COVENANT HEALTH CARE CENTER INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- COVENANT HEALTH CARE CENTER INC (EIN 52-1115873)
- Tax period
- 2011-02-01 to 2012-01-31
- Filed
- 2012-12-06
- IRS object ID
- 201223419349300522
- Schema version
- 2011v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-12-06T11:17:37-06:00 | Timestamp |
| Tax Period End Date | 2012-01-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-02-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 521115873 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Covenant Health Care Centers Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COVE | NameControl |
| Phone | 8474807110 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2155 Pfingsten Road | AddressLine1 |
| City | Northbrook | City |
| State | IL | State |
| ZIP Code | 60062 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Elizabeth Buikema | Name |
| Title | Senior VP - Finance/CFO | Title |
| Phone | 7738782294 | Phone |
| Date Signed | 2012-12-06 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Elizabeth Buikema | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | c/o CRC - 5700 Old Orchard Rd | AddressLine1 |
| City | Skokie | City |
| State | IL | State |
| ZIP Code | 60077 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 25036215 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Group Exemption Number | 2650 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.covenantretirement.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1969 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | Care for senior adults. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 21 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 17 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 360 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 174291 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 57362 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 23096597 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 23620982 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1295783 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1318340 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 45142 | OtherRevenuePriorYear |
| Other Revenue Current Year | 39531 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 24611813 | TotalRevenuePriorYear |
| Total Revenue Current Year | 25036215 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 12494130 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 12675018 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 33934 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 10265476 | OtherExpensePriorYear |
| Other Expenses Current Year | 10558476 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 22759606 | TotalExpensesPriorYear |
| Total Expenses Current Year | 23233494 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1852207 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1802721 | RevenuesLessExpensesCY |
| Total Assets BOY | 56892910 | TotalAssetsBOY |
| Total Assets EOY | 58754224 | TotalAssetsEOY |
| Total Liabilities BOY | 32586508 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 32640150 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 24306402 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 26114074 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | As a ministry of the Evangelical Covenant Church, Covenant Retirement Communities celebrates God's gift of life in Christian community. We follow the Great Commandment to love and serve God and one another as taught by Jesus Christ. (SEE SCHEDULE O) | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 5092302 | Expense |
| Revenue | 6573492 | Revenue |
| Description | Assisted Living & Assisted Dementia: The number of persons who benefited from the services we provided for the year ended January 31, 2012 were as follows:There were a total of 121 assisted living residents at 01/31/2012. Assisted living residency for the fiscal year totaled 43,955 patient days. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 14245432 | Expense |
| Revenue | 17087021 | Revenue |
| Description | Skilled Nursing & Skilled Dementia: The number of persons who benefited from the services we provided for the year ended January 31, 2012 were as follows:There were a total of 171 skilled care patients at 01/31/2012.Skilled care residency for the fiscal year totaled 64,937 patient days. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | The organization was involved in various community benefits projectswhich include the following:- Host site for Alzheimers' Support and Parkinsons' Support group meeting (equivalent to $132,000)- Host site for Student Internship Programs from local schools including Chamberlin, Fox Valley Career Center, NIU and Waubonsee Nursing Program (equivalent to $191,775) | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 19337734 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 1 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 1 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 21 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 17 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 1 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Elizabeth Buikema | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7738782294 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | C/O CRC 5700 Old Orchard Rd | AddressLine1 |
| City | Skokie | City |
| State | IL | State |
| ZIP Code | 60077 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (28 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| Jon P Aagaard MD | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| Curtis B Anderson | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| Rev Richard B Berry | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| Wendell Danielson | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| Rev Harvey Drake | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| James Elving | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| Marc E Espinosa | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| Lorene G Flewellen | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| Rhoda Friesen | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| Mary Miller | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| Cletus J Moll | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| Joyce Peterson | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| Norton Richards | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| Walter Schiller | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| Marlene Stante | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| Jean A Stebinger | ||||||
| Director | 1.00 | X | 0 | 0 | 0 | |
| Robert K Johnston | ||||||
| Ex-Officio | 1.00 | X | 0 | 0 | 0 | |
| David A Dwight | ||||||
| Ex-Officio | 1.00 | X | 0 | 848677 | 95681 | |
| Rick K Fisk | ||||||
| Ex-Officio/President | 1.00 | X | 0 | 897465 | 84268 | X |
| Scott MacDonald | ||||||
| Ex-Officio | 1.00 | X | 0 | 0 | 0 | |
| Gary Walter | ||||||
| Ex-Officio | 1.00 | X | 0 | 151985 | 115788 | |
| Steven P Anderson | ||||||
| Senior VP/Asst Secretary | 1.00 | 0 | 252774 | 70881 | X | |
| Elizabeth B Buikema | ||||||
| Senior VP/CFO/Treasurer | 1.00 | 0 | 358640 | 55395 | X | |
| Moraine M Byrne | ||||||
| Senior VP/Asst Secretary | 1.00 | 0 | 202945 | 47866 | X | |
| Terri S Cunliffe | ||||||
| EVP of Oper/Asst Sec | 1.00 | 0 | 350896 | 72409 | X | |
| John R Harriff | ||||||
| Senior VP/Asst Secretary | 1.00 | 0 | 273526 | 47657 | X | |
| David G Erickson | ||||||
| VP/Asst Secretary | 1.00 | 0 | 226176 | 40285 | X | |
| Kathleen Jenkins | ||||||
| Dir Admin Srvcs/Asst Secretary | 1.00 | 0 | 176448 | 70348 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3739532 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 700578 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| All Other Contributions | 57362 | AllOtherContributions |
| Total Contributions | 57362 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Routine Services | 623000 | 16821410 | 16821410 |
| Medicare/Medicaid | 623000 | 4003956 | 4003956 |
| Ancillary Services | 623000 | 2781507 | 2781507 |
| Meals | 623000 | 14109 | 14109 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 23620982 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 871832 | TotalRevenueColumn |
| Exclusion | $871,832 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 446508 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 446508 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 446508 | TotalRevenueColumn |
| Exclusion | $446,508 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Services to Residents | 623000 | 19410 | 19410 |
| Support Services | 623000 | 11767 | 11767 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 8354 | TotalRevenueColumn |
| Related Or Exempt Function Income | 8354 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 39531 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 25036215 | TotalRevenueColumn |
| Related Or Exempt Function Income | 23660513 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,318,340 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10121346 | Total |
| Program Services | 9102992 | ProgramServices |
| Management And General | 994402 | ManagementAndGeneral |
| Fundraising | 23952 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 336343 | Total |
| Program Services | 303576 | ProgramServices |
| Management And General | 31947 | ManagementAndGeneral |
| Fundraising | 820 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1464843 | Total |
| Program Services | 1290328 | ProgramServices |
| Management And General | 170500 | ManagementAndGeneral |
| Fundraising | 4015 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 752486 | Total |
| Program Services | 655307 | ProgramServices |
| Management And General | 95489 | ManagementAndGeneral |
| Fundraising | 1690 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 107284 | Total |
| Program Services | 107284 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24304 | Total |
| Management And General | 24304 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 47965 | Total |
| Management And General | 47965 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1708605 | Total |
| Program Services | 1525309 | ProgramServices |
| Management And General | 183134 | ManagementAndGeneral |
| Fundraising | 162 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4901 | Total |
| Program Services | 66 | ProgramServices |
| Management And General | 4835 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1075154 | Total |
| Program Services | 902120 | ProgramServices |
| Management And General | 169739 | ManagementAndGeneral |
| Fundraising | 3295 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 129336 | Total |
| Program Services | 8301 | ProgramServices |
| Management And General | 121035 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 556191 | Total |
| Program Services | 556191 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9822 | Total |
| Program Services | 5871 | ProgramServices |
| Management And General | 3951 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 52740 | Total |
| Program Services | 10625 | ProgramServices |
| Management And General | 42115 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1996724 | Total |
| Program Services | 1657281 | ProgramServices |
| Management And General | 339443 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1820715 | Total |
| Program Services | 1511193 | ProgramServices |
| Management And General | 309522 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 318019 | Total |
| Program Services | 318019 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Related Party Payments | 1203491 | 928 | 1202563 |
| Dining Services | 909940 | 909940 | |
| Resident Care | 365427 | 365427 | |
| Admin & General | 66983 | 20826 | 46157 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 160875 | Total |
| Program Services | 86150 | ProgramServices |
| Management And General | 74725 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23233494 | Total |
| Program Services | 19337734 | ProgramServices |
| Management And General | 3861826 | ManagementAndGeneral |
| Fundraising | 33934 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 250 | BOY |
| EOY | 150 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 45776 | BOY |
| EOY | 35072 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 974321 | BOY |
| EOY | 1882020 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 300 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31833 | BOY |
| EOY | 31133 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 41158647 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 19498306 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22567248 | BOY |
| EOY | 21660341 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11394661 | BOY |
| EOY | 10519169 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2370738 | BOY |
| EOY | 3697711 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19507783 | BOY |
| EOY | 20928628 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 56892910 | BOY |
| EOY | 58754224 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1133226 | BOY |
| EOY | 1403982 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31242856 | BOY |
| EOY | 31004450 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 48476 | BOY |
| EOY | 44523 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 161950 | BOY |
| EOY | 187195 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32586508 | BOY |
| EOY | 32640150 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24293616 | BOY |
| EOY | 26096338 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12786 | BOY |
| EOY | 17736 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24306402 | BOY |
| EOY | 26114074 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 56892910 | BOY |
| EOY | 58754224 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1802721 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 4951 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 42076 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 168263 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 41394 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 174291 | CurrentTaxYearMinus1Year |
| Current Tax Year | 57362 | CurrentTaxYear |
| Total | 483386 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 20612514 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 21558929 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 22256292 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 23096597 | CurrentTaxYearMinus1Year |
| Current Tax Year | 23620982 | CurrentTaxYear |
| Total | 111145314 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 20654590 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 21727192 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 22297686 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 23270888 | CurrentTaxYearMinus1Year |
| Current Tax Year | 23678344 | CurrentTaxYear |
| Total | 111628700 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 111628700 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 959205 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 905986 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1355567 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1295783 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1318340 | CurrentTaxYear |
| Total | 5834881 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 959205 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 905986 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1355567 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1295783 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1318340 | CurrentTaxYear |
| Total | 5834881 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 21613795 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 22633178 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 23653253 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 24566671 | CurrentTaxYearMinus1Year |
| Current Tax Year | 24996684 | CurrentTaxYear |
| Total | 117463581 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.95030 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.95310 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.04970 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.04690 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtc |
| Included On FS | 1 | IncludedOnFS |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 156030 | OtherCostOrOtherBasis |
| Book Value | 156030 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 36443380 | OtherCostOrOtherBasis |
| Depreciation | 17318763 | Depreciation |
| Book Value | 19124617 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3990937 | OtherCostOrOtherBasis |
| Depreciation | 2152759 | Depreciation |
| Book Value | 1838178 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 568300 | OtherCostOrOtherBasis |
| Depreciation | 26784 | Depreciation |
| Book Value | 541516 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 21660341 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (6 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| Mortgages | 126339 | F |
| Domestic Equity | 416496 | F |
| International Equity | 678900 | F |
| Hedge Funds & Derivatives | 1735270 | F |
| Private Equity | 474969 | F |
| International Real Estate | 265737 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 3697711 | TotalOfBookValueSecurities |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Unamortized Debt & Related Expenses | 765127 |
| Unamortized Original Issue Discount | 540980 |
| Inter-company Advance Accounts | 19622521 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 20928628 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Accrued Taxes & Employee Benefits | $63,223 |
| Other Liabilities | $123,972 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 187195 | TotalOfAmounts |
| Total Revenue | 25036215 | TotalRevenue |
| Total Expenses | 23233494 | TotalExpenses |
| Excess Or Deficit For Year | 1802721 | ExcessOrDeficitForYear |
| Other | $4,951 | OtherAmount |
| Total Adjustments | 4951 | TotalAdjustments |
| Excess Or Deficit Per FS | 1807672 | ExcessOrDeficitPerFS |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| 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: | A FIN 48 footnote was not included in the consolidated audited financial statements of Covenant Retirement Communities, Inc. and affiliates. A FIN 48 analysis was completed for Covenant Retirement Communities, Inc. and affiliates and it did not have a material impact on the financial position or results of operations. | Description of Uncertain Tax Positions Under FIN 48: |
| Change in Temporarily Restricted Net Assets not included on Income Stmnt 4,951. | Part XI, Line 8 - Other Adjustments: |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| David A Dwight | |||||||||||||
| 0 | 505032 | 0 | 0 | 0 | 343645 | 0 | 67314 | 0 | 28367 | 0 | 944358 | 0 | 0 |
| Rick K Fisk | |||||||||||||
| 0 | 401500 | 0 | 109285 | 0 | 386680 | 0 | 67384 | 0 | 23717 | 0 | 988566 | 0 | 18009 |
| Gary Walter | |||||||||||||
| 0 | 151985 | 0 | 0 | 0 | 0 | 0 | 27623 | 0 | 88165 | 0 | 267773 | 0 | 0 |
| Steven P Anderson | |||||||||||||
| 0 | 146862 | 0 | 21837 | 0 | 84075 | 0 | 52698 | 0 | 24166 | 0 | 329638 | 0 | 5634 |
| Elizabeth B Buikema | |||||||||||||
| 0 | 213636 | 0 | 38071 | 0 | 106933 | 0 | 34666 | 0 | 23948 | 0 | 417254 | 0 | 10768 |
| Moraine M Byrne | |||||||||||||
| 0 | 160778 | 0 | 21538 | 0 | 20629 | 0 | 33590 | 0 | 17108 | 0 | 253643 | 0 | 8210 |
| Terri S Cunliffe | |||||||||||||
| 0 | 169582 | 0 | 29138 | 0 | 152176 | 0 | 57714 | 0 | 17075 | 0 | 425685 | 0 | 0 |
| John R Harriff | |||||||||||||
| 0 | 128946 | 0 | 15355 | 0 | 129225 | 0 | 37805 | 0 | 16193 | 0 | 327524 | 0 | 0 |
| David G Erickson | |||||||||||||
| 0 | 149595 | 0 | 32240 | 0 | 44341 | 0 | 20060 | 0 | 23450 | 0 | 269686 | 0 | 0 |
| Kathleen Jenkins | |||||||||||||
| 0 | 80036 | 0 | 7500 | 0 | 88912 | 0 | 52257 | 0 | 20314 | 0 | 249019 | 0 | 11125 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part I, Line 3 | See Schedule O explanation for Form 990 Part VI Section B Line 15 for the methods used to determine CEO compensation. | |
| Part I, Line 4b | 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 - $78,250.81 Rick Fisk - $62,656.27 Elizabeth Buikema - $22,523.08 Steven P. Anderson - $19,775.86 John R. Harriff - $21,225.06 Terri Cunliffe - $18,594.60 David Erickson - $20,085.18 Kathleen Jenkins - $11,814.81 Moraine Byrne - $17,884.00 Pension Restoration Plan As certain individuals' pension benefits may be limited by tax code maximums on both eligible compensation and benefits, Covenant Ministries of Benevolence (CMB) provides a Pension Restoration Plan which entitles the individuals listed below to a pension benefit based on total cash compensation. David A. Dwight - $6,814 Rick K. Fisk - $25,517 | |
| Part I, Line 7 | Part I, Line 7: The following applies to certain individuals listed on Part VII whose compensation is paid from related organizations: The Executive Compensation Committee (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 III | Part 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 2011 relate to the achievement of targets for the fiscal year ended 1/31/2011. Part II, Column B (iii): Other Reportable Compensation - During the 2010 calendar year, Covenant Ministries of Benevolence (CMB) discontinued its sponsorship of a particular deferred benefit program that included employer contributions to split dollar life insurance arrangements for certain employees, including some individuals whose compensation is disclosed on this Form 990 Part VII and in Schedule J. While the sponsorship and employer contributions to the split dollar life insurance arrangements were discontinued in 2010, federal tax law rules prevented CMB from transferring the insurance policies to the affected employees, and fully terminating these arrangements, for 12 months following the Board action to end its sponsorship and contributions. As a result, affected employees were taxed on the value of those split dollar life insurance policies in 2011, when the policies or the value of them was actually transferred to the employees. Although these benefits were earned over many years of employment, the full value of the benefits must be treated as taxable compensation in the year that the employee receives the policy or the benefit. In prior years, the premiums paid for the life insurance arrangements were reported in Part II Column B(iii) as non-taxable benefits in the years they were paid. The portions of reportable compensation that were due to this acceleration treatment are as follows: David Dwight - $283,443.23 Rick Fisk - $274,538.58 Elizabeth Buikema - $75,181.58 Steven P. Anderson - $67,348.01 John R. Harriff - $92,164.41 Terri Cunliffe - $119,770.13 David Erickson - $19,001.89 Kathleen Jenkins - $45,430.60 Part II, Column C: Deferred compensation includes an 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)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Mission Statement: | Form 990 - Part III - Line 1 | As a ministry of the Evangelical Covenant Church, Covenant Retirement Communities celebrate God's gift of life in Christian community. We follow the Great Commandment to love and serve God and one another as taught by Jesus Christ. That compels us to affirm the dignity of each person and to pursue excellence and financial integrity in all that we do. As we provide a broad range of resources, services and programs to enhance individual and community wellness, we collaborate with residents and families to achieve the best possible results. While seeking to foster independence, we respond to each individual's evolving needs in order to provide the security that assures peace of mind. In living out the mission, the community provides a complete continuum of care from residential living through skilled nursing. Such services are guided by a series of values and goals addressing resident needs, privacy, safety and dignity, including appropriate access to services. In carrying out the mission statement of Covenant Retirement Communities (CRC), Covenant Health Care Centers, Inc. provided $727,088 free or discounted services to those residents unable to pay all or a portion of their charges, and who meet certain eligibility requirements. |
| Employees and Vendors | Form 990 - Part V - Lines 1a & 2a | Covenant Health Care Centers, Inc. (CHCC) is a combination of the assisted living and skilled nursing facilities of two continuing care retirement communities (CCRC), Covenant Home Illinois and The Holmstad, Inc. The W2's of employees and 1099-Misc for vendors that do work for CHCC are reported and issued under the FEIN of each campus. No wages or 1099's are issued under the FEIN of CHCC. There are about 723 employees working in these two campus locations and a combined total of 84 vendors were sent 1099's as of 1/31/12. |
| Form 990, Part VI, Section A, line 3 | Covenant Health Care Centers, Inc. delegated control over management duties to Covenant Retirement Communities, Inc. (CRC), its parent organization. | |
| Form 990, Part VI, Section A, line 6 | The sole member is Covenant Retirement Communities, Inc. (CRC) | |
| Form 990, Part VI, Section A, line 7b | S 2.4 of Bylaws include reserved powers to the [invidual] members such as appointment of president of CRC, changes to mission and strategic plan, approval of certain acquisitions, dispositions and financings, changes to articles and bylaws. | |
| Form 990, Part VI, Section B, line 11 | Management Review: The draft Form 990 was reviewed by multiple levels of management including the 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 12c | Covenant Retirement Communities, Inc. (CRC) has an Administrative Policy on conflict of interest, identifying the parameters of a conflict of interest and the requirement to disclose any such conflict of interest. Each January, the CRC policy is distributed to CRC board members and officers. They are asked to sign acknowledging receipt of the policy and to disclose if they have any conflict of interests. If someone is absent from the meeting or fails to return the acknowledgment, there is a follow-up with the individual until the signed acknowledgment is provided. In addition to the above, a separate and more comprehensive questionnaire is sent to the board members, officers, key employees and other interested persons. The completed questionnaires are reviewed by CRC's legal counsel to determine if any actual or potential conflicts exist. If a person becomes an interested person, he or she may be considered in determining whether a quorum is present. The interested person may make a short statement relating to the transaction or arrangement in question, but shall not be present during the discussion and shall not vote on the motion addressing the actual or potential conflict. | |
| Covenant Retirement Communities' (CRC) Board of Directors has duly appointed an Executive Compensation Committee (the "Committee"), which is responsible for the review and approval of all compensation and benefits provided to CRC's executive management. The Committee has adopted a written Executive Compensation Philosophy Statement and an Executive Compensation Committee Charter governing the work and review process of the Committee. The Committee follows the procedures described in the Philosophy Statement and the Charter when it reviews and approves the compensation and employee benefits provided to the CRC's senior management. The Committee's review analyzes every element of compensation, including current and deferred compensation, and benefits, including qualified and non-qualified benefits. The Committee conducts its review and approval process at least annually, and approves compensation and benefits only to the extent that the Committee has concluded that the compensation and benefits constitute no more than reasonable compensation for each executive. The Committee consists entirely of disinterested members of the Board, and the Committee works with an independent compensation consultant to prepare and review in advance comprehensive data showing the compensation provided by similarly situated organizations for functionally similar positions. The Committee also prepares a timely and thorough written record of its deliberations and conclusions. As a result, the Committee's review process is designed to satisfy the procedural criteria necessary to qualify for the rebuttable presumption of reasonableness under the federal income tax law intermediate sanctions rules. The resources utilized by the compensation Committee include: 1) independent compensation consultant; 2) written employment contract; 3) compensation survey or study; 4) approval by the board or compensation committee. | ||
| Form 990, Part VI, Section C, line 18 | Form 990, Part VI, Section C, Line 18: A copy of the organization's Form 990 is available upon request by contacting the CRC accounting department at 773-878-5744. | |
| Form 990, Part VI, Section C, line 19 | Form 990, Part VI, Section C, Line 19: The governing documents, conflict of interest policy and financial statements are available upon request by contacting the CRC accounting department at 773-878-5744. | |
| Contact Info for Directors & Officers | Form 990 - Part VI - Line 9 | All of the organization's directors and officers can be contacted at this address: Covenant Retirement Communities, Inc. - 5700 Old Orchard Road, Skokie, IL 60077. |
| Related Organization | Form 990 - Part VII - Section A | Officers and Directors devote less than 1 hour per week to related organizations except for those individuals that are employees of Covenant Retirement Communities, Inc. (CRC). Those that are employed by CRC devote approximately 40 hours per week to CRC. |
| Changes in Net Assets or Fund Balances: | Form 990, Part XI, line 5: | Change in Temporarily Restricted Net Assets not included on Income Stmnt 4,951. Total to Form 990, Part XI, Line 5: 4,951. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Evangelical Covenant Church | |||||||||||
| 8303 West Higgins Road | Chicago | IL | 60631 | 362167730 | Church | IL | 501(c)(3) | Line 1 | N/A | 0 | |
| Swedish Covenant Faculty Group (SCFG) | |||||||||||
| 5145 North California Avenue | Chicago | IL | 60625 | 363686216 | Patient Treatment/Education | IL | 501(c)(3) | Line 11a, I | 0 | Swedish Covenant Hospital | |
| Swedish Covenant Hospital | |||||||||||
| 5145 North California Avenue | Chicago | IL | 60625 | 362179813 | Hospital | IL | 501(c)(3) | Line 3 | 0 | Covenant Ministries of Benevolence | |
| Swedish Covenant Hospital Foundation (SCHF) | |||||||||||
| 5145 North California Avenue | Chicago | IL | 60625 | 205055155 | Supporting Organization of SCH | IL | 501(c)(3) | Line 7 | 0 | Swedish Covenant Hospital | |
| SC Insurance Company | |||||||||||
| 6970 E Chauncey Lane Suite 100 | Phoenix | AZ | 85054 | 273312053 | Insurance | AZ | 501(c)(3) | Line 11a, I | 0 | Swedish Covenant Hospital | |
Form990 Schedule R Part III Form990ScheduleRPartIII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Predominant Income TypePredominantIncomeType | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|---|
| Cardiovascular Performance Group LLC | ||||||||||
| 5145 N California Avenue | Chicago | IL | 60625 | 203587272 | Management Services | IL | N/A | N/A | 0 | 0 |
| Coast Asset Management LLC | ||||||||||
| 2450 Colorado Ave Suite 100 E Tower | Santa Monica | CA | 90404 | 954763400 | Hedge Fund Investment | CA | N/A | N/A | 0 | 0 |
| Covenant Village of Portland LP | ||||||||||
| 420 NE Mason St | Portland | OR | 97211 | 364356838 | Assisted Living Community | OR | N/A | N/A | 0 | 0 |
| Swedish Covenant Surgery LLC | ||||||||||
| 5215 N California Avenue | Chicago | IL | 60625 | 272485300 | Outpatient Medical Services | IL | N/A | N/A | 0 | 0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)
| Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | Primary ActivityPrimaryActivity | Legal Domicile Foreign CountryLegalDomicileForeignCountry | Direct Controlling Entity NADirectControllingEntityNA | Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Legal Domicile StateLegalDomicileState | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Covenant International Insurance Company Ltd | ||||||||||||
| Crawford House 50 Cedar Avenue | Hamilton | BD | Insurance | BD | N/A | |||||||
| Covenant Trust Company | ||||||||||||
| Financial Services | N/A | 5215 Old Orchard Road Suite 725 | Skokie | IL | 60077 | 363583163 | IL | C | ||||
| Swedish Covenant Management Services Inc (SCMS) | ||||||||||||
| Physician Practice Management | N/A | 5145 North California Avenue | Chicago | IL | 60625 | 364073303 | IL | C | ||||
| Swedish Covenant Managed Care Alliance (SCMCA) | ||||||||||||
| Physician - Hospital Organization | N/A | 2740 West Foster Avenue Suite 409 | Chicago | IL | 60625 | 364118659 | IL | C | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| Covenant Retirement Communities Inc | |
| O | 1945991 |
| Covenant Retirement Communities Inc | |
| A | 411212 |
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