COVENANT LIVING OF FLORIDA INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
COVENANT LIVING OF FLORIDA INC (EIN 52-1115870)
Tax period
2012-02-01 to 2013-01-31
Filed
2013-12-11
IRS object ID
201313459349300626
Schema version
2012v2.1
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

FieldValueIRS element (for citing)
Timestamp2013-12-11T13:58:25-06:00Timestamp
Tax Period End Date2013-01-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-02-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN521115870EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Covenant Village of Florida IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCOVENameControl
Phone9544722860Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line19215 W Broward Blvd No 100AddressLine1
CityPlantationCity
StateFLState
ZIP Code33324ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameElizabeth BuikemaName
TitleVP of Finance/CFOTitle
Phone7738782294Phone
Date Signed2013-12-11DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonElizabeth BuikemaNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1c/o CRC - 5700 Old Orchard RdAddressLine1
CitySkokieCity
StateILState
ZIP Code60077ZIPCode
FieldValueIRS element (for citing)
Gross Receipts16442471GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number2650GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.covenantretirement.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1978YearFormation
State Legal DomicileFLStateLegalDomicile
Activity Or Mission DescriptionCare for senior adults.ActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees236TotalNbrEmployees
Total Nbr Volunteers16TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year983401ContributionsGrantsPriorYear
Contributions Grants Current Year961797ContributionsGrantsCurrentYear
Program Service Revenue Prior Year14790848ProgramServiceRevenuePriorYear
Program Service Revenue CY14674726ProgramServiceRevenueCY
Investment Income Prior Year823232InvestmentIncomePriorYear
Investment Income Current Year654113InvestmentIncomeCurrentYear
Other Revenue Prior Year189763OtherRevenuePriorYear
Other Revenue Current Year145603OtherRevenueCurrentYear
Total Revenue Prior Year16787244TotalRevenuePriorYear
Total Revenue Current Year16436239TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year6460748SalariesEtcPriorYear
Salaries Etc Current Year7114859SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year318917TotalFundrsngExpCurrentYear
Other Expense Prior Year12311913OtherExpensePriorYear
Other Expenses Current Year11889169OtherExpensesCurrentYear
Total Expenses Prior Year18772661TotalExpensesPriorYear
Total Expenses Current Year19004028TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1985417RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-2567789RevenuesLessExpensesCY
Total Assets BOY52430722TotalAssetsBOY
Total Assets EOY54276617TotalAssetsEOY
Total Liabilities BOY54406775TotalLiabilitiesBOY
Total Liabilities EOY58839380TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-1976053NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-4562763NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionAs 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)MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense7099311Expense
Revenue6206091Revenue
DescriptionResidential Living: The number of persons who benefited from the services we provided for the year ended January 31, 2013 were as follows:There were a total of 245 residents, occupying 204 apartments at 01/31/2013. Residency for the fiscal year totaled 86,402 resident days.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense1333398Expense
Revenue1790701Revenue
DescriptionAssisted Living: The number of persons who benefited from the services we provided for the year ended January 31, 2013 were as follows:There were a total of 31 assisted living residents at 01/31/2013. Assisted living residency for the fiscal year totaled 11,634 patient days.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense4862840Expense
Revenue6823537Revenue
DescriptionSkilled Nursing: The number of persons who benefited from the services we provided for the year ended January 31, 2013 were as follows:There were a total of 52 skilled care patients at 01/31/2013.Skilled care residency for the fiscal year totaled 18,941 patient days.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
DescriptionThe organization was involved in various community benefits projectswhich include the following:- Staff members volunteered a total of 482 hours to variousorganizations or events in the community including Cancer Society Relay for Life, Alzheimer's Bake Sale and Walk, Heart 2 Heart, ESRN, Historical Society, Rotary Club, Boy Scout, local schools and churches and others (equivalent to $27,525)- Residents volunteered a total of 1,763 hours to various organizationsor events in the community including the Creation of Charity Bears, Bandage Rolling ministry with the Covenant Women's Ministries, local schools, churches and hospitals and others- Hosted student internship programs for Atlantic Vocational and Concord Vocational schools (equivalent to 240 staff hours and $60,150)- Provided space usage for meetings/events for small (under 35) tolarge groups (75+ people) including an ESRN Meetings, Nova SouthernUniversity Lifelong Learning Class, Alzheimer's Support Group, Leading Age, Thursday at 2, Girl Scout Troop meetings, various arts and music events such as Suzuki Violin, Sunshine Chordsmen, and recitals, fitness events such as Yoga and Zumba, Ann Stork Benefit and Fundraising Event, Polling Place and others (equivalent to $210,600)- In-Kind donations to the Bethesda Alliance Church, Immanuel Baptist Church, Eglise Baptiste Bethanie, Escarment Foundation for the Needy, Salvation Army, Faith Farm, Goodwill and Miami Rescue Mission (estimated value of $18,422)Description
FieldValueIRS element (for citing)
Total Program Service Expense13295549TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling1CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org1TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109643NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees236NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members20NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address1OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Elizabeth B BuikemaBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7738782294TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1C/O CRC 5700 Old Orchard RdAddressLine1
CitySkokieCity
StateILState
ZIP Code60077ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (33 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
Jon P Aagaard MD
Director1.001.00X000
Curtis B Anderson
Director1.001.00X000
Rev Richard B Berry
Director1.001.00X000
Pamela Christensen
Director1.001.00X000
Wendell Danielson
Director1.001.00X000
Rev Harvey Drake
Director1.001.00X000
Mark C Eastburg
Director1.001.00X000
James Elving
Director1.001.00X000
Marc E Espinosa
Director1.001.00X000
Carol A Findling
Director1.001.00X000
Lorene G Flewellen
Director1.001.00X000
Rhoda Friesen
Director1.001.00X000
Thomas F Heywood
Director1.001.00X000
Donald Hodgkinson
Director1.001.00X000
Jody Holt
Director1.001.00X000
Cletus J Moll
Director1.001.00X000
Joyce Peterson
Director1.001.00X000
Walter Schiller
Director1.001.00X000
Marlene Stante
Director1.001.00X000
Anne Vining
Director1.001.00X000
David A Dwight
Ex-Officio1.0040.00X0581280129403
Rick K Fisk
Ex-Officio/President1.0040.00X059426561092X
Scott MacDonald
Ex-Officio1.001.00X000
Gary Walter
Ex-Officio1.0040.00X0157472117568
Steven P Anderson
Senior VP/Asst Secretary1.0040.0002932512327X
Elizabeth B Buikema
Senior VP/CFO/Treasurer1.0040.00027655662425X
Moraine M Byrne
Senior VP/Asst Secretary1.0040.0007335247422X
Terri S Cunliffe
EVP of Oper/Asst Sec1.0040.00026639887577X
John R Harriff
Senior VP/Asst Secretary1.0040.00023600710277X
David G Erickson
VP/Asst Secretary1.0040.00021031344208X
Kathleen Jenkins
Dir Admin Srvcs/Asst Secretary1.0040.00013285655436X
Judith I Johnson
Healthcare Administrator40.000.00118587021548X
Charles W Johnson
Executive Director40.000.00128430042723X
FieldValueIRS element (for citing)
Total Reportable Comp From Org247017TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2557824TotalReportableCompFrmRltdOrgs
Total Other Compensation692006TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Sodexo Inc & AffiliatesBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14880 Paysphere CircleAddressLine1
CityChicagoCity
StateILState
ZIP Code60674ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesDining ServicesDescriptionOfServices
Compensation423420Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Fundraising Events8756FundraisingEvents
Related Organizations300000RelatedOrganizations
All Other Contributions653041AllOtherContributions
Total Contributions961797TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Routine Services62300080611268061126
Medicare/Medicaid62300024841112484111
Entrance Fee62300022728562272856
Ancillary Services62300018101271810127
Meals6230004650646506
FieldValueIRS element (for citing)
Total Program Service Revenue14674726TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column546875TotalRevenueColumn
Exclusion$546,875ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities107238Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities107238Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column107238TotalRevenueColumn
Exclusion$107,238ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events6232GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events8756CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses6232FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Support Services6230005953559535
Services to Resident6230002999129991

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column56077TotalRevenueColumn
Related Or Exempt Function Income56077RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue145603TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column16436239TotalRevenueColumn
Related Or Exempt Function Income14820329RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$654,113ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total5634304Total
Program Services4600458ProgramServices
Management And General1011677ManagementAndGeneral
Fundraising22169Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total170768Total
Program Services135249ProgramServices
Management And General34726ManagementAndGeneral
Fundraising793Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total849635Total
Program Services739906ProgramServices
Management And General108428ManagementAndGeneral
Fundraising1301Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total460152Total
Program Services370636ProgramServices
Management And General87766ManagementAndGeneral
Fundraising1750Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total25155Total
Program Services25155ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total22764Total
Management And General22764ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total1920Total
Management And General1920ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1209164Total
Program Services726895ProgramServices
Management And General482111ManagementAndGeneral
Fundraising158Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total369501Total
Program Services710ProgramServices
Management And General368791ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total890266Total
Program Services688587ProgramServices
Management And General201679ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total111166Total
Management And General111166ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1050368Total
Program Services1050368ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total20653Total
Program Services10780ProgramServices
Management And General9873ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total21295Total
Program Services7025ProgramServices
Management And General14270ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2185627Total
Program Services1517700ProgramServices
Management And General611975ManagementAndGeneral
Fundraising55952Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2644748Total
Program Services1840227ProgramServices
Management And General740529ManagementAndGeneral
Fundraising63992Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total291752Total
Program Services291752ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralFundraisingFundraisingProgram ServicesProgramServices
Related Party Activity965526793968171558
Dining Services693954693954
Resident Care553725553725
Admin & General31426529507319192

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total517320Total
Program Services23230ProgramServices
Management And General492846ManagementAndGeneral
Fundraising1244Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total19004028Total
Program Services13295549ProgramServices
Management And General5389562ManagementAndGeneral
Fundraising318917Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY136975BOY
EOY14135EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3685BOY
EOY3581EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY778185BOY
EOY592557EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY987628BOY
EOY2506427EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY92986BOY
EOY72799EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis61752041LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec26546351LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY34757379BOY
EOY35205690EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY13247281BOY
EOY13657927EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY2091730BOY
EOY1918449EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY334873BOY
EOY305052EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY52430722BOY
EOY54276617EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY688608BOY
EOY739223EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY9520738BOY
EOY9427317EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY28746429BOY
EOY28384553EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY69650BOY
EOY58581EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY15381350BOY
EOY20229706EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY54406775BOY
EOY58839380EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-2391809BOY
EOY-4959598EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY415756BOY
EOY396835EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-1976053BOY
EOY-4562763EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY52430722BOY
EOY54276617EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-2567789ReconcilationRevenueExpenses
Reconcilation Other Changes-18921ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement BothXFinancialStatementBoth
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5060261CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years383458CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years624287CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year683401CurrentTaxYearMinus1Year
Current Tax Year661797CurrentTaxYear
Total7413204Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years13957697CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years14661376CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years14752243CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14790848CurrentTaxYearMinus1Year
Current Tax Year14674726CurrentTaxYear
Total72836890Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years19017958CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years15044834CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years15376530CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year15474249CurrentTaxYearMinus1Year
Current Tax Year15336523CurrentTaxYear
Total80250094Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50980250094PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years707496CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1129990CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years875020CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year823232CurrentTaxYearMinus1Year
Current Tax Year654113CurrentTaxYear
Total4189851Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years707496CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1129990CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years875020CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year823232CurrentTaxYearMinus1Year
Current Tax Year654113CurrentTaxYear
Total4189851Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years19725454CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years16174824CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years16251550CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year16297481CurrentTaxYearMinus1Year
Current Tax Year15990636CurrentTaxYear
Total84439945Total
FieldValueIRS element (for citing)
Public Support Percentage5090.95040PublicSupportPercentage509
Prior Year Support Percentage0.94650PriorYearSupportPercentage
Investment Income Percentage0.04960InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.05350PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtc
Included On FS1IncludedOnFS
Explanation In Part XIIIXExplanationInPartXIII

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis565255OtherCostOrOtherBasis
Book Value565255BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis50509213OtherCostOrOtherBasis
Depreciation22515942Depreciation
Book Value27993271BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis7970549OtherCostOrOtherBasis
Depreciation3381262Depreciation
Book Value4589287BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2707024OtherCostOrOtherBasis
Depreciation649147Depreciation
Book Value2057877BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings35205690TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
Deferred Revenue Subject to Refund$4,189,151
Refundable Contract Liabilities$1,868,083
Accrued Taxes & Employee Benefits$42,263
Inter-company Advance Accounts$13,938,476
Other Liabilities$191,733
FieldValueIRS element (for citing)
Total Of Amounts20229706TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt15929263TotRevenueEtcAuditedFinclStmt
Other Revenues-169477OtherRevenues
Revenue Not Rptd F990-169477RevenueNotRptdF990
Revenue Subtotal16098740RevenueSubtotal
Other Revenues Not Included337499OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt337499RevenueNotRptdOnFinStmt
Total Revenue Per Form99016436239TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt18797052TotExpensesEtcAuditedFinclStmt
Other Expenses Included-37499OtherExpensesIncluded
Expenses Not Rptd F990-37499ExpensesNotRptdF990
Expenses Subtotal18834551ExpensesSubtotal
Other Expenses Not Included169477OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt169477ExpensesNotRptdOnFinStmt
Total Expenses Per Form99019004028TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part IV, Line 2b:Part IV, line 2b: Resident Entrance Fee Account: Prospective residents pay an application fee deposit which is carried in an escrow account. At move in, the deposit is applied against the total entrance fee amount and the remainder of the money is collected and put in this account. At the end of the month the resident has moved in, all money is transferred out of the escrow account.
Part X, Line 2:A FIN 48 footnote was included in the consolidated audited financial statements of Covenant Retirement Communities, Inc. and affiliates which states: "Accounting principles generally accepted in the United States of America require management to evaluate tax positions taken by the Retirement Communities and recognize a tax liability if the Retirement Communities have taken an uncertain position that more likely than not would not be sustained upon examination by the IRS or other applicable taxing authorities. Management has analyzed the tax positions taken by the Retirement Communities and has concluded that as of January 31, 2013, there are no uncertain positions taken or expected to be taken that would require recognition of a liability or disclosure in the consolidated financial statements. The Retirement communities are subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. The Retirement Communities believe they are no longer subject to U.S. federal, state, and local, or non-U.S. income tax examinations by tax authorities for years before 2010."Description of Uncertain Tax Positions Under FIN 48:
Contribution related expenses netted against contribution Revenue -198,973. Other non-operating income 29,496.Part XI, Line 2d - Other Adjustments:
Net assets transferred for benevolent care support from CRC, Inc. 300,000. Dining services revenue 46,506. Gain(Loss) - Disposal of Fixed Asset -9,007.Part XI, Line 4b - Other Adjustments:
Dining services revenue netted with Dietary expense -46,506. Gain(Loss) - Disposal of Fixed Asset 9,007.Part XII, Line 2d - Other Adjustments:
Contribution related expenses netted against contribution Revenue 198,973. Other non-operating income -29,496.Part XII, Line 4b - Other Adjustments:

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Benefit DinnerNameOfEvent1
Gross Receipts Event114988GrossReceiptsEvent1
Charitable Contributions Event18756CharitableContributionsEvent1
Gross Revenue Event16232GrossRevenueEvent1
Food And Beverage Event12778FoodAndBeverageEvent1
Entertainment Event1450EntertainmentEvent1
Other Direct Expenses Event13004OtherDirectExpensesEvent1
Gross Receipts Total14988GrossReceiptsTotal
Charitable Contributions Total8756CharitableContributionsTotal
Gross Revenue Total Events6232GrossRevenueTotalEvents
Food And Beverage Total Events2778FoodAndBeverageTotalEvents
Entertainment Total Events450EntertainmentTotalEvents
Other Direct Expenses Total Events3004OtherDirectExpensesTotalEvents
Direct Expense Summary Events6232DirectExpenseSummaryEvents
Net Income Summary0NetIncomeSummary

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
David A Dwight
Ex-Officio0503155000781250102125027278071068300
Rick K Fisk
Ex-Officio/President0412768091770089727038852022240065535700
Gary Walter
Ex-Officio01574720000028402089166027504000
Elizabeth B Buikema
Senior VP/CFO/Treasurer0212825031980031751035157030947034266000
Terri S Cunliffe
EVP of Oper/Asst Sec0198566032000035832072711017477035658600
John R Harriff
Senior VP/Asst Secretary047175016064017276806320122560248895024946
David G Erickson
VP/Asst Secretary0155845029129025339023153026818026028400
Kathleen Jenkins
Dir Admin Srvcs/Asst Secretary082597075000427590370650210410190962011185
Charles W Johnson
Executive Director106640080090137810299580158950174283000

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Line 3See Schedule O explanation for Form 990 Part VI Section B Line 15 for the methods used to determine CEO compensation.
Part I, Lines 4a-bPart I, Line 4a: John R. Harriff, an officer and Senior Vice President of Covenant Retirement Communities, Inc. (CRC) until February 2012 received $132,525 severance payment from CRC. 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 Compensation Committee of CMB's Board 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 following listed individuals participated in the Executive Benefit Plan: David Dwight - $78,482.61 Rick Fisk - $61,269.96 Elizabeth Buikema - $24,608.58 Steven P. Anderson - $19,987.26 John R. Harriff - $11,783.44 Terri Cunliffe - $21,899.90 David Erickson - $21,270.98 Kathleen Jenkins - $10,789.45 Moraine Byrne - $18,560.00 Judith I. Johnson - $11,935.12 Charles Johnson - $12,945.50
Part I, Line 7Part I, Line 7: The following applies to certain individuals listed on Part VII whose compensation is paid from related organizations: The Executive Compensation Committee (the "Committee") follows a prescribed method for calculating bonuses. 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. Refer to additional information on the Committee included in Schedule O.
Part IIIPart II, Column B (i): Base compensation for certain individuals may include payments from deferred compensation plans. Part II, Column B (ii): Bonus and incentive compensation - Certain key persons employed by CRC are eligible for incentive compensation as determined by the CRC Board Compensation Committee. Incentives paid in 2012 relate to the achievement of targets for the fiscal year ended 1/31/2012. Part II, Column C: Deferred compensation includes and estimate of the contribution made to an employer sponsored defined benefit pension plan. Part II, Column D: Nontaxable benefits include health insurance premiums paid by the employer and employee.Supplemental Information

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Mission Statement:Form 990 - Part III - Line 1As 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 Village of Florida, Inc. provided $408,645 free or discounted services to those residents unable to pay all or a portion of their charges, and who meet certain eligibility requirements.
Tax Exempt Bonds:Form 990 - Part IV - Line 24aThe organization has tax-exempt bonds issued 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 3Covenant Village of Florida, Inc. delegated control over management duties to Covenant Retirement Communities, Inc. (CRC), its parent organization.
Form 990, Part VI, Section A, line 6The sole member is Covenant Retirement Communities, Inc. (CRC).
Form 990, Part VI, Section A, line 7bS 2.4 of Bylaws include reserved powers to the [individual] 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 11Management Review: The draft Form 990 was reviewed by multiple levels of management including the President of CRC, the Vice President of Finance/CFO and the Vice President of Legal Affairs. Board Review: Prior to filing, key provisions of the Form were discussed 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 12cCovenant 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.
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 18Form 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 19Form 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.
Contact Info for Directors & OfficersForm 990 - Part VI - Line 9All of the organization's directors and officers can be contacted at this address: Covenant Retirement Communities, Inc. - 5700 Old Orchard Road, Skokie, IL 60077.
Related OrganizationForm 990 - Part VII - Section A Column BOfficers 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.
Changes in Net Assets or Fund Balances:Form 990, Part XI, line 9:Change in Temporarily Restricted Net Assets not included on Income Stmnt -18,921.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Evangelical Covenant Church
5101 North Francisco AvenueChicagoIL60625362167730ChurchIL501(c)(3)Line 1N/A0
Swedish Covenant Faculty Group (SCFG)
5145 North California AvenueChicagoIL60625363686216Patient Treatment/EducationIL501(c)(3)Line 11a, I0Swedish Covenant Hospital
Swedish Covenant Hospital
5145 North California AvenueChicagoIL60625362179813HospitalIL501(c)(3)Line 30Covenant Ministries of Benevolence
Swedish Covenant Hospital Foundation (SCHF)
5145 North California AvenueChicagoIL60625205055155Supporting Organization of SCHIL501(c)(3)Line 70Swedish Covenant Hospital
SC Insurance Company
6970 E Chauncey Lane Suite 100PhoenixAZ85054273312053InsuranceAZ501(c)(3)Line 11a, I0Swedish Covenant Hospital

Form990 Schedule R Part III Form990ScheduleRPartIII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAPredominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
Coast Asset Management LLC
2450 Colorado Ave Suite 100 E TowerSanta MonicaCA90404954763400Hedge Fund InvestmentCAN/AN/A00
Covenant Village of Portland LP
420 NE Mason StPortlandOR97211364356838Assisted Living CommunityORN/AN/A00
Swedish Covenant Surgery LLC
5215 N California AvenueChicagoIL60625272485300Outpatient Medical ServicesILN/AN/A00

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Address Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryPrimary ActivityPrimaryActivityLegal Domicile Foreign CountryLegalDomicileForeignCountryDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgAddress Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINLegal Domicile StateLegalDomicileStateType Of EntityTypeOfEntity
Covenant International Insurance Company Ltd
Crawford House 50 Cedar AvenueHamiltonBDInsuranceBDN/A0
Covenant Trust Company
Financial ServicesN/A05215 Old Orchard Road Suite 725SkokieIL60077363583163ILC
Swedish Covenant Management Services Inc (SCMS)
Physician Practice ManagementN/A05145 North California AvenueChicagoIL60625364073303ILC
Swedish Covenant Managed Care Alliance (SCMCA)
Physician - Hospital OrganizationN/A02740 West Foster Avenue Suite 409ChicagoIL60625364118659ILC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Covenant Retirement Communities Inc
P4707119
Covenant Retirement Communities Inc
O448275
covenant Retirement Communities Inc
C300000
Covenant Trust Company
P166558

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