COVENANT HEALTH CARE CENTER INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- COVENANT HEALTH CARE CENTER INC (EIN 52-1115873)
- Tax period
- 2015-02-01 to 2016-01-31
- Filed
- 2016-12-14
- IRS object ID
- 201613499349301321
- Schema version
- 2015v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-12-14T17:23:13-06:00 | ReturnTs |
| Tax Period End | 2016-01-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-02-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 521115873 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Covenant Health Care Centers Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COVE | BusinessNameControlTxt |
| Phone | 8474807110 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2155 Pfingsten Road | AddressLine1Txt |
| City | Northbrook | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60062 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Elizabeth Buikema | PersonNm |
| Person Title | Senior VP - Finance/CFO | PersonTitleTxt |
| Phone | 7738782294 | PhoneNum |
| Signature | 2016-12-14 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Elizabeth Buikema | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | c/o CRC - 5700 Old Orchard Rd | AddressLine1Txt |
| City | Skokie | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60077 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $28,769,944 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 2650 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.covenantretirement.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1969 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | Care for senior adults. | ActivityOrMissionDesc |
| Voting Members Governing Body | 21 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 18 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 293 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $201,863 | PYContributionsGrantsAmt |
| CY Contributions Grants | $79,329 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $26,513,103 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $27,236,752 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,144,403 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,195,906 | CYInvestmentIncomeAmt |
| PY Other Revenue | $231,889 | PYOtherRevenueAmt |
| CY Other Revenue | $257,957 | CYOtherRevenueAmt |
| PY Total Revenue | $28,091,258 | PYTotalRevenueAmt |
| CY Total Revenue | $28,769,944 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $13,661,138 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $14,263,408 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $54,934 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $12,079,711 | PYOtherExpensesAmt |
| CY Other Expenses | $12,267,152 | CYOtherExpensesAmt |
| PY Total Expenses | $25,740,849 | PYTotalExpensesAmt |
| CY Total Expenses | $26,530,560 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,350,409 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,239,384 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $63,322,701 | TotalAssetsBOYAmt |
| Total Assets EOY | $64,941,072 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $32,719,698 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $32,080,586 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $30,603,003 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $32,860,486 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | As a ministry of the Evangelical Covenant Church, Covenant Retirement Communities celebrates God's gift of life in Christian community. We follow the Great Commandment to love and serve God and one another as taught by Jesus Christ. (SEE SCHEDULE O) | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,075,223 | ExpenseAmt |
| Revenue | $7,793,035 | RevenueAmt |
| Desc | Assisted Living & Assisted Dementia: The number of persons who benefited from the services we provided for the year ended January 31, 2016 were as follows:There were a total of 120 assisted living residents at 01/31/2016 Assisted living residency for the fiscal year totaled 42,784 patient days. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $15,758,208 | ExpenseAmt |
| Revenue | $19,701,674 | RevenueAmt |
| Desc | Skilled Nursing & Skilled Dementia: The number of persons who benefited from the services we provided for the year ended January 31, 2016 were as follows:There were a total of 153 skilled care patients at 01/31/2016.Skilled care residency for the fiscal year totaled 51,688 patient days. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | The organization was involved in several community benefit projectswhich includes the following:- Residents volunteered a total of 2771 hours of their time tovarious activities/events in the community. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $20,833,431 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (1) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 21 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 18 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | Yes (1) | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Elizabeth Buikema | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7738782294 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | C/O CRC 5700 Old Orchard Rd | AddressLine1Txt |
| City | Skokie | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60077 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| Jon P Aagaard MD | |||||||
| Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Pamela Christensen | |||||||
| Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Kara E Davis MD | |||||||
| Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Rev Harvey Drake | |||||||
| Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Mark C Eastburg | |||||||
| Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| James Elving | |||||||
| Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Marc E Espinosa | |||||||
| Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Carol A Findling | |||||||
| Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Lorene G Flewellen | |||||||
| Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Rhoda Friesen | |||||||
| Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Thomas F Heywood | |||||||
| Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Donald Hodgkinson | |||||||
| Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Kathy Holmgren | |||||||
| Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Jody Holt | |||||||
| Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Scott Macdonald | |||||||
| Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Marlene Stante | |||||||
| Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Anne Vining | |||||||
| Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| David A Dwight | |||||||
| Ex-Officio | 1.00 | 40.00 | Yes (X) | $0 | $1,846,302 | $29,812 | |
| Rick K Fisk | |||||||
| Ex-Officio/President | 1.00 | 40.00 | Yes (X) | $0 | $1,037,707 | $19,210 | Yes (X) |
| Jennifer Larson | |||||||
| Ex-Officio | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Gary Walter | |||||||
| Ex-Officio | 1.00 | 40.00 | Yes (X) | $0 | $151,696 | $109,618 | |
| Terri S Cunliffe | |||||||
| Ex-Officio/President | 1.00 | 40.00 | Yes (X) | $0 | $482,038 | $73,683 | Yes (X) |
| Elizabeth B Buikema | |||||||
| Senior VP/CFO/Treasurer | 1.00 | 40.00 | $0 | $356,598 | $57,905 | Yes (X) | |
| David G Erickson | |||||||
| VP/Asst Secretary | 1.00 | 40.00 | $0 | $285,049 | $52,820 | Yes (X) | |
| Nadia Geigler | |||||||
| Dir Admin Srvcs/Asst Secretary | 1.00 | 40.00 | $0 | $100,457 | $10,051 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,259,847 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $353,099 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $79,329 | AllOtherContributionsAmt |
| Total Contributions | $79,329 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Routine Services | 623000 | $17,122,013 | $17,122,013 |
| Ancillary Services | 623000 | $5,183,357 | $5,183,357 |
| Medicare/Medicaid | 623000 | $4,919,282 | $4,919,282 |
| Meals | 623000 | $12,100 | $12,100 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $27,236,752 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,065,664 | TotalRevenueColumnAmt |
| Exclusion | $1,065,664 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $130,242 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $130,242 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $130,242 | TotalRevenueColumnAmt |
| Exclusion | $130,242 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Services to Residents | 623000 | $26,072 | $26,072 |
| Support Services | 623000 | $10,400 | $10,400 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $221,485 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $221,485 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $257,957 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,769,944 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $27,494,709 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,195,906 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,776,551 | TotalAmt |
| Program Services | $10,477,090 | ProgramServicesAmt |
| Management And General | $1,299,461 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $304,680 | TotalAmt |
| Program Services | $261,158 | ProgramServicesAmt |
| Management And General | $43,522 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,311,300 | TotalAmt |
| Program Services | $1,129,711 | ProgramServicesAmt |
| Management And General | $181,589 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $870,877 | TotalAmt |
| Program Services | $762,601 | ProgramServicesAmt |
| Management And General | $108,276 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $243,987 | TotalAmt |
| Program Services | $243,987 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,602 | TotalAmt |
| Management And General | $24,602 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,273 | TotalAmt |
| Management And General | $11,273 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,472,998 | TotalAmt |
| Program Services | $2,148,361 | ProgramServicesAmt |
| Management And General | $324,637 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $137,465 | TotalAmt |
| Management And General | $137,465 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,552,650 | TotalAmt |
| Program Services | $1,417,501 | ProgramServicesAmt |
| Management And General | $135,149 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $411,614 | TotalAmt |
| Program Services | $14,173 | ProgramServicesAmt |
| Management And General | $397,441 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $609,333 | TotalAmt |
| Program Services | $609,333 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,389 | TotalAmt |
| Program Services | $11,735 | ProgramServicesAmt |
| Management And General | $16,654 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,145 | TotalAmt |
| Program Services | $5,237 | ProgramServicesAmt |
| Management And General | $31,908 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,511,774 | TotalAmt |
| Program Services | $977,513 | ProgramServicesAmt |
| Management And General | $514,003 | ManagementAndGeneralAmt |
| Fundraising | $20,258 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,957,309 | TotalAmt |
| Program Services | $1,265,717 | ProgramServicesAmt |
| Management And General | $665,485 | ManagementAndGeneralAmt |
| Fundraising | $26,107 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $203,101 | TotalAmt |
| Program Services | $203,101 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|---|
| Related Party Activity | $1,432,369 | $1,423,800 | $8,569 | |
| Dining Services | $905,320 | $905,320 | ||
| Resident Care | $352,532 | $352,532 | ||
| Admin & General | $289,849 | $267,598 | $22,251 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,442 | TotalAmt |
| Program Services | $26,110 | ProgramServicesAmt |
| Management And General | $59,332 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,530,560 | TotalAmt |
| Program Services | $20,833,431 | ProgramServicesAmt |
| Management And General | $5,642,195 | ManagementAndGeneralAmt |
| Fundraising | $54,934 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150 | BOYAmt |
| EOY | $150 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,064 | BOYAmt |
| EOY | $34,529 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,295,121 | BOYAmt |
| EOY | $2,296,311 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,152 | BOYAmt |
| EOY | $11,153 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $45,235,581 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $24,873,444 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,046,179 | BOYAmt |
| EOY | $20,362,137 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,027,901 | BOYAmt |
| EOY | $10,637,942 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,570,943 | BOYAmt |
| EOY | $2,260,558 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,349,191 | BOYAmt |
| EOY | $29,338,292 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,322,701 | BOYAmt |
| EOY | $64,941,072 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,435,741 | BOYAmt |
| EOY | $1,393,598 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,870,125 | BOYAmt |
| EOY | $29,977,792 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,114 | BOYAmt |
| EOY | $35,879 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $391,718 | BOYAmt |
| EOY | $673,317 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,719,698 | BOYAmt |
| EOY | $32,080,586 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,591,376 | BOYAmt |
| EOY | $32,830,760 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,627 | BOYAmt |
| EOY | $29,726 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,603,003 | BOYAmt |
| EOY | $32,860,486 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,322,701 | BOYAmt |
| EOY | $64,941,072 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,239,384 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $18,099 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $57,362 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $196,820 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $100,481 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $201,863 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $79,329 | CurrentTaxYearAmt |
| Total | $635,855 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $23,620,982 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $23,712,015 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $25,840,663 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $26,513,103 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $27,236,752 | CurrentTaxYearAmt |
| Total | $126,923,515 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $23,678,344 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $23,908,835 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $25,941,144 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $26,714,966 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $27,316,081 | CurrentTaxYearAmt |
| Total | $127,559,370 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $127,559,370 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,318,340 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,139,889 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,132,198 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,144,403 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,195,906 | CurrentTaxYearAmt |
| Total | $5,930,736 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,318,340 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,139,889 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,132,198 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,144,403 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,195,906 | CurrentTaxYearAmt |
| Total | $5,930,736 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $24,996,684 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $25,048,724 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $27,073,342 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $27,859,369 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $28,511,987 | CurrentTaxYearAmt |
| Total | $133,490,106 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.95560 | PublicSupportCY509Pct |
| Public Support PY509 | 0.95340 | PublicSupportPY509Pct |
| Investment Income CY | 0.04440 | InvestmentIncomeCYPct |
| Investment Income PY | 0.04660 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $156,029 | OtherCostOrOtherBasisAmt |
| Book Value | $156,029 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $39,009,849 | OtherCostOrOtherBasisAmt |
| Depreciation | $22,420,904 | DepreciationAmt |
| Book Value | $16,588,945 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,852,472 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,401,178 | DepreciationAmt |
| Book Value | $2,451,294 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,217,231 | OtherCostOrOtherBasisAmt |
| Depreciation | $51,362 | DepreciationAmt |
| Book Value | $1,165,869 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $20,362,137 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Unamortized Debt & Related Expenses | $373,060 |
| Unamortized Original Issue Discount | $51,853 |
| Inter-company Advance Accounts | $28,913,379 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $29,338,292 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Accrued Taxes & Employee Benefits | $164,796 |
| Other Liabilities | $508,521 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $673,317 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part IV, Line 2b: | FormAndLineReferenceDesc |
| Explanation | Resident Trust Fund Account: Per state regulations, an account is made available to Skilled Nursing Facility residents wishing to deposit personal needs funds that they can access as needed. Interest is paid based on the interest received from the bank for those deposited funds and allocated among the individual trust fund accounts based on average balances. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| David A Dwight | ||||||||||||||
| Ex-Officio | $0 | $497,736 | $0 | $0 | $0 | $1,348,566 | $0 | $7,950 | $0 | $31,135 | $0 | $1,885,387 | $0 | $0 |
| Rick K Fisk | ||||||||||||||
| Ex-Officio/President | $0 | $461,683 | $0 | $222,540 | $0 | $353,484 | $0 | $7,950 | $0 | $18,993 | $0 | $1,064,650 | $0 | $0 |
| Gary Walter | ||||||||||||||
| Ex-Officio | $0 | $151,696 | $0 | $0 | $0 | $0 | $0 | $22,754 | $0 | $86,864 | $0 | $261,314 | $0 | $0 |
| Terri S Cunliffe | ||||||||||||||
| Ex-Officio/President | $0 | $341,165 | $0 | $77,220 | $0 | $63,653 | $0 | $54,291 | $0 | $22,034 | $0 | $558,363 | $0 | $0 |
| Elizabeth B Buikema | ||||||||||||||
| Senior VP/CFO/Treasurer | $0 | $240,768 | $0 | $75,396 | $0 | $40,434 | $0 | $30,133 | $0 | $31,216 | $0 | $417,947 | $0 | $0 |
| David G Erickson | ||||||||||||||
| VP/Asst Secretary | $0 | $193,687 | $0 | $41,895 | $0 | $49,467 | $0 | $25,505 | $0 | $31,019 | $0 | $341,573 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | See Schedule O explanation for Form 990 Part VI Section B Line 15 for the methods used to determine CEO compensation. The review and approval process is designed to satisfy and qualify for the rebuttable presumption of reasonableness under the Internal Revenue Code Section 4958. |
| Part I, Line 4b | Executive Benefit Plan Covenant Ministries of Benevolence (CMB) provides certain supplemental retirement benefits to its officers and key employees. These benefits are provided through a nonqualified deferred compensation plan, under which a portion of the benefits being earned are subject to a "substantial risk of forfeiture." The supplemental retirement benefits are structured to provide a retention incentive that has been determined by the Executive Compensation Committee of CMB's Board ("Committee") to be of substantial value to the organization. The Committee approves all retirement benefits, together with all other forms of compensation and benefits for these and other executives, in a manner intended to qualify for the rebuttable presumption of reasonableness under the intermediate sanctions rules of federal income tax law. The Committee has determined that total compensation for each such executive is reasonable. Contributions were made to the deferred compensation plan for the following participants: Elizabeth Buikema - $26,913 Terri Cunliffe - $45,986 David Dwight - $65,253 David Erickson - $24,737 Rick Fisk - $56,068 Nadia Geigler - $7,308 The compensation amounts reported for certain individuals in Part II, columns (B)(i) through (iii), include amounts earned over many years of employment under a supplemental nonqualified retirement plan. These amounts were at risk, and would have been forfeited if the reported individual had not satisfied a substantial service requirement. These amounts would be paid out over an individual's years of retirement, like a traditional pension plan benefit, but special laws for tax-exempt organizations require that the entire value be reported, taxed and paid out at one time. The individuals who earned these amounts over many years of service, and the amounts that were paid out in the reported year, are as follows: Rick Fisk: $248,729 David Dwight: $1,215,769 |
| Part I, Line 7 | The following applies to certain individuals listed on Part VII whose compensation is paid from related organizations: The Executive Compensation Committee (of CMB's board) follows a prescribed method for calculating incentive compensation awards. The calculation is based on measurable targets determined at the beginning of the year. The Committee has the ability to adjust the dollar value of the calculated awards by up to 10%. The adjustment can be an upward or downward adjustment based on various performance factors or on factors that will assure that final incentive compensation awards are in the best interest of the organization and appropriately reflect the performance of the organization. Refer to additional information on the Committee included in Schedule O. |
| Part II, Column B (ii): | Bonus and incentive compensation - Certain key persons employed by CRC and CMB are eligible for incentive compensation as determined by the Executive Compensation Committee of either the CRC or CMB's Board based on where these individuals are employed. Incentives paid in 2015 relate to the achievement of targets for the fiscal year ended 1/31/2015. |
| Part II, Column D: | Nontaxable benefits include health insurance premiums paid by the employer and employee. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990 - Part III - Line 1 | Mission Statement As a ministry of the Evangelical Covenant Church, Covenant Retirement Communities celebrate God's gift of life in Christian community. We follow the Great Commandment to love and serve God and one another as taught by Jesus Christ. That compels us to affirm the dignity of each person and to pursue excellence and financial integrity in all that we do. As we provide a broad range of resources, services and programs to enhance individual and community wellness, we collaborate with residents and families to achieve the best possible results. While seeking to foster independence, we respond to each individual's evolving needs in order to provide the security that assures peace of mind. In living out the mission, the community provides a complete continuum of care from residential living through skilled nursing. Such services are guided by a series of values and goals addressing resident needs, privacy, safety and dignity, including appropriate access to services. In carrying out the mission statement of Covenant Retirement Communities (CRC), Covenant Health Care Centers, Inc. provided $758,375 free or discounted services to those residents unable to pay all or a portion of their charges, and who meet certain eligibility requirements. |
| Form 990 - Part V - Lines 1a & 2a | Employees and Vendors Covenant Health Care Centers, Inc. (CHCC) is a combination of the assisted living and skilled nursing facilities of two continuing care retirement communities (CCRC), Covenant Home Illinois and The Holmstad, Inc. The W2's of employees and 1099-Misc for vendors that do work for CHCC are reported and issued under the FEIN of each campus. No wages or 1099's are issued under the FEIN of CHCC. There are about 817 employees working in these two campus locations and a combined total of 91 vendors were sent 1099's as of 1/31/16. |
| Form 990 - Part IV - Line 24a | Tax Exempt Bonds The organization has tax exempt bonds issue after December 31, 2002 with an outstanding principal of more than $100,000. The bonds are reported on Schedule K of the parent organization. |
| Form 990, Part VI, Section A, line 3 | Covenant Health Care Centers, Inc. delegated control over management duties to Covenant Retirement Communities, Inc. (CRC), its parent organization. |
| Form 990, Part VI, Section A, line 6 | The sole member is Covenant Retirement Communities, Inc. (CRC) |
| Form 990, Part VI, Section A, line 7b | S 2.4 of Bylaws include reserved powers to the [invidual] members such as appointment of president of CRC, changes to mission and strategic plan, approval of certain acquisitions, dispositions and financings, changes to articles and bylaws. |
| Form 990, Part VI, Section B, line 11 | Management Review: The draft Form 990 was reviewed by multiple levels of management including the Vice President of Finance/CFO and the Vice President of Legal Affairs. Board Review: Prior to filing, the 990 process was reviewed with the Board of Directors at the Board meeting and the final Form 990 was provided to each Board member. |
| Form 990, Part VI, Section B, line 12c | Covenant Retirement Communities, Inc. (CRC) has an Administrative Policy on conflict of interest, identifying the parameters of a conflict of interest and the requirement to disclose any such conflict of interest. Each January, the CRC policy is distributed to CRC board members and officers. They are asked to sign acknowledging receipt of the policy and to disclose if they have any conflict of interests. If someone is absent from the meeting or fails to return the acknowledgment, there is a follow-up with the individual until the signed acknowledgment is provided. In addition to the above, a separate and more comprehensive questionnaire is sent to the board members, officers, key employees and other interested persons. The completed questionnaires are reviewed by CRC's legal counsel to determine if any actual or potential conflicts exist. If a person becomes an interested person, he or she may be considered in determining whether a quorum is present. The interested person may make a short statement relating to the transaction or arrangement in question, but shall not be present during the discussion and shall not vote on the motion addressing the actual or potential conflict. |
| Form 990, Part VI, Section B, line 15 | Covenant Retirement Communities' (CRC) Board of Directors has duly appointed an Executive Compensation Committee (the "Committee"), which is responsible for the review and approval of all compensation and benefits provided to CRC's executive management. The Committee has adopted a written Executive Compensation Philosophy Statement and an Executive Compensation Committee Charter governing the work and review process of the Committee. The Committee follows the procedures described in the Philosophy Statement and the Charter when it reviews and approves the compensation and employee benefits provided to the CRC's senior management. The Committee's review analyzes every element of compensation, including current and deferred compensation, and benefits, including qualified and non-qualified benefits. The Committee conducts its review and approval process at least annually, and approves compensation and benefits only to the extent that the Committee has concluded that the compensation and benefits constitute no more than reasonable compensation for each executive. The Committee consists entirely of disinterested members of the Board, and the Committee works with an independent compensation consultant to prepare and review in advance comprehensive data showing the compensation provided by similarly situated organizations for functionally similar positions. The Committee also prepares a timely and thorough written record of its deliberations and conclusions. As a result, the Committee's review process is designed to satisfy the procedural criteria necessary to qualify for the rebuttable presumption of reasonableness under the federal income tax law intermediate sanctions rules. The resources utilized by the compensation Committee include: 1) independent compensation consultant; 2) written employment contract; 3) compensation survey or study; 4) approval by the board or compensation committee. |
| Form 990, Part VI, Section C, line 18 | A copy of the organization's Form 990 is available upon request by contacting the CRC accounting department at 773-878-5744. |
| Form 990, Part VI, Section C, line 19 | The governing documents, conflict of interest policy and financial statements are available upon request by contacting the CRC accounting department at 773-878-5744. |
| Form 990 - Part VI - Line 9 | Contact Info for Directors & Officers All of the organization's directors and officers can be contacted at this address: Covenant Retirement Communities, Inc. - 5700 Old Orchard Road, Skokie, IL 60077. |
| Form 990 - Part VII - Section A Column B | Related Organization Officers and Directors devote approximately 1 hour per week to related organizations except for those individuals that are employees of these related organizations; those individuals devote approximately 40 hours to the organizations at which they are employed. |
| Form 990, Part XI, line 9: | Change in Temporarily Restricted Net Assets not included on Income Stmnt 18,099. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Evangelical Covenant Church | |||||||||||
| 8303 West Higgins Road | Chicago | IL | 60631 | 362167730 | Church | IL | 501(c)(3) | Line 1 | N/A | 0 | |
| Swedish Covenant Faculty Group (SCFG) | |||||||||||
| 5145 North California Avenue | Chicago | IL | 60625 | 363686216 | Patient Treatment/Education | IL | 501(c)(3) | Line 11a, I | 0 | Swedish Covenant Hospital | |
| Swedish Covenant Hospital | |||||||||||
| 5145 North California Avenue | Chicago | IL | 60625 | 362179813 | Hospital | IL | 501(c)(3) | Line 3 | 0 | Covenant Ministries of Benevolence | |
| Swedish Covenant Hospital Foundation (SCHF) | |||||||||||
| 5145 North California Avenue | Chicago | IL | 60625 | 205055155 | Support of Swedish Covenant Hospital | IL | 501(c)(3) | Line 7 | 0 | Swedish Covenant Hospital | |
| SC Insurance Company | |||||||||||
| 6970 E Chauncey Lane Suite 100 | Phoenix | AZ | 85054 | 273312053 | Insurance | AZ | 501(c)(3) | Line 11a, I | 0 | Swedish Covenant Hospital | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Covenant Village of Portland LP | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 420 NE Mason St | AddressLine1Txt |
| City | Portland | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97211 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 364356838 | EIN |
| Primary Activities | Assisted Living Community | PrimaryActivitiesTxt |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Predominant Income Type | N/A | PredominantIncomeTypeTxt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Covenant International Insurance Company Ltd | |||||||||||||
| Crawford House 50 Cedar Avenue | Hamilton | BD | Insurance | BD | N/A | C | 0 | ||||||
| Covenant Trust Company | |||||||||||||
| Financial Services | N/A | C | 0 | 8303 West Higgins Road 6th Floor | Chicago | IL | 60631 | 363583163 | IL | ||||
| Swedish Covenant Management Services Inc (SCMS) | |||||||||||||
| Physician Practice Management | N/A | C | 0 | 5145 North California Avenue | Chicago | IL | 60625 | 364073303 | IL | ||||
| Swedish Covenant Managed Care Alliance (SCMCA) | |||||||||||||
| Physician - Hospital Organization | N/A | C | 0 | 2740 West Foster Avenue Suite 409 | Chicago | IL | 60625 | 364118659 | IL | ||||
| St Francis Health Care Ltd | |||||||||||||
| Independent Group of Physicians | N/A | C | 0 | 2740 West Foster Avenue Suite 002 | Chicago | IL | 60625 | 363208131 | IL | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt |
|---|---|
| Covenant Retirement Communities Inc | |
| Q | $1,636,289 |
| Covenant Retirement Communities Inc | |
| A | $613,152 |
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