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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," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
SISTERS OF CHARITY OF LEAVENWORTH HEALTH
SYSTEM INC
Employer identification number
23-7379161
Part I
General Information on Grants and Assistance
1
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? ........................
2
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 Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on 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 section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) MOUNT SAINT VINCENT HOME
4159 LOWELL BOULEVARD
DENVER,CO80211 		84-0405260 501(C)(3) 549,453       SUPPORT MISSION
(2) MARIAN CLINIC
1001 SW GARFIELD AVE
TOPEKA,KS66604 		48-1046905 501(C)(3) 157,013       SUPPORT MISSION
(3) CARITAS CLINICS
818 NORTH 7TH STREET
LEAVENWORTH,KS66048 		48-1009910 501(C)(3) 236,377       SUPPORT MISSION
(4) ST VINCENT HEALTHCARE
1233 NORTH 30TH STREET
BILLINGS,MT59101 		81-0232124 501(C)(3) 3,000,157       SUPPORT MISSION
(5) SCL HEALTH FOUNDATION
500 ELDORADO BLVD SUITE 4300
BROOMFLIELD,CO80021 		82-3290526 501(C)(3) 109,000       SUPPORT MISSION
(6) ST MARY'S HOSPITAL & MEDICAL CENTER INC
2635 N 7TH STREET
GRAND JUNCTION,CO81501 		84-0425720 501(C)(3) 31,832       SUPPORT MISSION
(7) COLORADO HEALTH INSTITUTE
303 E 17TH AVE SUITE 930
DENVER,CO80203 		74-3082235 501(C)(3) 30,000       SUPPORT MISSION
(8) DENVER METRO CHAMBER OF COMMERCE
1445 MARKET ST
DENVER,CO80202 		84-0186760 501(C)(3) 29,500       SUPPORT MISSION
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
8
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2018
Page 2

Schedule I (Form 990) 2018
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on 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
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1) SECONDARY EDUCATION SCHOLARSHIP 9 14,791      
(1)
(2)
(3)
(4)
(5)
(6)
(7)
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: SCLHS' MISSION DEPARTMENT REQUIRES WRITTEN STATEMENTS THREE TIMES A YEAR REGARDING THE PROGRESS AND STATUS OF THE GRANT.
Schedule I (Form 990) 2018



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