HEALTHEAST CARE CENTER-WHITE BEAR LAKE: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- HEALTHEAST CARE CENTER-WHITE BEAR LAKE (EIN 41-1983267)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-05-14
- IRS object ID
- 202101349349303725
- Schema version
- 2019v5.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-05-14T11:42:34-05:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 S 6TH STREET SUITE 300 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411983267 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CERENITY CARE CENTER - WHITE BEAR LAKE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CERE | BusinessNameControlTxt |
| Phone | 7633472200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6499 UNIVERSITY AVE NE SUITE 300 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55432 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEVIN RYMANOWSKI | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7633472200 | PhoneNum |
| Signature | 2021-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CHRISTOPHER STEINHOFF | PreparerPersonNm |
| PTIN | P01587351 | PTIN |
| Phone | 6123764500 | PhoneNum |
| Preparation | 2021-05-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PAT MCDONALD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6499 UNIVERSITY AVE NE SUITE 300 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55432 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $20,949,709 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CERENITYSENIORCARE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2000 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | TO ASSIST AND COORDINATE ACTIVITES OF, AND FACILITIES, FOR, HEALTH CARE, SOCIAL SERVICES, EDUCATION AND RESEARCH. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 437 | TotalEmployeeCnt |
| Total Volunteers | 500 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $654,978 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $19,433,979 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $20,275,941 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,661 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,208 | CYInvestmentIncomeAmt |
| PY Other Revenue | $14,044 | PYOtherRevenueAmt |
| CY Other Revenue | $13,582 | CYOtherRevenueAmt |
| PY Total Revenue | $19,451,684 | PYTotalRevenueAmt |
| CY Total Revenue | $20,949,709 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $113,478 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $107,746 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,262,268 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,215,670 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,554,219 | PYOtherExpensesAmt |
| CY Other Expenses | $6,937,841 | CYOtherExpensesAmt |
| PY Total Expenses | $18,929,965 | PYTotalExpensesAmt |
| CY Total Expenses | $19,261,257 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $521,719 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,688,452 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $19,523,223 | TotalAssetsBOYAmt |
| Total Assets EOY | $21,310,263 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $14,398,632 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $14,250,572 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,124,591 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $7,059,691 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | CERENITY CARE CENTER -WBL IS ORGANIZED TO OWN, MAINTAIN, OPERATE, AND CONDUCT, DIRECTLY AND INDIRECTLY, HEALTH CARE FACILITIES FOR LONG TERM CARE AND CONGREGATE, ASSISTED AND INDEPENDENT HOUSING FOR THE ELDERLY, AND TO ASSIST AND COORDINATE ACTIVITIES OF, AND FACILITIES FOR, HEALTH CARE, SOCIAL SERVICES, EDUCATION, AND RESEARCH. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $15,161,556 | ExpenseAmt |
| Grant | $107,746 | GrantAmt |
| Revenue | $18,542,011 | RevenueAmt |
| Desc | OPERATION OF CERENITY CARE CENTER - WHITE BEAR LAKE, IS A 138 BED LONG-TERM FACILITY IN WHITE BEAR LAKE, MINNESOTA WHICH PROVIDES SKILLED NURSING CARE TO THE ELDERLY.THE FACILITY HAD 90.8% OCCUPANCY AND SERVED 805 INDIVIDUALS DURING THE FISCAL YEAR ENDING 6/30/2020. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,417,812 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,733,930 | RevenueAmt |
| Desc | OPERATION OF WHITE BEAR LAKE ASSISTED LIVING CENTER, IS A 43 BED LONG-TERM CARE IN WHITE BEAR LAKE, MINNESOTA WHICH PROVIDES ASSISTED LIVING CARE TO THE ELDERLY.THE FACILITY HAD A 96.7% OCCUPANCY AND SERVED 64 INDIVIDUALS DURING THE FISCAL YEAR ENDING 6/30/2020. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $16,579,368 | 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 | Yes (1) | 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 | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | 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 | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 | 51 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 437 | 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 | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | 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 | Yes (1) | 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 | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEVIN RYMANOWSKI CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7636896107 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6499 UNIVERSITY AVE NE SUITE 300 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55432 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JERRY CARLEY | ||||||||
| DIRECTOR & CEO OF BHS | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $611,999 | $164,837 | |
| KEVIN RYMANOWSKI | ||||||||
| DIRECTOR & CFO OF BHS | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $403,074 | $164,300 | |
| STEVEN PZRYBILLA | ||||||||
| PRESIDENT | 1.00 | 39.00 | Yes (X) | $0 | $345,522 | $126,996 | ||
| PAT MCDONALD | ||||||||
| ADMINISTRATOR | 40.00 | 0.00 | Yes (X) | $0 | $133,533 | $42,579 | ||
| JOSEPH FOLABOMI | ||||||||
| RN | 40.00 | 0.00 | $106,537 | $0 | $11,966 | Yes (X) | ||
| RICHARD RAU | ||||||||
| CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| WILLIAM FOUSSARD | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOAN GRZYWINSKI | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAWN KSEPKA | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JONATHAN LUNDBERG | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $106,537 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,494,128 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $510,678 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BENEDICTINE HEALTH SYSTEM | |||||
| 1995 E RUM RIVER DRIVE S | CAMBRIDGE | MN | 55008 | MANAGING COMPANY | $1,162,989 |
| OTIS ELEVATOR COMPANY | |||||
| PO BOX 73579 | CHICAGO | IL | 606737579 | ELEVATOR SERVICE | $117,604 |
| NELSON ROOFING & SHEETMETAL INC | |||||
| PO BOX 10572 | WHITE BEAR LAKE | MN | 55110 | ROOFING REPAIRS | $101,150 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $132,000 | RelatedOrganizationsAmt |
| Government Grants | $522,978 | GovernmentGrantsAmt |
| Total Contributions | $654,978 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| RESIDENT SERVICES | 623000 | $18,533,535 | $18,533,535 |
| ASSISTED LIVING | 623000 | $1,731,401 | $1,731,401 |
| TELEPHONE REVENUE | 623000 | $8,476 | $8,476 |
| MEAL REVENUE | 623000 | $2,529 | $2,529 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $20,275,941 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,208 | TotalRevenueColumnAmt |
| Exclusion | $5,208 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $11,000 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $11,000 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,000 | TotalRevenueColumnAmt |
| Exclusion | $11,000 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| MISCELLANEOUS | 900099 | $1,976 | $1,976 |
| VENDING INCOME | 900099 | $606 | $606 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,582 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,949,709 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,275,941 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $18,790 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,550 | TotalAmt |
| Program Services | $64,550 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,196 | TotalAmt |
| Program Services | $43,196 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,915,361 | TotalAmt |
| Program Services | $9,495,969 | ProgramServicesAmt |
| Management And General | $419,392 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $215,834 | TotalAmt |
| Program Services | $206,705 | ProgramServicesAmt |
| Management And General | $9,129 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,328,191 | TotalAmt |
| Program Services | $1,272,012 | ProgramServicesAmt |
| Management And General | $56,179 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $756,284 | TotalAmt |
| Program Services | $724,295 | ProgramServicesAmt |
| Management And General | $31,989 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,384,694 | TotalAmt |
| Management And General | $1,384,694 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,891 | TotalAmt |
| Management And General | $2,891 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,356 | TotalAmt |
| Management And General | $4,356 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $781,227 | TotalAmt |
| Program Services | $674,394 | ProgramServicesAmt |
| Management And General | $106,833 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,584 | TotalAmt |
| Management And General | $100,584 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $148,930 | TotalAmt |
| Program Services | $30,489 | ProgramServicesAmt |
| Management And General | $118,441 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $617,633 | TotalAmt |
| Program Services | $606,943 | ProgramServicesAmt |
| Management And General | $10,690 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,362 | TotalAmt |
| Program Services | $19,792 | ProgramServicesAmt |
| Management And General | $9,570 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $385,048 | TotalAmt |
| Program Services | $384,688 | ProgramServicesAmt |
| Management And General | $360 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $855,895 | TotalAmt |
| Program Services | $855,895 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $155,886 | TotalAmt |
| Management And General | $155,886 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLY EXPENSE | $1,731,010 | $1,731,010 | |
| SURCHARGE | $388,510 | $388,510 | |
| BAD DEBTS | $182,876 | $182,876 | |
| DUES & SUBSCRIPTIONS | $52,930 | $17,319 | $35,611 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $116,009 | TotalAmt |
| Program Services | $63,601 | ProgramServicesAmt |
| Management And General | $52,408 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,261,257 | TotalAmt |
| Program Services | $16,579,368 | ProgramServicesAmt |
| Management And General | $2,681,889 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,392,213 | BOYAmt |
| EOY | $3,709,276 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,161,403 | BOYAmt |
| EOY | $2,547,810 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $231,327 | BOYAmt |
| EOY | $128,438 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $30,743,093 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $16,547,939 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,308,574 | BOYAmt |
| EOY | $14,195,154 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $429,706 | BOYAmt |
| EOY | $729,585 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,523,223 | BOYAmt |
| EOY | $21,310,263 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,832,284 | BOYAmt |
| EOY | $1,841,387 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $336,000 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,484,506 | BOYAmt |
| EOY | $11,905,926 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,334 | BOYAmt |
| EOY | $55,814 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,508 | BOYAmt |
| EOY | $111,445 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,398,632 | BOYAmt |
| EOY | $14,250,572 | 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 | $5,004,162 | BOYAmt |
| EOY | $6,692,614 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $120,429 | BOYAmt |
| EOY | $367,077 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,124,591 | BOYAmt |
| EOY | $7,059,691 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,523,223 | BOYAmt |
| EOY | $21,310,263 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,688,452 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $246,648 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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 | 0 | FederalGrantAuditRequiredInd |
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 | $51,932 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $20,523 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $28,021 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year | $654,978 | CurrentTaxYearAmt |
| Total | $755,454 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $16,487,588 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $17,116,339 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $18,650,811 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $19,433,979 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $20,275,941 | CurrentTaxYearAmt |
| Total | $91,964,658 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $16,539,520 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $17,136,862 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $18,678,832 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $19,433,979 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $20,930,919 | CurrentTaxYearAmt |
| Total | $92,720,112 | 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) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $92,720,112 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,707 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,977 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,396 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,161 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,208 | CurrentTaxYearAmt |
| Total | $39,449 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,707 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,977 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,396 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,161 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,208 | CurrentTaxYearAmt |
| Total | $39,449 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $2,544 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,582 | CurrentTaxYearAmt |
| Total | $5,126 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $16,542,227 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $17,138,839 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $18,682,228 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $19,451,684 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $20,949,709 | CurrentTaxYearAmt |
| Total | $92,764,687 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99950 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99970 | PublicSupportPY509Pct |
| Investment Income CY | 0.00040 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00030 | InvestmentIncomePYPct |
| 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 | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | MISCELLANEOUS INCOME VENDING INCOME | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,652,437 | OtherCostOrOtherBasisAmt |
| Book Value | $1,652,437 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $24,199,329 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,464,365 | DepreciationAmt |
| Book Value | $11,734,964 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $330,614 | OtherCostOrOtherBasisAmt |
| Depreciation | $196,453 | DepreciationAmt |
| Book Value | $134,161 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,371,968 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,887,121 | DepreciationAmt |
| Book Value | $484,847 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $188,745 | OtherCostOrOtherBasisAmt |
| Book Value | $188,745 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $14,195,154 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ASSET RETIREMENT OBLIGATION | $17,508 |
| DUE TO AFFILIATES | $93,937 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $111,445 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | CARETAKER OF RESIDENT TRUST FUNDS AND SECURITY DEPOSITS IN A SEPARATE ACCOUNT. |
| PART X, LINE 2: | TAX EXEMPT STATUS BHS 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BENEDICTINE HEALTH SYSTEM FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 503 EAST THIRD STREET | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55805 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 411513014 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $63,298 | CashGrantAmt |
| Valuation Method Used | N/A | ValuationMethodUsedDesc |
| Non Cash Assistance | N/A | NonCashAssistanceDesc |
| Purpose Of Grant | GENERAL OPERATING SUPPORT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIP PROGRAM | GrantTypeTxt |
| Recipient | 13 | RecipientCnt |
| Cash Grant | $43,196 | CashGrantAmt |
| Valuation Method Used | N/A | ValuationMethodUsedDesc |
| Non Cash Assistance | N/A | NonCashAssistanceDesc |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | CCC - WHITE BEAR LAKE 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 WITHIN WHITE BEAR LAKE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JERRY CARLEY | ||||||||||||||
| DIRECTOR & CEO OF BHS | $0 | $471,584 | $0 | $139,725 | $0 | $690 | $0 | $126,717 | $0 | $38,120 | $0 | $776,836 | $0 | $0 |
| KEVIN RYMANOWSKI | ||||||||||||||
| DIRECTOR & CFO OF BHS | $0 | $335,852 | $0 | $66,540 | $0 | $682 | $0 | $136,807 | $0 | $27,493 | $0 | $567,374 | $0 | $0 |
| STEVEN PZRYBILLA | ||||||||||||||
| PRESIDENT | $0 | $292,298 | $0 | $52,875 | $0 | $349 | $0 | $118,457 | $0 | $8,539 | $0 | $472,518 | $0 | $0 |
| PAT MCDONALD | ||||||||||||||
| ADMINISTRATOR | $0 | $122,804 | $0 | $10,598 | $0 | $131 | $0 | $27,192 | $0 | $15,387 | $0 | $176,112 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART III - ADDITIONAL INFORMATION | FormAndLineReferenceDesc |
| Explanation | 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. 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 COMMITTEE. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF WHITE BEAR LAKE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 416005641 | BondIssuerEIN |
| Bond Issued | 2015-12-29 | BondIssuedDt |
| Issue Price | $14,665,000 | IssuePriceAmt |
| Purpose | REFUND | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $2,485,503 | RetiredAmt |
| Total Proceeds | $14,665,000 | TotalProceedsAmt |
| Capitalized Interest | $500,626 | CapitalizedInterestAmt |
| Refunding Escrow | $13,894,641 | RefundingEscrowAmt |
| Issuance Costs From Proceeds | $269,733 | IssuanceCostsFromProceedsAmt |
| Substantial Completion | 2016 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | Yes (1) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE 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 DETERMINATE MATTERS OF POLICY WITHOUT PRIOR SPECIFIC AUTHORIZATION OF THE BOARD. |
| FORM 990, PART VI, SECTION A, LINE 3 | THE CORPORATION CONTRACTS WITH BENEDICTINE HEALTH SYSTEM, A RELATED ORGANIZATION, FOR MANAGEMENT SERVICES. BENEDICTINE HEALTH SYSTEM EMPLOYED THE PRESIDENT/CEO OF THE CORPORATION AND THE ADMINISTRATORS OF THE FACILITY. |
| FORM 990, PART VI, SECTION A, LINE 6 | CERENITY SENIOR CARE, A MINNESOTA NONPROFIT CORPORATION, IS THE SOLE MEMBER OF THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | EACH DIRECTOR OF THE CORPORATION IS APPOINTED BY THE VOTING MEMBERS IN ACCORDANCE WITH THE MEMBERSHIP AGREEMENT. |
| FORM 990, PART VI, SECTION A, LINE 7B | CERENITY SENIOR CARE HAS CERTAIN RESERVED POWERS RELATING TO THE ACTIVITIES OF THE CORPORATION AS SET OUT IN THE CORPORATION'S BY-LAWS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH INFORMATION PROVIDED BY MANAGEMENT. THE RETURN 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 12C | ON 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 C, LINE 19 | THE 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 THE FOLLOWING RELATED ORGANIZATIONS. SEE SCHEDULE R FOR INFORMATION ON RELATED ORGANIZATIONS. |
| FORM 990, PART XI, LINE 9: | CHANGE IN INTEREST IN FOUNDATION 246,648. |
| 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 Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (29 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| BENEDICTINE HEALTH SYSTEM | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 411531892 | SUPPORTING ORGANIZATION | MN | 501(C)(3) | LINE 10 | N/A | 0 | |
| BENEDICTINE HEALTH SYSTEM FOUNDATION | |||||||||||
| 503 E THIRD STREET | DULUTH | MN | 55805 | 411513014 | FUND DEVELOPMENT | MN | 501(C)(3) | LINE 10 | 0 | BHS | |
| BENEDICTINE CARE CENTERS | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 411907571 | NURSING HOMES | MN | 501(C)(3) | LINE 10 | 0 | BHS | |
| BENEDICTINE HEALTH CENTER | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 411381401 | NURSING HOME | MN | 501(C)(3) | LINE 10 | 0 | BHS | |
| CITY OF LAKES CARE CENTER | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 411985663 | NURSING HOME | MN | 501(C)(3) | LINE 10 | 0 | BHS | |
| BENEDICTINE LIVING COMMUNITIES | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 411639687 | NURSING HOMES | MN | 501(C)(3) | LINE 10 | 0 | BHS | |
| BLC OF ST PETER | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 861113231 | NURSING HOME | MN | 501(C)(3) | LINE 10 | 0 | BHS | |
| STEEPLE POINTE SEN LIVING COMMUNITY | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 411852273 | NURSING HOME | MN | 501(C)(3) | LINE 10 | 0 | BHS | |
| BRIDGES CARE CENTER | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 262620983 | NURSING HOME | MN | 501(C)(3) | LINE 10 | 0 | BHS | |
| ELLENDALE EVERGREEN PLACE | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 411796445 | ASSISTED LIVING | MN | 501(C)(3) | LINE 10 | 0 | BHS | |
| LIVING COMMUNITY OF ST JOSEPH | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 412011661 | NURSING HOME | MN | 501(C)(3) | LINE 10 | 0 | BHS | |
| MADONNA MEADOWS OF ROCHESTER | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 470855891 | ASSISTED LIVING | MN | 501(C)(3) | LINE 10 | 0 | BHS | |
| MADONNA TOWERS OF ROCHESTER | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 411809914 | NURSING HOME | MN | 501(C)(3) | LINE 10 | 0 | BHS | |
| ROSEWOOD COURT | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 412011389 | ASSISTED LIVING | MN | 501(C)(3) | LINE 10 | 0 | BHS | |
| SAINT ANNE OF WINONA | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 410850791 | NURSING HOME | MN | 501(C)(3) | LINE 10 | 0 | BHS | |
| ARROWHEAD SENIOR LIVING COMMUNITIES | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 411978619 | NURSING HOME | MN | 501(C)(3) | LINE 10 | 0 | BHS | |
| VILLA ST VINCENT | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 411352227 | NURSING HOME | MN | 501(C)(3) | LINE 10 | 0 | BHS | |
| BLC OF BISMARCK | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 264376543 | NURSING HOME | MN | 501(C)(3) | LINE 10 | 0 | BHS | |
| NAZARETH LIVING CENTER | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 431450394 | NURSING FACILITY | MN | 501(C)(3) | LINE 10 | N/A | 0 | |
| BLC OF NEW LONDON | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 274218436 | NURSING HOME | WI | 501(C)(3) | LINE 10 | 0 | BHS | |
| BLC OF WINSTED | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 274219293 | NURSING HOME | MN | 501(C)(3) | LINE 10 | 0 | BHS | |
| BSLC OF ST PETER | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 272716531 | ASSISTED LIVING | MN | 501(C)(3) | LINE 10 | 0 | BHS | |
| BLC OF WAHPETON | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 454274091 | ASSISTED LIVING | MN | 501(C)(3) | LINE 10 | 0 | BHS | |
| CATHOLIC RESIDENTIAL SERVICES | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 390982340 | NURSING HOME | WI | 501(C)(3) | LINE 10 | 0 | BHS | |
| REGINA SENIOR LIVING | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 463700475 | NURSING HOME | MN | 501(C)(3) | LINE 10 | 0 | BHS | |
| KODA LIVING COMMUNITY | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 270705237 | NURSING HOME | MN | 501(C)(3) | LINE 10 | N/A | 0 | |
| CERENITY SENIOR CARE | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 411983267 | NURSING HOME | MN | 501(C)(3) | LINE 10 | N/A | 0 | |
| ST GERTRUDE'S HEALTH CENTER | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 411848720 | NURSING HOME | MN | 501(C)(3) | LINE 10 | 0 | BHS | |
| VILLA ST BENEDICT | |||||||||||
| 6499 UNIVERSITY AVE NE SUITE 300 | MINNEAPOLIS | MN | 55432 | 364343235 | NURSING HOME | MN | 501(C)(3) | LINE 10 | N/A | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BENEDICTINE GROUP SELF-INSURANCE ASSOCIATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6499 UNIVERSITY AVE NE SUITE 300 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55432 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411548753 | EIN |
| Primary Activities | WORKERS' COMPENSATION PROGRAM | PrimaryActivitiesTxt |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | S | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | 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 | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |