FURP.ORG / PUBLIC DATA EXPLORER

TEKAKWITHA NURSING CENTER INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
TEKAKWITHA NURSING CENTER INC (EIN 41-1809912)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-07
IRS object ID
201231289349301423
Schema version
2010v3.2
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

FieldValueIRS element (for citing)
Timestamp2012-05-07T12:34:50-07:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN411809912EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1TEKAWITHA NURSING CENTER INCBusinessNameLine1
Business Name Line2dba TEKAWITHA LIVING CENTERBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlTEKANameControl
Phone7636891162Phone

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameKEVIN RYMANOWSKIName
TitleCFOTitle
Date Signed2012-05-07DateSigned
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJAMES CORNELIUSNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11995 E RUM RIVER DRIVE SAddressLine1
CityCAMBRIDGECity
StateMNState
ZIP Code55008ZIPCode
FieldValueIRS element (for citing)
Gross Receipts4169620GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.bhshealth.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1995YearFormation
State Legal DomicileMNStateLegalDomicile
Activity Or Mission DescriptionOur mission is to witness to God's love by providing compassionate, quality care with special concern for the underserved and those in need.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees104TotalNbrEmployees
Total Nbr Volunteers65TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year95849ContributionsGrantsPriorYear
Contributions Grants Current Year28324ContributionsGrantsCurrentYear
Program Service Revenue Prior Year3842778ProgramServiceRevenuePriorYear
Program Service Revenue CY4141206ProgramServiceRevenueCY
Investment Income Prior Year81InvestmentIncomePriorYear
Investment Income Current Year90InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year3938708TotalRevenuePriorYear
Total Revenue Current Year4169620TotalRevenueCurrentYear
Grants And Similar Amnts CY1200GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year2358890SalariesEtcPriorYear
Salaries Etc Current Year2472006SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1603361OtherExpensePriorYear
Other Expenses Current Year1713337OtherExpensesCurrentYear
Total Expenses Prior Year3962251TotalExpensesPriorYear
Total Expenses Current Year4186543TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-23543RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-16923RevenuesLessExpensesCY
Total Assets BOY2088715TotalAssetsBOY
Total Assets EOY2018757TotalAssetsEOY
Total Liabilities BOY1740811TotalLiabilitiesBOY
Total Liabilities EOY1673767TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY347904NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY344990NetAssetsOrFundBalancesEOY
Mission DescriptionTekakawitha Living Center is a Catholic organization entrusted with advancing the health care ministry of the Benedictine Sisters of Duluth, Minnesota. Our mission is to witness to God's love by providing compassionate, quality care with special concern for the underserved and those in need.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense3705002Expense
Grants1200Grants
Revenue4141206Revenue
DescriptionOperation of Tekawitha Living Center, is a 60 bed long-term care in Sisston, South Dakota which provides skilled nursing care to the elderly.The facility had a 94% occupancy and served 116 individuals during the fiscal yearending 6/30/11.Description
Total Program Service Expense3705002TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingtrueCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10967NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees104NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledMNStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

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

Address US AddressUS

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

Form990 Part VII Section A Form990PartVIISectionA (15 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
TIM NEUMANN
Director1.00X000
TIM COX
Treasurer1.00X000X
STEVE CHIES
EX-OFFICIO40.00X032123859425
SISTER MARY SUSAN DEWITT
Secretary1.00X000X
SISTER KATHLEEN DOYLE
Director1.00X000
SISTER CLAUDIA RIEHL
CHAIR ELECT1.00X000X
RICK LEHNHERR
Director1.00X000
PAT GLYNN
Director1.00X000
KEVIN RYMANOWSKI
BHS CFO40.00027041746886X
KEVIN GREFF
EX-OFFICIO40.00019398938308X
JOAN SHOCKMAN
Director1.00X000
JENNETTE BERGER
CHAIR1.00X000X
JAMES CORNELIUS
CEO / ADMIN.40.0008784022793X
DEE GINSBACH
Director1.00X000
DALE THOMPSON
EX-OFFICIO40.00X0571536109913X
FieldValueIRS element (for citing)
Total Reportable Comp Frm Rltd Orgs1445020TotalReportableCompFrmRltdOrgs
Total Other Compensation277325TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
BIG STONE THERAPIES
820 ROY STORTONVILLEMN56278THERAPY SERVICES122117
BENEDICTINE HEALTH SYSTEM
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008MANAGING COMPANY332007
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Related Organizations28324RelatedOrganizations
Total Contributions28324TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionRESIDENT SERVICESDescription
Business Code623000BusinessCode
Total Revenue Column4141206TotalRevenueColumn
Related Or Exempt Function Income4141206RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue4141206TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column90TotalRevenueColumn
Exclusion$90ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

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

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column4169620TotalRevenueColumn
Related Or Exempt Function Income4141206RelatedOrExemptFunctionIncome
Exclusion$90ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total1200Total
Program Services1200ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1792663Total
Program Services1712083ProgramServices
Management And General80580ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total39014Total
Program Services36829ProgramServices
Management And General2185ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total511535Total
Program Services482889ProgramServices
Management And General28646ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total128794Total
Program Services121582ProgramServices
Management And General7212ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total332007Total
Management And General332007ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total5656Total
Management And General5656ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total7297Total
Program Services7297ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total282016Total
Program Services277103ProgramServices
Management And General4913ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total266232Total
Program Services266232ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total32223Total
Program Services32223ProgramServices

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total12385Total
Program Services9083ProgramServices
Management And General3302ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total218171Total
Program Services218171ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total47382Total
Program Services47382ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
UNIFORMS3341133411
PURCHASED SERVICES225678225678
FOOD186838186838
EQUIPMENT REPAIRS20628169673661
Dues1283312833

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total30580Total
Program Services17201ProgramServices
Management And General13379ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total4186543Total
Program Services3705002ProgramServices
Management And General481541ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY123414BOY
EOY31166EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY233766BOY
EOY377744EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY628BOY
EOY662EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis4358050LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2859608LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1634740BOY
EOY1498442EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY96167BOY
EOY110743EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2088715BOY
EOY2018757EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY516085BOY
EOY553296EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY17449BOY
EOY18004EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1178515BOY
EOY1073704EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY28762BOY
EOY28763EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1740811BOY
EOY1673767EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY276525BOY
EOY259602EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY71379BOY
EOY85388EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY347904BOY
EOY344990EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2088715BOY
EOY2018757EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-16923ReconcilationRevenueExpenses
Reconcilation Other Changes14009ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years213405CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years47673CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1750CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year95849CurrentTaxYearMinus1Year
Current Tax Year28324CurrentTaxYear
Total387001Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3463297CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3538812CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3677134CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3842778CurrentTaxYearMinus1Year
Current Tax Year4141206CurrentTaxYear
Total18663227Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3676702CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3586485CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3678884CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3938627CurrentTaxYearMinus1Year
Current Tax Year4169530CurrentTaxYear
Total19050228Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50919050228PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years894CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years456CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years240CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year81CurrentTaxYearMinus1Year
Current Tax Year90CurrentTaxYear
Total1761Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years894CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years456CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years240CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year81CurrentTaxYearMinus1Year
Current Tax Year90CurrentTaxYear
Total1761Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Total0Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3677596CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3586941CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3679124CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3938708CurrentTaxYearMinus1Year
Current Tax Year4169620CurrentTaxYear
Total19051989Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99990PublicSupportPercentage509
Prior Year Support Percentage0.99990PriorYearSupportPercentage
Investment Income Percentage0.00010InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00010PriorYrInvestIncomePercentage
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 EtcfalseAgentTrusteeEtc
Included On FStrueIncludedOnFS

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis26562OtherCostOrOtherBasis
Book Value26562BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3668373OtherCostOrOtherBasis
Depreciation2319131Depreciation
Book Value1349242BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis111923OtherCostOrOtherBasis
Depreciation70976Depreciation
Book Value40947BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis551192OtherCostOrOtherBasis
Depreciation469501Depreciation
Book Value81691BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1498442TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
RESTRICTED ASSET18004
DEBT RETIREMENT92739
FieldValueIRS element (for citing)
Total Book Value Other Assets110743TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Rounding$2
ASSET RETIREMENT$28,761
FieldValueIRS element (for citing)
Total Of Amounts28763TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part XPart X : FIN48 FootnoteTax Exempt StatusBHS has been determined to qualify as a tax-exempt charitable, educational, and scientific organization under Section 501 (c)(3) of the Internal Revenue Code and also has been determined to be exempt from state income tax. The Organization follows the accounting standard for contingencies in evaluating the accounting for uncertainty in income taxes recognized in an entity's financial statements. The standard prescribes recognition and measurement of tax provisions taken or expected to be taken on a tax return that are not certain to be realized. The Organization income tax returns are subject to review and examination by federal, state, and local authorities. The Organization is not aware of any activities that would jeopardize its tax-exempt status. The Organization is not aware of any activities that are subject to tax on unrelated business income or excise or other taxes. The tax returns for the fiscal years 2008 to 2010 are open to examination by federal, local, and state authorities.
Part XI, Line 8Part XI, Line 8: Other Changes in Net Assets or Fund BalancesChange in Interest in Net Assets of Affiliated Foundation $14009
Part IV, Line 2bPart IV, Line 2b: Explanation of escrow account liabilityCARETAKER OF RESIDENT TRUST FUNDS IN A SEPARATE ACCOUNT.

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
STEVE CHIES
229840477934360549537988838066349537
KEVIN RYMANOWSKI
2116494441514353281961869031730328196
KEVIN GREFF
140269207003302035979232923229735979
DALE THOMPSON
451161120375946421527168144994642

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

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

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (19 entries)

EINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
BENEDICTINE HEALTH SYSTEM FOUNDATION
411513014SUPPORTING ORG.MN501 (C) 311BHSfalse
Villa St Vincent
411352227NURING HOMEMN501 (C) 39BHSfalse
ARROWHEAD SENIOR LIV COMMUNITY
411978619NURING HOMEMN501 (C) 39BHSfalse
St Gertrudes Health & Rehab
411848720NURING HOMEMN501 (C) 39BHSfalse
Saint Anne of Winona
410850791NURING HOMEMN501 (C) 39BHSfalse
Rosewood Court
412011389ASSISTED LIVINGMN501 (C) 39BHSfalse
Madonna Towers of Rochester
411809914NURING HOMEMN501 (C) 39BHSfalse
Madonna Meadows of Rochester
470855891ASSISTED LIVINGMN501 (C) 39BHSfalse
Living Community of St Joseph
412011661NURING HOMEMN501 (C) 39BHSfalse
Evergreen Place
411796445ASSISTED LIVINGMN501 (C) 39BHSfalse
Cerenity Care Cen- White Bear Lake
411983267NURING HOMEMN501 (C) 39BHSfalse
Cerenity Senior Care
363517696NURING HOMEMN501 (C) 39BHSfalse
Bridges Care Community
262620983NURING HOMEMN501 (C) 39BHSfalse
Benedictine Senior Liv Steeple Pointe
411852273ASSISTED LIVINGMN501 (C) 39BHSfalse
Benedictine Living Com of St Peter
861113231NURING HOMEMN501 (C) 39BHSfalse
Benedictine Living Communities
411639687NURING HOMEMN501 (C) 39BHSfalse
BENEDICTINE CARE CENTERS
411907571NURING HOMEMN501 (C) 39BHSfalse
BENEDICTINE HEALT CENTER
411381401NURING HOMEMN501 (C) 39BHSfalse
BENEDICTINE HEALTH SYSTEM
411531892SUPPORTING ORG.MN501 (C) 311falseN/A
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg