Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (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 | |||||
| (A)
Catholic Health Initiatives Colorado |
840405257 | 3 | Yes | 0 | 0 | |
| (B)
Portercare Adventist Health System |
840438224 | 3 | Yes | 0 | 0 | |
|
Total 2
|
0 | 0 | ||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| 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 | ||||
| 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 2019 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-2019 |
(iii) Distributable Amount for 2019 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2019 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2019: | ||||
| a From 2014....... | ||||
| b From 2015....... | ||||
| c From 2016....... | ||||
| d From 2017....... | ||||
| e From 2018....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2019 distributable amount | ||||
|
i
Carryover from 2014 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2019 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2019 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
7 Excess distributions carryover to 2020. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2015..... | ||||
| b Excess from 2016..... | ||||
| c Excess from 2017..... | ||||
| d Excess from 2018..... | ||||
| e Excess from 2019..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Form 990, Part VI, Section A, line 6 | The filing organization has two members. The members of the filing organization are Portercare Adventist Health System (PAHS), a Florida corporation and Catholic Health Initiatives Colorado (CHIC), a Colorado corporation. Both PAHS and CHIC are not-for-profit corporations that are exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). There are no other classes of membership in the filing organization. |
| Form 990, Part VI, Section A, line 7a | The Board of Trustees (the Board) of the filing organization are appointed by its members, Portercare Adventist Health System (PAHS) and Catholic Health Initiatives Colorado (CHIC). PAHS is entitled to appoint up to seven Trustees to the Board and CHIC is entitiled to appoint up to seven Trustees to the Board. The number of Trustees appointed by PAHS must equal the number of Trustees appointed by CHIC at all times. |
| Form 990, Part VI, Section A, line 7b | Portercare Adventist Health System (PAHS) and Catholic Health Initiatives Colorado (CHIC), as the sole members of Centura Health Corporation (the Corporation), have certain reserved powers as set forth in the Bylaws of the filing organization. These reserved powers include the following: (a) to sell, transfer or otherwise dispose of any real estate owned by the Corporation or any Managed Facility with a fair market value in excess of three million dollars ($3,000,000); (b) to sell, transfer or otherwise dispose, (collectively the "transfer") other than in the ordinary course of business, of any other asset by the Corporation or a Managed Facility with a fair market value (individually or collectively) at the time of such transfer in excess of three million dollars ($3,000,000); (c) to enter into any promissory note or debt instrument or guaranty any indebtedness by or on behalf of the Corporation or a Managed Facility in excess of two hundred fifty thousand dollars ($250,000) or to perform under any capital lease with future payments in excess of two hundred fifty thousand dollars ($250,000); (d) to alter, amend, restate or repeal the Articles of Incorporation, Bylaws or Mission Statement of the Corporation or a Managed Facility; action on these matters may also be initiated by one or both of the members; (e) to approve the admission of a new sponsor or other affiliation by a health care system or facility with the Corporation or a Managed Facility; (f) to approve a plan of merger, dissolution, consolidation or corporate reorganization involving the Corporation or a Managed Facility; (g) to waive, settle or compromise any legal proceeding, suit, claim or action (collecting a "claim") against or brought by or on behalf of the Corporation or a Managed Facility if the uninsured portion of the amount in controversy is in excess of two million dollars ($2,000,000); provided, however, the approval of the members shall be required to contest, settle or compromise any claim brought by or on behalf of the federal or state government relating to matters within the scope of the corporate compliance plan of a Managed Facility, regardless of the amount in controversy or the existence of insurance coverage; (h) to acquire any real estate, personal property, membership, ownership or investment interest for the Corporation or a Managed Facility or make any capital expenditure other than pursuant to an annual budget, or substitutions for capital expenditures within a capital budget, which exceed individually, or in the aggregate five million dollars ($5,000,000) in any fiscal year. |
| Form 990, Part VI, Section B, line 11b | The filing organization's current year Form 990 was reviewed by the CEO and by the CFO prior to its filing with the IRS. The review conducted by the CEO and the CFO did not include the review of any supporting workpapers that were used in preparation of the current year Form 990, but did include a review of the entire Form 990 and all supporting schedules. |
| Form 990, Part VI, Section B, line 12c | The Conflict of Interest Policy of the filing organization applies to members of its Board of Trustees (the Board) and its principal officers and key employees (to be known as Interested Persons). Consistent with the filing organization's integrity standards, it is policy that each Board of Trustee member, or any corporate officer or key employee of the filing organization act at all times in a manner that is consistent with the filing organization's mission and values-based service to the community and exercise care that he or she does not have any personal interest which might conflict with or appear to conflict with the interest of the filing organization or which might influence their judgment or actions in performing their duties. In connection with an actual or possible transaction or arrangement involving the filing organization, any board member, corporate officer, or key employee who has a direct or indirect financial interest must disclose and be given the opportunity to share all material facts with the Board considering the proposed transaction or arrangement. Board members, corporate officers, and key employees are also required to disclose any possible conflicts on an annual basis through a Conflict of Interest Questionnaire. Procedure for disclosing and reviewing transaction or arrangement potential conflicts of interest: 1) Board members, corporate officers, and key employees that have a financial interest in any actual or possible transaction involving the filing organization are required to disclose the financial interest. 2) In order to determine if a conflict of interest exists, the individual who is considered to have a financial interest may make a presentation to the Board or Board committee. After such presentation, the individual shall leave the meeting for discussion and a vote on the issue. 3) After exercising due diligence, the Board or Board committee shall determine whether the filing organization can obtain a more advantageous transaction with reasonable efforts from another person or entity. If a more advantageous transaction is not reasonably attainable, the Board or Board committee shall determine by a majority vote of the disinterested members whether the transaction is in the filing organization's best interest and is fair. Procedure for disclosing and reviewing other conflicts of interest: 1) Board members, corporate officers, and key employees shall also disclose in advance to the filing organization's leaders any non-transactional actions or relationships that have the potential to create a conflict of interest. 2) The Board or Board committee shall carefully review and scrutinize any potential conflict of interest. By a majority vote of the disinterested members, the Board shall take whatever action is deemed appropriate with respect to the Board member, corporate officer, or key employee under the circumstances, including possible corrective action, in order to best protect the interests of the filing organization. 3) On an annual basis, Board members, corporate officers, and key employees will also be sent an email requesting they complete the Board member and corporate officer Conflict of Interest Questionnaire by the specified due date in the email. 4) The corporate responsibility department shall notify the chairperson of the Board of any potential conflicts and the chairperson, or designee, shall perform further investigation as he or she deems appropriate. Record of proceedings: The minutes of the Board and Board committee shall contain the names of persons who disclosed or otherwise were found to have a financial interest and the nature of the financial interest; and the names of persons who were present for discussions and votes relating to any financial interest, the content of the discussion, including any alternatives, and a record of the Board or Board committee decision. Violations of the conflicts of interest policy: If the Board or Board committee has reasonable cause to believe that an individual has failed to disclose either an actual or potential conflict of interest, or all material facts surrounding an actual or possible conflict, the individual will be given a chance to explain. After hearing the response, the Board will conduct such additional investigation as appropriate. If the board determines that the individual has in fact failed to disclose as required by the Conflict of Interest Policy, the Board shall take appropriate disciplinary or corrective action. |
| Form 990, Part VI, Section B, line 15 | Question 15 a&b: External consultants are engaged to provide market-based compensation studies to make recommendations to the filing organization's Compensation Committee regarding the compensation of the filing organization's CEO and CFO. The Compensation Committee is appointed by the Board of Trustees. The Board of Trustees may remove at any time, with or without cause, any member of the Compensation Committee; provided the filing organization's members, Portercare Adventist Health System (PAHS) and Catholic Health Initiatives Colorado (CHIC), shall have exclusive authority to appoint or remove, with or without cause, any member it or they appoint to the Compensation Committee. The consultant's recommendations are presented to and deliberated by the Compensation Committee. The Compensation Committee relies upon all available comparable compensation data in finalizing its decision concerning compensation for its senior executive positions. The Compensation Committee deliberations and decisions are documented appropriately. The filing organization's Human Resources department performs an annual analysis of the market to determine compensation ranges for the remainder of the filing organization's Executives which are reviewed and approved by the filing organization's senior leadership. |
| Form 990, Part VI, Section C, line 19 | The filing organization's organizing and governing documents are available on the Colorado Secretary of State website. The filing organization does not generally make its Conflict of Interest Policy or financial statements available to the public. |
| Form 990, Part VI, Line 16B, Joint Venture Policy | Centura Health Corporation has not formally adopted a written policy or written procedure regarding joint ventures. Practices are in place that require the filing organization to perform an analysis and evaluation of its participation in every joint venture in which the filing organization will have an ownership interest. The internal review and analysis ensures that the filing organization will not become a participant in any joint ventures that could potentially threaten the tax-exempt status of the filing organization. |
| Form 990, Part IX, line 11g | Payments to Hlthcare Professionals: Program service expenses 3,172,323. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,172,323. Professional Fees: Program service expenses 21,967,952. Management and general expenses 0. Fundraising expenses 0. Total expenses 21,967,952. Purchased Medical Services: Program service expenses 8,167,745. Management and general expenses 0. Fundraising expenses 0. Total expenses 8,167,745. Environmental Services: Program service expenses 242,417. Management and general expenses 0. Fundraising expenses 0. Total expenses 242,417. Transcription & Coding Services: Program service expenses 205,572. Management and general expenses 0. Fundraising expenses 0. Total expenses 205,572. Recruiting: Program service expenses 527,670. Management and general expenses 0. Fundraising expenses 0. Total expenses 527,670. Lab Courier Fees: Program service expenses 3,042,663. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,042,663. Interpretation Services: Program service expenses 18,608. Management and general expenses 0. Fundraising expenses 0. Total expenses 18,608. Food Service Contracts: Program service expenses 113,291. Management and general expenses 0. Fundraising expenses 0. Total expenses 113,291. Management Fees: Program service expenses 0. Management and general expenses 5,483,164. Fundraising expenses 0. Total expenses 5,483,164. Billing and Collection Services: Program service expenses 0. Management and general expenses 5,046,644. Fundraising expenses 0. Total expenses 5,046,644. |
| Form 990, Part XI, line 9: | Contributions from Tax-Exempt Related Supported Organizations 10,000,000. ASC 842 Operating Lease Adjustment 483,729. Other Adjustment 1,586. Rounding 2. |
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| Software Version: |