FURP.ORG / PUBLIC DATA EXPLORER

BENEDICTINE LIVING COMMUNITIES - BISMARCK INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
BENEDICTINE LIVING COMMUNITIES - BISMARCK INC (EIN 26-4376543)
Tax period
2018-07-01 to 2019-06-30
Filed
2020-07-15
IRS object ID
202001979349308275
Schema version
2018v3.2
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)
Return2020-07-15T18:48:29-05:00ReturnTs
Tax Period End2019-06-30TaxPeriodEndDt

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 Begin2018-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN264376543EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BENEDICTINE LIVING COMMUNITIES -BusinessNameLine1Txt
Business Name Line2BISMARCK INC DBA ST GABRIELS COMMUNITYBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlBENEBusinessNameControlTxt
Phone7633472200PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16499 UNIVERSITY AVENUE NE NO 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55432ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKEVIN RYMANOWSKIPersonNm
Person TitleCFOPersonTitleTxt
Phone7633472200PhoneNum
Signature2020-07-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCHRISTOPHER STEINHOFFPreparerPersonNm
PTINP01587351PTIN
Phone6123764500PhoneNum
Preparation2020-07-13PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address67.137.57.251IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-07-13IPDt
IP Tm12:59:36IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id26C8EB6CBFF908C19EE8E81CE4CE9FA3BB38FC5CAtSubmissionCreationDeviceId
At Submission Filing Device Id8DF0D5A1DBF8E44DE93554FEEDBEEE801640FE4CAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-09-23 17:36:50ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTIA BOWEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line16499 UNIVERSITY AVENUE NE NO 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55432ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$15,982,021GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.BHSHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2009FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionWITNESS TO GOD'S LOVE BY PROVIDING COMPASSIONATE, QUALITY CARE WITH SPECIAL CONCERN FOR THE UNDERSERVED AND THOSE IN NEED.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee342TotalEmployeeCnt
Total Volunteers10TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$71,048PYContributionsGrantsAmt
CY Contributions Grants$825,076CYContributionsGrantsAmt
PY Program Service Revenue$13,247,032PYProgramServiceRevenueAmt
CY Program Service Revenue$15,154,239CYProgramServiceRevenueAmt
PY Investment Income$2,855PYInvestmentIncomeAmt
CY Investment Income$691CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$2,015CYOtherRevenueAmt
PY Total Revenue$13,320,935PYTotalRevenueAmt
CY Total Revenue$15,982,021CYTotalRevenueAmt
PY Grants And Similar Paid$52,275PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$7,413CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$7,673,468PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$8,180,912CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$6,092,559PYOtherExpensesAmt
CY Other Expenses$6,643,213CYOtherExpensesAmt
PY Total Expenses$13,818,302PYTotalExpensesAmt
CY Total Expenses$14,831,538CYTotalExpensesAmt
PY Revenues Less Expenses-$497,367PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,150,483CYRevenuesLessExpensesAmt
Total Assets BOY$14,473,183TotalAssetsBOYAmt
Total Assets EOY$16,376,833TotalAssetsEOYAmt
Total Liabilities BOY$16,051,185TotalLiabilitiesBOYAmt
Total Liabilities EOY$16,832,237TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$1,578,002NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$455,404NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionBENEDICTINE LIVING COMMUNITIES-BISMARCK IS A CATHOLIC ORGANIZATION ENTRUSTED WITH ADVANCING THE HEALTH CARE MINISTRY OF THE BENEDICTINE SISTERS OF DULUTH, MINNESOTA. OUR MISSION IS TO WITNESS TO GOD'S LOVE BY PROVIDING COMPASSIONATE, QUALITY CARE WITH SPECIAL CONCERN FOR THE UNDERSERVED AND THOSE IN NEED.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$8,305,015ExpenseAmt
Grant$7,413GrantAmt
Revenue$9,735,060RevenueAmt
DescOPERATION OF BLC BISMARCK ST. GABRIELS, IS A 72 BED LONG-TERM CARE FACILITY IN BISMARCK, ND WHICH PROVIDES SKILLED NURSING CARE TO THE ELDER1Y.THE FACILITY HAD 99% OCCUPANCY AND SERVED 318 INDIVIDUALS DURING THE FISCAL YEAR ENDING 6/30/2019.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$4,623,122ExpenseAmt
Grant$0GrantAmt
Revenue$5,419,179RevenueAmt
DescOPERATION OF BLC BISMARCK - HOUSING, IS A 56 UNIT ASSISTED LIVING FACILITY AND 41 UNIT BASIC CARE FACILITY IN BISMARCK, ND, WHICH PROVIDES SKILLED NURSING CARE TO THE ELDERLY.THE ASSISTED LIVING FACILITY HAD 79.8% OCCUPANCY AND SERVED 70 INDIVIDUALS DURING THE FISCAL YEAR ENDING 6/30/2019. THE BASIC CARE FACILITY HAD 97.9% OCCUPANCY AND SERVED 63 INDIVIDUALS DURING THE FISCAL YEAR ENDING 6/30/2019.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$12,928,137TotalProgramServiceExpensesAmt
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
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
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 Individuals0GrantsToIndividualsInd
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 With Officer Ent0BusinessRlnWithOfficerEntInd
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 Document34IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee342EmployeeCnt
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 Members10GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process 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 AVENUE NE SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55432ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
JERRY CARLEY
CEO OF BHS1.0039.00Yes (X)Yes (X)$0$493,059$136,483
KEVIN RYMANOWSKI
CFO OF BHS1.0039.00Yes (X)$0$360,445$87,709
STEVEN PRZYBILLA
SVP OF BHS (THRU NOV 2018)1.0039.00Yes (X)Yes (X)$0$266,893$66,321
TYLER HOEMBERG
ADMINISTRATOR (THRU SEPT 2018)40.000.00Yes (X)$0$59,856$3,210
TIA BOWE
PRESIDENT1.0039.00Yes (X)Yes (X)$0$39,025$0
JODI HENDRICKSON
CHAIR1.001.00Yes (X)Yes (X)$0$0$0
JEFF MOORE
VICE CHAIR1.001.00Yes (X)Yes (X)$0$0$0
SR LINDA WIGGINS
SECRETARY1.001.00Yes (X)Yes (X)$0$0$0
SR MARY SUSAN DEWITT
DIRECTOR1.001.00Yes (X)$0$0$0
KEVIN GREFF
DIRECTOR1.001.00Yes (X)$0$0$0
RICK LEHNHERR
DIRECTOR1.001.00Yes (X)$0$0$0
DAN NARUM
DIRECTOR1.001.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,219,278TotReportableCompRltdOrgAmt
Total Other Compensation$293,723TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BENEDICTINE HEALTH SYSTEMBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line16499 UNIVERSITY AVENUE NE SUITE 30AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55432ZIPCd
FieldValueIRS element (for citing)
ServicesMANAGEMENT SERVICESServicesDesc
Compensation$841,623CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Related Organizations$825,076RelatedOrganizationsAmt
Total Contributions$825,076TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescRESIDENT SERVICESDesc
Business623000BusinessCd
Total Revenue Column$15,154,239TotalRevenueColumnAmt
Related Or Exempt Func Income$15,154,239RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$15,154,239TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$691TotalRevenueColumnAmt
Exclusion$691ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS REVENUEDesc
Business900099BusinessCd
Total Revenue Column$2,015TotalRevenueColumnAmt
Exclusion$2,015ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,015OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$15,982,021TotalRevenueColumnAmt
Related Or Exempt Func Income$15,154,239RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$2,706ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$7,413TotalAmt
Program Services$7,413ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$6,752,446TotalAmt
Program Services$6,253,628ProgramServicesAmt
Management And General$498,818ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$74,740TotalAmt
Program Services$69,219ProgramServicesAmt
Management And General$5,521ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$856,233TotalAmt
Program Services$792,981ProgramServicesAmt
Management And General$63,252ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$497,493TotalAmt
Program Services$460,742ProgramServicesAmt
Management And General$36,751ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$841,623TotalAmt
Management And General$841,623ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$14,730TotalAmt
Management And General$14,730ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$320,728TotalAmt
Program Services$265,646ProgramServicesAmt
Management And General$55,082ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$80,066TotalAmt
Program Services$80,066ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$62,137TotalAmt
Program Services$25,327ProgramServicesAmt
Management And General$36,810ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$60TotalAmt
Program Services$60ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$479,197TotalAmt
Program Services$434,654ProgramServicesAmt
Management And General$44,543ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$37,531TotalAmt
Program Services$10,467ProgramServicesAmt
Management And General$27,064ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$735,479TotalAmt
Program Services$735,479ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$657,871TotalAmt
Program Services$657,871ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$109,506TotalAmt
Program Services$109,506ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BUILDING LEASE$1,857,699$1,857,699
FOOD$664,089$664,089
MEDICAL SUPPLY EXPENSE$483,866$464,572$19,294
MISCELLANEOUS$250,811$10,386$240,425

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$47,820TotalAmt
Program Services$28,332ProgramServicesAmt
Management And General$19,488ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$14,831,538TotalAmt
Program Services$12,928,137ProgramServicesAmt
Management And General$1,903,401ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$891,575BOYAmt
EOY$1,028,417EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,233,593BOYAmt
EOY$1,237,524EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
EOY$167,634EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$17,936,281LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,494,528LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$12,767,530BOYAmt
EOY$12,441,753EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$151,255EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY-$419,515BOYAmt
EOY$1,350,250EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$14,473,183BOYAmt
EOY$16,376,833EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$750,717BOYAmt
EOY$833,776EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,668,143BOYAmt
EOY$13,466,598EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$44,707BOYAmt
EOY$54,164EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$2,909,779BOYAmt
EOY$2,391,015EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY-$322,161BOYAmt
EOY$86,684EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$16,051,185BOYAmt
EOY$16,832,237EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$1,762,488BOYAmt
EOY-$606,659EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$179,486BOYAmt
EOY$141,255EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$5,000BOYAmt
EOY$10,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$1,578,002BOYAmt
EOY-$455,404EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$14,473,183BOYAmt
EOY$16,376,833EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,150,483ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$5,346NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$33,231OtherChangesInNetAssetsAmt
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$3,000CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$29,000CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$26,144CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$71,048CurrentTaxYearMinus1YearAmt
Current Tax Year$825,076CurrentTaxYearAmt
Total$954,268TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,896,419CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,233,957CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,477,892CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,247,032CurrentTaxYearMinus1YearAmt
Current Tax Year$15,154,239CurrentTaxYearAmt
Total$56,009,539TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,899,419CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,262,957CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,504,036CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,318,080CurrentTaxYearMinus1YearAmt
Current Tax Year$15,979,315CurrentTaxYearAmt
Total$56,963,807TotalAmt

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$56,963,807PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$22CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$26CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$26CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,855CurrentTaxYearMinus1YearAmt
Current Tax Year$691CurrentTaxYearAmt
Total$3,620TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$22CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$26CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$26CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,855CurrentTaxYearMinus1YearAmt
Current Tax Year$691CurrentTaxYearAmt
Total$3,620TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year$2,015CurrentTaxYearAmt
Total$2,015TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,899,441CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,262,983CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,504,062CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,320,935CurrentTaxYearMinus1YearAmt
Current Tax Year$15,982,021CurrentTaxYearAmt
Total$56,969,442TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99990PublicSupportCY509Pct
Public Support PY5090.99990PublicSupportPY509Pct
Investment Income CY0.00010InvestmentIncomeCYPct
Investment Income PY0.00010InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

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

Land LandGrp

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

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,290,433OtherCostOrOtherBasisAmt
Depreciation$3,354,279DepreciationAmt
Book Value$8,936,154BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$206,886OtherCostOrOtherBasisAmt
Depreciation$11,258DepreciationAmt
Book Value$195,628BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,491,012OtherCostOrOtherBasisAmt
Depreciation$2,128,991DepreciationAmt
Book Value$1,362,021BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$115,950OtherCostOrOtherBasisAmt
Book Value$115,950BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$12,441,753TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
DUE FROM AFFILIATE$5,293
RESIDENT CASH$53,569
BOND FUND$174,221
DEBT SERVICE RESERVE FUND$1,045,177
REPLACEMENT RESERVE FUND$71,990
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,350,250TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO AFFILIATEDesc
Amt$86,684Amt
FieldValueIRS element (for citing)
Total Liability$86,684TotalLiabilityAmt
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 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

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 E THIRD ST SUITE 400AddressLine1Txt
CityDULUTHCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55805ZIPCd
FieldValueIRS element (for citing)
Recipient EIN411513014RecipientEIN
IRC Section501(C)3IRCSectionDesc
Cash Grant$7,413CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt
Valuation Method UsedN/AValuationMethodUsedDesc
Non Cash AssistanceN/ANonCashAssistanceDesc
Purpose Of GrantCAPITAL FUND/SUPPORTPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTRANSFERS 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 PaymentYes (1)SeverancePaymentInd
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 (3 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$450,000$0$0$0$43,059$0$99,000$0$37,483$0$629,542$0$0
KEVIN RYMANOWSKI
CFO OF BHS$0$295,734$0$36,609$0$28,102$0$61,741$0$25,968$0$448,154$0$0
STEVEN PRZYBILLA
SVP OF BHS (THRU NOV 2018)$0$235,000$0$17,763$0$14,130$0$60,937$0$5,384$0$333,214$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 4ATYLER HOEMBERG, ADMINISTRATOR, LEFT THE COMPANY IN SEPTEMBER 2018, AND RECEIVED SEVERANCE COMPENSATION FOR TWO MONTHS AFTER HIS DEPARTURE.
PART III - ADDITIONAL INFORMATIONBENEDICTINE 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

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
BURLEIGH COUNTY ND
A456002204120906CZ32009-05-29$15,285,000SEE PART VIYes (1)00
BURLEIGH COUNTY ND
B456002204120906FC12019-04-30$13,902,838SEE PART VI000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtBond DefeasedBondDefeasedAmtTotal ProceedsTotalProceedsAmtCapitalized InterestCapitalizedInterestAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndIn Reserve FundInReserveFundAmtRefunding EscrowRefundingEscrowAmt
A$5,050,000$10,235,000$15,285,000$902,100$305,700$14,077,200200900Yes (1)Yes (1)
B$13,902,838$275,900$172,798Yes (1)0Yes (1)Yes (1)$1,043,016$12,411,124

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
A00Yes (1)00000Yes (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 ReferenceFORM 990, SCHEDULE K, PART I, COLUMN (F)FormAndLineReferenceDesc
ExplanationPROCEEDS OF THE 2009 BONDS WERE LOANED TO THE COMPANY TO (1) FINANCE A PORTION OF THE COSTS OF THE ACQUISITION, CONSTRUCTION, AND EQUIPPING OF A 72-BED SKILLED NURSING SENIOR CARE FACILITY LOCATED IN THE CITY OF BISMARCK, NORTH DAKOTA, (2) FUND A PORTION OF COSTS OF ISSUANCE FOR THE BONDS, AND (3) FUND 24 MONTHS OF CAPITALIZED INTEREST ON THE PROCEEDS OF THE SERIES 2019 BONDS WERE LOANED TO THE COMPANY TO (1) REFUND THE SERIES 2009 BONDS USED TO CONSTRUCT AND EQUIP A 72-BED SKILLED NURSING SENIOR CARE FACILITY LOCATED IN HTE CITY OF BISMARCK, NORTH DAKOTA, (2) FUND A PORTION OF THE COSTS OF ISSUANCE FOR THE BONDS, AND (3) PAY OFF OR REIMBURSE SOME EXPENSES RELATED TO CAPITAL PROJECTS UNDERTAKEN BY THE FACILITY.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 VI, SECTION A, LINE 3THE CORPORATION CONTRACTS WITH BENEDICTINE HEALTH SYSTEM, A RELATED ORGANIZATION, FOR MANAGEMENT SERVICES. BENEDICTINE HEALTH SYSTEM EMPLOYED THE ADMINISTRATOR/CEO OF THE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 6BENEDICTINE HEALTH SYSTEM, A MINNESOTA NONPROFIT CORPORATION, IS THE SOLE MEMBER OF THE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7AEACH DIRECTOR OF THE CORPORATION IS APPOINTED BY BENEDICTINE HEALTH SYSTEM.
FORM 990, PART VI, SECTION A, LINE 7BBENEDICTINE HEALTH SYSTEM HAS CERTAIN RESERVED POWERS RELATING TO THE ACTIVITIES OF THE CORPORATION AS SET OUT IN THE CORPORATION'S BY-LAWS. IN ADDITION, IN KEEPING WITH THE CORPORATION'S MISSION "TO ASSIST AND COORDINATE ACTIVITIES OF FACILITIES FOR HEALTH CARE, EDUCATION, AND CARE FOR THE AGED AND SOCIAL SERVICES IN ACCORDANCE WITH THE CHARITABLE WORKS TRADITION OF THE ROMAN CATHOLIC CHURCH", ALL ACTIVITIES OF THE CORPORATION ARE REQUIRED TO BE CARRIED OUT IN ACCORDANCE WITH THE CHARISMS OF THE BENEDICTINE SISTERS BENEVOLENT ASSOCIATION ("BSBA"), A CIVIL LAW CORPORATION FOR THE SISTERS OF ST. BENEDICT OF ST. SCHOLASTICA MONASTERY LOCATED IN DULUTH, MINNESOTA.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND REVIEWED BY MANAGEMENT. ONCE A DRAFT IS AVAILABLE, AN ELECTRONIC COPY OF THE FORM 990 WAS DISTRIBUTED TO THE BOARD PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO DISCLOSE ANY RELATIONSHIPS THAT CONSTITUTE OR MIGHT LEAD TO A CONFLICT OF INTEREST BY COMPLETING THE CONFLICT OF INTEREST AND GIFT DISCLOSURE STATEMENT. THE BHS COMPLIANCE DEPARTMENT WILL DISTRIBUTE THE STATEMENTS AND COLLECT AND MAINTAIN THE COMPLETED STATEMENTS. THE BHS COMPLIANCE MANAGER WILL REVIEW THE STATEMENTS AND PROVIDE A SUMMARY OF THE IDENTIFIED CONFLICTS OF INTEREST TO THE BHS CHIEF COMPLIANCE OFFICER, WHO WILL ALERT THE BHS CEO AND THE CHAIR OF THE BHS BOARD OF DIRECTORS TO ANY ITEMS OF CONCERN. AN "INTERESTED PERSON" IS ANY PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE SYSTEM, INCLUDING BUT NOT LIMITED TO A BOARD MEMBER, BOARD COMMITTEE MEMBER, OR OFFICER OR DIRECTOR OF BHS OR A FACILITY (SUCH AS FACILITY CEO/ADMINISTRATORS AND BHS SENIOR LEADERS AND DIRECTORS). FOR INTERESTED PERSONS WHO ARE EMPLOYEES (OTHER THAN THE BHS CEO), FOLLOWING DISCLOSURE OF THE ACTUAL OR POTENTIAL CONFLICT OF INTEREST AND ALL MATERIAL FACTS,THE INTERESTED PERSON'S SUPERVISOR WILL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. FOR THE BHS CEO AND BOARD AND COMMITTEE MEMBERS, FOLLOWING DISCLOSURE OF THE ACTUAL OR POTENTIAL CONFLICT OF INTEREST AND ALL MATERIAL FACTS, THE INTERESTED PERSON WILL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE REMAINING MEMBERS OF THE BOARD OR COMMITTEE DETERMINE IF A CONFLICT OF INTEREST EXISTS. THE INTERESTED PERSON MAY PARTICIPATE IN DELIBERATION REGARDING THE TRANSACTION IF THE APPLICABLE SUPERVISOR, BOARD, OR COMMITTEE DETERMINES A CONFLICT OF INTEREST DOES NOT EXIST. AN INTERESTED PERSON WHO HAS BEEN DETERMINED TO HAVE A CONFLICT OF INTEREST MAY NOT PARTICIPATE IN THE DELIBERATION OR DECISION REGARDING THE TRANSACTION OR ARRANGEMENT INVOLVING THE CONFLICT OF INTEREST AND MAY NOT BE PRESENT DURING SUCH DELIBERATION OR DECISION MAKING. THE INTERESTED PERSON MAY BE ALLOWED TO MAKE A PRESENTATION TO THE SUPERVISOR, BOARD, OR COMMITTEE CONSIDERING THE TRANSACTION OR ARRANGEMENT AS TO WHICH THE CONFLICT OF INTERESTS REFERS PRIOR TO THE DELIBERATION AND DECISION.
FORM 990, PART VI, SECTION C, LINE 19NOT AVAILABLE TO PUBLIC
FORM 990, PART XI, LINE 9:CHANGES IN TEMPORARILY RESTRICTED NET ASSETS -38,231. CHANGES IN PERMANENTLY RESTRICTED NET ASSETS 5,000.
FORM 990, PART XII, LINE 2C:THE BENEDICTINE HEALTH SYSTEM AUDIT/ FINANCE COMMITTEE OVERSEES THE SELECTION OF THE INDEPENDENT AUDITOR AND OVERSEES THE ANNUAL CONSOLIDATED AUDIT OF BENEDICTINE HEALTH SYSTEM AND AFFILIATES WHICH INCLUDES THE ORGANIZATION.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

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

US Address USAddress

FieldValueIRS element (for citing)
Address Line16499 UNIVERSITY AVENUE NE SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55432ZIPCd
FieldValueIRS element (for citing)
EIN811000404EIN
Primary ActivitiesASSISTED LIVING FACILITYPrimaryActivitiesTxt
Legal Domicile StateNDLegalDomicileStateCd
Total Income$5,419,185TotalIncomeAmt
End Of Year Assets$1,520,812EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

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

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (31 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 AVENUE NE SUITE 300MINNEAPOLISMN55432411531892SUPPORTING ORGANIZATIONMN501(C)(3)LINE 10N/A0
BENEDICTINE HEALTH CENTER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411381401NURSING HOMEMN501(C)(3)LINE 100BHS
BENEDICTINE CARE CENTERS
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411907571NURSING HOMEMN501(C)(3)LINE 100BHS
BENEDICTINE LIVING COMMUNITIES
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411639687NURSING HOMEMN501(C)(3)LINE 100BHS
BLC OF ST PETER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432861113231NURSING HOMEMN501(C)(3)LINE 100BHS
STEEPLE POINTE SENIOR LIVING COMMUNITY
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411852273ASSISTED LIVINGMN501(C)(3)LINE 100BHS
CERENITY SENIOR CARE
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432363517696NURSING HOMEMN501(C)(3)LINE 10N/A0
CERENITY CARE CENTER - WHITE BEAR LAKE
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411983267NURSING HOMEMN501(C)(3)LINE 10N/A0
BENEDICTINE HEALTH SYSTEM FOUNDATION
503 E THIRD ST SUITE 400DULUTHMN55805411513014FUND DEVELOPMENTMN501(C)(3)LINE 100BHS
LIVING COMMUNITY OF ST JOSEPH
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432412011661NURSING HOMEMN501(C)(3)LINE 100BHS
MADONNA TOWERS OF ROCHESTER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411809914NURSING HOMEMN501(C)(3)LINE 100BHS
SAINT ANNE OF WINONA
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432410850791NURSING HOMEMN501(C)(3)LINE 100BHS
ST GERTRUDE'S HEALTH CENTER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411848720NURSING HOMEMN501(C)(3)LINE 100BHS
ARROWHEAD SENIOR LIVING COMMUNITIES
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411978619NURSING HOMEMN501(C)(3)LINE 100BHS
BLC OF WINSTED
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432274219293NURSING HOMEMN501(C)(3)LINE 100BHS
BLC OF WAHPETON
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432454274091ASSISTED LIVINGMN501(C)(3)LINE 100BHS
BLC OF RED WING
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432454929398NURSING HOMEMN501(C)(3)LINE 100BHS
STEELE COUNTY FOR A LIFETIME INC
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432270705237NURSING HOMEMN501(C)(3)LINE 10N/A0
BRIDGES CARE CENTER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432262620983NURSING HOMEMN501(C)(3)LINE 100BHS
BSLC OF ST PETER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432272716531ASSISTED LIVINGMN501(C)(3)LINE 100BHS
CATHOLIC RESIDENTIAL SERVICES
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432390982340NURSING HOMEWI501(C)(3)LINE 100BHS
ROSEWOOD COURT
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432412011389ASSISTED LIVINGMN501(C)(3)LINE 100BHS
MADONNA MEADOWS OF ROCHESTER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432470855891ASSISTED LIVINGMN501(C)(3)LINE 100BHS
NAZARETH LIVING CENTER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432431450394NURSING HOMEMO501(C)(3)LINE 10N/A0
VILLA ST BENEDICT
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432364343235NURSING HOMEMN501(C)(3)LINE 10N/A0
VILLA ST VINCENT
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411352227NURSING HOMEMN501(C)(3)LINE 100BHS
REGINA SENIOR LIVING
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432463700475NURSING HOMEMN501(C)(3)LINE 100BHS
ELLENDALE EVERGREEN PLACE
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411796445ASSISTED LIVINGMN501(C)(3)LINE 100BHS
BLC OF BYRON
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432471538777NURSING HOMEMN501(C)(3)LINE 100BHS
CITY OF LAKES CARE CENTER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411985663NURSING HOMEMN501(C)(3)LINE 100BHS
BLC OF NEW LONDON
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432274218436NURSING HOMEMN501(C)(3)LINE 100BHS
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