FURP.ORG / PUBLIC DATA EXPLORER

BENEDICTINE LIVING COMMUNITIES - BISMARCK INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
BENEDICTINE LIVING COMMUNITIES - BISMARCK INC (EIN 26-4376543)
Tax period
2021-07-01 to 2022-06-30
Filed
2023-05-15
IRS object ID
202321359349313317
Schema version
2021v4.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-05-15T15:15:50-05:00ReturnTs
Tax Period End2022-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1220 S 6TH STREET SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN264376543EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BENEDICTINE LIVING COMMUNITIES -BusinessNameLine1Txt
Business Name Line2BISMARCK INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlBENEBusinessNameControlTxt
Phone7633472200PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16499 UNIVERSITY AVENUE NE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55432ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKEVIN RYMANOWSKIPersonNm
Person TitleCEOPersonTitleTxt
Phone7633472200PhoneNum
Signature2023-05-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstKEVINPersonFirstNm
Person LastRYMANOWSKIPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCHRISTOPHER STEINHOFFPreparerPersonNm
PTINP01587351PTIN
Phone6123764500PhoneNum
Preparation2023-05-05PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1ST GABRIELS COMMUNITYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerJERRY CARLEYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line16499 UNIVERSITY AVENUE NE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55432ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$17,226,407GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.BENEDICTINELIVING.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2009FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionOUR MISSION IS TO WITNESS TO GOD'S LOVE BY PROVIDING COMPASSIONATE, QUALITY CARE.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee338TotalEmployeeCnt
Total Volunteers20TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$793,629PYContributionsGrantsAmt
CY Contributions Grants$273,773CYContributionsGrantsAmt
PY Program Service Revenue$15,259,825PYProgramServiceRevenueAmt
CY Program Service Revenue$16,944,525CYProgramServiceRevenueAmt
PY Investment Income$5,172PYInvestmentIncomeAmt
CY Investment Income$4,304CYInvestmentIncomeAmt
PY Other Revenue$1,650PYOtherRevenueAmt
CY Other Revenue$3,805CYOtherRevenueAmt
PY Total Revenue$16,060,276PYTotalRevenueAmt
CY Total Revenue$17,226,407CYTotalRevenueAmt
PY Grants And Similar Paid$91,389PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$90,651CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$8,804,964PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$9,519,711CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$6,118,238PYOtherExpensesAmt
CY Other Expenses$6,376,201CYOtherExpensesAmt
PY Total Expenses$15,014,591PYTotalExpensesAmt
CY Total Expenses$15,986,563CYTotalExpensesAmt
PY Revenues Less Expenses$1,045,685PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,239,844CYRevenuesLessExpensesAmt
Total Assets BOY$16,928,888TotalAssetsBOYAmt
Total Assets EOY$35,192,489TotalAssetsEOYAmt
Total Liabilities BOY$15,545,566TotalLiabilitiesBOYAmt
Total Liabilities EOY$32,645,156TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,383,322NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,547,333NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionBENEDICTINE LIVING COMMUNITIES-BISMARCK IS A CATHOLIC ORGANIZATION ENTRUSTED WITH ADVANCING THE HEALTH CARE MINISTRY OF THE BENEDICTINE SISTERS OF DULUTH, MINNESOTA. OUR MISSION IS TO WITNESS TO GOD'S LOVE BY PROVIDING COMPASSIONATE, QUALITY CARE WITH SPECIAL CONCERN FOR THE UNDERSERVED AND THOSE IN NEED.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$9,167,885ExpenseAmt
Grant$89,151GrantAmt
Revenue$10,938,994RevenueAmt
DescOPERATION OF BENEDICTINE LIVING COMMUNITY - BISMARCK, A 72-BED SKILLED NURSING FACILITY IN BISMARCK, NORTH DAKOTA. THE FACILITY HAD A 98.9% AVERAGE OCCUPANCY AND SERVED 366 INDIVIDUALS DURING THE FISCAL YEAR ENDING 6/30/2022.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$4,708,062ExpenseAmt
Grant$1,500GrantAmt
Revenue$6,005,531RevenueAmt
DescOPERATION OF BENEDICTINE LIVING COMMUNITY - BISMARCK HOUSING, A 56-UNIT ASSISTED LIVING FACILITY AND 41-UNIT BASIC CARE FACILITY IN BISMARCK, NORTH DAKOTA WHICH PROVIDES HOUSING AND SERVICES TO THE ELDERLY. DURING THE FISCAL YEAR ENDED JUNE 30, 2022, THE FACILITY HAD AN AVERAGE OCCUPANCY OF 97.2% AND SERVED 131 INDIVIDUALS.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$13,875,947TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document40IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee338EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KEVIN RYMANOWSKI CFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7636896107PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16499 UNIVERSITY AVENUE NE SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55432ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
JERRY CARLEY
CEO OF BHS1.0039.00Yes (X)$0$698,969$136,710
KEVIN RYMANOWSKI
CFO OF BHS & TREASURER1.0039.00Yes (X)$0$421,705$75,427
TIA BOWE VP OF
BHS/PRESIDENT (THROUGH MARCH 2022)1.0039.00Yes (X)$0$235,701$51,003Yes (X)
TAYLAR HACK
EXECUTIVE DIRECTOR1.0039.00Yes (X)$0$134,062$28,149
RHONDA KRUEGER
DIRECTOR OF NURSING40.000.00$123,830$0$2,292Yes (X)
KATIE METTLER
OT EDUCATION SPECIALIST40.000.00$119,622$0$2,177Yes (X)
KEVIN GREFF
CHAIR1.000.00Yes (X)$0$0$0Yes (X)
SR LINDA WIGGINS
SECRETARY (THROUGH JULY 2021)1.000.00Yes (X)$0$0$0Yes (X)
SR MARY SUSAN DEWITT
DIRECTOR1.000.00$0$0$0Yes (X)
JODI HENDRICKSON
DIRECTOR1.000.00$0$0$0Yes (X)
BEVERLY KADRMAS
DIRECTOR1.000.00$0$0$0Yes (X)
KAREN KAISER
DIRECTOR1.000.00$0$0$0Yes (X)
RICK LEHNHERR
DIRECTOR1.000.00$0$0$0Yes (X)
DAN NARUM
DIRECTOR1.000.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$243,452TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,490,437TotReportableCompRltdOrgAmt
Total Other Compensation$295,758TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BENEDICTINE HEALTH SYSTEMBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line16499 UNIVERSITY AVE NE SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55432ZIPCd
FieldValueIRS element (for citing)
ServicesMANAGEMENT SERVICESServicesDesc
Compensation$998,944CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Related Organizations$41,562RelatedOrganizationsAmt
Government Grants$232,211GovernmentGrantsAmt
Total Contributions$273,773TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescRESIDENT SERVICESDesc
Business623000BusinessCd
Total Revenue Column$16,944,525TotalRevenueColumnAmt
Related Or Exempt Func Income$16,944,525RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$16,944,525TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,304TotalRevenueColumnAmt
Exclusion$4,304ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS REVENUEDesc
Business900099BusinessCd
Total Revenue Column$3,805TotalRevenueColumnAmt
Exclusion$3,805ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$3,805OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,226,407TotalRevenueColumnAmt
Related Or Exempt Func Income$16,944,525RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$8,109ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$84,151TotalAmt
Program Services$84,151ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$6,500TotalAmt
Program Services$6,500ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,880,353TotalAmt
Program Services$7,292,753ProgramServicesAmt
Management And General$587,600ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$102,175TotalAmt
Program Services$102,175ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$960,240TotalAmt
Program Services$960,240ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$576,943TotalAmt
Program Services$576,943ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$1,010,064TotalAmt
Management And General$1,010,064ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$50TotalAmt
Management And General$50ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$27,383TotalAmt
Management And General$27,383ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$209,199TotalAmt
Program Services$135,008ProgramServicesAmt
Management And General$74,191ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$59,588TotalAmt
Management And General$59,588ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$72,629TotalAmt
Program Services$25,632ProgramServicesAmt
Management And General$46,997ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$544,873TotalAmt
Program Services$489,597ProgramServicesAmt
Management And General$55,276ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$10,566TotalAmt
Program Services$7,598ProgramServicesAmt
Management And General$2,968ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,321,615TotalAmt
Program Services$1,321,615ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$660,034TotalAmt
Program Services$660,034ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$161,251TotalAmt
Management And General$161,251ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
EQUIPMENT LEASE$979,878$957,570$22,308
FOOD$692,454$692,454
MEDICAL SUPPLIES$561,329$530,688$30,641
MISCELLANEOUS$46,673$16,364$30,309

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$18,615TotalAmt
Program Services$16,625ProgramServicesAmt
Management And General$1,990ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$15,986,563TotalAmt
Program Services$13,875,947ProgramServicesAmt
Management And General$2,110,616ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,961,888BOYAmt
EOY$2,431,164EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,275,165BOYAmt
EOY$1,113,179EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$154,808BOYAmt
EOY$160,922EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$18,864,022LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$7,372,731LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$11,805,106BOYAmt
EOY$11,491,291EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$234,220BOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$18,491,457EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,497,701BOYAmt
EOY$1,504,476EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$16,928,888BOYAmt
EOY$35,192,489EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,161,071BOYAmt
EOY$928,112EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$16,400BOYAmt
EOY$16,400EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,619,715BOYAmt
EOY$12,176,272EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$36,770BOYAmt
EOY$28,103EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,699,814BOYAmt
EOY$19,451,241EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$11,796BOYAmt
EOY$45,028EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$15,545,566BOYAmt
EOY$32,645,156EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,149,102BOYAmt
EOY$2,318,956EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$234,220BOYAmt
EOY$228,377EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,383,322BOYAmt
EOY$2,547,333EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$16,928,888BOYAmt
EOY$35,192,489EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,239,844ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$69,991NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$5,842OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$71,048CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$825,076CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$191,236CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$793,629CurrentTaxYearMinus1YearAmt
Current Tax Year$273,773CurrentTaxYearAmt
Total$2,154,762TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,247,032CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$15,154,239CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,452,738CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$15,259,825CurrentTaxYearMinus1YearAmt
Current Tax Year$16,944,525CurrentTaxYearAmt
Total$76,058,359TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,318,080CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$15,979,315CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,643,974CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$16,053,454CurrentTaxYearMinus1YearAmt
Current Tax Year$17,218,298CurrentTaxYearAmt
Total$78,213,121TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$78,213,121PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,855CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$691CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$27,320CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,172CurrentTaxYearMinus1YearAmt
Current Tax Year$4,304CurrentTaxYearAmt
Total$40,342TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,855CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$691CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$27,320CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,172CurrentTaxYearMinus1YearAmt
Current Tax Year$4,304CurrentTaxYearAmt
Total$40,342TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$2,015CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,512CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,650CurrentTaxYearMinus1YearAmt
Current Tax Year$3,805CurrentTaxYearAmt
Total$12,982TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,320,935CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$15,982,021CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,676,806CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$16,060,276CurrentTaxYearMinus1YearAmt
Current Tax Year$17,226,407CurrentTaxYearAmt
Total$78,266,445TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99930PublicSupportCY509Pct
Public Support PY5090.99940PublicSupportPY509Pct
Investment Income CY0.00050InvestmentIncomeCYPct
Investment Income PY0.00050InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationMISCELLANEOUS REVENUEExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,832,000OtherCostOrOtherBasisAmt
Book Value$1,832,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,208,056OtherCostOrOtherBasisAmt
Depreciation$3,805,374DepreciationAmt
Book Value$8,402,682BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$713,562OtherCostOrOtherBasisAmt
Depreciation$607,229DepreciationAmt
Book Value$106,333BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,096,508OtherCostOrOtherBasisAmt
Depreciation$2,960,128DepreciationAmt
Book Value$1,136,380BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,896OtherCostOrOtherBasisAmt
Book Value$13,896BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$11,491,291TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO AFFILIATEDesc
Amt$45,028Amt
FieldValueIRS element (for citing)
Total Liability$45,028TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, LINE 2B:CARETAKER OF RESIDENT TRUST FUNDS AND SECURITY DEPOSITS IN A SEPARATE ACCOUNT.
PART X, LINE 2:THE ORGANIZATION HAS BEEN DETERMINED TO QUALIFY AS A TAX-EXEMPT CHARITABLE, EDUCATIONAL, AND SCIENTIFIC ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ALSO HAS BEEN DETERMINED TO BE EXEMPT FROM STATE INCOME TAX. THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES IN EVALUATING THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE ORGANIZATION FILES ALL APPLICABLE RETURNS FOR ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtPurpose Of GrantPurposeOfGrantTxt
BENEDICTINE FOUNDATION
4560 NORWAY PINES PLACEDULUTHMN55811411513014501(C)(3)$34,997$0FOUNDATION EXPENSES
BENEDICTINE HEALTH SYSTEM
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411531892501(C)(3)$46,404$0SYSTEM SUPPORT
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeSCHOLARSHIPSGrantTypeTxt
Recipient4RecipientCnt
Cash Grant$6,500CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationBENEDICTINE HEALTH CENTER OFFERS EMPLOYEES TUITION PAYMENT THROUGH AN EDUCATIONAL ASSISTANCE PLAN THAT COMPLIES WITH SECTION 127 OF THE INTERNAL REVENUE CODE AND THE MINNESOTA NURSING FACILITY EMPLOYEE SCHOLARSHIP FUND (BULLETIN #01-62-05). TO PROVIDE PAYMENT FOR EXPENSES INCURRED BY ELIGIBLE SENIOR CARE EMPLOYEES FOR THE SUCCESSFUL COMPLETION OF APPROVED COURSES THAT LEAD TO CAREER ADVANCEMENT. TRANSFERS BETWEEN RELATED ORGANIZATIONS ARE ACCOUNTED FOR IN INTERNAL FINANCIAL STATEMENTS, OF WHICH ALL ARE UNDER COMMON CONTROL.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JERRY CARLEY
CEO OF BHS$0$513,659$0$82,394$0$102,916$0$108,820$0$27,890$0$835,679$0$0
KEVIN RYMANOWSKI
CFO OF BHS & TREASURER$0$332,121$0$40,076$0$49,508$0$50,352$0$25,075$0$497,132$0$0
TIA BOWE VP OF
BHS/PRESIDENT (THROUGH MARCH 2022)$0$195,179$0$18,439$0$22,083$0$22,630$0$28,373$0$286,704$0$0
TAYLAR HACK
EXECUTIVE DIRECTOR$0$118,093$0$6,407$0$9,562$0$7,019$0$21,130$0$162,211$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationBENEDICTINE HEALTH SYSTEM'S (EIN: 41-1531892) CEO AND CFO, JERRY CARLEY AND KEVIN RYMANOWSKI, SHARE THEIR TIME BETWEEN THE REPORTING ORGANIZATION AND RELATED ORGANIZATIONS. SEE SCHEDULE R FOR INFORMATION ON RELATED ORGANIZATIONS. THE CEO IS COMPENSATED BY BENEDICTINE HEALTH SYSTEM, A RELATED ORGANIZATION. THIS ORGANIZATION USES THE FOLLOWING TO SET CEO/ ADMINISTRATIVE COMPENSATIONS: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. WRITTEN EMPLOYMENT CONTRACT 4. COMPENSATION SURVEY OR STUDY 5. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEEExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1BURLEIGH COUNTY NORTH DAKOTABusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN456002204BondIssuerEIN
CUSIP120906FC1CUSIPNum
Bond Issued2019-04-30BondIssuedDt
Issue Price$13,902,838IssuePriceAmt
PurposeSEE PART VIPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$1,340,000RetiredAmt
Total Proceeds$13,902,838TotalProceedsAmt
In Reserve Fund$1,043,016InReserveFundAmt
Refunding Escrow$12,411,124RefundingEscrowAmt
Issuance Costs From Proceeds$275,900IssuanceCostsFromProceedsAmt
Capital Expenditures$172,798CapitalExpendituresAmt
Substantial Completion2020SubstantialCompletionYr
Refunding Tax Exempt BondsYes (1)RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0.00000PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00000PrivateBusConcerningUBIPct
Total Private Business Use0.00000TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due YetYes (1)RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990, SCHEDULE K, PART I, COLUMN (F):FormAndLineReferenceDesc
ExplanationPROCEEDS OF THE SERIES 2019 BONDS WERE LOANED TO THE COMPANY TO (1) REFUND THE SERIES 2009 BONDS USED TO CONSTRUCT AND EQUIP A 72-BED SKILLED NURSING SENIOR CARE FACILITY LOCATED IN HTE CITY OF BISMARCK, NORTH DAKOTA, (2) FUND A PORTION OF THE COSTS OF ISSUANCE FOR THE BONDS, AND (3) PAY OFF OR REIMBURSE SOME EXPENSES RELATED TO CAPITAL PROJECTS UNDERTAKEN BY THE FACILITY.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1ATHE EXECUTIVE COMMITTEE (COMPRISED OF THE CHAIR, VICE-CHAIR, BOARD SECRETARY, AND THE CHAIRS OF THE STANDING COMMITTEES) IS AUTHORIZED TO ACT ON BEHALF OF THE BOARD IN THE INTERVAL BETWEEN MEETINGS OF THE BOARD, PROVIDED, HOWEVER, THAT IT MAY NOT DETERMINE MATTERS OF POLICY WITHOUT PRIOR SPECIFIC AUTHORIZATION OF THE BOARD.
FORM 990, PART VI, SECTION A, LINE 3THE CORPORATION CONTRACTS WITH BENEDICTINE HEALTH SYSTEM, A RELATED ORGANIZATION, FOR MANAGEMENT SERVICES. BENEDICTINE HEALTH SYSTEM EMPLOYED THE ADMINISTRATOR/CEO OF THE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 6BENEDICTINE HEALTH SYSTEM, A MINNESOTA NONPROFIT CORPORATION, IS THE SOLE MEMBER OF THE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7AEACH DIRECTOR OF THE CORPORATION IS APPOINTED BY BENEDICTINE HEALTH SYSTEM.
FORM 990, PART VI, SECTION A, LINE 7BBENEDICTINE HEALTH SYSTEM HAS CERTAIN RESERVED POWERS RELATING TO THE ACTIVITIES OF THE CORPORATION AS SET OUT IN THE CORPORATION'S BY-LAWS. IN ADDITION, IN KEEPING WITH THE CORPORATION'S MISSION "TO ASSIST AND COORDINATE ACTIVITIES OF FACILITIES FOR HEALTH CARE, EDUCATION, AND CARE FOR THE AGED AND SOCIAL SERVICES IN ACCORDANCE WITH THE CHARITABLE WORKS TRADITION OF THE ROMAN CATHOLIC CHURCH", ALL ACTIVITIES OF THE CORPORATION ARE REQUIRED TO BE CARRIED OUT IN ACCORDANCE WITH THE CHARISMS OF THE BENEDICTINE SISTERS BENEVOLENT ASSOCIATION ("BSBA"), A CIVIL LAW CORPORATION FOR THE SISTERS OF ST. BENEDICT OF ST. SCHOLASTICA MONASTERY LOCATED IN DULUTH, MINNESOTA.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON INFORMATION BY MANAGEMENT. THE REVIEW WAS THEN REVIEWED BY THE CFO. AN ELECTRONIC COPY OF THE FORM 990 WAS DISTRIBUTED TO THE GOVERNING BODY PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO DISCLOSE ANY RELATIONSHIPS THAT CONSTITUTE OR MIGHT LEAD TO A CONFLICT OF INTEREST BY COMPLETING THE CONFLICT OF INTEREST AND GIFT DISCLOSURE STATEMENT. THE BHS COMPLIANCE DEPARTMENT WILL DISTRIBUTE THE STATEMENTS AND COLLECT AND MAINTAIN THE COMPLETED STATEMENTS. THE BHS COMPLIANCE MANAGER WILL REVIEW THE STATEMENTS AND PROVIDE A SUMMARY OF THE IDENTIFIED CONFLICTS OF INTEREST TO THE BHS CHIEF COMPLIANCE OFFICER, WHO WILL ALERT THE BHS CEO AND THE CHAIR OF THE BHS BOARD OF DIRECTORS TO ANY ITEMS OF CONCERN. AN "INTERESTED PERSON" IS ANY PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE SYSTEM, INCLUDING BUT NOT LIMITED TO A BOARD MEMBER, BOARD COMMITTEE MEMBER, OR OFFICER OR DIRECTOR OF BHS OR A FACILITY (SUCH AS FACILITY CEO/ADMINISTRATORS AND BHS SENIOR LEADERS AND DIRECTORS). FOR INTERESTED PERSONS WHO ARE EMPLOYEES (OTHER THAN THE BHS CEO), FOLLOWING DISCLOSURE OF THE ACTUAL OR POTENTIAL CONFLICT OF INTEREST AND ALL MATERIAL FACTS,THE INTERESTED PERSON'S SUPERVISOR WILL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. FOR THE BHS CEO AND BOARD AND COMMITTEE MEMBERS, FOLLOWING DISCLOSURE OF THE ACTUAL OR POTENTIAL CONFLICT OF INTEREST AND ALL MATERIAL FACTS, THE INTERESTED PERSON WILL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE REMAINING MEMBERS OF THE BOARD OR COMMITTEE DETERMINE IF A CONFLICT OF INTEREST EXISTS. THE INTERESTED PERSON MAY PARTICIPATE IN DELIBERATION REGARDING THE TRANSACTION IF THE APPLICABLE SUPERVISOR, BOARD, OR COMMITTEE DETERMINES A CONFLICT OF INTEREST DOES NOT EXIST. AN INTERESTED PERSON WHO HAS BEEN DETERMINED TO HAVE A CONFLICT OF INTEREST MAY NOT PARTICIPATE IN THE DELIBERATION OR DECISION REGARDING THE TRANSACTION OR ARRANGEMENT INVOLVING THE CONFLICT OF INTEREST AND MAY NOT BE PRESENT DURING SUCH DELIBERATION OR DECISION MAKING. THE INTERESTED PERSON MAY BE ALLOWED TO MAKE A PRESENTATION TO THE SUPERVISOR, BOARD, OR COMMITTEE CONSIDERING THE TRANSACTION OR ARRANGEMENT AS TO WHICH THE CONFLICT OF INTERESTS REFERS PRIOR TO THE DELIBERATION AND DECISION.
FORM 990, PART VI, SECTION B, LINE 15ACOMPENSATION FOR THE ORGANIZATION'S CEO IS DETERMINED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THIS COMMITTEE IS COMPRISED ENTIRELY OF INDEPENDENT DIRECTORS. THE COMPENSATION COMMITTEE REVIEWS DATA ON COMPENSATION PROVIDED TO INDIVIDUALS HOLDING COMPARABLE POSITIONS IN COMPARABLE ORGANIZATIONS IN ORDER TO ESTABLISH A REASONABLE COMPENSATION RANGE. THE DATA IS COLLECTED AND REVIEWED WITH THE COMPENSATION COMMITTEE BY AN INDEPENDENT CONSULTANT. BASED ON THE MARKET DATA AND IN LIGHT OF ANY SPECIFIC INDIVIDUAL BENEDICTINE HEALTH SYSTEM 41-1531892 QUALIFICATIONS, THE COMPENSATION COMMITTEE DETERMINES COMPENSATION. THE DELIBERATIONS AND DETERMINATIONS OF THE COMPENSATION COMMITTEE ARE RECORDED CONTEMPORANEOUSLY AND PROVIDED TO THE GOVERNING BODY FOR REVIEW. COMPENSATION FOR THE CFO, OTHER OFFICERS, AND OTHER KEY EMPLOYEES OF THE ORGANIZATION IS DETERMINED BY THE CEO.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
OFFICER COMPENSATION:BENEDICTINE HEALTH SYSTEM'S (EIN: 41-1531892) CEO AND CFO, JERRY CARLEY AND KEVIN RYMANOWSKI, SHARE THEIR TIME BETWEEN THE REPORTING ORGANIZATION AND RELATED ORGANIZATIONS. SEE SCHEDULE R FOR INFORMATION ON RELATED ORGANIZATIONS.
FORM 990, PART XI, LINE 9:CHANGE IN INVESTMENT IN FOUNDATION -5,842.
FORM 990, PART XII, LINE 2C:THE BENEDICTINE HEALTH SYSTEM AUDIT/ FINANCE COMMITTEE OVERSEES THE SELECTION OF THE INDEPENDENT AUDITOR AND OVERSEES THE ANNUAL CONSOLIDATED AUDIT OF BENEDICTINE HEALTH SYSTEM AND AFFILIATES WHICH INCLUDES THE ORGANIZATION.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1BLC BISMARCK HOUSING LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line16499 UNIVERSITY AVENUE NE SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55432ZIPCd
FieldValueIRS element (for citing)
EIN811000404EIN
Primary ActivitiesASSISTED LIVING FACILITYPrimaryActivitiesTxt
Legal Domicile StateNDLegalDomicileStateCd
Total Income$6,062,109TotalIncomeAmt
End Of Year Assets$19,946,248EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1BLC - BISMARCK INCBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (30 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
APARTMENT COMMUNITY OF OUR LADY OF THE SNOWS
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432370909113SENIOR LIVING COMMUNITYIL501(C)(3)LINE 10BHSYes (1)
ARROWHEAD SENIOR LIVING COMMUNITIES
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411978619NURSING HOMESMN501(C)(3)LINE 10BHSYes (1)
BENEDICTINE CARE CENTERS
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411907571NURSING HOMESMN501(C)(3)LINE 10BHSYes (1)
BENEDICTINE HEALTH CENTER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411381401SENIOR LIVING COMMUNITYMN501(C)(3)LINE 10BHSYes (1)
BENEDICTINE HEALTH SYSTEM
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411531892SUPPORTING ORGANIZATIONMN501(C)(3)LINE 100N/A
BENEDICTINE FOUNDATION
4560 NORWAY PINES PLACEDULUTHMN55811411513014FUND DEVELOPMENTMN501(C)(3)LINE 10BHS0
BENEDICTINE LIVING COMMUNITIES INC
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411639687NURSING HOMESMN501(C)(3)LINE 10BHSYes (1)
BENEDICTINE LIVING COMMUNITY OF NEW LONDON
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432274218436NURSING HOMEMN501(C)(3)LINE 10BHSYes (1)
BENEDICTINE LIVING COMMUNITY OF WAHPETON
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432454274091ASSISTED LIVINGMN501(C)(3)LINE 10BHSYes (1)
BENEDICTINE LIVING COMMUNITY OF WINSTED
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432274219293NURSING HOMEMN501(C)(3)LINE 10BHSYes (1)
BENEDICTINE LIVING COMMUNITY OF ST PETER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432861113231NURSING HOMEMN501(C)(3)LINE 10BHSYes (1)
BRIDGES CARE CENTER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432262620983ASSISTED LIVINGMN501(C)(3)LINE 10BHSYes (1)
BENEDICTINE SENIOR LIVING COMMUNITY OF ST PETER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432272716531NURSING HOMEMN501(C)(3)LINE 10BHSYes (1)
CATHOLIC RESIDENTIAL SERVICES
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432390982340NURSING HOMEWI501(C)(3)LINE 10BHSYes (1)
CERENITY CARE CENTER - WHITE BEAR LAKE
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411983267NURSING HOMEMN501(C)(3)LINE 100N/A
CERENITY SENIOR CARE
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411983267NURSING HOMEMN501(C)(3)LINE 100N/A
CITY OF LAKES CARE CENTER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411985663NURSING HOMEMN501(C)(3)LINE 10BHSYes (1)
ELLENDALE EVERGREEN PLACE
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411796445ASSISTED LIVINGMN501(C)(3)LINE 10BHSYes (1)
BENEDICTINE LIVING COMMUNITY - OWATONNA
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411852273NURSING HOMEMN501(C)(3)LINE 10BHSYes (1)
LIVING COMMUNITY OF ST JOSEPH
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432412011661NURSING HOMEMN501(C)(3)LINE 10BHSYes (1)
MADONNA MEADOWS OF ROCHESTER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432470855891ASSISTED LIVINGMN501(C)(3)LINE 10BHSYes (1)
MADONNA TOWERS OF ROCHESTER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411809914NURSING HOMEMN501(C)(3)LINE 10BHSYes (1)
NAZARETH LIVING CENTER
2 NAZARETH LANEST LOUISMO63129431450394NURSING FACILITYMN501(C)(3)LINE 100N/A
REGINA SENIOR LIVING
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432463700475NURSING HOMEMN501(C)(3)LINE 10BHSYes (1)
ROSEWOOD COURT
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432412011389ASSISTED LIVINGMN501(C)(3)LINE 10BHSYes (1)
SAINT ANNE OF WINONA
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432410850791NURSING HOMEMN501(C)(3)LINE 10BHSYes (1)
ST GERTRUDE'S HEALTH CENTER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411848720NURSING HOMEMN501(C)(3)LINE 10BHSYes (1)
STEEPLE POINTE SENIOR LIVING COMMUNITY
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411852273ASSISTED LIVINGMN501(C)(3)LINE 10BHSYes (1)
VILLA ST BENEDICT
1920 MAPLE AVENUELISLEIL60532364343235NURSING HOMEMN501(C)(3)LINE 100N/A
VILLA ST VINCENT
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411352227NURSING HOMEMN501(C)(3)LINE 10BHSYes (1)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1BENEDICTINE GROUP SELF-INSURANCE ASSOCIATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line16499 UNIVERSITY AVE NE SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55432ZIPCd
FieldValueIRS element (for citing)
EIN411548753EIN
Primary ActivitiesWORKERS' COMPENSATION PROGRAMPrimaryActivitiesTxt
Legal Domicile StateMNLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeSEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd