, HOLDINGS AND INCOME OF OTHER U.S. SHAREHOLDERS AND THEIR PRO RATA SHARE OF SUBPART F INCOME; THIS STATEMENT IS INTENDED TO SERVE AS A STATEMENT OF REASONABLE CAUSE IN ACCORDANCE WITH TREASURY REG. SEC. 301.6679-1(A)(3). ------------------------------------------------------------------------- FORM 5471, STATEMENT OF REASONABLE CAUSE PURSUANT TO TREASURY REG. SEC. 301.6679-1(A)(3) AND 1.6038-2(K)(3)(II): SCLHS, A SHAREHOLDER OF THE JP MORGAN HEDGE FUND SPC, LTD -ACCESS MAR09 SEGREGATED PORTFOLIO, IS NOT IN POSSESSION OF CERTAIN INFORMATION REQUESTED BY THE IRS ON FORM 5471 AND IS UNABLE TO OBTAIN SUCH INFORMATION FROM JP MORGAN HEDGE FUND SPC, LTD -ACCESS MAR09 SEGREGATED PORTFOLIO. SPECIFICALLY, SCLHS IS NOT IN POSSESSION OF THE FOLLOWING INFORMATION REQUESTED IN FORM 5471: SCHEDULE B: THE IDENTITY, HOLDINGS AND INCOME OF OTHER U.S. SHAREHOLDERS AND THEIR PRO RATA SHARE OF SUBPART F INCOME; SCHEDULE E: THE INCOME, WAR PROFITS, AND EXCESS PROFITS TAXES PAID OR ACCRUED BY THE CORPORATION; SCHEDULE G: THE OTHER INFORMATION REGARDING THE CORPORATION. NOTE ALL BOXES ARE MARKED NO BY DEFAULT OF SCLHS' TAX SOFTWARE. ANSWERS MAY NOT BE ACCURATE; SCHEDULE H: THE CURRENT EARNINGS AND PROFITS OF THE CORPORATION; SCHEDULE I: THE SUMMARY OF SHAREHOLDER'S INCOME FROM FOREIGN CORPORATION. SCHEDULE J: THE INFORMATION REGARDING THE ACCUMULATED EARNINGS AND PROFITS (E&P) OF THE CORPORATION; SCHEDULE M: THE INFORMATION REGARDING TRANSACTIONS BETWEEN CONTROLLED FOREIGN CORPORATIONS AND SHAREHOLDERS OR OTHER RELATED PARTIES; AND SCHEDULE O, PART II, SECTIONS B, E AND F: SOCIAL SECURITY NUMBERS OF U.S. DIRECTORS OF THE CORPORATION, INFORMATION REGARDING THE ORGANIZATION OR REORGANIZATION OF THE FOREIGN CORPORATION, AND THE ADDITIONAL INFORMATION. THIS STATEMENT IS INTENDED TO SERVE AS A STATEMENT OF REASONABLE CAUSE IN ACCORDANCE WITH TREASURY REG. SEC. 301.6679-1(A)(3) AND 1.6038-2(K)(3)(II). ------------------------------------------------------------------------- FORM 5471, STATEMENT OF REASONABLE CAUSE PURSUANT TO TREASURY REG. SEC. 301.6679-1(A)(3) AND 1.6038-2(K)(3)(II): SCLHS, A SHAREHOLDER OF THE JP MORGAN HEDGE FUND SPC, LTD -ACCESS JUN09 SEGREGATED PORTFOLIO, IS NOT IN POSSESSION OF CERTAIN INFORMATION REQUESTED BY THE IRS ON FORM 5471 AND IS UNABLE TO OBTAIN SUCH INFORMATION FROM JP MORGAN HEDGE FUND SPC, LTD -ACCESS JUN09 SEGREGATED PORTFOLIO. SPECIFICALLY, SCLHS IS NOT IN POSSESSION OF THE FOLLOWING INFORMATION REQUESTED IN FORM 5471: SCHEDULE B: THE IDENTITY, HOLDINGS AND INCOME OF OTHER U.S. SHAREHOLDERS AND THEIR PRO RATA SHARE OF SUBPART F INCOME; SCHEDULE E: THE INCOME, WAR PROFITS, AND EXCESS PROFITS TAXES PAID OR ACCRUED BY THE CORPORATION; SCHEDULE G: THE OTHER INFORMATION REGARDING THE CORPORATION. NOTE ALL BOXES ARE MARKED NO BY DEFAULT OF SCLHS' TAX SOFTWARE. ANSWERS MAY NOT BE ACCURATE; SCHEDULE H: THE CURRENT EARNINGS AND PROFITS OF THE CORPORATION; SCHEDULE I: THE SUMMARY OF SHAREHOLDER'S INCOME FROM FOREIGN CORPORATION. SCHEDULE J: THE INFORMATION REGARDING THE ACCUMULATED EARNINGS AND PROFITS (E&P) OF THE CORPORATION; SCHEDULE M: THE INFORMATION REGARDING TRANSACTIONS BETWEEN CONTROLLED FOREIGN CORPORATIONS AND SHAREHOLDERS OR OTHER RELATED PARTIES; AND SCHEDULE O, PART II, SECTIONS B, E AND F: SOCIAL SECURITY NUMBERS OF U.S. DIRECTORS OF THE CORPORATION, INFORMATION REGARDING THE ORGANIZATION OR REORGANIZATION OF THE FOREIGN CORPORATION, AND THE ADDITIONAL INFORMATION. THIS STATEMENT IS INTENDED TO SERVE AS A STATEMENT OF REASONABLE CAUSE IN ACCORDANCE WITH TREASURY REG. SEC. 301.6679-1(A)(3) AND 1.6038-2(K)(3)(II). -------------------------------------------------------------------------
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:ROBERT W LADENBURGER TITLE:CEO EXEMPLA INC DENVER CO HOURS:40FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:JAMES T PAQUETTE TITLE:CEO ST VINCENT BILLINGS MT HOURS:40FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:LOURDES J LAZATIN TITLE:CEO SAINT JOHN'S SANTA MONICA HOURS:40FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:BAIN J FARRIS TITLE:CEO SAINT JOSEPH DENVER CO HOURS:40FORM 990 PART VII

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (28 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
CARITAS CLINICS INC
818 NORTH 7TH STREETLEAVENWORTHKS66048481009910CLINIC SVCSKS501(C)(3)3NA
MARIAN CLINIC INC
1001 SW GARFIELDTOPEKAKS66604481046905CLINIC SVCSKS501(C)(3)3NA
MARILLAC CLINIC INC
2333 N 6TH STREETGRAND JUNCTIONCO81501841085822CLINIC SVCSCO501(C)(3)3NA
PROVIDENCE MEDICAL CENTER
8929 PARALLEL PARKWAYKANSAS CITYKS66112480784446HEALTHCAREKS501(C)(3)3NA
ST JOHN HOSPITAL INC
3500 SOUTH FOURTH STREETLEAVENWORTHKS66048480543768HEALTHCAREKS501(C)(3)3NA
BETHANY COMMUNITY PLAZA INC
15 NORTH 12TH STREETKANSAS CITYKS66102481207407HEALTHCAREKS501(C)(3)3NA
PROVIDENCEST JOHN FOUNDATION INC
8929 PARALLEL PARKWAYKANSAS CITYKS661121689480925688SUPPORT 501C3KS501(C)(3)7NA
ST FRANCIS HEALTH CENTER INC
1700 SW 7TH STREETTOPEKAKS66606480547719HEALTHCAREKS501(C)(3)3NA
ST FRANCIS HEALTH CENTER FOUNDATION
1700 SW 7TH STREETTOPEKAKS66606481092520SUPPORT 501C3KS501(C)(3)11A-TYPE INA
ST MARYS HOSPITAL & MEDICAL CENTER INC
2635 N 7TH STREETGRAND JUNCTIONCO81502840425720HEALTHCARECO501(C)(3)3NA
ST MARYS HOSPITAL FOUNDATION
2635 N 7TH STREETGRAND JUNCTIONCO81502237001007SUPPORT 501C3CO501(C)(3)11A-TYPE INA
SAINT JOSEPH HOSPITAL FOUNDATION
1835 FRANKLIN STREETDENVERCO80218840735096SUPPORT 501C3CO501(C)(3)11A-TYPE INA
HOLY ROSARY HEALTHCARE
2600 WILSONMILES CITYMT59301810231792HEALTHCAREMT501(C)(3)3NA
HOLY ROSARY HEALTHCARE FOUNDATION INC
2600 WILSONMILES CITYMT59301202270238SUPPORT 501C3MT501(C)(3)11A-TYPE INA
ST VINCENT HEALTHCARE
1233 NORTH 30THBILLINGSMT59101810232124HEALTHCAREMT501(C)(3)3NA
ST VINCENT HEALTHCARE FOUNDATION
PO BOX 35200BILLINGSMT591075200810468034SUPPORT 501C3MT501(C)(3)7NA
NORTHWEST RESEARCH & EDUCATION INSTITUTE
315 NORTH 25TH STREETBILLINGSMT59101201343024COMM HLTH RESMT501(C)(3)9NA
ST JAMES HEALTHCARE
400 SOUTH CLARK STREETBUTTEMT597012328810231785HEALTHCAREMT501(C)(3)3NA
ST JAMES HEALTHCARE FOUNDATION
400 SOUTH CLARK STREETBUTTEMT59701651202190SUPPORT 501C3MT501(C)(3)11A-TYPE INA
SAINT JOHNS HEALTH CENTER
1328 22ND STREETSANTA MONICACA90404951684082HEALTHCARECA501(C)(3)3NA
JOHN WAYNE CANCER INSTITUTE
2000 SANTA MONICA BLVDSANTA MONICACA90404954291515CANCER R&DCA501(C)(3)4NA
SAINT JOHNS HOSPITAL & HLTH CENTER FNDTN
1328 22ND STREETSANTA MONICACA904042091956100079SUPPORT 501C3CA501(C)(3)11A-TYPE INA
EXEMPLA INC FKA LUTHERAN HOSPITAL
2420 W 26TH AVE SUITE 100DDENVERCO80211841103606HEALTHCARECO501(C)(3)3NA
EXEMPLA LUTHERAN MEDICAL CENTER FNDTN
2480 W 26TH AVESUITE 360BDENVERCO80211208846152SUPPORT 501C3CO501(C)(3)7NA
EXEMPLA GOOD SAMARITAN MEDICAL CTR FNDTN
200 EXEMPLA CIRCLELAFAYETTECO80026841649162SUPPORT 501C3CO501(C)(3)7NA
LUTH MED CNTR PRO&GEN LIAB SELF-INS TRST
2480 W 26TH AVESUITE 360BDENVERCO80211742571584INSURANCECO501(C)(3)11A-TYPE INA
MEDPARK INC
2480 W 26TH AVESUITE 360BDENVERCO80211841490379PARKINGCO501(C)(3)7NA
SAINT JOSEPH HOSPITAL
1835 FRANKLIN STREETDENVERCO80218840417134HEALTHCARECO501(C)(3)3NA

Form990 Schedule R Part III Form990ScheduleRPartIII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeType
PAVILION IMAGING LLC
750 WELLINGTONGRAND JUNCTIONCO81501030516198RADIOLOGYCONAN/A
GRAND VALLEY SURGICAL CENTER LLC
710 WELLINGTONGRAND JUNCTIONCO81501841505075OP SURGERYCONAN/A
SAN JUAN CANCER CENTER LLC
600 SOUTH 5TH STREETMONTROSECO81401202856331OP CANCERCONAN/A
BILLINGS MRI CENTER LLC
1041 NORTH 29TH STREETBILLINGSMT59101810450943MRI-PET SCANMTNAN/A
LUTHERAN CAMPUS ASC LLC
3455 LUTHRN PKW SUITE 150WHEATRIDGECO800336028020749532OP SURGERYCONAN/A
COLORADO SURGICAL VENTURES LLC
30 S WACKER DR SUITE 2302CHICAGOIL60605208038915OP SURGERYCONAN/A
COLORADO SURGICAL HOSPITAL LLC
30 S WACKER DR SUITE 2302CHICAGOIL60605208038977OP SURGERYCONAN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodeLegal Domicile Foreign CountryLegalDomicileForeignCountry
CARITAS INC AND SUBSIDIARIES
9801 RENNER BOULEVARD SUITE 100LENEXAKS66219480941069OTHER MEDICALKSN/AC CORP21339365269114961.00000
LEAVEN INSURANCE COMPANY LTD
980370522InsuranceN/A191385645995381.0000023 Lime Tree Bay AveGeorge TownGrand CaymanCJKY1-1102CJ
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiestrueReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (64 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
PROVIDENCE MEDICAL CENTER (PMC)
A494655
ST JOHN HOSPITAL INC (SJL)
A67325
ST JAMES HEALTHCARE (SJB)
A589288
ST MARY'S HOSPITAL & MEDICAL CTR (SMGJ)
A1868418
ST JOHN'S HEALTH CTR (SJSM)
A3848401
EXEMPLA INC FKA LUTHERAN HOSPITAL
A96078
ST JOSEPH HOSPITAL (SJD)
A1603840
ST JOHN'S HEALTH CTR (SJSM)
B65000
PROVIDENCE MEDICAL CENTER (PMC)
E15293174
ST JOHN HOSPITAL INC (SJL)
E127172
ST JAMES HEALTHCARE (SJB)
E4755889
ST MARY'S HOSPITAL & MEDICAL CTR (SMGJ)
E4274158
ST JOHN'S HEALTH CTR (SJSM)
E4000000
ST JOSEPH HOSPITAL (SJD)
E53954224
ST JOSEPH HOSPITAL (SJD)
D53675000
EXEMPLA INC FKA LUTHERAN HOSPITAL
D277365000
PROVIDENCE MEDICAL CENTER (PMC)
K5798992
ST FRANCIS HEALTH CENTER INC (SFT)
K6185705
HOLY ROSARY HEALTHCARE (HRH)
K1188554
ST VINCENT HEATHCARE (SVB)
K8429706
ST JAMES HEALTHCARE (SJB)
K2421591
ST MARY'S HOSPITAL & MEDICAL CTR (SMGJ)
K7545586
ST JOHN'S HEALTH CTR (SJSM)
K6836920
PROVIDENCE MEDICAL CENTER (PMC)
O215121
ST JAMES HEALTHCARE (SJB)
O149868
ST VINCENT HEATHCARE (SVB)
O288257
ST MARY'S HOSPITAL & MEDICAL CTR (SMGJ)
O148937
LEAVEN INSURANCE COMPANY LTD
O21185885
PROVIDENCE MEDICAL CENTER (PMC)
P146980636
ST JOHN HOSPITAL INC (SJL)
P29465837
ST FRANCIS HEALTH CENTER INC (SFT)
P203958301
HOLY ROSARY HEALTHCARE (HRH)
P33462479
ST VINCENT HEATHCARE (SVB)
P284610881
ST JAMES HEALTHCARE (SJB)
P76783579
ST MARY'S HOSPITAL & MEDICAL CTR (SMGJ)
P295029487
ST JOHN'S HEALTH CTR (SJSM)
P281309236
EXEMPLA INC FKA LUTHERAN HOSPITAL
P2747222
ST JOSEPH HOSPITAL (SJD)
P9225435
LEAVEN INSURANCE COMPANY LTD
P4760447
CARITAS INC & SUBSIDIARIES
P674483
CARITAS CLINICS INC
P337376
MARIAN CLINIC INC
P1897177
JOHN WAYNE CANCER INSTITUTE
P16511899
MARILLAC CLINIC INC
P213148
PROVIDENCE MEDICAL CENTER (PMC)
Q65440
ST JOHN HOSPITAL INC (SJL)
Q65815
ST FRANCIS HEALTH CENTER INC (SFT)
Q74293
HOLY ROSARY HEALTHCARE (HRH)
Q64511
ST VINCENT HEATHCARE (SVB)
Q328419
ST JAMES HEALTHCARE (SJB)
Q64511
ST MARY'S HOSPITAL & MEDICAL CTR (SMGJ)
Q83841
ST JOHN'S HEALTH CTR (SJSM)
Q83860
EXEMPLA INC FKA LUTHERAN HOSPITAL
Q984429
ST JOSEPH HOSPITAL (SJD)
Q589820
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