Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (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 listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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 VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 216,635 | 625,788 | 147,172 | 112,238 | 248,000 | 1,349,833 |
| 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...... | 17,283,938 | 19,548,018 | 21,058,706 | 23,214,978 | 25,087,538 | 106,193,178 |
| 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. | 17,500,573 | 20,173,806 | 21,205,878 | 23,327,216 | 25,335,538 | 107,543,011 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | 6,225 | 0 | 0 | 0 | 6,225 |
| 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. | 0 | 0 | 0 | 0 | 0 | 0 |
| c | Add lines 7a and 7b.. | 0 | 6,225 | 0 | 0 | 0 | 6,225 |
| 8 | Public support (Subtract line 7c from line 6.) | 107,536,786 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 17,500,573 | 20,173,806 | 21,205,878 | 23,327,216 | 25,335,538 | 107,543,011 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 74,206 | 88,740 | 88,928 | 92,929 | 102,187 | 446,990 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 74,206 | 88,740 | 88,928 | 92,929 | 102,187 | 446,990 |
| 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 VI.) .. | 980,630 | 927,410 | 981,608 | 983,503 | 975,309 | 4,848,460 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 18,555,409 | 21,189,956 | 22,276,414 | 24,403,648 | 26,413,034 | 112,838,461 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
||||
| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
||||
|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
||||
|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part III, Line 12 Other Income | DESCRIPTION - GROSS INCOME FROM FUNDRAISING/GAMING EVENTS, COLUMN A - 42523.0, COLUMN B - 51124.0, COLUMN C - 52515.0, COLUMN D - 39112.0, COLUMN E - 41522.0, COLUMN F - 226796.0; DESCRIPTION - CAFETERIA, COLUMN A - 301004.0, COLUMN B - 300567.0, COLUMN C - 322025.0, COLUMN D - 334636.0, COLUMN E - 329441.0, COLUMN F - 1587673.0; DESCRIPTION - PRODUCT SALES, COLUMN A - 255211.0, COLUMN B - 276162.0, COLUMN C - 270348.0, COLUMN D - 269973.0, COLUMN E - 277300.0, COLUMN F - 1348994.0; DESCRIPTION - SERVICES SOLD, COLUMN A - 242247.0, COLUMN B - 171321.0, COLUMN C - 169189.0, COLUMN D - 171941.0, COLUMN E - 163996.0, COLUMN F - 918694.0; DESCRIPTION - ALL OTHER REVENUE, COLUMN A - 139645.0, COLUMN B - 128236.0, COLUMN C - 167531.0, COLUMN D - 167841.0, COLUMN E - 163050.0, COLUMN F - 766303.0; |
| Software ID: | 14000329 |
| Software Version: | 2014v1.0 |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS | I. INTRODUCTION VILLA NAZARETH, INC. OPERATES TWO DISTINCT ENTITIES, 1) CHI FRIENDSHIP AND 2) CHI RIVERVIEW. CHI FRIENDSHIP'S ORIGIN DATES BACK TO 1897 TO ST. JOHN'S ORPHANAGE. OVER THE YEARS THE NAME AND THE MISSION OF THE ORGANIZATION HAVE CHANGED TO MEET THE NEEDS OF THE COMMUNITY. IN 1981, VILLA NAZARETH (THEN DBA FRIENDSHIP, INC.) WAS CREATED TO SERVE PEOPLE WITH DEVELOPMENTAL DISABILITIES IN A NON-INSTITUTIONAL, COMMUNITY-BASED PROGRAM. TODAY, CHI FRIENDSHIP IS ONE OF THE LARGEST NON-PROFIT PRIVATE PROVIDERS OF COMMUNITY SERVICES TO PEOPLE WITH DEVELOPMENTAL DISABILITIES IN NORTH DAKOTA. HUNDREDS OF PEOPLE WITH DEVELOPMENTAL DISABILITIES ARE SERVED BY CHI FRIENDSHIP IN A VARIETY OF VOCATIONAL AND RESIDENTIAL PROGRAMS. VILLA NAZARETH (DBA CHI RIVERVIEW) IS A RETIREMENT COMMUNITY FOR ADULTS 55 AND OLDER. CHI RIVERVIEW WAS FORMED IN 1987 OFFERING 148 INDEPENDENT APARTMENT SETTINGS. AS SENIORS BEGAN TO AGE IN PLACE, AN ASSISTED LIVING PROGRAM WAS DEVELOPED; AND APPROXIMATELY 50 OUT OF THE 148 APARTMENTS WERE DESIGNATED AS ASSISTED LIVING. A HEALTH SERVICE COMPONENT WAS ADDED TO ASSIST RESIDENTS WITH THEIR HEALTH CARE NEEDS. IN 2012 AN ENHANCED MEMORY CARE PROGRAM WAS STARTED IN RESPONSE TO THE MORE COMPREHENSIVE NEEDS OF RESIDENTS WITH MEMORY LOSS. AS OF THE END OF JUNE 2015, 12 APARTMENTS ARE AVAILABLE WITH THIS ENHANCED SERVICE; AND 136 APARTMENTS ARE OFFERED AS INDEPENDENT OR ASSISTED LIVING. DURING THE FISCAL YEAR 2015, VILLA NAZARETH PROVIDED BENEFITS TO LOW INCOME INDIVIDUALS AND THE BROADER COMMUNITY OF $172,455 AS DESCRIBED BELOW. APPROXIMATELY 6,900 PEOPLE BENEFITED FROM THESE SERVICES. THE MAJOR COMPONENTS OF THESE COMMUNITY BENEFITS ARE AS FOLLOWS: BENEFITS FOR LOW INCOME INDIVIDUALS: COST OF CHARITY CARE: PERSONS SERVED - 6 COMMUNITY BENEFIT - $65,789 COMMUNITY SERVICE TARGETED FOR POOR: PERSONS SERVED - 710 COMMUNITY BENEFIT - $82,268 TOTAL BENEFITS FOR LOW INCOME INDIVIDUALS: PERSONS SERVED - 716 COMMUNITY BENEFIT - $148,057 BENEFITS FOR THE BROADER COMMUNITY: EDUCATION AND RESEARCH: PERSONS SERVED - 1,050 COMMUNITY BENEFIT - $10,818 OTHER COMMUNITY BENEFITS: PERSONS SERVED - 5,092 COMMUNITY BENEFIT - $13,580 TOTAL BENEFITS FOR BROADER COMMUNITY: PERSONS SERVED - 6,142 COMMUNITY BENEFIT - $24,398 TOTAL BENEFITS: PERSONS SERVED - 6,858 COMMUNITY BENEFIT - $172,455 II. BENEFITS FOR LOW INCOME INDIVIDUALS CHARITY CARE THE CHARITY CARE PROGRAM WAS IMPLEMENTED TO ALLOW SENIORS TO REMAIN AT CHI RIVERVIEW AND RECEIVE NECESSARY SERVICES DESPITE THEIR SHRINKING ABILITY TO PAY FOR THE COSTS. AS SENIORS AGE AND LIFE EXPECTANCIES ARE EXCEEDED, A FEW OF OUR RESIDENTS FIND THEIR FINANCIAL MEANS CANNOT KEEP PACE WITH COSTS. IN FISCAL YEAR 2015, CHI RIVERVIEW PROVIDED $65,789 TO SIX PEOPLE IN RENT EXPENSE THROUGH OUR CHARITY CARE PROGRAM. COMMUNITY SERVICE TARGETED FOR POOR AS REPRESENTATIVE PAYEE FOR 102 INDIVIDUALS SUPPORTED BY CHI FRIENDSHIP, WE SET UP BANK ACCOUNTS AND ASSIST WITH, MONITOR, AND RECONCILE THE MONTHLY ACTIVITY IN EACH ACCOUNT. FEES FOR THESE SERVICES WOULD ORDINARILY COST THE INDIVIDUALS APPROXIMATELY $40 PER MONTH PER ACCOUNT. FOR MANY OF THE PEOPLE SUPPORTED BY CHI FRIENDSHIP, HOWEVER; INCOMES ARE LIMITED TO A LEVEL THAT COULD NOT SUPPORT THIS EXPENSE. FOR THIS REASON, WE HAVE MADE A DECISION TO COVER THESE CHARGES. THE TOTAL FOR THESE SERVICES AMOUNTED TO $48,000 IN FISCAL YEAR 2015. AT CHI FRIENDSHIP, FAMILY AND COMMUNITY LIVING (FCL) AND SUPPORTED EMPLOYMENT ARE TWO "MEDICAID WAIVERED" PROGRAMS WHEREBY WE OFFER OPTIONS FOR A CONTINUUM OF HOME AND COMMUNITY- BASED SERVICES IN THE LEAST RESTRICTIVE ENVIRONMENT. WE PRIDE OURSELVES ON SERVING PEOPLE WITH DEVELOPMENTAL DISABILITIES WHO ARE OF A MORE CHALLENGING NATURE. THE NEED TO SERVE THE MORE CHALLENGING PEOPLE IN THIS SETTING LEADS TO THE PROGRAM COSTS EXCEEDING REIMBURSEMENT LEVELS. IN FISCAL YEAR 2015, THE EXCESS COSTS WERE $20,958; AND THEY BENEFITTED 168 PEOPLE. SOME OTHER SITUATIONS OCCURRED DURING THE YEAR WHICH RESULTED IN PEOPLE SUPPORTED LOSING A JOB, ENCOUNTERING SIGNIFICANT CHANGES IN WAGES, OR DEVELOPING A NEED FOR MEDICAL EQUIPMENT THAT WAS NOT COVERED BY MEDICARE. AS A RESULT, SOME INDIVIDUALS SUPPORTED BY CHI FRIENDSHIP COULD NOT AFFORD TO COVER THEIR NEEDS. THESE ARE WHAT WE CONSIDER EXTREME NEED SITUATIONS, AND CERTAIN OF THESE EXPENSES WERE COVERED BY FRIENDSHIP INC. THIS FISCAL YEAR, $13,310 WAS SPENT TO ASSIST 421 PEOPLE SERVED UNDER OUR PROGRAMS. III. BENEFITS FOR THE BROADER COMMUNITY EDUCATION AND RESEARCH CHI RIVERVIEW SERVES AS A HOST SITE FOR COMMUNIVERSITY, A PROGRAM OFFERING ENRICHING EDUCATIONAL OPPORTUNITIES FOR COMMUNITY MEMBERS. COMMUNIVERSITY HOSTED SESSIONS OVER THE COURSE OF FISCAL YEAR 2015 WITH TOTAL ATTENDANCE OF APPROXIMATELY 238 PEOPLE AT A COST OF $4,153. OTHER COMMUNITY EDUCATION PROGRAMS AT CHI RIVERVIEW INCLUDED YMCA SWIMMING CLASSES, AARP-DRIVING SAFE PROGRAM, TOPS CLUB AND AQUA EXERCISE. THESE PROGRAMS ARE OPEN TO THE GREATER COMMUNITY AND ASSIST PEOPLE IN LIVING HEALTHILY. 812 PEOPLE BENEFITTED FROM THESE PROGRAMS AT A COST OF $6,665. OTHER COMMUNITY BENEFITS CHI RIVERVIEW CHAPEL IS OPEN FOR MEMBERS OF THE COMMUNITY TO ATTEND DAILY MASS AND ECUMENICAL SERVICES THROUGHOUT THE YEAR. MORE THAN 4,300 COMMUNITY MEMBERS ATTENDED SERVICES THIS PAST YEAR AT A COST OF $9,118. IN-KIND DONATIONS TO VARIOUS GROUPS TOTALED $4,462; FROM WHICH APPROXIMATELY 716 PEOPLE WERE IMPACTED. THESE INCLUDED ORGANIZATIONS SUCH AS UNITED WAY, ACCESS, THE NORTHERN PLAINS COUNCIL ON AGING AND DISABILITIES, AND THE NORTH DAKOTA ASSOCIATION OF COMMUNITY PROVIDERS. |
| Form 990, Part VI, Line 15a COMPENSATION OF TOP MANAGEMENT OFFICIAL | The organization's top management official's compensation is paid by Catholic Health Initiatives (CHI), a related organization. CHI has a defined compensation philosophy. Both the executive and non-executive compensation structures and ranges are reviewed annually in comparison to market data. CHI uses The Hay Group as the independent third party to assess executive compensation programs and to ensure the reasonableness of actual salaries and total compensation packages. Compensation of the senior most executives is reviewed annually. The Hay Group reviews both cash and total compensation for overall reasonableness, for adherence to CHI's compensation philosophy, and for comparability to the not-for-profit healthcare market. This independent review is delivered by Hay Group to the HR committee of the CHI Board of Stewardship Trustees annually at their September meeting and minutes are shared with the full board at the December meeting. The last review was September 14, 2015. In addition, Hay Group completed a comprehensive review of all positions at the level of vice president and above in the fall of 2014 to determine and validate appropriate compensation levels. These levels have been reviewed annually since and revised based on market data, where applicable. |
| Form 990, Part VI, Line 1a Delegate broad authority to a committee | THE EXECUTIVE COMMITTEE CONSISTS ONLY OF DIRECTORS OF THE CORPORATION AND IS COMPOSED OF THE CHAIRPERSON OF THE BOARD, THE VICE CHAIRPERSON OF THE BOARD, AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, EACH OF WHOM SERVE AS EX OFFICIO VOTING MEMBERS OF THE EXECUTIVE COMMITTEE, AND TWO MEMBERS APPOINTED BY THE BOARD OF DIRECTORS. EXCEPT AS PROVIDED BY LAW, THE EXECUTIVE COMMITTEE SHALL HAVE AND MAY EXERCISE SUCH POWERS AS MAY BE DELEGATED TO IT BY THE BOARD OF DIRECTORS. ALL ACTIONS TAKEN BY THE EXECUTIVE COMMITTEE SHALL BE DOCUMENTED IN MINUTES AND PROMPTLY REPORTED TO THE BOARD AT THE NEXT EARLIEST MEETING. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | THE SOLE MEMBER OF THE ORGANIZATION IS CATHOLIC HEALTH INITIATIVES, A COLORADO NONPROFIT CORPORATION. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | THE SOLE MEMBER HAS THE POWER TO APPOINT ORGANIZATION DIRECTORS, AND AFTER RECOMMENDATION BY THE BOARD OF DIRECTORS, MAY ACCEPT OR REJECT ANY INDIVIDUAL NOMINATED TO SERVE AS A DIRECTOR. THE SOLE MEMBER MAY ALSO UNILATERALLY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS IF THE BOARD FAILS TO FURNISH A LIST OF QUALIFIED INDIVIDUALS TO SERVE. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | THE ORGANIZATION'S CORPORATE MEMBER IS CATHOLIC HEALTH INITIATIVES ("CHI"). THE CORPORATE MEMBER SHALL HAVE THE SPECIFIC RIGHTS SET FORTH IN THE GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE RESERVED TO THE CHI BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE CHI CHIEF EXECUTIVE OFFICER: - SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF VILLA NAZARETH, INC. - AMENDMENT OF THE CORPORATE DOCUMENTS OF VILLA NAZARETH, INC. - APPROVE MEMBERS OF THE VILLA NAZARETH, INC. BOARD - REMOVAL OF A MEMBER OF THE GOVERNING BODY OF VILLA NAZARETH,INC. - APPROVAL OF ISSUANCE OF DEBT BY VILLA NAZARETH, INC. - APPROVAL OF PARTICIPATION OF VILLA NAZARETH, INC. IN A JOINT VENTURE - APPROVAL OF FORMATION OF A NEW CORPORATION BY VILLA NAZARETH, INC. - APPROVAL OF A MERGER INVOLVING VILLA NAZARETH, INC. - APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF VILLA NAZARETH, INC. - TO REQUIRE THE TRANSFER OF ASSETS BY VILLA NAZARETH, INC. TO CHI TO ACCOMPLISH CHI'S GOALS AND OBJECTIVES, AND TO SATISFY CHI DEBTS. - ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR VILLA NAZARETH, INC. PURSUANT TO THE ORGANIZATION'S BYLAWS, CHI MAY, IN EXERCISE OF ITS APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | THE RETURN IS PREPARED/COMPILED BY CHI'S TAX DEPARTMENT. ONCE COMPLETED IT IS REVIEWED BY THE ORGANIZATION'S FINANCE, AUDIT AND COMPLIANCE (FAC) COMMITTEE., THE CONTROLLER/TREASURER WILL REVIEW ANY SIGNIFICANT AND/OR UNUSUAL ITEMS AND WILL FIELD ANY QUESTIONS AT THE FAC MEETING. THE FAC COMMITTEE WILL THEN VOTE TO RECOMMEND APPROVAL OF THE RETURN TO THE FULL BOARD. AN ELECTRONIC COPY OF THE RETURN IS THEN IS SENT TO EACH BOARD MEMBER FOR THEIR REVIEW TO APPROVE. THE RETURN IS THEN FILED WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES BY CHI, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD. |
| Form 990, Part VI, Line 12c Conflict of interest policy | Catholic Health Initiatives ("CHI") has a Conflicts of Interest ("COI") policy in place to maintain the integrity of all of its activities. The policy applies to CHI Board of Stewardship Trustees and members of its committees; all board and board committee members of CHI Entities; all CHI employees; all CHI physicians (both employed and non-employed) and all physician administrators and leaders; advanced practice clinicians (both employed and non-employed); and all CHI research personnel (both employed and non-employed). Disclosure, review and management of perceived, potential or actual conflicts of interest are accomplished through a defined COI disclosure process. Each person has a general ongoing obligation to promptly and fully report to his/her direct manager, supervisor, medical staff office, board or board committee chair any situation or circumstance that may create a conflict of interest. The person must report the actual or potential conflict as soon as she/he becomes aware of it. In any situation where the person may be in doubt, a full disclosure should be made to permit an impartial and objective determination. In addition to the general ongoing obligation, there are initial disclosure obligations. The board, board committee members, and new employees are required to make disclosures at the time of their initial hiring/appointment. All non-employed, credentialed or contracted physicians are required to make disclosures at the time of their credentialing and during any subsequent reappointment or recredentialing. All researchers are required to make disclosures upon consideration of affiliation with a research sponsor. In addition to the general ongoing and initial disclosure obligations, there is an annual disclosure obligation. All corporate officers, board and board committee members, employees at the level of manager and above, researchers, supply chain employees, employed physicians, physician administrators and leaders, and employed advanced practice clinicians must complete a new conflict of interest disclosure annually. Disclosures of perceived, potential or actual conflicts involving financial interests are forwarded to the Conflicts of Interest Review Committee ("C-CIRC") or Legal Services Group for review depending on the position of the person involved. The C-CIRC reviews COI questionnaires containing disclosures of perceived or possible conflicts for employees at a level of manager or above, supply chain employees, researchers and physicians, physician administrators and leaders, and advanced practice clinicians (both employed and non-employed). In the determination of a conflict, a COI management plan will be developed for that person. With respect to those audiences for which the C-CIRC has review responsibility, the C-CIRC will facilitate development of any such conflict of interest management plan in collaboration with local CRP staff. A designated CHI Entity staff will be responsible for monitoring the COI management plan and for documenting monitoring activities. At its sole discretion, a CHI Entity may reject a Person's request to enter into the relationship in question, or require the relationship be sufficiently altered to avoid a potential COI. If the C-CIRC determines that there is a potential or actual conflict of interest that does not currently have appropriate controls to address the conflict of interest, it may recommend that the disclosing person be allowed to participate in the activity or transaction subject to restrictions as outlined in the COI management plan. If a Person does not agree with a determination made by the C-CIRC, its interpretation of the Policy or Addenda, or seeks an exemption or exception, the following steps should be followed. The Employee disputing the review decision, interpretation of the Policy, or seeking exemption or exception must present the matter to the Employee's immediate direct manager or supervisor for review and determination. If the Employee and the manager do not agree with the review decision, interpretation of the Policy, or seek exemption or exception, the manager shall consult with the manager's Vice President (or higher if the manager is a Vice President) to reach a determination. If the matter remains unresolved, it shall be referred to the CHI Vice President of Human Resources and the CHI Corporate Responsibility Officer. If they are unable to reach agreement, the matter shall be referred to the CHI General Counsel, whose decision shall be final. Reviews and determinations involving board and board committee members and corporate officers will be the responsibility of the board, board executive committee, or board chair, with guidance from the Legal Services Group (LSG). Annual COI disclosures of all trustee and corporate officers will be reviewed by the CHI Senior Vice President, Legal Services, and General Counsel or his or her designee who will report potential conflicts to the applicable Board Chair. The Board Chair or designee shall make such further investigation of any conflict of interest disclosures as he or she may deem appropriate. If the conflict involves the Board Chair, the Vice Chair will assume the Chair's role. Based on review and evaluation of the relevant facts and circumstances, the Board Chair will make an initial determination as to whether a conflict of interest exists and whether, pursuant to the COI Policy, review and approval or other action by the Board is required. A written record of the Board Chair's determination, including relevant facts and circumstances, will be made. The Board Chair shall then make an appropriate report to the Executive Committee of the Board concerning such review, evaluation and determination. If a difference of opinion exists between the Board Chair and another Trustee as to whether the facts and circumstances of a given situation constitute a conflict of interest or whether Board review and approval or other action is required within the COI Policy, the matter shall be submitted to the Board's Executive Committee, which shall make a final determination as to the matter presented. Such determination, including relevant facts and circumstances, will be reflected in the Executive Committee minutes and will be reported to the Board. When any conflict of interest is considered by the board, the trustee or corporate officer, as appropriate, must disclose all of the material facts to the Board. The trustee shall not vote and the trustee or corporate officer shall not use his or her personal influence on the matter. The trustee or corporate officer shall be excused from the meeting during discussion and vote on the conflict of interest. In reviewing such transactions between CHI or CHI Entities and vendors or other contractors who are, or are affiliated with, Trustees or Corporate Officers, the Board will act as it would in reviewing transactions with unrelated third parties. The transaction is not be approved unless the Board determines that the transaction is fair to CHI or the CHI Entity. The Board must approve the transaction by a majority of the Trustees on the Board, without counting the vote of any individual who has an interest in the transaction. All determinations of conflicts of interest are reported as required by law, regulations, and CHI policy. |
| Form 990, Part VI, Line 15b Process to establish compensation of other employees | THE CEO OF THE MBO DOES A MARKET STUDY TO DETERMINE IF THE SALARIES OF THE SENIOR MANAGEMENT TEAM ARE COMPARABLE. THIS MARKET STUDY IS SHARED WITH THE CEO OF THE FARGO DIVISION AND A SALARY RANGE IS SET FOR EACH POSITION. THIS RANGE IS ADJUSTED ANNUALLY BASED ON THE APPROVED PERCENTAGE INCREASE OF THE MEDICAID BUDGET AS SET BY THE STATE OF NORTH DAKOTA DEPARTMENT OF HUMAN SERVICES. THIS PERCENTAGE ADJUSTMENT IS KEEPING THE SENIOR MANAGEMENT'S SALARY RANGE MARKETABLE. IN ADDITION, THE DIVISION OFFICE OF CHI IN FARGO AND THE COMPENSATION COMMITTEE OF THE BOARD ALSO REVIEW AND APPROVE THE SALARY RANGES OF THE SENIOR MANAGEMENT TEAM. THE REVIEW AND APPROVAL OF OTHER OFFICERS' COMPENSATION WAS LAST PERFORMED IN OCTOBER 2012. |
| Form 990, Part VI, Line 19 Required documents available to the public | THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT WWW.DACBOND.ORG. ADDITIONALLY, THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE ON THE NORTH DAKOTA SECRETARY OF STATE'S WEBSITE. |
| Form 990, Part VIII, Line 11d Other Miscellaneous Revenue | Other Miscellaneous Revenue - Total Revenue: 163050, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 163050; |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | Unrealized Loss on Restricted Funds - -906; Capital Pool Resource Contribution - -29698; Other - 5; |
| Software ID: | 14000329 |
| Software Version: | 2014v1.0 |