FURP.ORG / PUBLIC DATA EXPLORER

BENEDICTINE LIVING COMMUNITY OF MORA: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
BENEDICTINE LIVING COMMUNITY OF MORA (EIN 27-4219119)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-02-11
IRS object ID
201320429349300837
Schema version
2011v1.5
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)
Timestamp2013-02-11T12:11:53-08:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN274219119EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BENEDICTINE LIVING COMMUNITY OF MORABusinessNameLine1
Business Name Line2dba ST CLARE LIVING COMMUNITY OF MORABusinessNameLine2
FieldValueIRS element (for citing)
Name ControlBENENameControl
Phone7636891162Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11995 E RUM RIVER DRIVE SAddressLine1
CityCAMBRIDGECity
StateMNState
ZIP Code55008ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKEVIN RYMANOWSKIName
TitleCFOTitle
Date Signed2013-02-11DateSigned
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJACK L'HEUREUXNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11995 E RUM RIVER DRIVE SAddressLine1
CityCAMBRIDGECity
StateMNState
ZIP Code55008ZIPCode
FieldValueIRS element (for citing)
Gross Receipts6579163GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.bhshealth.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2010YearFormation
State Legal DomicileMNStateLegalDomicile
Activity Or Mission DescriptionOur mission is to witness to God's love by providing compassionate, quality care with special concern for the underserved and those in need.ActivityOrMissionDescription
Nbr Voting Members Governing Body3NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees149TotalNbrEmployees
Total Nbr Volunteers50TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year1338ContributionsGrantsPriorYear
Contributions Grants Current Year12160ContributionsGrantsCurrentYear
Program Service Revenue Prior Year2774963ProgramServiceRevenuePriorYear
Program Service Revenue CY6566930ProgramServiceRevenueCY
Investment Income Prior Year1503InvestmentIncomePriorYear
Investment Income Current Year73InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year2777804TotalRevenuePriorYear
Total Revenue Current Year6579163TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year9852GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY34456GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year1554425SalariesEtcPriorYear
Salaries Etc Current Year3773479SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year1311TotalFundrsngExpCurrentYear
Other Expense Prior Year1100361OtherExpensePriorYear
Other Expenses Current Year2605395OtherExpensesCurrentYear
Total Expenses Prior Year2664638TotalExpensesPriorYear
Total Expenses Current Year6413330TotalExpensesCurrentYear
Revenues Less Expenses Prior Year113166RevenuesLessExpensesPriorYear
Revenues Less Expenses CY165833RevenuesLessExpensesCY
Total Assets BOY791259TotalAssetsBOY
Total Assets EOY827953TotalAssetsEOY
Total Liabilities BOY846887TotalLiabilitiesBOY
Total Liabilities EOY716629TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-55628NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY111324NetAssetsOrFundBalancesEOY
Mission DescriptionBenedictine Living Community of Mora, dba St. Clare Living Community of Mora is a Catholic organization entrusted with advancing the health care ministry of the Benedictine Sisters of Duluth, Minnesota. Our mission is to witness to God's love by providing compassionate, quality care with special concern for the underserved and those in need.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense4955745Expense
Grants34456Grants
Revenue5571705Revenue
DescriptionSt. Clare Living Community of Mora, is a 77 bed long-term care facility in Mora, Minnesota which provides skilled nursing care to the elderly.The facility had a 87% occupancy and served 219 individuals during the fiscal year ending 6/30/12.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense846881Expense
Revenue995225Revenue
DescriptionSt. Clare Living Community of Mora, also provides a 35 unit Assisted Living facility in Mora, Minnesota.The facility had a 110% occupancy and served 52 individuals during the fiscal year ending 6/30/12.Description
FieldValueIRS element (for citing)
Total Program Service Expense5802626TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingtrueCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109628NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees149NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members3NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledMNStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonKEVIN RYMANOWSKI CFONamePerson
Telephone Number7636891162TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11995 E RUM RIVER DRIVE SAddressLine1
CityCAMBRIDGECity
StateMNState
ZIP Code55008ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (4 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
KEVIN RYMANOWSKI
CFO OF BHS40.00XX030516958226
STEVE CHIES
SVP OF BHS40.00XX033102060142
DALE THOMPSON
CEO OF BHS40.00XX0744687111422
JACK L'HEUREUX
CEO / ADMIN40.00X09078217795
FieldValueIRS element (for citing)
Total Reportable Comp Frm Rltd Orgs1471658TotalReportableCompFrmRltdOrgs
Total Other Compensation247585TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1BENEDICTINE HEALTH SYSTEMBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11995 E RUM RIVER DRIVE SAddressLine1
CityCAMBRIDGECity
StateMNState
ZIP Code55008ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesMANAGING COMPANYDescriptionOfServices
Compensation398767Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
All Other Contributions12160AllOtherContributions
Total Contributions12160TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
RESIDENT SERVICES62300055717055571705
ASSISTED LIVING623000995225995225
FieldValueIRS element (for citing)
Total Program Service Revenue6566930TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column73TotalRevenueColumn
Exclusion$73ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column6579163TotalRevenueColumn
Related Or Exempt Function Income6566930RelatedOrExemptFunctionIncome
Exclusion$73ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total30408Total
Program Services30408ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total4048Total
Program Services4048ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total3112293Total
Program Services3017920ProgramServices
Management And General94373ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total42808Total
Program Services40025ProgramServices
Management And General2783ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total367886Total
Program Services343973ProgramServices
Management And General23913ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total250492Total
Program Services234210ProgramServices
Management And General16282ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total388064Total
Program Services72097ProgramServices
Management And General315967ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total6057Total
Management And General6057ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total256998Total
Program Services256998ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total20022Total
Program Services20022ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total456543Total
Program Services437240ProgramServices
Management And General17992ManagementAndGeneral
Fundraising1311Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total82800Total
Management And General82800ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total651921Total
Program Services651921ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total10708Total
Program Services8027ProgramServices
Management And General2681ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total7800Total
Program Services5965ProgramServices
Management And General1835ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total273Total
Program Services273ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total14505Total
Program Services14505ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total90728Total
Program Services90728ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
EQUIPMENT REPAIRS / LEASES415142924712267
MISCELLANOUS5429454294
FOOD199371199371
SURCHARGE216755216755

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total107042Total
Program Services74599ProgramServices
Management And General32443ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total6413330Total
Program Services5802626ProgramServices
Management And General609393ManagementAndGeneral
Fundraising1311Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY243437BOY
EOY131479EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY522816BOY
EOY571323EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY14889BOY
EOY4506EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis105459LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec14712LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY2909BOY
EOY90747EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY7208BOY
EOY29898EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY791259BOY
EOY827953EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY797166BOY
EOY641493EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY4365BOY
EOY8088EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY45356BOY
EOY67048EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY846887BOY
EOY716629EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-55628BOY
EOY89514EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY21810EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-55628BOY
EOY111324EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY791259BOY
EOY827953EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses165833ReconcilationRevenueExpenses
Reconcilation Other Changes1119ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year1338CurrentTaxYearMinus1Year
Current Tax Year12160CurrentTaxYear
Total13498Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year2774963CurrentTaxYearMinus1Year
Current Tax Year6566930CurrentTaxYear
Total9341893Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year2776301CurrentTaxYearMinus1Year
Current Tax Year6579090CurrentTaxYear
Total9355391Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total5099355391PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year1503CurrentTaxYearMinus1Year
Current Tax Year73CurrentTaxYear
Total1576Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year1503CurrentTaxYearMinus1Year
Current Tax Year73CurrentTaxYear
Total1576Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Total0Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year2777804CurrentTaxYearMinus1Year
Current Tax Year6579163CurrentTaxYear
Total9356967Total
FieldValueIRS element (for citing)
First5 Years509XFirst5Years509
Public Support Percentage5090.00000PublicSupportPercentage509
Investment Income Percentage0.00000InvestmentIncomePercentage

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FStrueIncludedOnFS

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis89887OtherCostOrOtherBasis
Depreciation13126Depreciation
Book Value76761BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis14422OtherCostOrOtherBasis
Depreciation1586Depreciation
Book Value12836BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1150OtherCostOrOtherBasis
Book Value1150BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings90747TotalOfBookValueLandBuildings

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part XPart X : FIN48 FootnoteTax Exempt StatusBHS has been determined to qualify as a tax-exempt charitable, educational, and scientific organization under Section 501 (c)(3) of the Internal Revenue Code and also has been determined to be exempt from state income tax. The Organization follows the accounting standard for contingencies in evaluating the accounting for uncertainty in income taxes recognized in an entity's financial statements. The standard prescribes recognition and measurement of tax provisions taken or expected to be taken on a tax return that are not certain to be realized. The Organization income tax returns are subject to review and examination by federal, state, and local authorities. The Organization is not aware of any activities that would jeopardize its tax-exempt status. The Organization is not aware of any activities that are subject to tax on unrelated business income or excise or other taxes. The tax returns for the fiscal years 2009 to 2011 are open to examination by federal, local, and state authorities.
Part XI, Line 8Part XI, Line 8: Other Changes in Net Assets or Fund Balances$0 Change in Interest in Net Assets of Affiliated Foundation $9650 NET ASSETS RELEASED FROM REST. USED FOR PURCHASE OF PROP. $ -7089 INSURANCE REFUND - TRANSFERED TO PREVIOUS OWNER $ -1442
Part IV, Line 2bPart IV, Line 2b: Explanation of escrow account liabilityCARETAKER OF RESIDENT TRUST FUNDS IN A SEPARATE ACCOUNT.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1BENEDICTINE HEALTH SYSTEMBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11995 E RUM RIVER DRIVE SAddressLine1
CityCAMBRIDGECity
StateMNState
ZIP Code55008ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient411531892EINOfRecipient
IRC Section501 (C) 3IRCSection
Amount Of Cash Grant30408AmountOfCashGrant
Amount Of Non Cash Assistance0AmountOfNonCashAssistance
Purpose Of GrantCAPITAL FUND / SUPPORTPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantSCHOLARSHIPSTypeOfGrant
Number Of Recipients3NumberOfRecipients
Amount Of Cash Grant4048AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierGrantmaker's Description of How Grants are UsedIdentifier
ExplanationSt. Clare Living Community of Mora offers employees tuition payment through an educational assistance plan that complies with Section 127 of the Internal Revenue Code and the Minnesota Nursing Facility Employee Scholarship Fund (Bulletin #01-62-05).To provide payment for expenses incurred by eligible Senior Care employees for the successful completion of approved courses that lead to career advancement.TRANSFERS BETWEEN RELATED ORGANIZATIONS ARE ACCOUNTED FOR IN INTERNAL FINANCIAL STATEMENTS, OF WHICH ALL ARE UNDER COMMON CONTROL.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
STEVE CHIES
2372084779446018490751106739116249075
KEVIN RYMANOWSKI
2237064441537048373902083636339537390
DALE THOMPSON
456495120375167817948491657385610994849

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSch J, Part III, Additional InformationIdentifier
Return ReferencePart III, Additional InformationReturnReference
ExplanationDALE THOMPSON CEO, STEVE CHIES VP, AND KEVIN RYMANOWSKI CFO OF BENEDICTINE HEALTH SYSTEM 41-1531892 SHARE THEIR TIME BETWEEN THE REPORTING ORGANIZATION AND RELATED ORGANIZATIONS.THE CEO IS COMPENSATED BY BENEDICTINE HEALTH SYSTEM, A RELATED ORGANIZATION. THIS ORGANIZATION USES THE FOLLOWING TO SET CEO / ADMINISTRATIVE COMPENSATIONS:1. COMPENSATION COMMITTEE2. INDEPENDENT COMPENSATION CONSULTANT3. WRITTEN EMPLOYMENT CONTRACT4. COMPENSATION SURVEY OR STUDY5. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
OFFICER COMPENSATIONDALE THOMPSON CEO, STEVE CHIES VP, AND KEVIN RYMANOWSKI CFO OF BENEDICTINE HEALTH SYSTEM 41-1531892 SHARE THEIR TIME BETWEEN THE REPORTING ORGANIZATION AND THE FOLLOWING RELATED ORGANIZATIONS.ARROWHEAD SENIOR LIVING COMMUNITY41-1978619BENEDICTINE CARE CENTERS41-1907571BENEDICTINE HEALTH CENTER41-1381401BENEDICTINE HEALTH SYSTEM 41-1531892BENEDICTINE HEALTH SYSTEM FOUNDATION41-1513014BENEDICTINE LIVING COMMUNITIES41-1639687BENEDICTINE LIVING COMMUNITIES -BISMARCK INC.26-4376543BENEDICTINE LIVING COMMUNITY OF MORA27-4219119BENEDICTINE LIVING COMMUNITY OF NEW LONDON27-4218436BENEDICTINE LIVING COMMUNITY OF SPOONER45-0700468BENEDICTINE LIVING COMMUNITY OF ST. PETER86-1113231BENEDICTINE LIVING COMMUNITY OF WINSTED27-4219293BENEDICTINE SENIOR LIVING COMMUNITY OF ST PETER27-2716531BRIDGES CARE COMMUNITY26-2620983CENERITY SENIOR CARE36-3517696CERENITY CARE CENTER - WHITE BEAR LAKE41-1983267CITY OF LAKES CARE CENTER41-1985663ELLENDALE EVERGREEN PLACE, INC41-1796445LIVING COMMUNITY OF ST. JOSEPH41-2011661MADONNA MEADOWS OF ROCHESTER47-0855891MADONNA TOWERS OF ROCHESTER, INC41-1809914NAZARETH LIVING CENTER43-1450394ROSEWOOD COURT41-2011389SAINT ANNE OF WINONA41-0850791ST. GERTRUDE'S HEALTH CENTER41-1848720STEELE COUNTY COMMUNITIES FOR A LIFETIME INC27-0705237STEEPLE POINTE SENIOR LIVING COMMUNITY41-1852273TEKAWITHA NURSING CENTER, INC41-1809912VILLA ST. BENEDICT36-4343235VILLA ST. VINCENT 41-1352227BLC OF RED WING 45-4929398BLC OF WAHPETON 45-4274091
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableNOT AVAILABLE TO PUBLICForm 990, Part VI, Line 19
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsThis Corporation shall not enter into any contract or transaction with (a) its Director or officer or a member of the family of a Director or an officer; (b) a director or officer of a related organization (within the meaning of Minnesota Statutes, section 317A.011, Subd. 18) or a member of the family of a director or officer of a related organization; or (c) an organization in or of which this Corporation's Director or officer is a director, officer or legal representative or has a material financial interest; unless the material facts as to the contract or transaction and as to the director's or officer's interest are fully disclosed or known to the Board of Directors, and the Board of Directors authorizes, approves, or ratifies the contract or transaction in good faith by the affirmative vote (without counting any interested Director) of a majority of the entire Board of Directors, at a meeting at which there is a quorum without counting any interested Director. For purposes of these Bylaws, "member of the family" of a director or officer shall mean a spouse, parent, child, spouse of a child, brother, sister, or spouse of a brother or sister, of the director or officer. Failure to comply with the provisions of this section shall not invalidate any contract or transaction to which this Corporation is a party. The provisions of this section shall not apply to any contracts or transaction between or among BHS and its Subsidiaries.Form 990, Part VI, Line 12c
Form 990, Part VI, Line 11: Form 990 Review ProcessAN ELECTRONIC COPY OF THE FORM 990 WAS DISTRIBUTED PRIOR TO FILING.Form 990, Part VI, Line 11
Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or ShareholdersBenedictine Health System has certain Reserved Powers relating to the activities of the Corporation as set out in the Corporation's By-Laws. In addition, in keeping with the Corporation's mission "to assist and coordinate activities of facilities for health care, education, and care for the aged and social services in accordance with the charitable works tradition of the Roman Catholic Church", all activities of the Corporation are required to be carried out in accordance with the charisms of the Benedictine Sisters Benevolent Association ("BSBA"), a civil law corporation for the Sisters of St. Benedict of St. Scholastica Monastery located in Duluth, Minnesota.Form 990, Part VI, Line 7b
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyEach Director of the Corporation is appointed by Benedictine Health System.Form 990, Part VI, Line 7a
Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderBenedictine Health System, a Minnesota nonprofit corporation, is the sole member of the Corporation.Form 990, Part VI, Line 6
Form 990, Part VI, Line 3: Description of Delegated Duties to Management CompanyThe Corporation contracts with Benedictine Health System, a related organization, for Management Services. Benedictine Health System employed the Administrator/CEO of the CorporationForm 990, Part VI, Line 3

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (18 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
BENEDICTINE LIVING COMMUNITY OF WINSTED
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008274219293NURSING HOMEMN501 (C) 39BHSfalse
BENEDICTINE LIVING COMM OF SPOONER
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008450700468NURSING HOMEMN501 (C) 39BHSfalse
BENEDICTINE LIVING COMM OF NEW LONDON
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008274218436NURSING HOMEMN501 (C) 39BHSfalse
ARROWHEAD SENIOR LIV COM
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008411978619NURSING HOMEMN501 (C) 39BHSfalse
Tekakwitha Living Center
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008411809912NURSING HOMEMN501 (C) 39BHSfalse
St Gertrudes Health & Rehab
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008411848720NURSING HOMEMN501 (C) 39BHSfalse
Saint Anne of Winona
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008410850791NURSING HOMEMN501 (C) 39BHSfalse
Madonna Towers of Rochester
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008411809914NURSING HOMEMN501 (C) 39BHSfalse
Living Community of St Joseph
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008412011661NURSING HOMEMN501 (C) 39BHSfalse
BHS FOUNDATION
503 E THIRD ST SUITE 400DULUTHMN55805411513014SUPPORTING ORGMN501 (C) 39BHSfalse
Cerenity Care Cen- White Bear Lake
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008411983267NURSING HOMEMN501 (C) 39BHSfalse
Cerenity Senior Care
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008363517696NURSING HOMEMN501 (C) 39BHSfalse
Benedictine Senior Liv at Steeple Point
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008411852273NURSING HOMEMN501 (C) 39BHSfalse
Benedictine Living Com of St Peter
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008861113231NURSING HOMEMN501 (C) 39BHSfalse
Benedictine Living Communities
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008411639687NURSING HOMEMN501 (C) 39BHSfalse
BENEDICTINE CARE CENTERS
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008411907571NURSING HOMEMN501 (C) 39BHSfalse
BENEDICTINE HEALTH CENTER
1995 E RUM RIVER DRIVE SCAMRIDGEMN55008411381401NURSING HOMEMN501 (C) 39BHSfalse
BENEDICTINE HEALTH SYSTEM
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008411531892SUPPORTIN ORGMN501 (C) 311falseN/A
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg