TY 2013 Form 990

- TIN:

Form990

Department of the Treasury
Internal Revenue Service

Return of Organization Exempt From Income Tax

Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)

Do not enter Social Security numbers on this form as it may be made public. By law, the IRS

generally cannot redact the information on the form.

Information about Form 990 and its instructions is at www.IRS.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

A For the 2013 calendar year, or tax year beginning 01-01-2013 , 2013, and ending 12-31-2013

BCheck if applicable: Address change Name change Initial return Terminated Amended return Application pending

CName of organization
THE ST JOSEPH COMMUNITY HEALTH FOUNDATION INC

Doing Business As

Number and street (or P.O. box if mail is not delivered to street address)
347 W BERRY STREET SUITE 101

Room/suite

City or town, state or province, country, and ZIP or foreign postal code
FORT WAYNE, IN46802

D Employer identification number

31-1016570

E Telephone number

G Gross receipts $ 9,989,571

F Name and address of principal officer:
MARGARET K DISTLER
347 W BERRY STREET SUITE 101
FORT WAYNE,IN46802

Tax-exempt status: 501(c)(3) 501(c) ( ) LeftBullet

(insert no.) 4947(a)(1) or 527

Website:

WWW.SJCHF.ORG

H(a)

Is this a group return for
subordinates? Yes No

H(b)

Are all subordinates
included?

Yes No

If "No," attach a list. (see instructions)

H(c)

Group exemption number MediumBullet

K Form of organization: Corporation Trust Association Other MediumBullet

L Year of formation: 1998

M State of legal domicile: IN

Part I

Summary

1	Briefly describe the organization’s mission or most significant activities: THE FOUNDATION IS ORGANIZED AND OPERATED TO SUPPORT THE WORK OF THE POOR (CONTINUED ON SCHEDULE O.) HANDMAIDS OF JESUS CHRIST, CONTINUING THEIR LEGACY OF SERVICE ESTABLISHED IN THE 1860'S BY THE ST. JOSEPH HOSPITAL OF HELPING THE POOR AND UNDERSERVED ACCESS QUALITY HEALTH CARE AND WELLNESS. THE FOUNDATION ACCOMPLISHES THIS BY PROVIDING FUNDING TO SPIRITUAL, MENTAL, PHYSICAL, AND DENTAL HEALTH AND WELLNESS PROGRAMS IN ALLEN COUNTY, INDIANA.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	19
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	19
5	Total number of individuals employed in calendar year 2013 (Part V, line 2a) ......	5	12
6	Total number of volunteers (estimate if necessary) .............	6	25
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	212,533	225,618
9	Program service revenue (Part VIII, line 2g) .........	37,762	57,681
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	689,457	1,532,312
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-1,726	8,450
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	938,026	1,824,061
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	919,017	1,015,537
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	360,915	410,761
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	338,972	199,028
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,618,904	1,625,326
19	Revenue less expenses. Subtract line 18 from line 12.......	-680,878	198,735
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	30,101,326	34,154,731
21	Total liabilities (Part X, line 26).............	320,442	264,927
22	Net assets or fund balances. Subtract line 21 from line 20.....	29,780,884	33,889,804

Part II

Signature Block

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.

Sign Here

	Signature of officer	Date

	Type or print name and title

Paid Preparer Use Only

Print/Type preparer's name

Preparer's signature

Date

Check if
self-employed

PTIN

Firm's name MediumBullet

Firm's EIN MediumBullet

Firm's address MediumBullet

Phone no.

May the IRS discuss this return with the preparer shown above? (see instructions) ............YesNo

For Paperwork Reduction Act Notice, see the separate instructions.

Cat. No. 11282Y

Form 990 (2013)

Page 2

Part III

Statement of Program Service Accomplishments

Check if Schedule O contains a response or note to any line in this Part III ..............

Briefly describe the organization’s mission: THE FOUNDATION IS ORGANIZED AND OPERATED TO SUPPORT THE WORK OF THE POOR HANDMAIDS OF JESUS CHRIST, CONTINUING THEIR LEGACY OF SERVICE ESTABLISHED IN THE 1860'S BY THE ST. JOSEPH HOSPITAL OF HELPING THE POOR AND UNDERSERVED ACCESS QUALITY HEALTH (CONTINUED ON SCHEDULE O.) CARE AND WELLNESS. THE FOUNDATION ACCOMPLISHES THIS BY PROVIDING FUNDING TO SPIRITUAL, MENTAL, PHYSICAL, AND DENTAL HEALTH AND WELLNESS PROGRAMS IN ALLEN COUNTY, INDIANA.

Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ...................... Yes No

If "Yes," describe these new services on Schedule O.

Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................ Yes No

If "Yes," describe these changes on Schedule O.

Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.


4a	(Code: ) (Expenses $ 1,015,537 including grants of $ 1,015,537 ) (Revenue $ )
	GRANTMAKING - INVESTING INTO ALLEN COUNTY AGENCIES TO ADVANCE PROGRAMMING THAT CONTINUES THE LEGACY OF THE FOUNDATION'S SPONSOR, THE POOR HANDMAIDS OF JESUS CHRIST, TO IMPROVE THE HEALTH AND WELLNESS AS WELL AS EMPOWER VULNERABLE POPULATIONS IN THE COMMUNITY.

4b	(Code: ) (Expenses $ 185,505 including grants of $ ) (Revenue $ 57,681 )
	MEDICAL INTERPRETATION & HEALTHCARE NAVIGATION - PROGRAMMING TO REMOVE LANGUAGE BARRIERS BETWEEN LIMITED ENGLISH SPEAKING MEDICAL PATIENTS AND THEIR HEALTHCARE PROVIDERS THROUGH PROJECT CONNECT MEDICAL INTERPRETATION AND HEALTHCARE NAVIGATION.

4c	(Code: ) (Expenses $ 64,831 including grants of $ ) (Revenue $ )
	REFUGEE AGRICULTURAL PARTNERSHIP PROJECT - TEACHING NEWLY ARRIVED REFUGEES LOCAL AGRICULTURAL PRACTICES AND MARKETING STRATEGIES THAT ARE SUCCESSFUL IN THIS REGION AS WELL AS PROVIDING LAND, SEEDS, WATER AND RELATED RESOURCES NECESSARY TO GROW FRESH FOOD.

	(Code: ) (Expenses $ 22,292 including grants of $ ) (Revenue $ )
	THE FOUNDATION CONTINUES ITS MINISTRY OF HELPING VULNERABLE, LOW-INCOME POPULATIONS ACCESS QUALITY HEALTHCARE AND WELLNESS IN ALLEN COUNTY, INDIANA BY PROVIDING A VARIETY OF TECHNICAL SUPPORT STRATEGIES INCLUDING MINI GRANTS, COUNSELING, ADVOCACY AND ASSISTANCE WITH LOCATING APPROPRIATE PROFESSIONAL RESOURCES TO HELP SECURE THE SUCCESS OF THE APPROXIMATELY 60+ PROGRAMS SUPPORTED ANNUALLY. THE FOUNDATION ALSO OPERATES PROGRAMS FOCUSING ON DISEASE PREVENTION AND IMPROVED LOW-COST HEALTHCARE DELIVERY INCLUDING A PRINT AND ON-LINE DIRECTORY OF LOW-COST PROVIDERS.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 22,292 including grants of $ ) (Revenue $ )
4e	Total program service expenses1,288,165

Form 990 (2013)

Page 3

Part IV

Checklist of Required Schedules

Yes

Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule A Click to see attachment

........................

Yes

Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment

...

Yes

Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I..........

Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II........

Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part III............................

Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I Click to see attachment

........................

Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II Click to see attachment

...

Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment

....................

Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IV Click to see attachment

..............

Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part V Click to see attachment

......

Yes

If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.

Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI. Click to see attachment

...................

11a

Yes

Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VII Click to see attachment

.......

11b

Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII Click to see attachment

.......

11c

Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IX Click to see attachment

............

11d

Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part X Click to see attachment

11e

Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part X Click to see attachment

.........................

11f

Yes

12a

Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment

.................

12a

Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment

12b

Yes

Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....

14a

Did the organization maintain an office, employees, or agents outside of the United States?.....

14a

Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........

14b

Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV

Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...

Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions)....

Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............

Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................

20a

Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....

20a

If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?

20b

Form 990 (2013)

Page 4

Part IV

Checklist of Required Schedules (continued)

Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II... Click to see attachment

Yes

Did the organization report more than $5,000 of grants or other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment

Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J.......................

24a

Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................

24a

Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...

24b

Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................

24c

Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...

24d

25a

Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I........

25a

Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I...................

25b

Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so, complete Schedule L, Part II....................

Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........

Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):

A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV ..........................

28a

A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV.....................

28b

An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV...

28c

Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..

Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............

Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I...........................

Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................

Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment

Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment

Yes

35a

Did the organization have a controlled entity within the meaning of section 512(b)(13)?

35a

If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2...

35b

Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment

Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI Click to see attachment

Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............

Yes

Form 990 (2013)

Page 5

Part V

Statements Regarding Other IRS Filings and Tax Compliance

Check if Schedule O contains a response or note to any line in this Part V ..............

Yes

Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..

Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .

Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................

Yes

Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................

If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)

Yes

Did the organization have unrelated business gross income of $1,000 or more during the year?...

If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...

At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................

If "Yes," enter the name of the foreign country: MediumBullet

See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.

Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..

Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?

If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............

Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...

If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................

Organizations that may receive deductible contributions under section 170(c).

Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................

If "Yes," did the organization notify the donor of the value of the goods or services provided?.....

Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................

If "Yes," indicate the number of Forms 8282 filed during the year ....

Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................

Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..

If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................

If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................

Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............

Sponsoring organizations maintaining donor advised funds.

Did the organization make any taxable distributions under section 4966?..........

Did the organization make a distribution to a donor, donor advisor, or related person?.......

Section 501(c)(7) organizations. Enter:

Initiation fees and capital contributions included on Part VIII, line 12 ...

10a

Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities

10b

Section 501(c)(12) organizations. Enter:

Gross income from members or shareholders .........

11a

Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........

11b

12a

Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?

12a

If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................

12b

Section 501(c)(29) qualified nonprofit health insurance issuers.

Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.

13a

Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....

13b

Enter the amount of reserves on hand ............

13c

14a

Did the organization receive any payments for indoor tanning services during the tax year?.....

14a

If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..

14b

Form 990 (2013)

Page 6

Part VI

Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.

Check if Schedule O contains a response or note to any line in this Part VI ..............

Section A. Governing Body and Management

Yes

Enter the number of voting members of the governing body at the end of the tax year .....................

If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.

Enter the number of voting members included in line 1a, above, who are independent ...................

Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................

Yes

Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .

Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................

Did the organization become aware during the year of a significant diversion of the organization’s assets? .

Did the organization have members or stockholders? ................

Yes

Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................

Yes

Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................

Yes

Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:

The governing body? .........................

Yes

Each committee with authority to act on behalf of the governing body? ............

Yes

Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......

Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)

Yes

10a

Did the organization have local chapters, branches, or affiliates? ............

10a

If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?

10b

11a

Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................

11a

Yes

Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....

12a

Did the organization have a written conflict of interest policy? If "No," go to line 13.......

12a

Yes

Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................

12b

Yes

Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................

12c

Yes

Did the organization have a written whistleblower policy? ...............

Yes

Did the organization have a written document retention and destruction policy? .........

Yes

Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?

The organization’s CEO, Executive Director, or top management official ...........

15a

Yes

Other officers or key employees of the organization ................

15b

If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).

16a

Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................

16a

If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............

16b

Section C. Disclosure

List the States with which a copy of this Form 990 is required to be filed MediumBullet

Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.

Own website Another's website Upon request Other (explain in Schedule O)

Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.

State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBullet

MELISSA PIAZZA3700 179TH STREETHAMMONDIN46323 (260) 844-2698

Form 990 (2013)

Page 7

Part VII

Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors

Check if Schedule O contains a response or note to any line in this Part VII ..............

Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees

1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet

List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

List all of the organization’s current key employees, if any. See instructions for definition of "key employee."

List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.

Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)		(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(1) MARGARET DISTLER........................................................................ EXECUTIVE DIRECTOR, EX-OFF	40.00 .......................	X		104,561	0	7,964
(2) MICHAEL CAHILL........................................................................ IMMEDIATE PAST CHAIR	1.00 .......................	X		0	0	0
(3) DR JAMES BUCHANAN........................................................................ VICE CHAIR	1.00 .......................	X	X	0	0	0
(4) BARBARA S AULT........................................................................ TREASURER	1.00 .......................	X	X	0	0	0
(5) NANCY M O'BRIEN........................................................................ BOARD MEMBER	1.00 .......................	X		0	0	0
(6) SR KATHY HAAS PHJC........................................................................ BOARD MEMBER	1.00 .......................	X		0	0	0
(7) DR ROBERT DETTMER........................................................................ BOARD CHAIR	1.00 .......................	X	X	0	0	0
(8) GERVAISE BASTIAN........................................................................ BOARD MEMBER	1.00 .......................	X		0	0	0
(9) JAMES KODAY........................................................................ BOARD MEMBER	1.00 .......................	X		0	0	0
(10) SR CAROLE LANGHAUSER PHJC........................................................................ BOARD MEMBER	1.00 .......................	X		0	0	0
(11) SR GERMAINE HUSTEDDE PHJC........................................................................ BOARD MEMBER	1.00 .......................	X		0	0	0
(12) DR DAVID R JOHNSON........................................................................ BOARD MEMBER	1.00 .......................	X		0	0	0
(13) DR MICHAEL MASTRANGELO........................................................................ BOARD MEMBER	1.00 .......................	X		0	0	0
(14) ALICE KOPFER........................................................................ BOARD MEMBER	1.00 .......................	X		0	0	0
(15) MARY HESS........................................................................ SECRETARY	1.00 .......................	X	X	0	0	0
(16) DR DAVID STEIN........................................................................ BOARD MEMBER	1.00 .......................	X		0	0	0
(17) RICHARD L PHILLIPS JR........................................................................ BOARD MEMBER	1.00 .......................	X		0	0	0

Form 990 (2013)

Page 8

Part VII

Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) KEVIN T NOLL........................................................................ BOARD MEMBER	1.00 .......................	X	0	0	0
(19) WILLIAM NIEZER........................................................................ BOARD MEMBER	1.00 .......................	X	0	0	0
(20) SR CONNIE C BACH PHJC........................................................................ BOARD MEMBER	1.00 .......................	X	0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	104,561	0	7,964

Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet

Yes

Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............

For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................

Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........

Section B. Independent Contractors

Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.

(A) Name and business address	(B) Description of services	(C) Compensation





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 0

Form 990 (2013)

Page 9

Part VIII

Statement of Revenue

Check if Schedule O contains a response or note to any line in this Part VIII .............

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d
e	Government grants (contributions)1e		81,511

f	All other contributions, gifts, grants, and similar amounts not included above1f		144,107

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			225,618
			Business Code
2a	OTHER PROGRAM REVENUE		900001	57,681	57,681
b
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			57,681
3	Investment income (including dividends, interest, and other similar amounts).......			815,034			815,034
4	Income from investment of tax-exempt bond proceeds..
5	Royalties...........
		(i) Real	(ii) Personal
6a	Gross rents	8,450
b	Less: rental expenses	0
c	Rental income or (loss)	8,450
d	Net rental income or (loss).......			8,450	8,450
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	8,882,788
b	Less: cost or other basis and sales expenses	8,165,510
c	Gain or (loss)	717,278
d	Net gain or (loss)..........			717,278			717,278
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Miscellaneous Revenue			Business Code
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See Instructions......			1,824,061	66,131	0	1,532,312

Form 990 (2013)

Page 10

Part IX

Statement of Functional Expenses

Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.		(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the United States. See Part IV, line 21	1,015,537	1,015,537
2	Grants and other assistance to individuals in the United States. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	112,525		112,525
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	222,721	172,995	49,726
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	9,963	6,820	3,143
9	Other employee benefits .......	41,381	19,212	22,169
10	Payroll taxes ...........	24,171	12,644	11,527
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	443		443
c	Accounting ...........	19,250	1,500	17,750
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	51,681	28,225	23,456
12	Advertising and promotion ....	631	143	488
13	Office expenses .......	18,746	6,955	11,791
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	45,695	549	45,146
17	Travel ............	6,866	2,808	4,058
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	4,677	976	3,701
20	Interest ...........	107		107
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	10,643		10,643
23	Insurance ..............	7,125	500	6,625
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	BAD DEBT EXPENSE	15,612	15,612
b	EQUIPMENT RENTAL	5,709		5,709
c	MISCELLANEOUS EXPENSE	4,203	789	3,414
d	SOFTWARE MAINTENANCE	1,825		1,825
e	All other expenses	5,815	2,900	2,915
25	Total functional expenses. Add lines 1 through 24e	1,625,326	1,288,165	337,161	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Form 990 (2013)

Page 11


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			43,840	1	41,788
2	Savings and temporary cash investments .........			194,943	2	50,058
3	Pledges and grants receivable, net ...........			9,986	3	0
4	Accounts receivable, net .............			229,463	4	182,585
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6
7	Notes and loans receivable, net .............				7
8	Inventories for sale or use ..............				8
9	Prepaid expenses and deferred charges ..........			7,938	9	8,204
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	89,560
b	Less: accumulated depreciation .....	10b	57,621	42,582	10c	31,939
11	Investments—publicly traded securities ..........			29,245,856	11	33,283,202
12	Investments—other securities. See Part IV, line 11 .....			275,994	12	507,244
13	Investments—program-related. See Part IV, line 11 .....				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			50,724	15	49,711
16	Total assets. Add lines 1 through 15 (must equal line 34)......			30,101,326	16	34,154,731
17	Accounts payable and accrued expenses .........			58,067	17	56,369
18	Grants payable .................			262,375	18	208,558
19	Deferred revenue ................				19
20	Tax-exempt bond liabilities .............				20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..				23
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................				25
26	Total liabilities. Add lines 17 through 25.........			320,442	26	264,927
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			29,608,219	27	33,669,443
28	Temporarily restricted net assets ...........			115,668	28	159,893
29	Permanently restricted net assets ...........			56,997	29	60,468
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances ...........			29,780,884	33	33,889,804
34	Total liabilities and net assets/fund balances ........			30,101,326	34	34,154,731

Form 990 (2013)

Page 12

Part XI

Reconcilliation of Net Assets

Check if Schedule O contains a response or note to any line in this Part XI ..............

Total revenue (must equal Part VIII, column (A), line 12) ............

1,824,061

Total expenses (must equal Part IX, column (A), line 25) ............

1,625,326

Revenue less expenses. Subtract line 2 from line 1 ..............

198,735

Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..

29,780,884

Net unrealized gains (losses) on investments ...............

3,910,185

Donated services and use of facilities .................

Investment expenses .....................

Prior period adjustments .....................

Other changes in net assets or fund balances (explain in Schedule O) ........

Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))

33,889,804

Part XII

Financial Statements and Reporting

Check if Schedule O contains a response or note to any line in this Part XII .............

Yes

Accounting method used to prepare the Form 990: Cash Accrual Other
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.

Were the organization’s financial statements compiled or reviewed by an independent accountant?

If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:

Separate basis Consolidated basis Both consolidated and separate basis

Were the organization’s financial statements audited by an independent accountant?

Yes

If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:

Separate basis Consolidated basis Both consolidated and separate basis

If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?

Yes

If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.

As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?

If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.

Form 990 (2013)

Form 990, Special Condition Description:

Special Condition Description

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.
right arrow

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

THE ST JOSEPH COMMUNITY HEALTH FOUNDATION INC

Employer identification number

31-1016570

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Non-functionally integrated

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the supported organization? ................

11g(i)

(ii) A family member of a person described in (i) above? ......................

11g(ii)

(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of monetary support
(i) Name of supported organization	(ii) EIN		Yes	No	Yes	No	Yes	No	(vii) Amount of monetary support
(A) ANCILLA DOMINI SISTERS INC	350867952	1	Yes						53,512

Total									53,512

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2013

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2012 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2013. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2012. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2013. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2012. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2013

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2012 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2012 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2013. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ........ right arrow

33 1/3% support tests—2012. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2013

Page 4

Part IV

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Name of the organization

THE ST JOSEPH COMMUNITY HEALTH FOUNDATION INC

Employer identification number

31-1016570

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi) and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year ......................... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 2

Name of organization THE ST JOSEPH COMMUNITY HEALTH FOUNDATION INC

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTEDRESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 3

Name of organization THE ST JOSEPH COMMUNITY HEALTH FOUNDATION INC

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 4

Name of organization
THE ST JOSEPH COMMUNITY HEALTH FOUNDATION INC

Employer identification number

31-1016570

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

$
Use duplicate copies of Part III if additional space is needed.

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions. SchDMd Bullet

Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

THE ST JOSEPH COMMUNITY HEALTH FOUNDATION INC

Employer identification number

31-1016570

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) .....
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2013

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIII and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....	56,997	56,861	60,468	59,541	55,461
b	Contributions ........
c	Net investment earnings, gains, and losses	3,471	136	-3,607	927	4,080
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......	60,468	56,997	56,861	60,468	59,541

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

100.000 %

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................
b	Buildings ................
c	Leasehold improvements ............	33,664	6,198	27,466
d	Equipment ................	55,896	51,423	4,473
e	Other .................
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				31,939

Schedule D (Form 990) 2013

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes









Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
2. Liability for uncertain tax positions In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII ..................................................

Schedule D (Form 990) 2013

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	5,734,246
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a	3,910,185
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................			2e	3,910,185
3	Subtract line 2e from line 1.....................			3	1,824,061
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.......................			4c	0
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	1,824,061

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1	1,625,326
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d......................		2e	0
3	Subtract line 2e from line 1.....................		3	1,625,326
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.......................		4c	0
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5	1,625,326

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
PART V, LINE 4:	J & N NILL UNITRUST -- A UNITRUST WITH A FIXED QUARTERLY PAYOUT TO NEVA NILL FOR THE REMAINDER OF HER LIFE. AT HER DEATH, THE ASSETS PASS TO THE ST. JOSEPH COMMUNITY HEALTH FOUNDATION, WHICH IS ALSO TRUSTEE OF THIS ACCOUNT. BURN CARE ENDOWMENT -- DONATED FUNDS TO BE USED FOR THE PURPOSE OF PROVIDING NON-PROFITS WITH FUNDS IN SUPPORT OF BURN TRAUMA, FIRST RESPONSE, BURN EDUCATION AND OTHER RELATED AREAS IN ACCORDANCE WITH THE FOUNDATION'S MISSION STATEMENT. MELVIN J. POWELL ENDOWMENT -- SCHOLARSHIP FUNDS TO BE USED TO ADVANCE STUDIES OF RADIOLOGY BY AREA STUDENTS.
PART X, LINE 2:	THE ST JOSEPH COMMUNITY HEALTH FOUNDATION, INC AND CATHERINE KASPER PLACE, INC ARE EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND SIMILAR PROVISIONS OF STATE LAW. HOWEVER, THE ST JOSEPH COMMUNITY HEALTH FOUNDATION, INC AND CATHERINE KASPER PLACE, INC ARE SUBJECT TO FEDERAL INCOME TAX ON ANY UNREALTED BUSINESS TAXABLE INCOME. MANAGEMENT BELIEVES THE ST JOSEPH COMMUNITY HEALTH FOUNDATION, INC AND CATHERINE KASPER PLACE, INC ARE NO LONGER SUBJECT TO EXAMINATION BY TAX AUTHORITIES FOR YEARS BEFORE DECEMBER 31, 2010.

Return Reference

Explanation

PART V, LINE 4:

J & N NILL UNITRUST -- A UNITRUST WITH A FIXED QUARTERLY PAYOUT TO NEVA NILL FOR THE REMAINDER OF HER LIFE. AT HER DEATH, THE ASSETS PASS TO THE ST. JOSEPH COMMUNITY HEALTH FOUNDATION, WHICH IS ALSO TRUSTEE OF THIS ACCOUNT. BURN CARE ENDOWMENT -- DONATED FUNDS TO BE USED FOR THE PURPOSE OF PROVIDING NON-PROFITS WITH FUNDS IN SUPPORT OF BURN TRAUMA, FIRST RESPONSE, BURN EDUCATION AND OTHER RELATED AREAS IN ACCORDANCE WITH THE FOUNDATION'S MISSION STATEMENT. MELVIN J. POWELL ENDOWMENT -- SCHOLARSHIP FUNDS TO BE USED TO ADVANCE STUDIES OF RADIOLOGY BY AREA STUDENTS.

PART X, LINE 2:

THE ST JOSEPH COMMUNITY HEALTH FOUNDATION, INC AND CATHERINE KASPER PLACE, INC ARE EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND SIMILAR PROVISIONS OF STATE LAW. HOWEVER, THE ST JOSEPH COMMUNITY HEALTH FOUNDATION, INC AND CATHERINE KASPER PLACE, INC ARE SUBJECT TO FEDERAL INCOME TAX ON ANY UNREALTED BUSINESS TAXABLE INCOME. MANAGEMENT BELIEVES THE ST JOSEPH COMMUNITY HEALTH FOUNDATION, INC AND CATHERINE KASPER PLACE, INC ARE NO LONGER SUBJECT TO EXAMINATION BY TAX AUTHORITIES FOR YEARS BEFORE DECEMBER 31, 2010.

Schedule D (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization
THE ST JOSEPH COMMUNITY HEALTH FOUNDATION INC

Employer identification number
31-1016570

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) AIDS TASK FORCE INC 525 OXFORD STREET FORT WAYNE,IN46806	31-1191147	501(C)(3)	8,000	TO PROVIDE EMERGENCY MEDICAL ASSISTANCE TO MEN, WOMEN, AND CHILDREN LIVING WITH HIV IN ALLEN COUNTY
(2) CATHERINE KASPER PLACE INC 347 W BERRY STREET SUITE 101 FORT WAYNE,IN46802	27-3213747	501(C)(3)	65,785	FOR OPERATING EXPENSES
(3) ALLEN COUNTY DEPARTMENT OF HEALTH 200 E BERRY ST SUITE 360 FORT WAYNE,IN46802	35-6000124	501(C)(3)	44,000	TO CONTINUE PROVIDING EFFICIENT, TIMELY AND ACCURATE INTERPRETATION AND TRANSLATION SERVICES TO REFUGEES SEEKING MEDICAL AND ENVIRONMENTAL SERVICES
(4) EAST WAYNE STREET CENTER INC 801 EAST WAYNE STREET FORT WAYNE,IN46803	35-1587206	501(C)(3)	20,000	FOR THE HEALTH COORD. SALARY, TO ENSURE THAT HEAD START CHILDREN ARE UP TO DATE ON ALL HEALTH SCREENING, DIAGNOSTIC, AND TREATMENT PROGRAMS, INCLUDING VISION, VACCINATION, HEARING, GROWTH, NUTRITION, ASTHMA, LEAD POISONING, DEVELOPMENTAL AND BEHAVIORAL
(5) CANCER SERVICES OF NORTHEAST INDIANA INC 6316 MUTUAL DRIVE FORT WAYNE,IN46825	35-0965609	501(C)(3)	15,000	SUPPORT FOR THE CLIENT ADVOCATE PROGRAM AND FINANCIAL ASSISTANCE TO PROVIDE FUNDS TO HELP LOW-INCOME CANCER PATIENTS AND THEIR FAMILIES WITH PRESCRIPTION COSTS AND MEDICAL CO-PAYS FOR CANCER-RELATED COSTS
(6) CATHOLIC CHARITIES OF THE DIOCESE OF FORT WAYNE-SOUTH BEND INC 315 EAST WASHINGTON BLVD FORT WAYNE,IN46802	35-1038653	501(C)(3)	27,000	FOR THE HISPANIC HEALTH ADVOCATE PROGRAM TO PROVIDE SUPPORTED SERVICES FOR SPANISH SPEAKING INDIVIDUALS AND FAMILIES IN ORDER TO MAXIMIZE THEIR ACCESS TO HEALTH CARE SERVICES THROUGH INTERPRETATION, TRANSLATION, AND COORDINATION OF HEALTH SERVICES
(7) CATHOLIC CHARITIES OF THE DIOCESE OF FORT WAYNE-SOUTH BEND INC 315 EAST WASHINGTON BLVD FORT WAYNE,IN46802	35-1038653	501(C)(3)	10,000	HELP FUND THE REFUGEE HEALTH COORDINATOR POSITION TO ASSIST PRIMARY AND SECONDARY REFUGEES WITH THEIR HEALTH SCREENINGS AND MEDICAL APPOINTMENTS, AS WELL AS GAINING A BETTER UNDERSTANDING OF THEIR OWN HEALTH STATUS
(8) LUTHERAN SOCIAL SERVICES OF INDIANA 330 MADISON STREET PO BOX 11329 FORT WAYNE,IN46857	35-0868124	501(C)(3)	25,000	ONGOING SUPPORT OF 550 HOURS OF INTERGENERATIONAL ACTIVITIES THROUGH 160 DIFFERENT MONTHLY ACTIVITIES TO ENHANCE WELLNESS FOR 100 CHILDREN AT CHILDREN'S VILLAGE AND 75 RESIDENTS OF LUTHERAN LIFE VILLAGE
(9) CENTER FOR NON VIOLENCE 235 W CREIGHTON FORT WAYNE,IN46807	31-1045334	501(C)(3)	15,000	TO CONTINUE TO PROVIDE HEALTH EDUCATION, CASE MANAGEMENT, MEDICAL TRANSLATION AND OTHER RELATED SERVICES TO NON-ENGLISH SPEAKING POPULATIONS WHO HAVE SIGNIFICANT BARRIERS TO HEALTH SERVICES
(10) CRIME VICTIM CARE OF ALLEN COUNTY LAKEPARK MEDICAL BUILDING 2456 LAKE AVE FORT WAYNE,IN46805	41-2205791	501(C)(3)	20,000	FOR THE SALARIES OF THE IMMIGRANT ADDICTIONS SUPPORT COORDINATORS WHO RUN SUPPORT GROUPS SERVING NON-ENGLISH, NON-SPANISH SPEAKING REFUGEE ADDICTION CLIENTS AND THEIR FAMILIES
(11) CLINICA MADRE DE DIOS INC 2120 S HARRISON ST FORT WAYNE,IN46802	80-0354227	501(C)(3)	10,000	FUNDING FOR OPERATING SUPPORT SO THAT QUALITY MEDICAL CARE WILL BE PROVIDED TO THE POOREST OF THE POOR IN FORT WAYNE
(12) COMMUNITY TRANSPORTATION NETWORK INC 2701 S COLISEUM BLVD SUITE 1315 FORT WAYNE,IN46803	35-2109955	501(C)(3)	30,000	TO PROVIDE AFFORDABLE, DEPENDABLE SPECIALIZED MEDICAL TRANSPORTATION SERVICES FOR SENIORS, PERSONS WITH DISABILITIES, AND LOW-INCOME PERSONS
(13) FAMILY & CHILDREN'S SERVICES INC DBA HEADWATERS COUNSELING 2712 SOUTH CALHOUN STREET FORT WAYNE,IN46807	35-0868078	501(C)(3)	40,000	TO SUPPLEMENT HEADWATERS' PROGRAM TO PROVIDE MENTAL HEALTH AND SUBSTANCE ABUSE COUNCELING TO VERY LOW INCOME FAMILIES AND INDIVIDUALS ($20,000) AND FOR MENTAL HEALTH ASSESSMENTS AND COUNSELING AS NEEDED FOR PARTNERING HOMELESS SHELTERS ($5,000).
(14) HEARCARE CONNECTION INC 5933 E STATE BLVD FORT WAYNE,IN46815	45-2803181	501(C)(3)	20,000	SUPPORT FOR HEARING CLINICS FOR LOW-INCOME INDIVIDUALS
(15) FORT WAYNE CLUBHOUSE INC 3327 LAKE AVE FORT WAYNE,IN46805	35-2026647	501(C)(3)	30,000	TO ASSIST ADULTS WITH LIMITED RESOURCES IN RECLAIMING THEIR LIVES FROM DEVASTATION OF SERIOUS MENTAL ILLNESS BY PROVIDING UNIQUE AND EFFECTIVE CLUBHOUSE MODEL PSYCHOSOCIAL REHABILITATION
(16) HEALTHIER MOMS AND BABIES 700 BROADWAY FORT WAYNE,IN46802	35-6049685	501(C)(3)	15,000	TO BE USED AS A $1 FOR $1 MATCHING GRANT FOR DONATIONS FROM BUSINESSES AND INDIVIDUALS TO FURTHER HEALTHIER MOMS AND BABIES' MISSION OF IMPROVING THE OUTCOME OF PREGNANCY AND REDUCING INFANT MORTALITY AMONG HIGH RISK, LOW INCOME FAMILIES; $600 FOR SPONSORSHIP OF THE 2012 HEALTHIER MOMS AND BABIES LUNCHEON
(17) A HOPE CENTER 3630 HOBSON RD FORT WAYNE,IN46805	31-1113254	501(C)(3)	40,000	TO SUPPORT THE LIMITED MEDICAL MODEL, PROVIDING CLIENTS WITH FREE NURSE-ADMINISTERED PREGNANCY TESTING; EDUCATION RELATED TO PREGNANCY, ABORTION AND STDS; PRENATAL VITAMINS; AND A FIRST TRIMESTER ULTRASOUND (IF ABORTION VULNERABLE)
(18) HOPE HOUSE INC 1129 GARDEN ST FORT WAYNE,IN46802	35-1537053	501(C)(3)	12,500	TO PROVIDE THERAPEUTIC FAMILY SUPPORT TO HOMELESS, CHEMICALLY DEPENDENT WOMEN AND THEIR FAMILIES ANNUALLY, AND TO PROVIDE SOME RECOVERY COUNSELING GROUPS ON-SITE
(19) CEDARS HOPE 527 W BERRY ST FORT WAYNE,IN46802	35-1862531	501(C)(3)	7,500	TO PROVIDE MEDICAL ADVOCACY AND SUPPORTIVE SERVICES FOR CEDARS HOPE RESIDENTS WHO WERE HOMELESS, HAVE A SERIOUS MENTAL ILLNESS, AND ARE OF LOW INCOME
(20) MATTHEW 25 HEALTH AND DENTAL CLINIC 413 E JEFFERSON BLVD FORT WAYNE,IN46802	35-1484951	501(C)(3)	210,000	FOR THE DENTAL DIRECTOR'S SALARY, TO OVERSEE APPROXIMATELY 7,000+ DENTAL PATIENTS ANNUALLY; TO HELP SUPPORT THE MEDICAL DIRECTOR'S POSITION, PROVIDING PROFESSIONAL OVERSIGHT OF SERVICE TO 3,000+ MEDICAL PATIENTS ANNUALLY
(21) NEIGHBORHOOD HEALTH CLINICS INC 1717 S CALHOUN ST FORT WAYNE,IN46802	35-1922483	501(C)(3)	50,000	TO SUBSIDIZE DENTAL OPERATIONS TO COVER THE DIFFERENCE BETWEEN THE AVERAGE MINIMUM CO-PAY AND ACTUAL AVERAGE COST AT THE CLINIC
(22) MCMILLEN CENTER FOR HEALTH EDUCATION INC 600 JIM KELLEY BLVD FORT WAYNE,IN46816	35-1186994	501(C)(3)	25,000	TO UNDERWRITE AT LEAST 60 PROGRAMS IN SCHOOLS/GROUPS WHERE GREATER THAN 50% ARE LOW INCOME YOUTH AND THE STUDENTS IMPROVE THEIR HEALTH KNOWLEDGE BY 15 POINTS, REACHING 1,600-2,000 STUDENTS IN PRESCHOOL THROUGH GRADE FOUR
(23) MENTAL HEALTH AMERICA IN ALLEN COUNTY 227 E WASHINGTON BLVD SUITE 300 FORT WAYNE,IN46802	35-0896905	501(C)(3)	20,000	TO PROVIDE OPERATING SUPPORT FOR THE CLIENT ADVOCACY PROGRAM TO HELP PEOPLE WITH MENTAL HEALTH ISSUES ACCESS PREVENTION, TREATMENT AND RECOVERY PROGRAMS
(24) HOPE ALIVE INC 1747 N WELLS STREET FORT WAYNE,IN46808	35-1365346	501(C)(3)	19,665	FOR GENERAL OPERATING SUPPORT TO BENEFIT HOMELESS WOMEN, WHICH INCLUDES COUNSELING, CASE MANAGEMENT, TRANSITIONAL HOUSING AND ASSISTANCE WITH FINDING A JOB OR FINISHING THEIR EDUCATION
(25) SCAN INC 500 W MAIN ST FORT WAYNE,IN46802	31-0899309	501(C)(3)	15,000	TO HELP FUND MEDICAL TRANSPORTATION COSTS FOR HEALTHY FAMILIES CLIENTS
(26) SOULMEDIC MEDIA GROUP - REMEDYLIVE 6429 OAKBROOK PARKWAY FORT WAYNE,IN46825	27-2417633	501(C)(3)	15,000	TO CONTINUE TO GIVE BIBLICAL GUIDANCE TO THE 15,000+ YOUNG ADULTS IN THE FORT WAYNE AREA WHO GO TO THE WEBSITE OR TEXT WITH HURTS, DAMAGING HABITS AND HANG UPS
(27) WOMEN'S CARE CENTER 921 W COLISEUM BLVD FORT WAYNE,IN46808	35-1609945	501(C)(3)	35,000	TO UNDERWRITE CLIENT CARE WITH THE OBJECTIVE OF HELPING MORE WOMEN CHOOSE LIFE FOR THEIR BABIES AND HAVE ACCESS TO QUALITY HEALTH CARE & HEALTH EDUCATION
(28) YMCA OF GREATER FORT WAYNE 347 W BERRY STREET SUITE 500 FORT WAYNE,IN46802	35-0886850	501(C)(3)	23,080	FOR 20 MEMBERSHIPS IN OBESITY WELLNESS NETWORK AND 10 MEMBERSHIPS IN THE DIABETES PREVENTION PROGRAM TO COMBAT OBESITY AND DIABETES BY PROVIDING HEALTH AND FITNESS SERVICES TO LOW-INCOME OVERWEIGHT AND OBESE INDIVIDUALS AND THEIR FAMILIES IN ALLEN COUNTY
(29) SUPER SHOT INC 709 CLAY STREET 300 FORT WAYNE,IN46802	35-2122575	501(C)(3)	55,000	$55,000 FOR SUPPORT OF FREE COMMUNITY IMMUNIZATIONS FOR LOW-INCOME FAMILIES AND REFUGEES AT ANTHONY MEDICAL CENTER
(30) TURNSTONE CENTER FOR CHILDREN AND ADULTS WITH DISABILITIES INC 3320 NORTH CLINTON STREET FORT WAYNE,IN46805	35-0913541	501(C)(3)	10,000	$10,000 TO HELP SUBSIDIZE OPERATING SUPPORT TO BENEFIT THE 15,300 HOURS OF THERAPY AND 4,500 HOURS OF CASE MANAGEMENT SERVICES PROVIDED ANNUALLY FOR CHILDREN AND ADULTS WITH DISABILITIES
(31) LUTHERAN AGENCY FOR MISSIONS TO BURMESE 225 E WOODLAND AVE FORT WAYNE,IN46803	35-2036409	501(C)(3)	15,000	TO PROVIDE MEDICAL ADVOCACY, TRANSLATION, TRANSPORTATION, AND HOME VISITS FOR FOLLOW-UP, ASSISTANCE AND TEACHING FOR 400+ BURMESE INDIVIDUALS
(32) WOMEN'S HEALTH LINK 2126 INWOOD DR FORT WAYNE,IN46803	35-1547508	501(C)(3)	7,500	FOR TECHNICAL ASSISTANCE TO HELP WITH STRATEGIC PLANNING FOR WOMEN'S HEALTH LINK

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2013

Page 2

Part III

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant	(d)Amount of non-cash assistance	(e)Method of valuation (book, FMV, appraisal, other)	(f)Description of non-cash assistance

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference	Explanation
PART I, LINE 2:	THE FOUNDATION MONITORS GRANT FUNDING BY REQUIRING WRITTEN JOB DESCRIPTIONS AND RESUMES FOR ALL POSITIONS FUNDED; PROGRESS REPORTS AT 8 MONTHS AND FINAL REPORTS WITHIN 60 DAYS OF COMPLETION OF ALL PROJECTS FUNDED AND DOES SITE VISITS TO VIEW PROGRESS AND OPERATION OF THE PROGRAMS FUNDED.

Schedule I (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

THE ST JOSEPH COMMUNITY HEALTH FOUNDATION INC

Employer identification number

31-1016570

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 2	SR. KATHY HAAS PHJC, SR. GERMAINE HUSTEDDE PHJC, SR. CAROLE LANGHAUSER PHJC, AND SR. CONNIE C. BACH PHJC ARE MEMBERS OF THE POOR HANDMAIDS OF JESUS CHRIST, THE SPONSORING ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 6	THE PROVINCIAL OF THE AMERICAN PROVINCE OF THE POOR HANDMAIDS AND THE INDIVIDUALS HOLDING MEMBERSHIP POSITIONS IN THE PROVINCIAL COUNCIL OF THE AMERICAN PROVINCE OF THE POOR HANDMAIDS ARE THE VOTING MEMBERS OF THE ST. JOSEPH COMMUNITY HEALTH FOUNDATION, INC. (SJCHF)
FORM 990, PART VI, SECTION A, LINE 7A	THE MEMBERS OF THE SJCHF APPOINT THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B	THE APPROVAL OF THE MEMBERS IS REQUIRED WITH RESPECT TO THE FOLLOWING: (A) ANY ACTION WHICH MIGHT BE CONSIDERED AS INCONSISTENT WITH THE OBJECTIVES AND PURPOSES SET FORTH IN THE ARTICLES; (B) THE INCURRENCE OF DEBT IN EXCESS OF THE LESSER OF ONE MILLION DOLLARS OR TEN PERCENT (10%) OF THE BOOK VALUE OF THE CORPORATION'S FIXED ASSETS; (C) THE AMENDMENT OF THE ARTICLES OF INCORPORATION OR BYLAWS; (D) THE MERGER OF SJCHF WITH OR INTO ANY OTHER ENTITY; (E) THE VOLUNTARY DISSOLUTION OF SJCHF; (F) THE ACQUISITION, SALE, LEASE, TRANSFER, ASSIGNMENT, MORTGAGE OR ENCUMBRANCE OF ANY FIXED CAPITAL, BUILDINGS OR PARCEL OF REAL ESTATE WITH A VALUE OF ONE MILLION DOLLARS OR GREATER; (G) THE SELECTION OF THE CERTIFIED PUBLIC ACCOUNTANTS; AND (H) THE ACCEPTANCE OF ANY DONATION, GIFT, DEVISE OR BEQUEST WHICH IMPOSES AN OBLIGATION UPON SJCHF, THE SPONSOR, OR ANY AFFILIATE.
FORM 990, PART VI, SECTION B, LINE 11	THE FORM 990 WAS PREPARED BY HAINES, ISENBARGER & SKIBA, LLC, INDEPENDENT ACCOUNTANTS. A COPY OF THE FORM 990 WAS PROVIDED TO ALL DIRECTORS AND THEY VOTED TO APPROVE THE FINANCIALS AT THE SEPTEMBER 24, 2014 BOARD MEETING.
FORM 990, PART VI, SECTION B, LINE 12C	EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE IS REQUIRED TO COMPLETE A DISCLOSURE STATEMENT, WHICH IDENTIFIES CONFLICT OF INTEREST, ANNUALLY. THE COMPLIANCE OFFICER REVIEWS THE DISCLOSURE STATEMENT AND REPORTS ANY POTENTIAL CONFLICTS OF INTEREST TO THE EXECUTIVE DIRECTOR, WHO WOULD SUBSEQUENTLY DISCLOSE THE POTENTIAL COFLICTS OF INTEREST TO THE BOARD. IN 2013, NO POTENTIAL CONFLICTS OF INTEREST WERE NOTED.
FORM 990, PART VI, SECTION B, LINE 15A	AN INDEPENDENT CONSULTANT GATHERS DATA OF COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS AND MAKES A RECOMMENDATION AS TO ANNUAL ADJUSTMENTS FOR THE FOUNDATION'S OFFICERS. THE EXECUTIVE COMMITTEE AND THE MEMBERS APPROVE THE COMPENSATION LEVELS.
FORM 990, PART VI, SECTION C, LINE 19	SJCHF DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC, EXCEPT TO THE EXTENT THAT THEY ARE IN A PUBLICLY AVAILABLE DOCUMENT SUCH AS THE FORM 990 OR 1023.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

THE ST JOSEPH COMMUNITY HEALTH FOUNDATION INC

Employer identification number

31-1016570

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) EARTHWORKS INC 9815 UNION ROAD PLYMOUTH,IN46563 35-1793328	EDUCATION	IN	501(C)(3)	9	ANCILLA DOMINI SISTERS INC		No
(2) THE LINDEN HOUSE OF GARY INC CO EVERGREEN REAL ESTATE 566 W LAKE STREET CHICAGO,IL60661 35-1954676	SENIOR HOUSING	IN	501(C)(3)	9	ANCILLA SYSTEMS INCORPORATED		No
(3) THE LINDEN HOUSE OF HOBART INC CO EVERGREEN REAL ESTATE 566 W LAKE STREET CHICAGO,IL60661 35-2006008	SENIOR HOUSING	IN	501(C)(3)	9	ANCILLA SYSTEMS INCORPORATED		No
(4) THE LINDEN HOUSE OF MISHAWAKA INC CO EVERGREEN REAL ESTATE 566 W LAKE STREET CHICAGO,IL60661 35-1968002	SENIOR HOUSING	IN	501(C)(3)	9	ANCILLA SYSTEMS INCORPORATED		No
(5) WEST TOWN SENIOR RESIDENCE INC CO EVERGREEN REAL ESTATE 566 W LAKE STREET CHICAGO,IL60661 36-3768678	SENIOR HOUSING	IL	501(C)(3)	9	ANCILLA SYSTEMS INCORPORATED		No
(6) SOJOURNER TRUTH HOUSE INC 1419 S LAKE PARK AVENUE HOBART,IN46342 27-0296707	SOCIAL SERVICES	IN	501(C)(3)	7	ANCILLA SYSTEMS INCORPORATED		No
(7) CATHERINE KASPER PLACE INC 347 W BERRY STREET STE 101 FORT WAYNE,IN46802 27-3213747	SOCIAL SERVICES	IN	501(C)(3)	7	ST JOSEPH COMMUNITY HEALTH FOUNDATION	Yes
(8) PHJC FOUNDATION INC 1419 S LAKE PARK AVENUE HOBART,IN46342 27-1688707	FUNDRAISING FOUNDATION	IN	501(C)(3)	7	ANCILLA DOMINI SISTERS INC		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2013

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) ANCILLA HEALTH SERVICES INC 1419 S LAKE PARK AVE HOBART,IN46342 35-1938745	MANAGEMENT SERVICES	IN	ANCILLA SYSTEMS INCORPORATED	C				No
(2) L GILBRAITH SPC LTD 23 LIME TREE BAY AVENUE PO BOX 105 GRAND CAYMAN,KY1-1102 CJ	EXCESS INSURANCE	CJ	ANCILLA SYSTEMS INCORPORATED					No

Schedule R (Form 990) 2013

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2013

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V?UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V?UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2013

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2013

Additional Data

Software ID:
Software Version: