COVENANT HOME SERVICES: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- COVENANT HOME SERVICES (EIN 26-0744025)
- Tax period
- 2021-10-01 to 2022-09-30
- Filed
- 2023-08-10
- IRS object ID
- 202342229349301784
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-08-10T15:35:13-05:00 | ReturnTs |
| Tax Period End | 2022-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10 S RIVERSIDE PLAZA 9TH FLOOR | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60606 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 260744025 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COVENANT HOME SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COVE | BusinessNameControlTxt |
| Phone | 7738782294 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5700 OLD ORCHARD RD | AddressLine1Txt |
| City | SKOKIE | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 600771036 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEAN E JUSTIE | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7738782294 | PhoneNum |
| Signature | 2023-08-01 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JEAN | PersonFirstNm |
| Person Last | JUSTIE | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID LOWENTHAL | PreparerPersonNm |
| PTIN | P00378651 | PTIN |
| Phone | 3122071040 | PhoneNum |
| Preparation | 2023-08-01 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COVENANTCARE AT HOME | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TERRI S CUNLIFFE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5700 OLD ORCHARD RD | AddressLine1Txt |
| City | SKOKIE | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 600771036 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $17,696,111 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 2650 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.COVLIVING.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2007 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | TO PROMOTE AND MAINTAIN THE WELL-BEING OF INDIVIDUALS IN THEIR HOMES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 16 | VotingMembersIndependentCnt |
| Total Employee | 288 | TotalEmployeeCnt |
| Total Volunteers | 18 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,254,941 | PYContributionsGrantsAmt |
| CY Contributions Grants | $331,178 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $17,689,859 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $17,364,376 | CYProgramServiceRevenueAmt |
| PY Investment Income | $210 | PYInvestmentIncomeAmt |
| CY Investment Income | $557 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $19,945,010 | PYTotalRevenueAmt |
| CY Total Revenue | $17,696,111 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,185,589 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,280,824 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,087,529 | PYOtherExpensesAmt |
| CY Other Expenses | $4,991,955 | CYOtherExpensesAmt |
| PY Total Expenses | $17,273,118 | PYTotalExpensesAmt |
| CY Total Expenses | $17,272,779 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,671,892 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $423,332 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,392,429 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,543,383 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,309,344 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,036,966 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$5,916,915 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$5,493,583 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | OUR MISSION IS TO PROMOTE AND MAINTAIN THE WELL-BEING OF INDIVIDUALS IN THEIR HOMES. COMMITTED TO EXCELLENCE, WE MAXIMIZE THEIR PHYSICAL, PSYCHOLOGICAL AND SPIRITUAL HEALTH WHILE CELEBRATING GOD'S GIFT OF LIFE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,399,595 | ExpenseAmt |
| Revenue | $7,604,650 | RevenueAmt |
| Desc | MEDICARE-CERTIFIED HOME HEALTH CARE:- MEDICARE-CERTIFIED AND STATE LICENSED TO PROVIDE SKILLED HOME HEALTH AND PERSONAL ASSISTANCE CARE. THE AGENCY PROVIDES COMMUNITY HOME CARE SERVICES TO INDIVIDUALS IN THEIR OWN HOMES AS WELL AS THOSE WHO LIVE IN RESIDENTIAL RETIREMENT COMMUNITIES. - PATIENT ASSESSMENT, INCLUDING HOME SAFETY ASSESSMENT- EDUCATION AND MANAGEMENT FOR CHRONIC AND ACUTE DISEASE STATES- SYMPTOM MANAGEMENT FOR CHRONIC AND ACUTE DISEASE STATES- MEDICATION AND IV ADMINISTRATION- COORDINATION OF HEALTH CARE SERVICES AMONG RESIDENTS AND THEIR HEALTH CARE TEAMS- REHABILITATION SERVICES- WOUND AND OSTOMY CARE- PALLIATIVE CARETHE ORGANIZATION HAS LOCATIONS AND PROVIDES SERVICES IN COMMUNITIES SURROUNDING THE FOLLOWING MARKETS:- GENEVA, CAROL STREAM AND NORTHBROOK, IL- TURLOCK, CA | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,672,590 | ExpenseAmt |
| Revenue | $2,350,660 | RevenueAmt |
| Desc | PRIVATE DUTY (PERSONAL ASSISTANCE):- PERSONAL CARE FOR BATHING, GROOMING, DRESSING- SKILLED NURSING CARE FOR MEDICALLY FRAGILE CHILDREN- MEDICATION REMINDERS- PERSONAL CARE FOR 24 HOURS (LIGHT HOUSEKEEPING, MEAL PREPARATION, LAUNDRY, COMPANIONSHIP)- TRANSPORTATION (MEDICAL APPOINTMENTS, SHOPPING AND DINING OUT TRIPS)- EXPANDED HOMEMAKER SERVICES (VACUUMING, DUSTING, CLEANING, ERRANDS)- OTHER SUPPORTIVE SERVICES AS NEEDEDTHE ORGANIZATION HAS LOCATIONS AND PROVIDES SERVICES IN COMMUNITIES SURROUNDING THE FOLLOWING MARKETS:- GENEVA, CAROL STREAM AND NORTHBROOK, IL- TURLOCK, CA | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $4,579,982 | ExpenseAmt |
| Revenue | $7,409,066 | RevenueAmt |
| Desc | MEDICARE-CERTIFIED HOSPICE: - LICENSED HOSPICE AGENCY PROVIDING END OF LIFE CARETHE ORGANIZATION HAS LOCATIONS AND PROVIDES SERVICES IN COMMUNITIES SURROUNDING THE FOLLOWING MARKETS:- GENEVA, CAROL STREAM AND NORTHBROOK, IL- TURLOCK, CA | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $11,652,167 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 23 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 288 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 16 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEAN E JUSTIE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7738782294 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | C/O CLCS 5700 OLD ORCHARD RD | AddressLine1Txt |
| City | SKOKIE | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60077 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (33 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| TERRI S CUNLIFFE | ||||||||||
| DIRECTOR/CLCS PRESIDENT/CEO | 1.00 | 58.00 | Yes (X) | Yes (X) | $0 | $716,837 | $43,631 | |||
| DAVID G ERICKSON | ||||||||||
| SR VP & GEN COUNSEL/ASST SECRETARY | 1.00 | 58.00 | Yes (X) | $0 | $387,363 | $116,243 | ||||
| JEAN E JUSTIE | ||||||||||
| CFO/TREASURER/ASST SECRETARY | 1.00 | 58.00 | Yes (X) | $0 | $324,380 | $77,262 | ||||
| AMY LACROIX | ||||||||||
| SVP, COMMUNITY OPS/ASST SECRETARY | 1.00 | 58.00 | Yes (X) | $0 | $312,458 | $65,934 | ||||
| WILLIAM RABE | ||||||||||
| SR VP ENTERPRISE OPS/ASST SECRETARY | 1.00 | 58.00 | Yes (X) | $0 | $312,536 | $50,684 | ||||
| ELIZABETH MCLAREN | ||||||||||
| SVP REV CYCLE, REIMB AND HCBS | 7.50 | 37.50 | $0 | $287,696 | $31,330 | Yes (X) | ||||
| TODD SLECHTA | ||||||||||
| DIRECTOR/EX-OFFICIO | 0.10 | 41.90 | Yes (X) | $0 | $198,247 | $41,623 | ||||
| CORY STERN | ||||||||||
| FORMER INTERIM FINANCE LEAD/TREAS. | 0.00 | 0.00 | $0 | $198,613 | $29,124 | Yes (X) | ||||
| JOHN WENRICH - END 9122 | ||||||||||
| DIRECTOR/EX-OFFICIO | 0.10 | 41.90 | Yes (X) | $0 | $127,532 | $97,677 | ||||
| RONDA MALMBERG | ||||||||||
| HEALTHCARE ADMINISTRATOR | 40.00 | 0.00 | $156,389 | $0 | $31,836 | Yes (X) | ||||
| CHERYL R WOLFLEY | ||||||||||
| REHAB TEAM LEADER | 40.00 | 0.00 | $136,376 | $0 | $33,548 | Yes (X) | ||||
| HIREN DESAI | ||||||||||
| RN, CASE MANAGER | 40.00 | 0.00 | $129,753 | $0 | $35,990 | Yes (X) | ||||
| TERESA FELDER | ||||||||||
| HEALTHCARE ADMINISTRATOR | 40.00 | 0.00 | $140,533 | $0 | $20,176 | Yes (X) | ||||
| OLLIVIER LEPKOWICZ | ||||||||||
| RN, CASE MANAGER | 40.00 | 0.00 | $122,959 | $0 | $22,250 | Yes (X) | ||||
| JERRY VILLARENTE | ||||||||||
| HOME HEALTH NURSE | 40.00 | 0.00 | $115,444 | $0 | $13,029 | Yes (X) | ||||
| EMILY WARNYGORA | ||||||||||
| ASSISTANT SECRETARY | 1.00 | 58.00 | Yes (X) | $0 | $79,457 | $11,021 | ||||
| MATTHEW MANLOVE | ||||||||||
| DIRECTOR/CHAIR | 0.10 | 1.90 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JANET CREANEY | ||||||||||
| DIRECTOR/VICE CHAIR | 0.10 | 1.90 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| SARAH BENTLEY - END 42922 | ||||||||||
| DIRECTOR/SECRETARY | 0.10 | 1.90 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| LORENE FLEWELLEN | ||||||||||
| DIRECTOR/SECRETARY | 0.10 | 1.90 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| TAMMY SWANSON-DRAHEIM | ||||||||||
| DIRECTOR/EX-OFFICIO | 0.10 | 41.90 | Yes (X) | $0 | $0 | $0 | ||||
| KATHY BUETTNER | ||||||||||
| DIRECTOR | 0.10 | 1.90 | Yes (X) | $0 | $0 | $0 | ||||
| PAMELA CHRISTENSEN | ||||||||||
| DIRECTOR | 0.10 | 1.90 | Yes (X) | $0 | $0 | $0 | ||||
| JOHN FREDRICKSON | ||||||||||
| DIRECTOR | 0.10 | 1.90 | Yes (X) | $0 | $0 | $0 | ||||
| JANET GOELZ HOFFMAN | ||||||||||
| DIRECTOR | 0.10 | 1.90 | Yes (X) | $0 | $0 | $0 | ||||
| KURT KINCANON | ||||||||||
| DIRECTOR | 0.10 | 1.90 | Yes (X) | $0 | $0 | $0 | ||||
| ROBERT MARTIN | ||||||||||
| DIRECTOR | 0.10 | 1.90 | Yes (X) | $0 | $0 | $0 | ||||
| JENNIFER MEANS | ||||||||||
| DIRECTOR | 0.10 | 1.90 | Yes (X) | $0 | $0 | $0 | ||||
| MARY PALMER | ||||||||||
| DIRECTOR | 0.10 | 1.90 | Yes (X) | $0 | $0 | $0 | ||||
| LOANN PETERSON | ||||||||||
| DIRECTOR | 0.10 | 1.90 | Yes (X) | $0 | $0 | $0 | ||||
| SUSAN POSTON | ||||||||||
| DIRECTOR/EX-OFFICIO | 0.10 | 1.90 | Yes (X) | $0 | $0 | $0 | ||||
| DIXIE REPPE | ||||||||||
| DIRECTOR | 0.10 | 1.90 | Yes (X) | $0 | $0 | $0 | ||||
| ANDREW VANOVER | ||||||||||
| DIRECTOR | 0.10 | 1.90 | Yes (X) | $0 | $0 | $0 | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $801,454 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,945,119 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $721,358 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 15 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDWEST HOME CARE SERVICES INC | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 121 FAIRFIELD WAY SUITE 270 | AddressLine1Txt |
| City | BLOOMINGDALE | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60108 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | MEDICAL SERVICES | ServicesDesc |
| Compensation | $101,572 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $100,000 | RelatedOrganizationsAmt |
| Government Grants | $168,940 | GovernmentGrantsAmt |
| All Other Contributions | $62,238 | AllOtherContributionsAmt |
| Total Contributions | $331,178 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| HOME HEALTH | 621610 | $7,604,650 | $7,604,650 |
| HOSPICE | 621610 | $7,409,066 | $7,409,066 |
| PRIVATE DUTY | 621610 | $2,350,660 | $2,350,660 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $17,364,376 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $557 | TotalRevenueColumnAmt |
| Exclusion | $557 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,696,111 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,364,376 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $557 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $222,451 | TotalAmt |
| Management And General | $222,451 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,880,210 | TotalAmt |
| Program Services | $7,144,034 | ProgramServicesAmt |
| Management And General | $2,736,176 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,798 | TotalAmt |
| Program Services | $98,143 | ProgramServicesAmt |
| Management And General | $60,655 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,333,360 | TotalAmt |
| Program Services | $718,116 | ProgramServicesAmt |
| Management And General | $615,244 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $686,005 | TotalAmt |
| Program Services | $512,640 | ProgramServicesAmt |
| Management And General | $173,365 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $297,130 | TotalAmt |
| Program Services | $263,880 | ProgramServicesAmt |
| Management And General | $33,250 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,247 | TotalAmt |
| Management And General | $1,247 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,422 | TotalAmt |
| Management And General | $7,422 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,654,436 | TotalAmt |
| Program Services | $1,274,042 | ProgramServicesAmt |
| Management And General | $380,394 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,306 | TotalAmt |
| Management And General | $12,306 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,150,925 | TotalAmt |
| Program Services | $964,385 | ProgramServicesAmt |
| Management And General | $186,540 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $341,856 | TotalAmt |
| Management And General | $341,856 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,808 | TotalAmt |
| Program Services | $584 | ProgramServicesAmt |
| Management And General | $34,224 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $325,001 | TotalAmt |
| Program Services | $283,796 | ProgramServicesAmt |
| Management And General | $41,205 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,542 | TotalAmt |
| Management And General | $31,542 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,669 | TotalAmt |
| Program Services | $114,458 | ProgramServicesAmt |
| Management And General | $55,211 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $195,861 | TotalAmt |
| Program Services | $195,861 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| BAD DEBT EXPENSE | $139,785 | $139,785 | |
| RELATED PARTY ACTIVITY | $90,517 | $90,517 | |
| RECRUITING | $58,069 | $58,069 | |
| TRAINING | $17,752 | $17,525 | $227 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $463,629 | TotalAmt |
| Program Services | $82,001 | ProgramServicesAmt |
| Management And General | $381,628 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,272,779 | TotalAmt |
| Program Services | $11,652,167 | ProgramServicesAmt |
| Management And General | $5,620,612 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97,564 | BOYAmt |
| EOY | $55,857 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $500,697 | BOYAmt |
| EOY | $500,697 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,677,098 | BOYAmt |
| EOY | $2,982,861 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,689 | BOYAmt |
| EOY | $39,091 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $558,763 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $410,553 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $133,598 | BOYAmt |
| EOY | $148,210 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $957,783 | BOYAmt |
| EOY | $816,667 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,392,429 | BOYAmt |
| EOY | $4,543,383 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $401,221 | BOYAmt |
| EOY | $319,823 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,908,123 | BOYAmt |
| EOY | $9,717,143 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,309,344 | BOYAmt |
| EOY | $10,036,966 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$6,306,645 | BOYAmt |
| EOY | -$5,702,339 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $389,730 | BOYAmt |
| EOY | $208,756 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$5,916,915 | BOYAmt |
| EOY | -$5,493,583 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,392,429 | BOYAmt |
| EOY | $4,543,383 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $423,332 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,201,979 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $233,642 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $625,695 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,254,941 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $331,178 | CurrentTaxYearAmt |
| Total | $4,647,435 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $17,722,406 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,450,936 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $17,364,282 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $17,689,859 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $17,364,376 | CurrentTaxYearAmt |
| Total | $81,591,859 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $18,924,385 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,684,578 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $17,989,977 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $19,944,800 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $17,695,554 | CurrentTaxYearAmt |
| Total | $86,239,294 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $38,009 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $62,935 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $81,391 | CurrentTaxYearAmt |
| Total | $182,335 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $38,009 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $62,935 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $81,391 | CurrentTaxYearAmt |
| Total | $182,335 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $86,056,959 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $3,944 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $210 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $557 | CurrentTaxYearAmt |
| Total | $4,711 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $3,944 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $210 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $557 | CurrentTaxYearAmt |
| Total | $4,711 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $18,924,385 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,684,578 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $17,993,921 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $19,945,010 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $17,696,111 | CurrentTaxYearAmt |
| Total | $86,244,005 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99780 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99880 | PublicSupportPY509Pct |
| Investment Income CY | 0.00010 | InvestmentIncomeCYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART III | FormAndLineReferenceDesc |
| Explanation | BECAUSE OF THE SHORT YEAR-END FILING, THE COLUMNS IN SCHEDULE A III CORRESPOND TO THE FOLLOWING TAX YEARS: 2017 = FYE 1/31/19 2018 = SHORT YEAR-END 9/30/19 2019 = FYE 9/30/20 2020 = FYE 9/30/21 2021 = FYE 9/30/22 | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $558,763 | OtherCostOrOtherBasisAmt |
| Depreciation | $410,553 | DepreciationAmt |
| Book Value | $148,210 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $148,210 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| ILLINOIS AGENCY ACQUISITION - GOODWILL & INTANGIBLE ASSETS | $239,045 |
| TURLOCK AGENCY ACQUISITION - GOODWILL & INTANGIBLE ASSETS | $577,622 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $816,667 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| INTERCOMPANY ADVANCE ACCOUNTS | $8,538,616 |
| OTHER LIABILITIES | $1,178,527 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $9,717,143 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TERRI S CUNLIFFE | ||||||||||||||
| DIRECTOR/CLCS PRESIDENT/CEO | $0 | $556,285 | $0 | $0 | $0 | $160,552 | $0 | $8,700 | $0 | $35,047 | $0 | $760,584 | $0 | $20,790 |
| DAVID G ERICKSON | ||||||||||||||
| SR VP & GEN COUNSEL/ASST SECRETARY | $0 | $309,874 | $0 | $0 | $0 | $77,489 | $0 | $83,565 | $0 | $38,614 | $0 | $509,542 | $0 | $0 |
| JEAN E JUSTIE | ||||||||||||||
| CFO/TREASURER/ASST SECRETARY | $0 | $263,821 | $0 | $0 | $0 | $60,559 | $0 | $45,344 | $0 | $38,938 | $0 | $408,662 | $0 | $0 |
| AMY LACROIX | ||||||||||||||
| SVP, COMMUNITY OPS/ASST SECRETARY | $0 | $276,919 | $0 | $0 | $0 | $35,539 | $0 | $42,510 | $0 | $24,085 | $0 | $379,053 | $0 | $0 |
| WILLIAM RABE | ||||||||||||||
| SR VP ENTERPRISE OPS/ASST SECRETARY | $0 | $260,946 | $0 | $0 | $0 | $51,590 | $0 | $39,116 | $0 | $17,228 | $0 | $368,880 | $0 | $0 |
| ELIZABETH MCLAREN | ||||||||||||||
| SVP REV CYCLE, REIMB AND HCBS | $0 | $239,562 | $0 | $0 | $0 | $48,134 | $0 | $8,138 | $0 | $23,630 | $0 | $319,464 | $0 | $0 |
| TODD SLECHTA | ||||||||||||||
| DIRECTOR/EX-OFFICIO | $0 | $130,651 | $0 | $38,725 | $0 | $28,871 | $0 | $19,346 | $0 | $22,563 | $0 | $240,156 | $0 | $0 |
| CORY STERN | ||||||||||||||
| FORMER INTERIM FINANCE LEAD/TREAS. | $0 | $143,143 | $0 | $0 | $0 | $55,470 | $0 | $20,557 | $0 | $8,861 | $0 | $228,031 | $0 | $0 |
| JOHN WENRICH - END 9122 | ||||||||||||||
| DIRECTOR/EX-OFFICIO | $0 | $127,532 | $0 | $0 | $0 | $0 | $0 | $26,249 | $0 | $71,428 | $0 | $225,209 | $0 | $0 |
| RONDA MALMBERG | ||||||||||||||
| HEALTHCARE ADMINISTRATOR | $146,473 | $0 | $0 | $0 | $9,916 | $0 | $14,421 | $0 | $17,649 | $0 | $188,459 | $0 | $0 | $0 |
| CHERYL R WOLFLEY | ||||||||||||||
| REHAB TEAM LEADER | $113,835 | $0 | $2,100 | $0 | $20,441 | $0 | $4,456 | $0 | $29,240 | $0 | $170,072 | $0 | $0 | $0 |
| HIREN DESAI | ||||||||||||||
| RN, CASE MANAGER | $116,304 | $0 | $0 | $0 | $13,449 | $0 | $4,312 | $0 | $31,847 | $0 | $165,912 | $0 | $0 | $0 |
| TERESA FELDER | ||||||||||||||
| HEALTHCARE ADMINISTRATOR | $137,447 | $0 | $0 | $0 | $3,086 | $0 | $8,654 | $0 | $11,778 | $0 | $160,965 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | SEE SCHEDULE O EXPLANATION FOR FORM 990 PART VI SECTION B LINE 15 FOR THE METHODS USED TO DETERMINE CEO COMPENSATION. THE REVIEW AND APPROVAL PROCESS IS DESIGNED TO SATISFY AND QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERNAL REVENUE CODE SECTION 4958. |
| PART I, LINE 4B | LINE 4B: EXECUTIVE BENEFIT PLAN COVENANT MINISTRIES OF BENEVOLENCE (CMB), A RELATED ORGANIZATION, PROVIDES CERTAIN SUPPLEMENTAL RETIREMENT BENEFITS TO ITS OFFICERS AND KEY EMPLOYEES. THESE BENEFITS ARE PROVIDED THROUGH A NONQUALIFIED DEFERRED COMPENSATION PLAN, UNDER WHICH A PORTION OF THE BENEFITS BEING EARNED ARE SUBJECT TO A "SUBSTANTIAL RISK OF FORFEITURE." THE SUPPLEMENTAL RETIREMENT BENEFITS ARE STRUCTURED TO PROVIDE A RETENTION INCENTIVE THAT HAS BEEN DETERMINED BY THE EXECUTIVE COMPENSATION COMMITTEE OF CMB'S BOARD ("COMMITTEE") TO BE OF SUBSTANTIAL VALUE TO THE ORGANIZATION. THE COMMITTEE APPROVES ALL RETIREMENT BENEFITS, TOGETHER WITH ALL OTHER FORMS OF COMPENSATION AND BENEFITS FOR THESE AND OTHER EXECUTIVES, IN A MANNER INTENDED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTION'S RULES OF FEDERAL INCOME TAX LAW. THE FOLLOWING ARE PARTICIPANTS IN THE PLAN: TERRI CUNLIFFE DAVID ERICKSON TERESA FELDER JEAN JUSTIE AMY LACROIX RONDA MALMBERG ELIZABETH MCLAREN TODD SLECHTA CORY STERN WILLIAM RABE IN 2021, THESE INDIVIDUALS VESTED IN THE PLAN IN THE FOLLOWING AMOUNTS: TERRI CUNLIFFE - $65,665 DAVID ERICKSON - $23,147 ELIZABETH MCLAREN - $14,367 WILLIAM RABE - $19,251 CORY STERN - $12,367 IN 2021, THESE INDIVIDUALS RECEIVED DISTRIBUTIONS FROM THE PLAN IN THE FOLLOWING AMOUNTS: TERRI CUNLIFFE - $39,525 DAVID ERICKSON - $29,992 |
| PART I, LINE 7 | THE FOLLOWING APPLIES TO CERTAIN INDIVIDUALS LISTED ON PART VII WHOSE COMPENSATION IS PAID FROM RELATED ORGANIZATIONS: THE EXECUTIVE COMPENSATION COMMITTEE (OF CMB'S BOARD) FOLLOWS A PRESCRIBED METHOD FOR CALCULATING INCENTIVE COMPENSATION AWARDS. THE CALCULATION IS BASED ON MEASURABLE TARGETS DETERMINED AT THE BEGINNING OF THE YEAR. THE COMMITTEE HAS THE ABILITY TO ADJUST THE DOLLAR VALUE OF THE CALCULATED AWARDS BY UP TO 10%. THE ADJUSTMENT CAN BE AN UPWARD OR DOWNWARD ADJUSTMENT BASED ON VARIOUS PERFORMANCE FACTORS OR ON FACTORS THAT WILL ASSURE THAT FINAL INCENTIVE COMPENSATION AWARDS ARE IN THE BEST INTEREST OF THE ORGANIZATION AND APPROPRIATELY REFLECT THE PERFORMANCE OF THE ORGANIZATION. REFER TO ADDITIONAL INFORMATION ON THE COMMITTEE INCLUDED IN SCHEDULE O. PART II, COLUMN B (II): BONUS AND INCENTIVE COMPENSATION - CERTAIN KEY PERSONS EMPLOYED BY COVENANT LIVING AND CMB ARE ELIGIBLE FOR INCENTIVE COMPENSATION AS DETERMINED BY THE EXECUTIVE COMPENSATION COMMITTEE OF EITHER THE COVENANT LIVING OR CMB'S BOARD BASED ON WHERE THESE INDIVIDUALS ARE EMPLOYED. INCENTIVES RELATED TO THE ACHIEVEMENT OF TARGETS FOR THE EIGHT-MONTHS ENDED 9/30/20 WERE NOT PAID OUT IN 2021 FOR CLCS AND RELATED ENTITIES, BUT INCENTIVES RELATED TO CMB'S ACHIEVEMENT OF TARGETS FOR THE TWELVE-MONTHS ENDED 9/30/21 WERE PAID OUT IN 2021. PART II, COLUMN D: NONTAXABLE BENEFITS INCLUDE HEALTH INSURANCE PREMIUMS PAID BY THE EMPLOYER AND EMPLOYEE. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, ITEM C | DBA: HOSPICE OF COVENANTCARE |
| FORM 990, PART VI, SECTION A, LINE 3 | COVENANT HOME SERVICES DELEGATED CONTROL OVER MANAGEMENT DUTIES TO COVENANT LIVING COMMUNITIES AND SERVICES. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER IS COVENANT LIVING SERVICES. THE SOLE MEMBER OF COVENANT LIVING SERVICES IS COVENANT LIVING COMMUNITIES AND SERVICES. |
| FORM 990, PART VI, SECTION A, LINE 7B | S 2.4 OF BYLAWS INCLUDE RESERVED POWERS TO THE [INDIVIDUAL] MEMBERS SUCH AS APPOINTMENT OF PRESIDENT OF COVENANT LIVING COMMUNITIES AND SERVICES, CHANGES TO MISSION AND STRATEGIC PLAN, APPROVAL OF CERTAIN ACQUISITIONS, DISPOSITIONS AND FINANCINGS, CHANGES TO ARTICLES AND BYLAWS. |
| FORM 990, PART VI, SECTION B, LINE 11B | MANAGEMENT REVIEW: THE DRAFT FORM 990 WAS REVIEWED BY MULTIPLE LEVELS OF MANAGEMENT INCLUDING THE CHIEF FINANCIAL OFFICER. BOARD REVIEW: PRIOR TO FILING, THE 990 PROCESS WAS REVIEWED WITH THE BOARD OF DIRECTORS AT THE BOARD MEETING AND THE FINAL FORM 990 WAS PROVIDED TO EACH BOARD MEMBER. |
| FORM 990, PART VI, SECTION B, LINE 12C | COVENANT HOME SERVICES (CHS) HAS AN ADMINISTRATIVE POLICY ON CONFLICT OF INTEREST, IDENTIFYING THE PARAMETERS OF A CONFLICT OF INTEREST AND THE REQUIREMENT TO DISCLOSE ANY SUCH CONFLICT OF INTEREST. THE POLICY IS DISTRIBUTED ANNUALLY TO CHS BOARD MEMBERS AND OFFICERS. THEY ARE ASKED TO SIGN ACKNOWLEDGING RECEIPT OF THE POLICY AND TO DISCLOSE IF THEY HAVE ANY CONFLICT OF INTERESTS. IF SOMEONE IS ABSENT FROM THE MEETING OR FAILS TO RETURN THE ACKNOWLEDGMENT, THERE IS A FOLLOW-UP WITH THE INDIVIDUAL UNTIL THE SIGNED ACKNOWLEDGMENT IS PROVIDED. IN ADDITION TO THE ABOVE, A SEPARATE AND MORE COMPREHENSIVE QUESTIONNAIRE IS SENT TO THE BOARD MEMBERS, OFFICERS, KEY EMPLOYEES AND OTHER INTERESTED PERSONS. THE COMPLETED QUESTIONNAIRES ARE REVIEWED BY LEGAL COUNSEL TO DETERMINE IF ANY ACTUAL OR POTENTIAL CONFLICTS EXIST. IF A PERSON BECOMES AN INTERESTED PERSON, HE OR SHE MAY BE CONSIDERED IN DETERMINING WHETHER A QUORUM IS PRESENT. THE INTERESTED PERSON MAY MAKE A SHORT STATEMENT RELATING TO THE TRANSACTION OR ARRANGEMENT IN QUESTION, BUT SHALL NOT BE PRESENT DURING THE DISCUSSION AND SHALL NOT VOTE ON THE MOTION ADDRESSING THE ACTUAL OR POTENTIAL CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15B | COVENANT LIVING COMMUNITIES AND SERVICES' BOARD OF DIRECTORS HAS DULY APPOINTED AN EXECUTIVE COMPENSATION COMMITTEE (THE "COMMITTEE"), WHICH IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF ALL COMPENSATION AND BENEFITS PROVIDED TO COVENANT LIVING'S EXECUTIVE MANAGEMENT AND SENIOR MANAGEMENT ASSIGNED TO CHS. THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY STATEMENT AND AN EXECUTIVE COMPENSATION COMMITTEE CHARTER GOVERNING THE WORK AND REVIEW PROCESS OF THE COMMITTEE. THE COMMITTEE FOLLOWS THE PROCEDURES DESCRIBED IN THE PHILOSOPHY STATEMENT AND THE CHARTER WHEN IT REVIEWS AND APPROVES THE COMPENSATION AND EMPLOYEE BENEFITS PROVIDED TO THE COVENANT LIVING'S SENIOR MANAGEMENT AND COVENANT LIVING'S MANAGEMENT ASSIGNED TO CHS. THE COMMITTEE'S REVIEW ANALYZES EVERY ELEMENT OF COMPENSATION, INCLUDING CURRENT AND DEFERRED COMPENSATION, AND BENEFITS, INCLUDING QUALIFIED AND NON-QUALIFIED BENEFITS. THE COMMITTEE CONDUCTS ITS REVIEW AND APPROVAL PROCESS AT LEAST ANNUALLY, AND APPROVES COMPENSATION AND BENEFITS ONLY TO THE EXTENT THAT THE COMMITTEE HAS CONCLUDED THAT THE COMPENSATION AND BENEFITS CONSTITUTE NO MORE THAN REASONABLE COMPENSATION FOR EACH EXECUTIVE. THE COMMITTEE CONSISTS ENTIRELY OF DISINTERESTED MEMBERS OF THE BOARD, AND THE COMMITTEE WORKS WITH AN INDEPENDENT COMPENSATION CONSULTANT TO PREPARE AND REVIEW IN ADVANCE COMPREHENSIVE DATA SHOWING THE COMPENSATION PROVIDED BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY SIMILAR POSITIONS. THE COMMITTEE ALSO PREPARES A TIMELY AND THOROUGH WRITTEN RECORD OF ITS DELIBERATIONS AND CONCLUSIONS. AS A RESULT, THE COMMITTEE'S REVIEW PROCESS IS DESIGNED TO SATISFY THE PROCEDURAL CRITERIA NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES. THE RESOURCES UTILIZED BY THE COMPENSATION COMMITTEE INCLUDE: 1) INDEPENDENT COMPENSATION CONSULTANT; 2) COMPENSATION SURVEY OR STUDY; 3) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST BY CONTACTING THE COVENANT LIVING COMMUNITIES AND SERVICES FINANCE DEPARTMENT AT 773-878-2294. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (28 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| EVANGELICAL COVENANT CHURCH | |||||||||||
| 8303 WEST HIGGINS ROAD | CHICAGO | IL | 60631 | 362167730 | CHURCH | IL | 501(C)(3) | LINE 1 | N/A | 0 | |
| COVENANT LIVING COMMUNITIES AND SERVICES | |||||||||||
| 5700 OLD ORCHARD RD | SKOKIE | IL | 60077 | 363478388 | MANAGEMENT/SUPPORT SERVICES | IL | 501(C)(3) | LINE 12B, II | 0 | EVANGELICAL COVENANT CHURCH | |
| COVENANT LIVING OF GOLDEN VALLEY | |||||||||||
| 5800 ST CROIX AVE | MINNEAPOLIS | MN | 55422 | 410841150 | CONTINUING CARE RETIREMENT COMMUNITY | MN | 501(C)(3) | LINE 10 | 0 | COVENANT LIVING COMMUNITIES AND SERVICES | |
| COVENANT HEALTH CARE CENTERS INC | |||||||||||
| 2155 PFINGSTEN ROAD | NORTHBROOK | IL | 60062 | 521115873 | CONTINUING CARE RETIREMENT COMMUNITY | IL | 501(C)(3) | LINE 10 | 0 | COVENANT LIVING COMMUNITIES AND SERVICES | |
| COVENANT HOME | |||||||||||
| 2625 TECHNY ROAD | NORTHBROOK | IL | 60062 | 362643638 | CONTINUING CARE RETIREMENT COMMUNITY | IL | 501(C)(3) | LINE 10 | 0 | COVENANT LIVING COMMUNITIES AND SERVICES | |
| COVENANT LIVING OF CROMWELL INC | |||||||||||
| 52 MISSIONARY ROAD | CROMWELL | CT | 06416 | 131740015 | CONTINUING CARE RETIREMENT COMMUNITY | CT | 501(C)(3) | LINE 10 | 0 | COVENANT LIVING COMMUNITIES AND SERVICES | |
| COVENANT HOME OF CHICAGO | |||||||||||
| 2720 W FOSTER AVE | CHICAGO | IL | 60625 | 363095932 | ASSISTED LIVING FACILITY | IL | 501(C)(3) | LINE 10 | 0 | COVENANT LIVING COMMUNITIES AND SERVICES | |
| COVENANT HOUSING CORPORATION | |||||||||||
| 5700 OLD ORCHARD RD | SKOKIE | IL | 60077 | 364484624 | MANAGEMENT/SUPPORT SERVICES | IL | 501(C)(3) | LINE 12B, II | 0 | COVENANT LIVING COMMUNITIES AND SERVICES | |
| COVENANT MINISTRIES OF BENEVOLENCE | |||||||||||
| 5145 N CALIFORNIA AVE | CHICAGO | IL | 60625 | 363486813 | CHURCH AFFLIATE | IL | 501(C)(3) | LINE 12A, I | 0 | EVANGELICAL COVENANT CHURCH | |
| COVENANT LIVING OF BIXBY INC | |||||||||||
| 5700 OLD ORCHARD RD | SKOKIE | IL | 60077 | 320419173 | CONTINUING CARE RETIREMENT COMMUNITY | IL | 501(C)(3) | LINE 10 | 0 | COVENANT LIVING SERVICES INC | |
| COVENANT LIVING OF THE GREAT LAKES | |||||||||||
| 2520 LAKE MICHIGAN DRIVE NW | GRAND RAPIDS | MI | 49504 | 383244636 | CONTINUING CARE RETIREMENT COMMUNITY | MI | 501(C)(3) | LINE 10 | 0 | COVENANT LIVING COMMUNITIES AND SERVICES | |
| COVENANT LIVING WEST | |||||||||||
| 2550 TREASURE DRIVE | SANTA BARBARA | CA | 93105 | 953472345 | CONTINUING CARE RETIREMENT COMMUNITY | CA | 501(C)(3) | LINE 10 | 0 | COVENANT LIVING COMMUNITIES AND SERVICES | |
| COVENANT LIVING SERVICES | |||||||||||
| 5700 OLD ORCHARD RD | SKOKIE | IL | 60077 | 272480652 | MANAGEMENT/SUPPORT SERVICES | IL | 501(C)(3) | LINE 12B, II | 0 | COVENANT LIVING COMMUNITIES AND SERVICES | |
| COVENANT LIVING OF COLORADO | |||||||||||
| 9153 YARROW STREET | WESTMINSTER | CO | 80021 | 841084331 | CONTINUING CARE RETIREMENT COMMUNITY | CO | 501(C)(3) | LINE 10 | 0 | COVENANT LIVING COMMUNITIES AND SERVICES | |
| COVENANT LIVING OF FLORIDA INC | |||||||||||
| 9215 W BROWARD BLVD | PLANTATION | FL | 33324 | 521115870 | CONTINUING CARE RETIREMENT COMMUNITY | FL | 501(C)(3) | LINE 10 | 0 | COVENANT LIVING COMMUNITIES AND SERVICES | |
| COVENANT LIVING AT THE HOLMSTAD | |||||||||||
| 700 W FABYAN PARKWAY | BATAVIA | IL | 60510 | 362835154 | CONTINUING CARE RETIREMENT COMMUNITY | IL | 501(C)(3) | LINE 10 | 0 | COVENANT LIVING COMMUNITIES AND SERVICES | |
| COVENANT LIVING AT WINDSOR PARK | |||||||||||
| 124 WINDSOR PARK DRIVE | CAROL STREAM | IL | 60188 | 363385581 | CONTINUING CARE RETIREMENT COMMUNITY | IL | 501(C)(3) | LINE 10 | 0 | COVENANT LIVING COMMUNITIES AND SERVICES | |
| COVENANT LIVING OF GENEVA | |||||||||||
| 5700 OLD ORCHARD RD | SKOKIE | IL | 60077 | 843227613 | RENTAL SENIOR HOUSING | IL | 501(C)(3) | LINE 10 | 0 | COVENANT LIVING SERVICES INC | |
| TULSA HILLS COMMUNITY INC | |||||||||||
| 5700 OLD ORCHARD RD | SKOKIE | IL | 60077 | 842854729 | CONTINUING CARE RETIREMENT COMMUNITY | IL | 501(C)(3) | LINE 10 | 0 | COVENANT LIVING SERVICES INC | |
| EMC HEALTH INC | |||||||||||
| 2881 GEER ROAD SUITE A | TURLOCK | CA | 95382 | 942281314 | MANAGEMENT/SUPPORT SERVICES | CA | 501(C)(3) | LINE 12B, II | 0 | COVENANT MINISTRIES OF BENEVOLENCE | |
| COVENANT INITIATIVES FOR CARE INC | |||||||||||
| 4055 W PETERSON AVE SUITE 106 | CHICAGO | IL | 60646 | 271841721 | MANAGEMENT/SUPPORT SERVICES | IL | 501(C)(3) | LINE 12B, II | 0 | COVENANT MINISTRIES OF BENEVOLENCE | |
| COVENANT CARE CENTER | |||||||||||
| 9201 WEST BROWARD BLVD | PLANTATION | FL | 33324 | 591948940 | CONTINUING CARE RETIREMENT COMMUNITY | FL | 501(C)(3) | LINE 10 | 0 | COVENANT LIVING COMMUNITIES AND SERVICES | |
| COVENANT PALMS OF MIAMI | |||||||||||
| 9201 WEST BROWARD BLVD | PLANTATION | FL | 33324 | 590653300 | CONTINUING CARE RETIREMENT COMMUNITY | FL | 501(C)(3) | LINE 10 | 0 | COVENANT LIVING COMMUNITIES AND SERVICES | |
| COVENANT RETIREMENT COMMUNITIES OF MINNESOTA INC | |||||||||||
| 5825 SAINT CROIX AVENUE | MINNEAPOLIS | MN | 55422 | 411506900 | CONTINUING CARE RETIREMENT COMMUNITY | MN | 501(C)(3) | LINE 10 | 0 | COVENANT LIVING COMMUNITIES AND SERVICES | |
| CRC FOUNDATION | |||||||||||
| 5700 OLD ORCHARD RD STE 100 | SKOKIE | IL | 60077 | 300763748 | FUNDRAISING | IL | 501(C)(3) | LINE 7 | 0 | COVENANT LIVING COMMUNITIES AND SERVICES | |
| THREE CROWNS FOUNDATION | |||||||||||
| 2323 MCDANIEL AVENUE | EVANSTON | IL | 60201 | 201060468 | FOUNDATION | IL | 501(C)(3) | LINE 12B, II | 0 | COVENANT LIVING SERVICES INC | |
| THREE CROWNS PARK | |||||||||||
| 2323 MCDANIEL AVENUE | EVANSTON | IL | 60201 | 362030089 | RETIREMENT LIVING COMMUNITY | IL | 501(C)(3) | LINE 10 | 0 | THREE CROWNS FOUNDATION | |
| COVENANT LIVING OF KEENE | |||||||||||
| 5700 OLD ORCHARD RD | SKOKIE | IL | 60077 | 873525712 | RETIREMENT LIVING COMMUNITY | IL | 501(C)(3) | LINE 10 | 0 | COVENANT LIVING SERVICES INC | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COVENANT INTERNATIONAL INSURANCE COMPANY LTD | |||||||||||||
| INNOVATION HOUSE 3RD FLOOR 46 REI | HAMILTON | BD | INSURANCE | BD | N/A | C | 0 | ||||||
| COVENANT TRUST COMPANY | |||||||||||||
| FINANCIAL SERVICES | N/A | C | 0 | 141 W JACKSON BLVD SUITE 1850A | CHICAGO | IL | 60604 | 363583163 | IL | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COVENANT LIVING COMMUNITIES AND SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | P | TransactionTypeTxt |
| Involved | $395,612 | InvolvedAmt |
| Method Of Amount Determination | ALLOCATION OF ACTUAL COST | MethodOfAmountDeterminationTxt |
Comments