COVENANT LIVING WEST: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
COVENANT LIVING WEST (EIN 95-3472345)
Tax period
2011-02-01 to 2012-01-31
Filed
2012-12-06
IRS object ID
201243419349300719
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

FieldValueIRS element (for citing)
Timestamp2012-12-06T11:17:37-06:00Timestamp
Tax Period End Date2012-01-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2011-02-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN953472345EIN

Name Name

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

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameElizabeth BuikemaName
TitleVP of Finance/CFOTitle
Phone7738782294Phone
Date Signed2012-12-06DateSigned
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

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

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line15700 Old Orchard RdAddressLine1
CitySkokieCity
StateILState
ZIP Code60077ZIPCode
FieldValueIRS element (for citing)
Gross Receipts75810958GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number2650GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.covenantretirement.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1975YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionCare for Senior AdultsActivityOrMissionDescription
Nbr Voting Members Governing Body21NbrVotingMembersGoverningBody
Nbr Independent Voting Members17NbrIndependentVotingMembers
Total Nbr Employees902TotalNbrEmployees
Total Nbr Volunteers323TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1090543ContributionsGrantsPriorYear
Contributions Grants Current Year1355050ContributionsGrantsCurrentYear
Program Service Revenue Prior Year66153466ProgramServiceRevenuePriorYear
Program Service Revenue CY68782939ProgramServiceRevenueCY
Investment Income Prior Year5841970InvestmentIncomePriorYear
Investment Income Current Year4037656InvestmentIncomeCurrentYear
Other Revenue Prior Year1251230OtherRevenuePriorYear
Other Revenue Current Year1525072OtherRevenueCurrentYear
Total Revenue Prior Year74337209TotalRevenuePriorYear
Total Revenue Current Year75700717TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year58535GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY52538GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year27700991SalariesEtcPriorYear
Salaries Etc Current Year28301187SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year510566TotalFundrsngExpCurrentYear
Other Expense Prior Year40336092OtherExpensePriorYear
Other Expenses Current Year40025637OtherExpensesCurrentYear
Total Expenses Prior Year68095618TotalExpensesPriorYear
Total Expenses Current Year68379362TotalExpensesCurrentYear
Revenues Less Expenses Prior Year6241591RevenuesLessExpensesPriorYear
Revenues Less Expenses CY7321355RevenuesLessExpensesCY
Total Assets BOY250464521TotalAssetsBOY
Total Assets EOY260622710TotalAssetsEOY
Total Liabilities BOY170177740TotalLiabilitiesBOY
Total Liabilities EOY172278448TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY80286781NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY88344262NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionAs a ministry of the Evangelical Covenant Church, Covenant Retirement Communities celebrates God's gift of life in Christian community. We follow the Great Commandment to love and serve God and one another as taught by Jesus Christ. (SEE SCHEDULE O)MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense23646351Expense
Revenue33890599Revenue
DescriptionResidential Living:The number of persons who benefited from the services we provided for the year ended January 31, 2012 were as follows:There were 1,081 Residents occupying 776 apartments as of 1/31/12 The residency for the fiscal year totaled 390,476 resident days.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense7724501Expense
Revenue9857103Revenue
DescriptionAssisted 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 176 assisted living residents at 01/31/12 Assisted living residency for the fiscal year totaled 66,233 patient days.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense20567441Expense
Revenue26564238Revenue
DescriptionSkilled Nursing: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 224 skilled care patients at 01/31/12.Skilled care residency for the fiscal year totaled 80,744 patient days.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
DescriptionThe organization was involved in various community benefits projects which include the followingThe Samarkand: - Staff members volunteered a total of 611 hours of their time to various activities/events in the community including the Empty Bowls Fundraiser for a local food bank and others (equivalent to $63,788)- Residents volunteered a total of 6,649 hours to various activities/events in the community including the Empty Bowls Fundraiser for a local food bank, Operation Christmas Child project and others. They also raised a total of $1,742 and made a monetary donation to Operation Christmas Child as well as collected 500 lbs. of food for the Santa Barbara Food Bank ($2,500 in estimated value). - Hosted monthly student internship programs for nursing students from the Santa Barbara City College and San Marcos High School (equivalent to $27,713)- Provided space usage for meetings & events for small (under 35) to large groups (75+ people) including Gideon's International dinner meetings, Montecito Covenant Church, Samarkand Neighborhood Association, California Lutheran University Luncheon, Evangelical Covenant Church meeting, Los Padres Chapter Aging Services of California, DAWG Board, PEO, Santa Barbara Clergy Association, Community Covenant Church Elderberries Christmas Luncheon, various memorial services and others (equivalent to $78,935)- Participated in the Recycling project and conversion to Reclaimed Water Irrigation project (equivalent to $140,000)- Provided temporary residence to missionaries (equivalent to $140)- Monetary Donations to Alaska Christian College, American Bible College, Bridge of Hope, Campus Crusade, CHET, Covenant Radio for Russia, Covenant Women's Project, Covenant World Mission, Covenant World Relief, Gideon's International, Habitat for Humanity, International Bible Society, KICY Radio-Alaska, Life Network, Mission Aviation Fellowship, North Park Covenant Seminary, PSWC Covenant Help Fund, Santa Barbara Community Development Center, Santa Barbara Community Kitchen (Casa Esperanza), Santa Barbara Rescue Mission, Santa Barbara Salvation Army, Santa Barbara Food bank, Transition House, Villa Majella and Wycliffe Bible Translators ($37,281 in Total)-In-Kind Donations to Alpha Thrift Store, Empty Bowls fundraiser, 1st Presbyterian Church, Willbridge for homeless housing, and Boys' and Girls' Club of Santa Barbara. ($6,591 in estimated value)Covenant Village of Turlock:- Staff members volunteered a total of 705 hours of their time to various areas in the community which includes the 4th of July Parade, local churches, serving food for the homeless, Relay for Life, and others (equivalent to $53,150)- Residents volunteered a total of 2,895 hours in the community which includes local churches, Medic Alert Foundation, Hope Ranch Animal Rescue, Delta Blood Bank, Salvation Army, sewing projects for various groups, United Samaritans and others.- Provided space usage for meetings/events for small (under 35) to large groups (75+ people) including different support group meetings (Alzheimers', Loss of Spouse, Parkinsons', Peripheral Neuropathy, Cancer Survivors), Gideon's International, AARP Drivers Class, Turlock Historical Society, music recitals and other music/arts events (TCC Brass band, Covenant Four Quartet, Hand bell Ensemble concert, Debra Dance Recital, Community Hymn Sing, Children's Harp Ensemble, Jack Martens Music program, Virginia's Choir), Church and Community Outreach, Aging in Place Fair, TCC Health and Safety meeting, Pastors' meeting, Mayor's Prayer Breakfast meeting, County Fair Relaxation Station, SCAMPS, Thursday Bible Study, Pacific SW Conference meetings, Voting place, and others (equivalent to $901,740 and a total of 515 Staff volunteer hours)- In kind Donations to the Turlock Concert Association, Animal Shelter, Ballico School, Food and Toy Drive, Goodwill, Joni and Friends, Missionary Gospel, Modesto Shelter, Needy Family, North Avenue Church, Off Center, Salvation Army, United Samaritans, Women's Shelter, yard sale ($16,370 estimated value)Mt. Miguel Covenant Village:- Staff members volunteered a total of 569 hours of their time in various areas of the community such as the Activity Directors of Greater San Diego meetings, Animal Shelter, caroling and delivering gifts to Elder Abuse victims, Community Theater rehearsal and performance, Homeless Outreach, San Diego Master Chorale concerts, Medical Outreach, Backpack drive, Turkey Give-away, Seasons of Love food drive and others (equivalent to $33,925)- Residents volunteered a total of 9,352 hours to the different areas of the community such as in local schools, local churches, knitting and sewing for various projects, food distributions to different groups and individuals and others. They also donated to various groups/organizations such as the Alpine Conference Center, Bethel Seminary of San Diego, Christian Radio for Russia, Covenant World Missions, Covenant World Relief, Grace Covenant Church, North Park Theological Seminary and others (16,607 in total)- Monetary Donations to San Diego Military Outreach ministries and Backpack Drive ($5,368 in total).- In-Kind Donations to 1st Baptist Church ($760 in estimated value)- Provided space usage for meetings and community events for small (under 35) to large groups (75+ people) including the Alaska Christian College Program, Red Hat Day Program, San Diego Harmony Makers, Aqua Fitness program, Friends of Bethel event, Marketing seminar, Volunteer Appreciation event, Concert on Green, Accordion Lovers Society International, Activity Directors of Greater San Diego meetings, Ambassador Event for Shadow Mtn. Church, The Applique Society, and Gideon's Fish Fry (equivalent to $558,204)Covenant Shores:- Staff members volunteered a total of 106 hours in different areas in the community including Covenant Church Outreach event, Bellevue School, New Covenant Church, M.I. Youth and Family Services and a non-profit community theater (equivalent to $14,738)- Residents volunteered a total of 4,785 hours to various areas in the community including the Stitches from the Heart (knitting 309 items for Neighborcare Health, Seattle and Eastside Baby Corner), local schools, churches, hospitals and nursing homes, The Ernest Baker Foundation, Museum of Flight and others.- Provided space usage for the North Park University Event (equivalent to $3,500)-Provided scholarships to individuals ($13,020.00 in total)- Monetary Donations to Asian Counseling and Referral Service and Salvation Army ($330 in total)- In-kind Donations to Seattle's Union Gospel Mission and M.I. Youth and Family Services ($5,250 in estimated value).Description
FieldValueIRS element (for citing)
Total Program Service Expense51938293TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling1CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org1TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096221NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees902NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members21NbrVotingGoverningBodyMembers
Number Independent Voting Members17NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address1OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

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

Address US AddressUS

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

Form990 Part VII Section A Form990PartVIISectionA (35 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Jon P Aagaard MD
Director1.00X000
Curtis B Anderson
Director1.00X000
Rev Richard B Berry
Director1.00X000
Wendell Danielson
Director1.00X000
Rev Harvey Drake
Director1.00X000
James Elving
Director1.00X000
Marc E Espinosa
Director1.00X000
Lorene G Flewellen
Director1.00X000
Rhoda Friesen
Director1.00X000
Mary Miller
Director1.00X000
Cletus J Moll
Director1.00X000
Joyce Peterson
Director1.00X000
Norton Richards
Director1.00X000
Walter Schiller
Director1.00X000
Marlene Stante
Director1.00X000
Jean A Stebinger
Director1.00X000
Robert K Johnston
Ex-Officio1.00X000
David A Dwight
Ex-Officio1.00X084867795681
Rick K Fisk
Ex-Officio/President1.00X089746584268X
Scott MacDonald
Ex-Officio1.00X000
Gary Walter
Ex-Officio1.00X0151985115788
Steven P Anderson
Senior VP/Asst Secretary1.00025277470881X
Elizabeth B Buikema
Senior VP/CFO/Treasurer1.00035864055395X
Moraine M Byrne
Senior VP/Asst Secretary1.00020294547866X
Terri S Cunliffe
EVP of Oper/Asst Sec1.00035089672409X
John R Harriff
Senior VP/Asst Secretary1.00027352647657X
David G Erickson
VP/Asst Secretary1.00022617640285X
Kathleen Jenkins
Dir Admin Srvcs/Asst Secretary1.00017644870348X
Thad D Rothrock
Executive Director40.00223133041736X
Anne Arakaki-Lock
Executive Director40.00210009035089X
Dwayne D Gabrielson
Executive Director40.00175173051874X
Paul D Peterson
Executive Director40.00167471045797X
Jay S Caddell
Healthcare Admin40.00113673022034X
Edna Briones
Director of Nursing40.0010966406445X
Robert Mann
Director of Nursing40.00108135022247X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1107258TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3739532TotalReportableCompFrmRltdOrgs
Total Other Compensation925800TotalOtherCompensation
Number Individuals GT100 K8NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Sodexo Inc & Affiliates
Dept 43283Los AngelesCA900883283Dining Services2188507
Aegis Therapies
PO Box 8103Fort SmithAR72902Therapy Services1067299
Pannel Construction Company
9623 Kenora LaneSpring ValleyCA91977Maintenance/Construction Services959498
Hallmark Rehabilitation
27442 Portola Parkway Suite 200Foothill RanchCA92610Therapy Services613196
John S Jewel
1337 Lone Palm AvenueModestoCA95351Roof Repair/Replacement277600
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Fundraising Events150246FundraisingEvents
Related Organizations21876RelatedOrganizations
All Other Contributions1182928AllOtherContributions
Total Contributions1355050TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Routine Services6230004340675543406755
Entrance Fees6230001132113511321135
Medicare/Medicaid62300079615877961587
Ancillary Services62300056828325682832
Meals623000410630410630
FieldValueIRS element (for citing)
Total Program Service Revenue68782939TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2830990TotalRevenueColumn
Exclusion$2,830,990ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real79463Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real83392Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-3929Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-3929TotalRevenueColumn
Exclusion-$3,929ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1206666Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1206666Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1206666TotalRevenueColumn
Exclusion$1,206,666ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events26849GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events150246CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses26849FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Support Services623000908935908935
Services to Residents623000113964113964

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column506102TotalRevenueColumn
Related Or Exempt Function Income506102RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue1529001TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column75700717TotalRevenueColumn
Related Or Exempt Function Income70311940RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$4,033,727ExclusionAmount

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total52538Total
Program Services52538ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total341077Total
Management And General341077ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total21853082Total
Program Services18336579ProgramServices
Management And General3404338ManagementAndGeneral
Fundraising112165Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total771451Total
Program Services636970ProgramServices
Management And General128844ManagementAndGeneral
Fundraising5637Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3613078Total
Program Services3039827ProgramServices
Management And General568545ManagementAndGeneral
Fundraising4706Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1722499Total
Program Services1356902ProgramServices
Management And General357231ManagementAndGeneral
Fundraising8366Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total369102Total
Program Services369102ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total105068Total
Management And General105068ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total119517Total
Management And General119517ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5861383Total
Program Services5252193ProgramServices
Management And General606955ManagementAndGeneral
Fundraising2235Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total792274Total
Management And General786947ManagementAndGeneral
Fundraising5327Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2969085Total
Program Services2386240ProgramServices
Management And General571306ManagementAndGeneral
Fundraising11539Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total591549Total
Program Services860ProgramServices
Management And General590622ManagementAndGeneral
Fundraising67Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3966976Total
Program Services3966976ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total127790Total
Program Services40888ProgramServices
Management And General86902ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total142208Total
Program Services15103ProgramServices
Management And General127105ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total4929883Total
Program Services3736372ProgramServices
Management And General1133873ManagementAndGeneral
Fundraising59638Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total8026712Total
Program Services6084188ProgramServices
Management And General1846144ManagementAndGeneral
Fundraising96380Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total865389Total
Program Services865389ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Related Party Payments45910931804391611199302
Dining Services29371442937144
Resident Care18227521822752
Admin & General2125795087207492

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1595133Total
Program Services1033003ProgramServices
Management And General556926ManagementAndGeneral
Fundraising5204Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total68379362Total
Program Services51938293ProgramServices
Management And General15930503ManagementAndGeneral
Fundraising510566Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY183108BOY
EOY210504EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY100107BOY
EOY107126EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY1279703BOY
EOY1577110EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2511060BOY
EOY3099883EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY261355BOY
EOY420377EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY353362BOY
EOY423177EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis214328538LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec93678694LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY119918189BOY
EOY120649844EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY49849001BOY
EOY43994909EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY13089816BOY
EOY19271083EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY62918820BOY
EOY70868697EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY250464521BOY
EOY260622710EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2351453BOY
EOY2364792EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY60358492BOY
EOY59917398EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY72122561BOY
EOY70252741EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY1392415BOY
EOY749118EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY33952819BOY
EOY38994399EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY170177740BOY
EOY172278448EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY78368070BOY
EOY85689426EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1918711BOY
EOY2611943EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY42893EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY80286781BOY
EOY88344262EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY250464521BOY
EOY260622710EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses7321355ReconcilationRevenueExpenses
Reconcilation Other Changes736125ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years676059CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years969650CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years770727CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1090543CurrentTaxYearMinus1Year
Current Tax Year1355050CurrentTaxYear
Total4862029Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years60997665CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years60030554CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years65618602CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year66153466CurrentTaxYearMinus1Year
Current Tax Year68782939CurrentTaxYear
Total321583226Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years61673724CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years61000204CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years66389329CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year67244009CurrentTaxYearMinus1Year
Current Tax Year70137989CurrentTaxYear
Total326445255Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total509326445255PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4127962CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3476399CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6049754CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3529628CurrentTaxYearMinus1Year
Current Tax Year4037656CurrentTaxYear
Total21221399Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4127962CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3476399CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6049754CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3529628CurrentTaxYearMinus1Year
Current Tax Year4037656CurrentTaxYear
Total21221399Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years65801686CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years64476603CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years72439083CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year70773637CurrentTaxYearMinus1Year
Current Tax Year74175645CurrentTaxYear
Total347666654Total
FieldValueIRS element (for citing)
Public Support Percentage5090.93900PublicSupportPercentage509
Prior Year Support Percentage0.93820PriorYearSupportPercentage
Investment Income Percentage0.06100InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.06180PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtc
Included On FS1IncludedOnFS

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance0BeginningOfYearBalance
Contributions42980Contributions
Investment Earnings Or Losses-87InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures0OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance42893EndOfYearBalance
FieldValueIRS element (for citing)
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis4608401OtherCostOrOtherBasis
Book Value4608401BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis174589223OtherCostOrOtherBasis
Depreciation74355914Depreciation
Book Value100233309BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis28834450OtherCostOrOtherBasis
Depreciation16598181Depreciation
Book Value12236269BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6296464OtherCostOrOtherBasis
Depreciation2724599Depreciation
Book Value3571865BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings120649844TotalOfBookValueLandBuildings

Other Securities OtherSecurities (6 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
Mortgages658434F
Domestic Equity2170620F
International Equity3538171F
Hedge Funds & Derivatives9043575F
Private Equity2475362F
International Real Estate1384921F
FieldValueIRS element (for citing)
Total Of Book Value Securities19271083TotalOfBookValueSecurities

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
Unamortized Debt & Related Expenses1264456
Other Investments2538325
Unamortized Original Issue Discount401483
Intercompany Advance Accounts66664433
FieldValueIRS element (for citing)
Total Book Value Other Assets70868697TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Deferred Revenue Subject to Refund$23,295,032
Refundable Contract Liabilities$14,234,849
Accrued Taxes & Employee Benefits$141,612
Other Liabilities$1,322,906
FieldValueIRS element (for citing)
Total Of Amounts38994399TotalOfAmounts
Total Revenue75700717TotalRevenue
Total Expenses68379362TotalExpenses
Excess Or Deficit For Year7321355ExcessOrDeficitForYear
Other$736,125OtherAmount
Total Adjustments736125TotalAdjustments
Excess Or Deficit Per FS8057480ExcessOrDeficitPerFS

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part IV, Line 2b:Part IV, line 2b: Resident Trust Fund Account: Per state regulations, an account is made available to Skilled Nursing Facility residents wishing to deposit personal needs funds that they can access as needed. Interest is paid based on the interest received from the bank for those deposited funds and allocated among the individual trust fund accounts based on average balances. Resident Entrance Fee Account: Prospective residents pay an application fee deposit which is carried in an escrow account. At move in, the deposit is applied against the total entrance fee amount and the remainder of the money is collected and put in this account. At the end of the month the resident has moved in, all money is transferred out of the escrow account.
Part X:Part X, Line 2: 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 693,232. Change in Permanently Restricted Net Assets not included on Income Stmnt 42,893. Total to Schedule D, Part XI, Line 8: 736,125.Part XI, Line 8 - Other Adjustments:

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1SAM Benefit DinnerNameOfEvent1
Gross Receipts Event158475GrossReceiptsEvent1
Charitable Contributions Event153510CharitableContributionsEvent1
Gross Revenue Event14965GrossRevenueEvent1
Cash Prizes Event1300CashPrizesEvent1
Non Cash Prizes Event1150NonCashPrizesEvent1
Food And Beverage Event13065FoodAndBeverageEvent1
Entertainment Event1800EntertainmentEvent1
Other Direct Expenses Event1650OtherDirectExpensesEvent1
Name Of Event2MMCV Benefit DinnerNameOfEvent2
Gross Receipts Event260058GrossReceiptsEvent2
Charitable Contributions Event255045CharitableContributionsEvent2
Gross Revenue Event25013GrossRevenueEvent2
Other Direct Expenses Event25013OtherDirectExpensesEvent2
Total Number Of Other Events2TotalNumberOfOtherEvents
Gross Receipts Other Events58562GrossReceiptsOtherEvents
Charitable Contrib Other Events41691CharitableContribOtherEvents
Gross Revenue Other Events16871GrossRevenueOtherEvents
Rent Facility Costs Other Events2157RentFacilityCostsOtherEvents
Food And Beverage Other Events6755FoodAndBeverageOtherEvents
Entertainment Other Events2000EntertainmentOtherEvents
Other Direct Expenses Other Events5959OtherDirectExpensesOtherEvents
Gross Receipts Total177095GrossReceiptsTotal
Charitable Contributions Total150246CharitableContributionsTotal
Gross Revenue Total Events26849GrossRevenueTotalEvents
Cash Prizes Total Events300CashPrizesTotalEvents
Non Cash Prizes Total Events150NonCashPrizesTotalEvents
Rent Facility Costs Total Events2157RentFacilityCostsTotalEvents
Food And Beverage Total Events9820FoodAndBeverageTotalEvents
Entertainment Total Events2800EntertainmentTotalEvents
Other Direct Expenses Total Events11622OtherDirectExpensesTotalEvents
Direct Expense Summary Events26849DirectExpenseSummaryEvents
Net Income Summary0NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantGood Neighbor FundTypeOfGrant
Number Of Recipients9NumberOfRecipients
Amount Of Cash Grant52538AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: When a resident's financial need becomes known, consideration is given by the executive director of the facility to determine if the resident qualifies for assistance based on the guidelines established for the fund. Each expenditure from the fund is approved by the executive director.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
David A Dwight
0505032000343645067314028367094435800
Rick K Fisk
0401500010928503866800673840237170988566018009
Gary Walter
01519850000027623088165026777300
Steven P Anderson
0146862021837084075052698024166032963805634
Elizabeth B Buikema
021363603807101069330346660239480417254010768
Moraine M Byrne
0160778021538020629033590017108025364308210
Terri S Cunliffe
01695820291380152176057714017075042568500
John R Harriff
01289460153550129225037805016193032752400
David G Erickson
0149595032240044341020060023450026968600
Kathleen Jenkins
080036075000889120522570203140249019011125
Thad D Rothrock
1560070128320542940208080229890266930000
Anne Arakaki-Lock
1262990122010715090330890560002486980113070
Dwayne D Gabrielson
1011670105900634160336910235610232425000
Paul D Peterson
134648083160245070264450226320216548000

Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Line 1aPart I, Line 1a: The following are available benefits and are treated as taxable compensation: - Travel for companions paid for three (3) senior-level employees. - Health club dues paid for two (2) senior-level employees.
Part I, Line 3Part I, Line 3: See Schedule O explanation for Form 990 Part VI Section B Line 15 for the methods used to determine CEO compensation.
Part I, Line 4bExecutive 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 Thad D. Rothrock - $15,336.00 Dwayne D. Gabrielson - $15,860.88 Anne A. Arakaki-Lock - $15,660.24 Paul D. Peterson - $15,467.00 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 7Part I, Line 7: The following applies to certain individuals listed on Part VII whose compensation is paid from related organizations: The Executive Compensation Committee (the "Committee") follows a prescribed method for calculating bonuses. The calculation is based on measurable targets determined at the beginning of the year. The Committee has the ability to adjust the dollar value of the calculated awards by up to 10%. The adjustment can be an upward or downward adjustment based on various performance factors. Refer to additional information on the Committee included in Schedule O.
Part IIIPart II, Column B (i): Base compensation for certain individuals may include payments from deferred compensation plans. Part II, Column B (ii): Bonus and incentive compensation - Certain key persons employed by CRC are eligible for incentive compensation as determined by the CRC Board Compensation Committee. Incentives paid in 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 Thad D. Rothrock - $48,802.10 Dwayne D. Gabrielson - $53,537.28 Anne A. Arakaki-Lock - $59,593.11 Paul D. Peterson - $21,061.78 Part II, Column C: Deferred compensation includes and estimate of the contribution made to an employer sponsored defined benefit pension plan. Part II, Column D: Nontaxable benefits include health insurance premiums paid by the employer and employee.Supplemental Information

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Mission Statement:Form 990 - Part III - Line 1As a ministry of the Evangelical Covenant Church, Covenant Retirement Communities celebrate God's gift of life in Christian community. We follow the Great Commandment to love and serve God and one another as taught by Jesus Christ. That compels us to affirm the dignity of each person and to pursue excellence and financial integrity in all that we do. As we provide a broad range of resources, services and programs to enhance individual and community wellness, we collaborate with residents and families to achieve the best possible results. While seeking to foster independence, we respond to each individual's evolving needs in order to provide the security that assures peace of mind. In living out the mission, the community provides a complete continuum of care from residential living through skilled nursing. Such services are guided by a series of values and goals addressing resident needs, privacy, safety and dignity, including appropriate access to services. In carrying out the mission statement of Covenant Retirement Communities, Covenant Retirement Communties West provided $1,493,917 of free or discounted services to those residents unable to pay all or a portion of their charges, and who meet certain eligibility requirements.
Tax-Exempt Bonds:Form 990 - Part IV - Line 24aThe organization has tax-exempt bonds issued after December 31, 2002 with an outstanding principal of more than $100,000. The bonds are reported on Schedule K of the parent organization.
Form 990, Part VI, Section A, line 3Covenant Retirement Communities West delegated control over management duties to Covenant Retirement Communities, Inc. (CRC), its parent organization.
Form 990, Part VI, Section A, line 6The sole member of Covenant Retirement Communities West (CRC-West) is Covenant Retirement Communities, Inc. (CRC).
Form 990, Part VI, Section A, line 7bS 2.4 of Bylaws include reserved powers to the [individual] members such as appointment of president of CRC, changes to mission and strategic plan, approval of certain acquisitions, dispositions and financings, changes to articles and bylaws.
Form 990, Part VI, Section B, line 11Management Review: The draft Form 990 was reviewed by multiple levels of management including the President of CRC, the Vice President of Finance/CFO and the Vice President of Legal Affairs. Board Review: Prior to filing, key provisions of the Form were discussed with the Board of Directors at the Board meeting and the final Form 990 was provided to each Board member.
Form 990, Part VI, Section B, line 12cCovenant Retirement Communities, Inc. (CRC) has an Administrative Policy on conflict of interest, identifying the parameters of a conflict of interest and the requirement to disclose any such conflict of interest. Each January, the CRC policy is distributed to CRC board members and officers. They are asked to sign acknowledging receipt of the policy and to disclose if they have any conflicts of interest. If someone is absent from the meeting or fails to return the acknowledgment, there is a follow-up with the individual until the signed acknowledgment is provided. In addition to the above, a separate and more comprehensive questionnaire is sent to the board members, officers, key employees and other interested persons. The completed questionnaires are reviewed by CRC's legal counsel to determine if any actual or potential conflicts exist. If a person becomes an interested person, he or she may be considered in determining whether a quorum is present. The interested person may make a short statement relating to the transaction or arrangement in question, but shall not be present during the discussion and shall not vote on the motion addressing the actual or potential conflict.
Form 990, Part VI, Section B, line 15bCovenant Retirement Communities' (CRC) Board of Directors has duly appointed an Executive Compensation Committee (the "Committee"), which is responsible for the review and approval of all compensation and benefits provided to CRC's executive management. The Committee has adopted a written Executive Compensation Philosophy Statement and an Executive Compensation Committee Charter governing the work and review process of the Committee. The Committee follows the procedures described in the Philosophy Statement and the Charter when it reviews and approves the compensation and employee benefits provided to the CRC's senior management. The Committee's review analyzes every element of compensation, including current and deferred compensation, and benefits, including qualified and non-qualified benefits. The Committee conducts its review and approval process at least annually, and approves compensation and benefits only to the extent that the Committee has concluded that the compensation and benefits constitute no more than reasonable compensation for each executive. The Committee consists entirely of disinterested members of the Board, and the Committee works with an independent compensation consultant to prepare and review in advance comprehensive data showing the compensation provided by similarly situated organizations for functionally similar positions. The Committee also prepares a timely and thorough written record of its deliberations and conclusions. As a result, the Committee's review process is designed to satisfy the procedural criteria necessary to qualify for the rebuttable presumption of reasonableness under the federal income tax law intermediate sanctions rules. The resources utilized by the compensation Committee include: 1) independent compensation consultant; 2) written employment contract; 3) compensation survey or study; 4) approval by the board or compensation committee.
Form 990, Part VI, Section C, line 18Form 990, Part VI, Section C, Line 18: A copy of the organization's Form 990 is available upon request by contacting the CRC accounting department at 773-878-5744.
Form 990, Part VI, Section C, line 19Form 990, Part VI, Section C, Line 19: The governing documents, conflict of interest policy and financial statements are available upon request by contacting the CRC accounting department at 773-878-5744.
Contact Information for Directors and Officers:Form 990 - Part VI - Line 9All of the organization's directors and officers can be contacted at this address: Covenant Retirement Communities, Inc. - 5700 Old Orchard Road, Skokie, IL 60077.
Related Organization:Form 990 - Part VII - Section AOfficers 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 693,232. Change in Permanently Restricted Net Assets not included on Income Stmnt 42,893. Total to Form 990, Part XI, Line 5: 736,125.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsDirect Controlling Entity NADirectControllingEntityNA
The Samarkand
2550 Treasure DriveSanta BarbaraCA93105953472345Continuing Care Retirement CommunityCA2304418585266074N/A
Covenant Village of Turlock
2125 North Olive AveTurlockCA95380953472345Continuing Care Retirement CommunityCA1424293564484400N/A
Mount Miguel Covenant Village
325 Kempton StreetSpring ValleyCA91977953472345Continuing Care Retirement CommunityCA2029757060752785N/A
Covenant Shores
9150 Fortuna DriveMercer IslandWA98040953472345Continuing Care Retirement CommunityWA1811602650119451N/A

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Evangelical Covenant Church
8303 West Higgins RoadChicagoIL60631362167730ChurchIL501(c)(3)Line 1N/A0
Swedish Covenant Faculty Group (SCFG)
5145 North California AvenueChicagoIL60625363686216Patient Treatment/EducationIL501(c)(3)Line 11a, I0Swedish Covenant Hospital
Swedish Covenant Hospital
5145 North California AvenueChicagoIL60625362179813HospitalIL501(c)(3)Line 30Covenant Ministries of Benevolence
Swedish Covenant Hospital Foundation (SCHF)
5145 North California AvenueChicagoIL60625205055155Supporting Organization of SCHIL501(c)(3)Line 70Swedish Covenant Hospital
SC Insurance Company
6970 E Chauncey Lane Suite 100PhoenixAZ85054273312053InsuranceAZ501(c)(3)Line 11a, I0Swedish Covenant Hospital

Form990 Schedule R Part III Form990ScheduleRPartIII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAPredominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
Cardiovascular Performance Group LLC
5145 N California AvenueChicagoIL60625203587272Management ServicesILN/AN/A00
Coast Asset Management LLC
2450 Colorado Ave Suite 100 E TowerSanta MonicaCA90404954763400Hedge Fund InvestmentCAN/AN/A00
Covenant Village of Portland LP
420 NE Mason StPortlandOR97211364356838Assisted Living CommunityORN/AN/A00
Swedish Covenant Surgery LLC
5215 N California AvenueChicagoIL60625272485300Outpatient Medical ServicesILN/AN/A00

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Address Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryPrimary ActivityPrimaryActivityLegal Domicile Foreign CountryLegalDomicileForeignCountryDirect Controlling Entity NADirectControllingEntityNAAddress Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINLegal Domicile StateLegalDomicileStateType Of EntityTypeOfEntity
Covenant International Insurance Company Ltd
Crawford House 50 Cedar AveHamiltonBDInsuranceBDN/A
Covenant Trust Company
Financial ServicesN/A5215 Old Orchard Rd Suite 725SkokieIL60077363583163ILC
Swedish Covenant Management Services Inc (SCMS)
Physician Practice ManagementN/A5145 N California AvenueChicagoIL60625364073303ILC
Swedish Covenant Managed Care Alliance (SCMCA)
Physician - Hospital OrganizationN/A2740 W Foster Suite 409ChicagoIL60625364118659ILC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Covenant Retirement Communities Inc
A1187945
Covenant Retirement Communities Inc
O7099709
Covenant Trust Company
O199302

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