COVENANT LIVING WEST: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
COVENANT LIVING WEST (EIN 95-3472345)
Tax period
2012-02-01 to 2013-01-31
Filed
2013-12-11
IRS object ID
201323459349300627
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)
EIN953472345EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Covenant Retirement Communities WestBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCOVENameControl
Phone8056870701Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12550 Treasure DriveAddressLine1
CitySanta BarbaraCity
StateCAState
ZIP Code931054892ZIPCode

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 Line15700 Old Orchard RdAddressLine1
CitySkokieCity
StateILState
ZIP Code60077ZIPCode
FieldValueIRS element (for citing)
Gross Receipts79528955GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number2650GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.covenantretirement.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1975YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionCare for Senior AdultsActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees909TotalNbrEmployees
Total Nbr Volunteers184TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1355050ContributionsGrantsPriorYear
Contributions Grants Current Year1625354ContributionsGrantsCurrentYear
Program Service Revenue Prior Year68782939ProgramServiceRevenuePriorYear
Program Service Revenue CY71252501ProgramServiceRevenueCY
Investment Income Prior Year4037656InvestmentIncomePriorYear
Investment Income Current Year5219430InvestmentIncomeCurrentYear
Other Revenue Prior Year1525072OtherRevenuePriorYear
Other Revenue Current Year1328412OtherRevenueCurrentYear
Total Revenue Prior Year75700717TotalRevenuePriorYear
Total Revenue Current Year79425697TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year52538GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY61891GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year28301187SalariesEtcPriorYear
Salaries Etc Current Year30186366SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year778019TotalFundrsngExpCurrentYear
Other Expense Prior Year40025637OtherExpensePriorYear
Other Expenses Current Year41648160OtherExpensesCurrentYear
Total Expenses Prior Year68379362TotalExpensesPriorYear
Total Expenses Current Year71896417TotalExpensesCurrentYear
Revenues Less Expenses Prior Year7321355RevenuesLessExpensesPriorYear
Revenues Less Expenses CY7529280RevenuesLessExpensesCY
Total Assets BOY260622710TotalAssetsBOY
Total Assets EOY268258025TotalAssetsEOY
Total Liabilities BOY172278448TotalLiabilitiesBOY
Total Liabilities EOY172294351TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY88344262NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY95963674NetAssetsOrFundBalancesEOY
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
Expense24296750Expense
Revenue34831568Revenue
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 1,056 residents occupying 763 apartments as of 1/31/13 The residency for the fiscal year totaled 390,433 resident days.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense8533114Expense
Revenue10471352Revenue
DescriptionAssisted Living & Assisted Dementia: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 181 assisted living residents at 01/31/13 Assisted living residency for the fiscal year totaled 65,747 patient days.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense21671482Expense
Grants61891Grants
Revenue27269583Revenue
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 216 skilled care patients at 01/31/13.Skilled care residency for the fiscal year totaled 80,246 patient days.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
DescriptionThe organization was involved in various community benefits projects which include the followingThe Samarkand: - Staff members volunteered a total of 285 hours of their time to various activities/events in the community including the Empty Bowls Fundraiser for a local food bank and others (equivalent to $24,988)- Residents volunteered a total of 7,349 hours to various activities/events in the community including the Empty Bowls Fundraiser for a local food bank, Operation Christmas Child project and others. - Hosted monthly student internship programs and training for nursing students from the Santa Barbara City College (equivalent to $7,025)- Provided space usage for meetings & events for small (under 35) to large groups (75+ people) including the Gideon's International dinner meetings, Montecito Covenant Church, Samarkand Neighborhood Association, Los Padres Chapter Aging Services of California, PEO, Santa Barbara Clergy Association, Community Covenant Church Luncheon, Christ the King Episcopal Church, First Presbyterian Church, Prime Time Band and others (equivalent to $54,391)- Participated in the Recycling project and conversion to Reclaimed Water Irrigation project (equivalent to $80,200)- Monetary Donations to Alaska Christian College, American Bible Society, Bridges of Hope, Casa Esperanza, Covenant Radio for Russia, Covenant Women's Project, Compassion Mercy and Justice, Covenant Hispanic Seminary, Covenant World Mission, Covenant World Relief, Domestic Violence Solutions, Habitat for Humanity, International Bible Society, KICY Radio Alaska, Life Network, Mission Aviation Fellowship, North Park Covenant Seminary, Paul Carlson Partnership, Santa Barbara Community Development Center, Santa Barbara Community Kitchen (Casa Esperanza), Santa Barbara Rescue Mission, Santa Barbara Youth Football, The Gideon's International, The Jesus Film Project, Salvation Army of Santa Barbara, Transition House, Villa Majella and Wycliffe Bible Translators ($10,950 in Total)-In-Kind Donations to Alzheimer's Association, Purple Hearth organization, Su Casa Restaurant, low income housing (New Faulding Hotel), Empty Bowls Fundraiser and other. ($6,580 in estimated value)Covenant Village of Turlock:- Staff members volunteered a total of 2 hours of their time to the Pregnancy Run (equivalent to $253)- Residents volunteered a total of 2,347 hours in the community which includes local churches, Emanuel Hospital, Blood Bank, knitting and sewing projects for World Vision and other organization, feeding the homeless, tutoring and others.- Provided space usage for meetings/events for small (under 35) to large groups (75+ people) including different support group meetings (Alzheimer's, Loss of Spouse, Parkinson's, Peripheral Neuropathy), AARP Drivers Class, Turlock Historical Society, Barbershop rehearsals and dinner, Toastmaster meeting, Gideon's International and various bible studies, Voting place, Forum for City Election, CSU Health Fair, Mayor's Prayer Breakfast and others (equivalent to $128,000)- In kind Donations to the local churches, Goodwill, Habitat for Humanity, Joni and Friends, Off Center Thrift Store, Salvation Army, United Samaritans, and others ($5,226 estimated value)Mt. Miguel Covenant Village:- Staff members volunteered a total of 558 hours of their time in various areas of the community such as the Backpack drive, Camp Hope, Autism Walk, City on a Hill Homeless Outreach, Cultural Fair, Health Fair, Medical and Homeless outreach, San Diego Rescue Mission, Seasons of Love food drive and others (equivalent to $40,150)- Residents volunteered a total of 7,116 hours to the different areas of the community such as in local schools, local churches, knitting and sewing for various projects, bandages for Congo project, food and clothing distributions to different groups and individuals, tutoring, and others. They also donated to various groups/organizations such as the Rady Hospital, SD Rescue Mission, Polinsky Children's Center, Disabled American Veterans, Living Well Medical Clinic, SD Military Outreach Ministries, Shadow Mountain Church and others (9,468 in total)- Monetary Donations to Cultural Fair, Susan G. Komen Race for the Cure and Backpack Drive ($3,434 in total).- In-Kind Donations to Camp Hope, Grace Covenant Church, Rady Children's Hospital, and SD Military Outreach Ministries ($9,634 in estimated value)-Hosted student internship program for seven schools (equivalent to $36,300)-Participated in various environmental projects such as irrigation upgrades and using energy efficient roofing (equivalent to $91,319)- Provided space usage for meetings and community events for small (under 35) to large groups (75+ people) including Aqua Fitness/Water Aerobics program, Health Literacy Physical Fitness, Cultural Fair, Health Fair, Recycling Fair, Christmas Boutique, National Applique Society, AARP Driving Class, Accordion Lovers Society International, various music events, Flag Raising ceremony, Breakfast Club, Polling place, and others (equivalent to $791,750)Covenant Shores:- Staff members volunteered a total of 287 hours in different areas in the community including Having Conversation events at local churches, NWU and Seattle University nursing student training, Senior Wellness Fair and others (equivalent to $17,250)- Residents volunteered a total of 13,080 hours to various areas in the community including the various knitting and sewing projects such as Stitches from the Heart, local schools, churches, hospitals and nursing homes, Rotary International Salvation Army, Museum of Flight and others. They also raised $125 from Silent Auction and In-Kind Donations to Asian Counseling and Referral Services (equivalent to $230)- Provided space usage for nursing training for NWU and Seattle University, Dementia class, Leading Age activity forum, M.I. Covenant Church and First Covenant Church picnics, Senior Wellness, Solemates Walking Group lunch and others (equivalent to $73,000)-Provided scholarships to individuals ($250.00 in total)- Monetary Donation to World Concern ($192 in total)- In-kind Donations to Operation Nitewatch, Bridge Ministries, Kennedy, National Senior Citizen's Day and Covenant World Mission ($4,033 in estimated value)Description
FieldValueIRS element (for citing)
Total Program Service Expense54501346TotalProgramServiceExpense
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 Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
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 Individuals1GrantsToIndividuals
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 With1096235NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees909NumberOfEmployees
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 Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Elizabeth 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 (37 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest 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
Thad D Rothrock
Executive Director40.000.00183893045244X
Anne Arakaki-Lock
Executive Director40.000.00139208035846X
Dwayne D Gabrielson
Executive Director40.000.00128656054362X
Paul D Peterson
Executive Director40.000.00144528047088X
Jay S Caddell
Healthcare Admin40.000.00120107013533X
Urbano B Lopez
LPN Spvr. Non-Direct Care40.000.0010069702145X
FieldValueIRS element (for citing)
Total Reportable Comp From Org817089TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2557824TotalReportableCompFrmRltdOrgs
Total Other Compensation825953TotalOtherCompensation
Number Individuals GT100 K6NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Sodexo Inc & Affiliates
Dept 43283Los AngelesCA900883283Dining Services2332832
Aegis Therapies
PO Box 8103Fort SmithAR72902Therapy Services835221
Pannel Construction Company
9623 Kenora LaneSpring ValleyCA91977Maintenance/Construction Services726345
Hallmark Rehabilitation
27442 Portola Parkway Suite 200Foothill RanchCA92610Therapy Services131499
Isan Najera
18325 52nd Ave W 169LynnwoodWA98037Painting Services119198
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Fundraising Events124277FundraisingEvents
All Other Contributions1501077AllOtherContributions
Total Contributions1625354TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Routine Services6230004357453943574539
Entrance Fees6230001191849811918498
Medicare/Medicaid62300091701909170190
Ancillary Services62300061067726106772
Meals623000482502482502
FieldValueIRS element (for citing)
Total Program Service Revenue71252501TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3762598TotalRevenueColumn
Exclusion$3,762,598ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real84827Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real76417Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real8410Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column8410TotalRevenueColumn
Exclusion$8,410ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1456832Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1456832Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1456832TotalRevenueColumn
Exclusion$1,456,832ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events26841GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events124277CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses26841FundraisingDirectExpenses

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 Services623000896636896636
Services to Residents623000139925139925

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column283441TotalRevenueColumn
Related Or Exempt Function Income283441RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue1320002TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column79425697TotalRevenueColumn
Related Or Exempt Function Income72572503RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$5,227,840ExclusionAmount

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total61891Total
Program Services61891ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total213276Total
Management And General213276ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total23289605Total
Program Services19644183ProgramServices
Management And General3521711ManagementAndGeneral
Fundraising123711Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total911819Total
Program Services745350ProgramServices
Management And General160387ManagementAndGeneral
Fundraising6082Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3915099Total
Program Services3336874ProgramServices
Management And General576936ManagementAndGeneral
Fundraising1289Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1856567Total
Program Services1453687ProgramServices
Management And General393393ManagementAndGeneral
Fundraising9487Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total416076Total
Program Services416076ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total142966Total
Management And General142966ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total8809Total
Management And General8809ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5414748Total
Program Services4615767ProgramServices
Management And General797623ManagementAndGeneral
Fundraising1358Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total848433Total
Program Services1025ProgramServices
Management And General843966ManagementAndGeneral
Fundraising3442Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3203490Total
Program Services2633940ProgramServices
Management And General553156ManagementAndGeneral
Fundraising16394Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total747793Total
Program Services2785ProgramServices
Management And General744573ManagementAndGeneral
Fundraising435Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4015126Total
Program Services4015126ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total106504Total
Program Services33416ProgramServices
Management And General73088ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total145957Total
Program Services15165ProgramServices
Management And General130792ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total4647552Total
Program Services3522450ProgramServices
Management And General1068937ManagementAndGeneral
Fundraising56165Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total8517161Total
Program Services6456238ProgramServices
Management And General1958947ManagementAndGeneral
Fundraising101976Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total913804Total
Program Services913804ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Related Party Activity51297289804679707449041
Dining Services30363173036317
Resident Care19981301998130
Admin & General18929451353029539916

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total462621Total
Program Services245113ProgramServices
Management And General208869ManagementAndGeneral
Fundraising8639Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total71896417Total
Program Services54501346ProgramServices
Management And General16617052ManagementAndGeneral
Fundraising778019Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY210504BOY
EOY63838EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY107126BOY
EOY96917EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY1577110BOY
EOY1788041EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY3099883BOY
EOY2710017EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY420377BOY
EOY256971EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY423177BOY
EOY399904EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis220507335LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec96186735LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY120649844BOY
EOY124320600EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY43994909BOY
EOY40325466EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY19271083BOY
EOY23625857EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY70868697BOY
EOY74670414EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY260622710BOY
EOY268258025EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2364792BOY
EOY2449503EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY59917398BOY
EOY59475936EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY70252741BOY
EOY69032334EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY749118BOY
EOY657182EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY38994399BOY
EOY40679396EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY172278448BOY
EOY172294351EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY85689426BOY
EOY93218707EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2611943BOY
EOY2700452EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY42893BOY
EOY44515EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY88344262BOY
EOY95963674EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY260622710BOY
EOY268258025EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses7529280ReconcilationRevenueExpenses
Reconcilation Other Changes90132ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
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 Years969650CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years770727CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1090543CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1355050CurrentTaxYearMinus1Year
Current Tax Year1625354CurrentTaxYear
Total5811324Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years60030554CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years65618602CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years66153466CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year68782939CurrentTaxYearMinus1Year
Current Tax Year71252501CurrentTaxYear
Total331838062Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years61000204CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years66389329CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years67244009CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year70137989CurrentTaxYearMinus1Year
Current Tax Year72877855CurrentTaxYear
Total337649386Total

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 Total509337649386PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3476399CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6049754CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3529628CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4037656CurrentTaxYearMinus1Year
Current Tax Year5219430CurrentTaxYear
Total22312867Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3476399CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6049754CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3529628CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4037656CurrentTaxYearMinus1Year
Current Tax Year5219430CurrentTaxYear
Total22312867Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years64476603CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years72439083CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years70773637CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year74175645CurrentTaxYearMinus1Year
Current Tax Year78097285CurrentTaxYear
Total359962253Total
FieldValueIRS element (for citing)
Public Support Percentage5090.93800PublicSupportPercentage509
Prior Year Support Percentage0.93900PriorYearSupportPercentage
Investment Income Percentage0.06200InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.06100PriorYrInvestIncomePercentage
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

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance42893BeginningOfYearBalance
Contributions0Contributions
Investment Earnings Or Losses-1622InvestmentEarningsOrLosses
End Of Year Balance41271EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Contributions42980Contributions
Investment Earnings Or Losses-87InvestmentEarningsOrLosses
End Of Year Balance42893EndOfYearBalance
FieldValueIRS element (for citing)
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis4884038OtherCostOrOtherBasis
Book Value4884038BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis178702714OtherCostOrOtherBasis
Depreciation79230572Depreciation
Book Value99472142BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis28207406OtherCostOrOtherBasis
Depreciation14613741Depreciation
Book Value13593665BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis8713177OtherCostOrOtherBasis
Depreciation2342422Depreciation
Book Value6370755BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings124320600TotalOfBookValueLandBuildings

Other Securities OtherSecurities (6 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
Mortgages2258357F
Domestic Equity3134602F
International Equity4981990F
Hedge Funds & Derivatives8241858F
Private Equity3703232F
International Real Estate1305818F
FieldValueIRS element (for citing)
Total Of Book Value Securities23625857TotalOfBookValueSecurities

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
Unamortized Debt & Related Expenses847990
Other Investments2483075
Unamortized Original Issue Discount240393
Intercompany Advance Accounts71098956
FieldValueIRS element (for citing)
Total Book Value Other Assets74670414TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Deferred Revenue Subject to Refund$23,258,362
Refundable Contract Liabilities$16,123,481
Accrued Taxes & Employee Benefits$185,207
Other Liabilities$1,112,346
FieldValueIRS element (for citing)
Total Of Amounts40679396TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part IV, Line 2b:Part IV, line 2b: 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. 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: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:

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1CS Benefit DinnerNameOfEvent1
Gross Receipts Event140660GrossReceiptsEvent1
Charitable Contributions Event132893CharitableContributionsEvent1
Gross Revenue Event17767GrossRevenueEvent1
Rent Facility Costs Event11746RentFacilityCostsEvent1
Food And Beverage Event12685FoodAndBeverageEvent1
Entertainment Event1600EntertainmentEvent1
Other Direct Expenses Event12736OtherDirectExpensesEvent1
Name Of Event2MMCV Benefit DinnerNameOfEvent2
Gross Receipts Event267710GrossReceiptsEvent2
Charitable Contributions Event260663CharitableContributionsEvent2
Gross Revenue Event27047GrossRevenueEvent2
Other Direct Expenses Event27047OtherDirectExpensesEvent2
Total Number Of Other Events2TotalNumberOfOtherEvents
Gross Receipts Other Events42748GrossReceiptsOtherEvents
Charitable Contrib Other Events30721CharitableContribOtherEvents
Gross Revenue Other Events12027GrossRevenueOtherEvents
Food And Beverage Other Events5111FoodAndBeverageOtherEvents
Entertainment Other Events750EntertainmentOtherEvents
Other Direct Expenses Other Events6166OtherDirectExpensesOtherEvents
Gross Receipts Total151118GrossReceiptsTotal
Charitable Contributions Total124277CharitableContributionsTotal
Gross Revenue Total Events26841GrossRevenueTotalEvents
Rent Facility Costs Total Events1746RentFacilityCostsTotalEvents
Food And Beverage Total Events7796FoodAndBeverageTotalEvents
Entertainment Total Events1350EntertainmentTotalEvents
Other Direct Expenses Total Events15949OtherDirectExpensesTotalEvents
Direct Expense Summary Events26841DirectExpenseSummaryEvents
Net Income Summary0NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantGood Neighbor FundTypeOfGrant
Number Of Recipients8NumberOfRecipients
Amount Of Cash Grant61891AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: When a resident's financial need becomes known, consideration is given by the executive director of the facility to determine if the resident qualifies for assistance based on the guidelines established for the fund. Each expenditure from the fund is approved by the executive director. In addition, each year the executive director authorizes an amount from the fund to be released for purposes of hiring an additional social worker to tend to residents daily needs in the skilled nursing facility. This staffing is unique to skilled nursing facilites and is beyond statutory requirements for activities or social work at licensed skilled nursing facilities.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
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 (12 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
Thad D Rothrock
Executive Director1588720138130112080232820242340231409000
Anne Arakaki-Lock
Executive Director117766010269011173033346066960179250000
Dwayne D Gabrielson
Executive Director114438000142180347360268470190239048780
Paul D Peterson
Executive Director13298308711028340236020272130195343000

Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Line 1aPart I, Line 1a: The following are available benefits and are treated as taxable compensation: - Health club dues paid for two (2) senior-level employees. - Housing allowance provided for one (1) senior-level employee.
Part I, Line 3Part I, Line 3: See 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 Thad D. Rothrock - $15,805.00 Dwayne D. Gabrielson - $17,011.48 Anne A. Arakaki-Lock - $14,729.35 Paul D. Peterson - $15,883.00
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, Covenant Retirement Communties West provided $1,506,347 of 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 Retirement Communities West delegated control over management duties to Covenant Retirement Communities, Inc. (CRC), its parent organization.
Form 990, Part VI, Section A, line 6The sole member of Covenant Retirement Communities West (CRC-West) 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 conflicts of interest. 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 15bCovenant 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 Information for Directors and Officers:Form 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 Organization:Form 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 88,510. Change in Permanently Restricted Net Assets not included on Income Stmnt 1,622.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsDirect Controlling Entity NADirectControllingEntityNA
The Samarkand
2550 Treasure DriveSanta BarbaraCA93105953472345Continuing Care Retirement CommunityCA2341779587537591N/A
Covenant Village of Turlock
2125 North Olive AveTurlockCA95380953472345Continuing Care Retirement CommunityCA1435010762992183N/A
Mount Miguel Covenant Village
325 Kempton StreetSpring ValleyCA91977953472345Continuing Care Retirement CommunityCA2161398564140593N/A
Covenant Shores
9150 Fortuna DriveMercer IslandWA98040953472345Continuing Care Retirement CommunityWA2004381253587657N/A

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
8303 West Higgins RoadChicagoIL60631362167730ChurchIL501(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 AveHamiltonBDInsuranceBDN/A0
Covenant Trust Company
Financial ServicesN/A05215 Old Orchard Rd Suite 725SkokieIL60077363583163ILC
Swedish Covenant Management Services Inc (SCMS)
Physician Practice ManagementN/A05145 N California AvenueChicagoIL60625364073303ILC
Swedish Covenant Managed Care Alliance (SCMCA)
Physician - Hospital OrganizationN/A02740 W Foster 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 (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Covenant Retirement Communities Inc
A1372772
Covenant Retirement Communities Inc
P3508465
Covenant Trust Company
P446821

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