FURP.ORG / PUBLIC DATA EXPLORER

CERENITY SENIOR CARE: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
CERENITY SENIOR CARE (EIN 36-3517696)
Tax period
2019-07-01 to 2020-06-30
Filed
2021-05-14
IRS object ID
202141349349303479
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 ReturnHeader

FieldValueIRS element (for citing)
Return2021-05-14T11:43:04-05:00ReturnTs
Tax Period End2020-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1220 S 6TH STREET SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN363517696EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CERENITY SENIOR CAREBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCEREBusinessNameControlTxt
Phone7633472200PhoneNum

US Address USAddress

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

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKEVIN RYMANOWSKIPersonNm
Person TitleCFOPersonTitleTxt
Phone7633472200PhoneNum
Signature2021-05-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCHRISTOPHER STEINHOFFPreparerPersonNm
PTINP01587351PTIN
Phone6123764500PhoneNum
Preparation2021-05-12PreparationDt
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerRICHARD RAUPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line16499 UNIVERSITY AVE NE SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55432ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$33,124,202GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CERENITYSENIORCARE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1983FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionTO ASSIST AND COORDINATE ACTIVITES OF, AND FACILITIES FOR, HEALTH CARE AND RELATED AREAS.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee783TotalEmployeeCnt
Total Volunteers500TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$189,615PYContributionsGrantsAmt
CY Contributions Grants$824,812CYContributionsGrantsAmt
PY Program Service Revenue$30,722,051PYProgramServiceRevenueAmt
CY Program Service Revenue$32,068,010CYProgramServiceRevenueAmt
PY Investment Income$39,343PYInvestmentIncomeAmt
CY Investment Income$38,058CYInvestmentIncomeAmt
PY Other Revenue$227,369PYOtherRevenueAmt
CY Other Revenue$193,322CYOtherRevenueAmt
PY Total Revenue$31,178,378PYTotalRevenueAmt
CY Total Revenue$33,124,202CYTotalRevenueAmt
PY Grants And Similar Paid$50,451PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$178,682CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$19,858,914PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$19,044,879CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$11,988,752PYOtherExpensesAmt
CY Other Expenses$12,754,590CYOtherExpensesAmt
PY Total Expenses$31,898,117PYTotalExpensesAmt
CY Total Expenses$31,978,151CYTotalExpensesAmt
PY Revenues Less Expenses-$719,739PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,146,051CYRevenuesLessExpensesAmt
Total Assets BOY$42,243,411TotalAssetsBOYAmt
Total Assets EOY$47,621,611TotalAssetsEOYAmt
Total Liabilities BOY$31,041,743TotalLiabilitiesBOYAmt
Total Liabilities EOY$35,152,735TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$11,201,668NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$12,468,876NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE OCERENITY SENIOR CARE 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 Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$19,861,152ExpenseAmt
Grant$178,682GrantAmt
Revenue$23,360,941RevenueAmt
DescOPERATION OF TWO CARE FACILITIES, WITH 207 LONG-TERM CARE BEDS IN THE ST. PAUL, MINNESOTA AREA, WHICH PROVIDES SKILLED NURSING CARE TO THE ELDERLY.THE FACILITIES HAD A 81.3% OCCUPANCY AND SERVED 623 INDIVIDUALS DURING THE FISCAL YEAR ENDING 6/30/2020.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$7,402,631ExpenseAmt
Grant$0GrantAmt
Revenue$8,707,069RevenueAmt
DescOPERATION OF FOUR ASSISTED LIVING FACILITIES WITH 276 UNITS IN THE ST. PAUL, MINNESOTA AREA, WHICH PROVIDES ASSISTED LIVING SERVICES TO THE ELDERLY.THE FACILITIES HAD AN AVERAGE OCCUPANCY OF 87% AND SERVED 289 INDIVIDUALS DURING THE FISCAL YEAR ENDING 6/30/2020.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$27,263,783TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document126IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee783EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonKEVIN RYMANOWSKI CFOPersonNm
Phone7636896107PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
JERRY CARLEY
CEO OF BHS1.0039.00Yes (X)Yes (X)$0$611,999$164,837
KEVIN RYMANOWSKI
CFO OF BHS1.0039.00Yes (X)Yes (X)$0$403,074$164,300
STEVEN PZRYBILLA
PRESIDENT1.0039.00Yes (X)$0$345,522$126,996
TODD CARSEN
EXECUTIVE DIRECTOR OF CCH40.000.00Yes (X)$0$172,004$25,841
SALLY NEAL
RN40.000.00$167,414$0$6,074Yes (X)
KAY SCHUMACHER
EXECUTIVE DIRECTOR OF MINNEAPOLIS40.000.00Yes (X)$0$136,160$24,378
DAUDA OGUNFOWORA
RN40.000.00$110,491$0$17,903Yes (X)
ADERONKE OLUWANIYL
LPN40.000.00$109,835$0$12,011Yes (X)
RICHARD RAU
CHAIR1.001.00Yes (X)Yes (X)$0$0$0
WILLIAM FOUSSARD
DIRECTOR1.001.00Yes (X)$0$0$0
JOAN GRZYWINSKI
DIRECTOR1.001.00Yes (X)$0$0$0
DAWN KSEPKA
DIRECTOR1.001.00Yes (X)$0$0$0
JONATHAN LUNDBERG
DIRECTOR1.001.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$387,740TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,668,759TotReportableCompRltdOrgAmt
Total Other Compensation$542,340TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K3IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
BENEDICTINE HEALTH SYSTEM
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432MANAGEMENT SERVICES$1,605,562
US FOOD SERVICE - NW 6059
BOA ATTN US FOODS 3682 COLLECTIONCHICAGOIL60693FOOD & CULINARY SERVICE$1,202,239
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Government Grants$824,312GovernmentGrantsAmt
All Other Contributions$500AllOtherContributionsAmt
Total Contributions$824,812TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
RESIDENT REVENUE623000$23,360,941$23,360,941
ASSISTED LIVING623000$8,707,069$8,707,069
FieldValueIRS element (for citing)
Total Program Service Revenue$32,068,010TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$38,058TotalRevenueColumnAmt
Exclusion$38,058ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$76,253RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$76,253RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$76,253TotalRevenueColumnAmt
Exclusion$76,253ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUSDesc
Business900099BusinessCd
Total Revenue Column$117,069TotalRevenueColumnAmt
Exclusion$117,069ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$117,069OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$33,124,202TotalRevenueColumnAmt
Related Or Exempt Func Income$32,068,010RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$231,380ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$169,535TotalAmt
Program Services$169,535ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$9,147TotalAmt
Program Services$9,147ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$15,604,547TotalAmt
Program Services$14,235,439ProgramServicesAmt
Management And General$1,369,108ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$302,367TotalAmt
Program Services$275,838ProgramServicesAmt
Management And General$26,529ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,909,870TotalAmt
Program Services$1,742,302ProgramServicesAmt
Management And General$167,568ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,228,095TotalAmt
Program Services$1,120,345ProgramServicesAmt
Management And General$107,750ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$1,511,320TotalAmt
Management And General$1,511,320ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$5,675TotalAmt
Management And General$5,675ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$37,878TotalAmt
Management And General$37,878ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$19,000TotalAmt
Management And General$19,000ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,879,612TotalAmt
Program Services$1,582,071ProgramServicesAmt
Management And General$297,541ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$87,713TotalAmt
Management And General$87,713ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$112,644TotalAmt
Program Services$31,560ProgramServicesAmt
Management And General$81,084ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,856,436TotalAmt
Program Services$1,724,102ProgramServicesAmt
Management And General$132,334ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$34,002TotalAmt
Program Services$16,495ProgramServicesAmt
Management And General$17,507ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,261,552TotalAmt
Program Services$1,260,222ProgramServicesAmt
Management And General$1,330ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,771,039TotalAmt
Program Services$1,771,039ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$315,129TotalAmt
Management And General$315,129ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLY EXPENSE$1,296,021$1,273,140$22,881
FOOD$1,123,672$1,123,672
SURCHARGE$582,705$582,705
PROVISION FOR BAD DEBTS$335,619$335,619

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$524,573TotalAmt
Program Services$346,171ProgramServicesAmt
Management And General$178,402ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$31,978,151TotalAmt
Program Services$27,263,783ProgramServicesAmt
Management And General$4,714,368ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,142,160BOYAmt
EOY$2,718,680EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,525,979BOYAmt
EOY$1,573,836EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,201,396BOYAmt
EOY$5,023,314EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$233,738BOYAmt
EOY$241,831EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$51,807,801LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$19,095,506LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$30,748,659BOYAmt
EOY$32,712,295EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$5,391,479BOYAmt
EOY$5,351,655EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$42,243,411BOYAmt
EOY$47,621,611EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$4,070,645BOYAmt
EOY$3,964,501EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$522,000EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$15,464,332BOYAmt
EOY$13,881,837EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$231,702BOYAmt
EOY$236,661EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$10,378,998BOYAmt
EOY$15,457,884EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$896,066BOYAmt
EOY$1,089,852EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$31,041,743BOYAmt
EOY$35,152,735EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$9,883,268BOYAmt
EOY$11,053,739EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,318,400BOYAmt
EOY$1,415,137EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,201,668BOYAmt
EOY$12,468,876EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$42,243,411BOYAmt
EOY$47,621,611EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,146,051ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$24,420NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$96,737OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

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

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$31,098CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$40,127CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,029,490CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$189,615CurrentTaxYearMinus1YearAmt
Current Tax Year$824,812CurrentTaxYearAmt
Total$4,115,142TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$34,022,744CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$34,521,796CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$33,114,680CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$30,722,051CurrentTaxYearMinus1YearAmt
Current Tax Year$32,068,010CurrentTaxYearAmt
Total$164,449,281TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$34,053,842CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$34,561,923CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$36,144,170CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$30,911,666CurrentTaxYearMinus1YearAmt
Current Tax Year$32,892,822CurrentTaxYearAmt
Total$168,564,423TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$168,564,423PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$19,538CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$22,742CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$28,614CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$113,258CurrentTaxYearMinus1YearAmt
Current Tax Year$114,311CurrentTaxYearAmt
Total$298,463TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$19,538CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$22,742CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$28,614CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$113,258CurrentTaxYearMinus1YearAmt
Current Tax Year$114,311CurrentTaxYearAmt
Total$298,463TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$153,454CurrentTaxYearMinus1YearAmt
Current Tax Year$117,069CurrentTaxYearAmt
Total$270,523TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$34,073,380CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$34,584,665CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$36,172,784CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$31,178,378CurrentTaxYearMinus1YearAmt
Current Tax Year$33,124,202CurrentTaxYearAmt
Total$169,133,409TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99660PublicSupportCY509Pct
Public Support PY5090.99740PublicSupportPY509Pct
Investment Income CY0.00180InvestmentIncomeCYPct
Investment Income PY0.00110InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationMISCELLANEOUS INCOME - 2018 AMOUNT: $ 153,454. 2019 AMOUNT: $ 117,069.ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

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

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$606,569OtherCostOrOtherBasisAmt
Book Value$606,569BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$44,058,049OtherCostOrOtherBasisAmt
Depreciation$14,000,474DepreciationAmt
Book Value$30,057,575BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,566,084OtherCostOrOtherBasisAmt
Depreciation$1,213,869DepreciationAmt
Book Value$352,215BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,551,239OtherCostOrOtherBasisAmt
Depreciation$3,881,163DepreciationAmt
Book Value$1,670,076BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$25,860OtherCostOrOtherBasisAmt
Book Value$25,860BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$32,712,295TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (8 entries)

DescDescBook ValueBookValueAmt
AMOUNT DUE FROM AFFILIATES$514,914
BOND FUNDS$197,465
THIRD PARTY PAYOR SETTLEMENTS$8,767
REPLACEMENT RESERVE FUNDS$1,987,961
DEBT SERVICE FUNDS$1,087,953
INVESTMENT IN FOUNDATION$1,415,137
RESIDENT TRUST FUNDS$92,020
ESCROW DEPOSITS$47,438
FieldValueIRS element (for citing)
Total Book Value Other Assets$5,351,655TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
AMOUNTS DUE TO AFFILIATES$561,104
ASSET RETIREMENT$219,117
HEALTH INSURANCE RESERVE PAYABLE$309,631
FieldValueIRS element (for citing)
Total Liability$1,089,852TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

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

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1BENEDICTINE HEALTH SYSTEM FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1503 EAST THIRD STREETAddressLine1Txt
CityDULUTHCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55805ZIPCd
FieldValueIRS element (for citing)
Recipient EIN411513014RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$169,535CashGrantAmt
Valuation Method UsedN/AValuationMethodUsedDesc
Non Cash AssistanceN/ANonCashAssistanceDesc
Purpose Of GrantGENERAL OPERATING SUPPORTPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeSCHOLARSHIPSGrantTypeTxt
Recipient6RecipientCnt
Cash Grant$9,147CashGrantAmt
Valuation Method UsedN/AValuationMethodUsedDesc
Non Cash AssistanceN/ANonCashAssistanceDesc

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationCERENITY SENIOR CARE 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 CERENITY SENIOR CARE. TRANSFERS BETWEEN RELATED ORGANIZATIONS ARE ACCOUNTED FOR IN INTERNAL FINANCIAL STATEMENTS, OF WHICH ALL ARE UNDER COMMON CONTROL.ExplanationTxt

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JERRY CARLEY
CEO OF BHS$0$471,584$0$139,725$0$690$0$126,717$0$38,120$0$776,836$0$0
KEVIN RYMANOWSKI
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
TODD CARSEN
EXECUTIVE DIRECTOR OF CCH$0$164,633$0$6,804$0$567$0$16,637$0$9,204$0$197,845$0$0
SALLY NEAL
RN$167,414$0$0$0$0$0$3,037$0$3,037$0$173,488$0$0$0
KAY SCHUMACHER
EXECUTIVE DIRECTOR OF MINNEAPOLIS$0$119,114$0$16,962$0$84$0$15,175$0$9,203$0$160,538$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART III - ADDITIONAL INFORMATIONFormAndLineReferenceDesc
ExplanationBENEDICTINE HEALTH SYSTEM'S (EIN: 41-1531892) CEO AND CFO, JERRY CARLEY AND KEVIN RYMANOWSKI, SHARE THEIR TIME BETWEEN THE REPORTING ORGANIZATION AND RELATED ORGANIZATIONS. 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 (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
CITY OF ST PAUL 2007 BOND
A416005521792892HM62007-04-17$17,240,000SEE PART VI000
CITY OF ST PAUL 2017 BOND
B416005521792892HM62017-12-18$15,910,000REFINANCING BOND000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtRefunding EscrowRefundingEscrowAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$2,765,000$17,240,000$1,087,934$14,326,773$309,224$1,516,0692007Yes (1)0Yes (1)Yes (1)
B$112,989$15,910,000$13,726,469$2,133,530$50,0012018Yes (1)0Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A00000.000000.000000.0000000Yes (1)
B000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A000Yes (1)Yes (1)000Yes (1)
B0Yes (1)00Yes (1)000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceADDITIONAL INFORMATIONFormAndLineReferenceDesc
ExplanationPURSUANT TO THE LOAN AGREEMENT, PROCEEDS FROM THE SALE OF THE SERIES 2007 BONDS WILL BE LOANED TO THE COMPANY TO REFINANCE A 127-UNIT ASSISTED-LIVING AND INDEPENDENT LIVING MULTIFAMILY RENTAL HOUSING DEVELOPMENT FOR THE ELDERLY LOCATED IN ST. PAUL,MINNESOTA. IN ADDITION, PROCEEDS FROM THE SALE OF SERIES 2007 BONDS, TOGETHER WITH OTHER SOURCES, WILL FUND CERTAIN ACCRUED ASSET MANAGEMENT FEES AND GROUND LEASE RENTS,FUND CERTAIN RESERVE FUNDS DESCRIBED HEREIN AND PAY THE COSTS OF ISSUANCE. LAST REBATE COMPUTATION WAS PERFORMED ON 10/31/2016.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1THE 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 3THE 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 FACILITIES.
FORM 990, PART VI, SECTION A, LINE 6BENEDICTINE HEALTH SYSTEM, A MINNESOTA NONPROFIT CORPORATION AND HEALTHEAST, A MINNESOTA NONPROFIT CORPORATION, AND CLEMENT MANOR INC, A WISCONSIN NONPROFIT CORPORATION, ARE THE MEMBERS OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7AEACH DIRECTOR OF THE CORPORATION IS APPOINTED BY THE VOTING MEMBERS IN ACCORDANCE WITH THE MEMBERSHIP AGREEMENT. THE VOTING MEMBERS SHOULD BE COMPRISED OF FIVE PERSONS, TWO REPRESENTING HEALTHEAST, TWO REPRESENTING BHS AND ONE REPRESENTING CMI.
FORM 990, PART VI, SECTION A, LINE 7BBENEDICTINE HEALTH SYSTEM AND HEALTHEAST HAVE 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 11BTHE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON 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 12CON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO DISCLOSE ANY RELATIONSHIPS THAT CONSTITUTE OR MIGHT LEAD TO A CONFLICT OF INTEREST BY COMPLETING THE CONFLICT OF INTEREST AND GIFT DISCLOSURE STATEMENT. THE BHS COMPLIANCE DEPARTMENT WILL DISTRIBUTE THE STATEMENTS AND COLLECT AND MAINTAIN THE COMPLETED STATEMENTS. THE BHS COMPLIANCE MANAGER WILL REVIEW THE STATEMENTS AND PROVIDE A SUMMARY OF THE IDENTIFIED CONFLICTS OF INTEREST TO THE BHS CHIEF COMPLIANCE OFFICER, WHO WILL ALERT THE BHS CEO AND THE CHAIR OF THE BHS BOARD OF DIRECTORS TO ANY ITEMS OF CONCERN. AN "INTERESTED PERSON" IS ANY PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE SYSTEM, INCLUDING BUT NOT LIMITED TO A BOARD MEMBER, BOARD COMMITTEE MEMBER, OR OFFICER OR DIRECTOR OF BHS OR A FACILITY (SUCH AS FACILITY CEO/ADMINISTRATORS AND BHS SENIOR LEADERS AND DIRECTORS). FOR INTERESTED PERSONS WHO ARE EMPLOYEES (OTHER THAN THE BHS CEO), FOLLOWING DISCLOSURE OF THE ACTUAL OR POTENTIAL CONFLICT OF INTEREST AND ALL MATERIAL FACTS,THE INTERESTED PERSON'S SUPERVISOR WILL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. FOR THE BHS CEO AND BOARD AND COMMITTEE MEMBERS, FOLLOWING DISCLOSURE OF THE ACTUAL OR POTENTIAL CONFLICT OF INTEREST AND ALL MATERIAL FACTS, THE INTERESTED PERSON WILL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE REMAINING MEMBERS OF THE BOARD OR COMMITTEE DETERMINE IF A CONFLICT OF INTEREST EXISTS. THE INTERESTED PERON 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 19THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
OFFICER COMPENSATIONBENEDICTINE HEALTH SYSTEM'S (EIN: 41-1531892) CEO AND CFO, JERRY CARLEY AND KEVIN RYMANOWSKI, SHARE THEIR TIME BETWEEN THE REPORTING ORGANIZATION AND RELATED ORGANIZATIONS. SEE SCHEDULE R FOR INFORMATION ON RELATED ORGANIZATIONS.
FORM 990, PART XI, LINE 9:CHANGE IN INTEREST IN FOUNDATION 96,737.
FORM 990, PART XII, LINE 2C:THE BENEDICTINE HEALTH SYSTEM AUDIT/ FINANCE COMMITTEE OVERSEES THE SELECTION OF THE INDEPENDENT AUDITOR AND OVERSEES THE ANNUAL CONSOLIDATED AUDIT OF BENEDICTINE HEALTH SYSTEM AND AFFILIATES WHICH INCLUDES THE ORGANIZATION.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
MARIAN CENTER - GEAC LLC
6063 HUDSON RD 300WOODBURYMN55125411988959ASSISTED LIVINGMN$4,491,321$15,149,439CERENITY SENIOR CARE
CERENITY - MARIAN OF ST PAUL LLC
6063 HUDSON RD 300WOODBURYMN55125320542938NURSING HOME AND ASSISTED LIVINGMN$12,284,489$25,657,023CERENITY SENIOR CARE

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (29 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
BENEDICTINE HEALTH SYSTEM
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432411531892SUPPORTING ORGANIZATIONMN501(C)(3)LINE 10N/A0
BENEDICTINE HEALTH SYSTEM FOUNDATION
503 E THIRD STREETDULUTHMN55805411513014FUND DEVELOPMENTMN501(C)(3)LINE 100BHS
BENEDICTINE CARE CENTERS
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432411907571NURSING HOMESMN501(C)(3)LINE 100BHS
BENEDICTINE HEALTH CENTER
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432411381401NURSING HOMEMN501(C)(3)LINE 100BHS
CITY OF LAKES CARE CENTER
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432411985663NURSING HOMEMN501(C)(3)LINE 100BHS
BENEDICTINE LIVING COMMUNITIES
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432411639687NURSING HOMESMN501(C)(3)LINE 100BHS
BLC OF ST PETER
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432861113231NURSING HOMEMN501(C)(3)LINE 100BHS
STEEPLE POINTE SEN LIVING COMMUNITY
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432411852273ASSISTED LIVINGMN501(C)(3)LINE 100BHS
BRIDGES CARE CENTER
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432262620983NURSING HOMEMN501(C)(3)LINE 100BHS
ELLENDALE EVERGREEN PLACE
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432411796445ASSISTED LIVINGMN501(C)(3)LINE 100BHS
LIVING COMMUNITY OF ST JOSEPH
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432412011661NURSING HOMEMN501(C)(3)LINE 100BHS
MADONNA MEADOWS OF ROCHESTER
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432470855891ASSISTED LIVINGMN501(C)(3)LINE 100BHS
MADONNA TOWERS OF ROCHESTER
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432411809914NURSING HOMEMN501(C)(3)LINE 100BHS
ROSEWOOD COURT
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432412011389ASSISTED LIVINGMN501(C)(3)LINE 100BHS
SAINT ANNE OF WINONA
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432410850791NURSING HOMEMN501(C)(3)LINE 100BHS
ST GERTRUDE'S HEALTH CENTER
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432411848720NURSING HOMEMN501(C)(3)LINE 100BHS
ARROWHEAD SENIOR LIVING COMMUNITIES
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432411978619NURSING HOMEMN501(C)(3)LINE 100BHS
VILLA ST VINCENT
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432411352227NURSING HOMEMN501(C)(3)LINE 100BHS
BLC - BISMARCK
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432264376543NURSING HOMEMN501(C)(3)LINE 100BHS
NAZARETH LIVING CENTER
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432431450394NURSING FACILITYMN501(C)(3)LINE 10N/A0
BLC - NEW LONDON
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432274218436NURSING HOMEMN501(C)(3)LINE 100BHS
BLC - WINSTED
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432274219293NURSING HOMEMN501(C)(3)LINE 100BHS
BSLC - ST PETER
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432272716531ASSISTED LIVINGMN501(C)(3)LINE 100BHS
BLC - WAHPETON
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432454274091ASSISTED LIVINGMN501(C)(3)LINE 100BHS
CATHOLIC RESIDENTIAL SERVICES
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432390982340NURSING HOMEMN501(C)(3)LINE 100BHS
REGINA SENIOR LIVING
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432463700475NURSING HOMEMO501(C)(3)LINE 100BHS
KODA LIVING COMMUNITY
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432270705237NURSING HOMEMN501(C)(3)LINE 10N/A0
CERENITY CARE CENTER - WHITE BEAR LAKE
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432411983267NURSING HOMEMN501(C)(3)LINE 10N/A0
VILLA ST BENEDICT
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55432364343235NURSING HOMEMN501(C)(3)LINE 10N/A0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

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

US Address USAddress

FieldValueIRS element (for citing)
Address Line16499 UNIVERSITY AVE NE SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55432ZIPCd
FieldValueIRS element (for citing)
EIN411548753EIN
Primary ActivitiesWORKERS' COMPENSATION PROGRAMPrimaryActivitiesTxt
Legal Domicile StateMNLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeSEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd