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BENEDICTINE LIVING COMMUNITY OWATONNA: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
BENEDICTINE LIVING COMMUNITY OWATONNA (EIN 27-0705237)
Tax period
2022-07-01 to 2023-06-30
Filed
2024-05-09
IRS object ID
202421309349304097
Schema version
2022v5.0
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)
Return2024-05-09T14:54:04-05:00ReturnTs
Tax Period End2023-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1220 S 6TH STREET SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN270705237EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BENEDICTINE LIVING COMMUNITY - OWATONNABusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBENEBusinessNameControlTxt
Phone7633472200PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16499 UNIVERSITY AVENUE NE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55432ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKEVIN RYMANOWSKIPersonNm
Person TitleCFOPersonTitleTxt
Phone7633472200PhoneNum
Signature2024-05-08SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstKEVINPersonFirstNm
Person LastRYMANOWSKIPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMACKENZIE MCNAUGHTONPreparerPersonNm
PTINP02025805PTIN
Phone6123764500PhoneNum
Preparation2024-05-08PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJERRY CARLEYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line16499 UNIVERSITY AVENUE NE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55432ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$11,012,295GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.BENEDICTINELIVING.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2009FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionBY WORKING TOGETHER, OUR MISSION IS TO INTEGRATE A CONTINUUM OF SERVICES WITH GENUINE COMPASSIONATE CARE FOR OUR COMMUNITIES.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee236TotalEmployeeCnt
Total Volunteers24TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$650,608PYContributionsGrantsAmt
CY Contributions Grants$10,113CYContributionsGrantsAmt
PY Program Service Revenue$10,716,646PYProgramServiceRevenueAmt
CY Program Service Revenue$10,984,879CYProgramServiceRevenueAmt
PY Investment Income-$4,322PYInvestmentIncomeAmt
CY Investment Income$16,890CYInvestmentIncomeAmt
PY Other Revenue$127,873PYOtherRevenueAmt
CY Other Revenue$413CYOtherRevenueAmt
PY Total Revenue$11,490,805PYTotalRevenueAmt
CY Total Revenue$11,012,295CYTotalRevenueAmt
PY Grants And Similar Paid$166,658PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$76,281CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$6,241,481PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$6,397,798CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$4,735,435PYOtherExpensesAmt
CY Other Expenses$4,930,656CYOtherExpensesAmt
PY Total Expenses$11,143,574PYTotalExpensesAmt
CY Total Expenses$11,404,735CYTotalExpensesAmt
PY Revenues Less Expenses$347,231PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$392,440CYRevenuesLessExpensesAmt
Total Assets BOY$16,288,578TotalAssetsBOYAmt
Total Assets EOY$15,447,491TotalAssetsEOYAmt
Total Liabilities BOY$14,020,074TotalLiabilitiesBOYAmt
Total Liabilities EOY$13,583,942TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,268,504NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,863,549NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionWE ARE A CATHOLIC, FAITH-BASED ORGANIZATION ENTRUSTED WITH ADVANCING THE LIFE-ENAHANCING SENIOR CARE MINISTRY OF THE BENEDICTINE SISTERS OF DULUTH, MINNESOTA. WE WITNESS TO GOD'S LOVE BY CREATING COMPASSIONATE COMMUNITIES PROVIDING SUPPORT TO THOSE WE SERVE TO LIVE FULLY AND LIVE WELL WITH SPECIAL CONCERN FOR THE UNDERSERVED AND THOSE IN NEED.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$10,008,431ExpenseAmt
Grant$76,281GrantAmt
Revenue$10,984,879RevenueAmt
DescOPERATION OF BENEDICTINE LIVING COMMUNITY - OWATONNA IS A79-BED SKILLED NURSING FACILITY IN OWATONNA, MN. THE FACILITY HAD 94.8% OCCUPANCY AND SERVED 551 INDIVIDUALS DURING THE YEAR ENDED 6/30/23.Desc
Total Program Service Expenses$10,008,431TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document40IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee236EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonKEVIN RYMANOWSKI CFOPersonNm
Phone7636896107PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16499 UNIVERSITY AVENUE NE SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55432ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
JERRY CARLEY
CEO OF BHS1.0039.00Yes (X)Yes (X)$0$654,097$158,313
KEVIN RYMANOWSKI
CFO OF BHS & TREASURER1.0039.00Yes (X)Yes (X)$0$389,056$83,733
JENNIFER BRUHN
OPERATIONS VP1.0039.00Yes (X)Yes (X)$0$212,586$45,164
TOM SHEA
CHAIR1.000.00Yes (X)Yes (X)$0$0$0
RICHARD SLIETER
VICE CHAIR1.000.00Yes (X)Yes (X)$0$0$0
SANDRA MILLER
DIRECTOR1.000.00Yes (X)$0$0$0
JIM OBERG
DIRECTOR1.000.00Yes (X)$0$0$0
ANNE DRAEGER
DIRECTOR1.000.00Yes (X)$0$0$0
MATT KOTTKE
DIRECTOR1.000.00Yes (X)$0$0$0
LISA KERN
EXECUTIVE DIRECTOR40.000.00Yes (X)$0$108,168$25,289
WANDA DELEON
CNA-NAR40.000.00$117,370$0$6,580Yes (X)
BOBBI-JO NESSETH
DIRECTOR OF NURSING40.000.00$102,371$0$25,889Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$219,741TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,363,907TotReportableCompRltdOrgAmt
Total Other Compensation$344,968TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
BENEDICTINE HEALTH SYSTEM
6499 UNIVERSITY AVE NE SUITE 300MINNEAPOLISMN55442MANAGEMENT SERVICES$859,526
RTG MEDICAL
4611 EAST 22ND STREETFREMONTNE68025TEMPORARY NURSING STAFF$739,039
GRAPETREE MEDICAL STAFFING
PO BOX 5340SIOUX FALLSSD57117TEMPORARY NURSING STAFF$273,046
FAMILY TRUST HOME HEALTH LLC
5901 BROOKLYN BLVDBROOKLYN CENTERMN55429TEMPORARY NURSING STAFF$184,448
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt
Related Organizations$10,113RelatedOrganizationsAmt
Total Contributions$10,113TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescSKILLED NURSINGDesc
Business623000BusinessCd
Total Revenue Column$10,984,879TotalRevenueColumnAmt
Related Or Exempt Func Income$10,984,879RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$10,984,879TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,890TotalRevenueColumnAmt
Exclusion$16,890ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS REVENUEDesc
Business623990BusinessCd
Total Revenue Column$413TotalRevenueColumnAmt
Exclusion$413ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$413OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,012,295TotalRevenueColumnAmt
Related Or Exempt Func Income$10,984,879RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$17,303ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$69,893TotalAmt
Program Services$69,893ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$6,388TotalAmt
Program Services$6,388ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,224,576TotalAmt
Program Services$4,901,410ProgramServicesAmt
Management And General$323,166ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$57,220TotalAmt
Program Services$57,220ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$728,244TotalAmt
Program Services$728,244ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$387,758TotalAmt
Program Services$387,758ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$654,611TotalAmt
Management And General$654,611ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$31,090TotalAmt
Management And General$31,090ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$18,630TotalAmt
Management And General$18,630ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,615,910TotalAmt
Program Services$1,571,825ProgramServicesAmt
Management And General$44,085ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$32,224TotalAmt
Management And General$32,224ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$66,252TotalAmt
Program Services$32,007ProgramServicesAmt
Management And General$34,245ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$359,665TotalAmt
Program Services$329,624ProgramServicesAmt
Management And General$30,041ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$26,560TotalAmt
Program Services$22,884ProgramServicesAmt
Management And General$3,676ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$366,871TotalAmt
Program Services$366,871ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$497,830TotalAmt
Program Services$497,830ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$94,808TotalAmt
Management And General$94,808ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLY EXPENSE$407,777$399,910$7,867
FOOD$315,357$315,357
SURCHARGE$222,385$222,385
MISCELLANEOUS$122,204$2,219$119,985

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$98,482TotalAmt
Program Services$96,606ProgramServicesAmt
Management And General$1,876ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$11,404,735TotalAmt
Program Services$10,008,431ProgramServicesAmt
Management And General$1,396,304ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,720,615BOYAmt
EOY$1,509,190EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,415,568BOYAmt
EOY$1,236,393EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$46,599BOYAmt
EOY$34,792EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$14,307,595LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$3,253,758LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$11,459,994BOYAmt
EOY$11,053,837EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$882,431BOYAmt
EOY$856,893EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$763,371BOYAmt
EOY$756,386EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$16,288,578BOYAmt
EOY$15,447,491EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$794,654BOYAmt
EOY$943,084EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$78,741BOYAmt
EOY$43,141EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,972,546BOYAmt
EOY$12,439,484EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$15,160BOYAmt
EOY$17,526EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$117,513BOYAmt
EOY$68,428EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$41,460BOYAmt
EOY$72,279EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$14,020,074BOYAmt
EOY$13,583,942EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,199,901BOYAmt
EOY$1,801,945EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$68,603BOYAmt
EOY$61,604EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,268,504BOYAmt
EOY$1,863,549EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$16,288,578BOYAmt
EOY$15,447,491EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$392,440ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$5,515NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$7,000OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$75,029CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$531,920CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$650,608CurrentTaxYearMinus1YearAmt
Current Tax Year$10,113CurrentTaxYearAmt
Total$1,267,670TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,823,775CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,191,887CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,077,163CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,716,646CurrentTaxYearMinus1YearAmt
Current Tax Year$10,984,879CurrentTaxYearAmt
Total$55,794,350TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,823,775CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,266,916CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,609,083CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$11,367,254CurrentTaxYearMinus1YearAmt
Current Tax Year$10,994,992CurrentTaxYearAmt
Total$57,062,020TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$101,626CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$382,619CurrentTaxYearMinus1YearAmt
Current Tax Year$695,403CurrentTaxYearAmt
Total$1,179,648TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$101,626CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$382,619CurrentTaxYearMinus1YearAmt
Current Tax Year$695,403CurrentTaxYearAmt
Total$1,179,648TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$55,882,372PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,271CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,868CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,942CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year-$4,322CurrentTaxYearMinus1YearAmt
Current Tax Year$16,890CurrentTaxYearAmt
Total$24,649TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,271CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,868CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,942CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year-$4,322CurrentTaxYearMinus1YearAmt
Current Tax Year$16,890CurrentTaxYearAmt
Total$24,649TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,538CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$134,652CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years-$178,041CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$127,873CurrentTaxYearMinus1YearAmt
Current Tax Year$413CurrentTaxYearAmt
Total$91,435TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,831,584CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,403,436CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,439,984CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$11,490,805CurrentTaxYearMinus1YearAmt
Current Tax Year$11,012,295CurrentTaxYearAmt
Total$57,178,104TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.97730PublicSupportCY509Pct
Public Support PY5090.91850PublicSupportPY509Pct
Investment Income CY0.00040InvestmentIncomeCYPct
Investment Income PY0.00010InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationMISCELLANEOUS INCOMEExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$710,000OtherCostOrOtherBasisAmt
Book Value$710,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,592,615OtherCostOrOtherBasisAmt
Depreciation$1,814,689DepreciationAmt
Book Value$9,777,926BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$769,354OtherCostOrOtherBasisAmt
Depreciation$408,611DepreciationAmt
Book Value$360,743BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,235,626OtherCostOrOtherBasisAmt
Depreciation$1,030,458DepreciationAmt
Book Value$205,168BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$11,053,837TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO AFFILIATESDesc
Amt$72,279Amt
FieldValueIRS element (for citing)
Total Liability$72,279TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, LINE 2B:CARETAKER OF RESIDENT TRUST FUNDS AND SECURITY DEPOSITS IN A SEPARATE ACCOUNT.
PART X, LINE 2:INCOME TAXES HE ORGANIZATION 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'S 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 FILES ALL APPLICABLE RETURNS FOR ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtValuation Method UsedValuationMethodUsedDescNon Cash AssistanceNonCashAssistanceDescPurpose Of GrantPurposeOfGrantTxt
BENEDICTINE HEALTH SYSTEM
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411531892501(C)(3)$31,608$0N/AN/ASYSTEM SUPPORT &
BENEDICTINE LIVING COMMUNITIES INC
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411639687501(C)(3)$38,047$0N/AN/ASTRATEGIC CAPITAL
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeSCHOLARSHIPSGrantTypeTxt
Recipient10RecipientCnt
Cash Grant$6,388CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt
Valuation Method UsedN/AValuationMethodUsedDesc
Non Cash AssistanceN/ANonCashAssistanceDesc

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTRANSFERS BETWEEN RELATED ORGANIZATIONS ARE ACCOUNTED FOR IN INTERNAL FINANCIAL STATEMENTS, OF WHICH ALL ARE UNDER COMMON CONTROL.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JERRY CARLEY
CEO OF BHS$0$531,906$0$13,264$0$108,927$0$134,579$0$23,734$0$812,410$0$0
KEVIN RYMANOWSKI
CFO OF BHS & TREASURER$0$344,257$0$6,421$0$38,378$0$65,610$0$18,123$0$472,789$0$0
JENNIFER BRUHN
OPERATIONS VP$0$183,732$0$1,500$0$27,354$0$36,054$0$9,110$0$257,750$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART III - ADDITIONAL INFORMATIONFormAndLineReferenceDesc
ExplanationBENEDICTINE HEALTH SYSTEM'S (EIN: 41-1531892) CEO, JERRY CARLEY, SHARE THEIR TIME BETWEEN THE REPORTING ORGANIZATION AND RELATED ORGANIZATIONS. THE CEO IS COMPENSATED BY BENEDICTINE HEALTH SYSTEM, A RELATED ORGANIZATION. THIS ORGANIZATION USES THE FOLLOWING TO SET CEO/ ADMINISTRATIVE COMPENSATIONS: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. WRITTEN EMPLOYMENT CONTRACT 4. COMPENSATION SURVEY OR STUDY 5. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1DULUTH ECONOMIC DEVELOPMENT AUTHORITYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN900848286BondIssuerEIN
CUSIP26444VAH3CUSIPNum
Bond Issued2021-07-15BondIssuedDt
Issue Price$13,711,917IssuePriceAmt
PurposeREFINANCING AND PROJECT COSTSPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$958,495RetiredAmt
Total Proceeds$13,711,917TotalProceedsAmt
In Reserve Fund$507,700InReserveFundAmt
Refunding Escrow$12,779,191RefundingEscrowAmt
Issuance Costs From Proceeds$250,029IssuanceCostsFromProceedsAmt
Unspent$175,000UnspentAmt
Substantial Completion2021SubstantialCompletionYr
Refunding Tax Exempt BondsYes (1)RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0.00000PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00000PrivateBusConcerningUBIPct
Total Private Business Use0.00000TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due YetYes (1)RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1ATHE EXECUTIVE COMMITTEE (COMPRISED OF THE CHAIR, VICE-CHAIR, BOARD SECRETARY, AND THE CHAIRS OF THE STANDING COMMITTEES) IS AUTHORIZED TO ACT ON BEHALF OF THE BOARD IN THE INTERVAL BETWEEN MEETINGS OF THE BOARD, PROVIDED, HOWEVER, THAT IT MAY NOT DETERMINE MATTERS OF POLICY WITHOUT PRIOR SPECIFIC AUTHORIZATION OF THE BOARD.
FORM 990, PART VI, SECTION A, LINE 3THE CORPORATION CONTRACTS WITH BENEDICTINE HEALTH SYSTEM, A RELATED ORGANIZATION, FOR MANAGEMENT SERVICES. BENEDICTINE HEALTH SYSTEM EMPLOYED THE ADMINISTRATOR/CEO OF THE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 6BENEDICTINE HEALTH SYSTEM, A MINNESOTA NONPROFIT CORPORATION, IS THE SOLE MEMBER OF THE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7AEACH DIRECTOR OF THE CORPORATION IS APPOINTED BY BENEDICTINE HEALTH SYSTEM.
FORM 990, PART VI, SECTION A, LINE 7BTHE FOLLOWING ACTIONS OF THIS CORPORATION ARE RESERVED TO THE MEMBERS WHICH MAY ONLY ACT ON UNANIMOUS APPROVAL OF THE MEMBERS: - AMENDMENTS TO THE GOVERNING INSTRUMENTS - MERGER, CONSOLIDATION, LIQUIDATION OR DISOLUTION OF THE ORGANIZATION - ISSUANCE AND TRANSFER OF MEMBERSHIP INTERESTS - DISTRIBUTIONS OF ASSETS
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH INFORMATION PROVIDED BY MANAGEMENT. THE RETURN WAS THEN REVIEWED BY THE CFO. AN ELECTRONIC COPY OF THE FORM 990 WAS DISTRIBUTED TO THE GOVERNING BODY PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO DISCLOSE ANY RELATIONSHIPS THAT CONSTITUTE OR MIGHT LEAD TO A CONFLICT OF INTEREST BY COMPLETING THE CONFLICT OF INTEREST AND GIFT DISCLOSURE STATEMENT. THE BHS COMPLIANCE DEPARTMENT WILL DISTRIBUTE THE STATEMENTS AND COLLECT AND MAINTAIN THE COMPLETED STATEMENTS. THE BHS COMPLIANCE MANAGER WILL REVIEW THE STATEMENTS AND PROVIDE A SUMMARY OF THE IDENTIFIED CONFLICTS OF INTEREST TO THE BHS CHIEF COMPLIANCE OFFICER, WHO WILL ALERT THE BHS CEO AND THE CHAIR OF THE BHS BOARD OF DIRECTORS TO ANY ITEMS OF CONCERN. AN "INTERESTED PERSON" IS ANY PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE SYSTEM, INCLUDING BUT NOT LIMITED TO A BOARD MEMBER, BOARD COMMITTEE MEMBER, OR OFFICER OR DIRECTOR OF BHS OR A FACILITY (SUCH AS FACILITY CEO/ADMINISTRATORS AND BHS SENIOR LEADERS AND DIRECTORS). FOR INTERESTED PERSONS WHO ARE EMPLOYEES (OTHER THAN THE BHS CEO), FOLLOWING DISCLOSURE OF THE ACTUAL OR POTENTIAL CONFLICT OF INTEREST AND ALL MATERIAL FACTS,THE INTERESTED PERSON'S SUPERVISOR WILL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. FOR THE BHS CEO AND BOARD AND COMMITTEE MEMBERS, FOLLOWING DISCLOSURE OF THE ACTUAL OR POTENTIAL CONFLICT OF INTEREST AND ALL MATERIAL FACTS, THE INTERESTED PERSON WILL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE REMAINING MEMBERS OF THE BOARD OR COMMITTEE DETERMINE IF A CONFLICT OF INTEREST EXISTS. THE INTERESTED PERSON MAY PARTICIPATE IN DELIBERATION REGARDING THE TRANSACTION IF THE APPLICABLE SUPERVISOR, BOARD, OR COMMITTEE DETERMINES A CONFLICT OF INTEREST DOES NOT EXIST. AN INTERESTED PERSON WHO HAS BEEN DETERMINED TO HAVE A CONFLICT OF INTEREST MAY NOT PARTICIPATE IN THE DELIBERATION OR DECISION REGARDING THE TRANSACTION OR ARRANGEMENT INVOLVING THE CONFLICT OF INTEREST AND MAY NOT BE PRESENT DURING SUCH DELIBERATION OR DECISION MAKING. THE INTERESTED PERSON MAY BE ALLOWED TO MAKE A PRESENTATION TO THE SUPERVISOR, BOARD, OR COMMITTEE CONSIDERING THE TRANSACTION OR ARRANGEMENT AS TO WHICH THE CONFLICT OF INTERESTS REFERS PRIOR TO THE DELIBERATION AND DECISION.
FORM 990, PART VI, SECTION B, LINE 15ACOMPENSATION FOR THE ORGANIZATION'S CEO IS DETERMINED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THIS COMMITTEE IS COMPRISED ENTIRELY OF INDEPENDENT DIRECTORS. THE COMPENSATION COMMITTEE REVIEWS DATA ON COMPENSATION PROVIDED TO INDIVIDUALS HOLDING COMPARABLE POSITIONS IN COMPARABLE ORGANIZATIONS IN ORDER TO ESTABLISH A REASONABLE COMPENSATION RANGE. THE DATA IS COLLECTED AND REVIEWED WITH THE COMPENSATION COMMITTEE BY AN INDEPENDENT CONSULTANT. BASED ON THE MARKET DATA AND IN LIGHT OF ANY SPECIFIC INDIVIDUAL BENEDICTINE HEALTH SYSTEM 41-1531892 QUALIFICATIONS, THE COMPENSATION COMMITTEE DETERMINES COMPENSATION. THE DELIBERATIONS AND DETERMINATIONS OF THE COMPENSATION COMMITTEE ARE RECORDED CONTEMPORANEOUSLY AND PROVIDED TO THE GOVERNING BODY FOR REVIEW. COMPENSATION FOR THE CFO, OTHER OFFICERS, AND OTHER KEY EMPLOYEES OF THE ORGANIZATION IS DETERMINED BY THE CEO.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO PUBLIC.
OFFICER COMPENSATIONBENEDICTINE HEALTH SYSTEM'S (EIN: 41-1531892) CEO AND CFO, JERRY CARLEY AND KEVIN RYMANOWSKI, SHARE THEIR TIME BETWEEN THE REPORTING ORGANIZATION AND RELATED ORGANIZATIONS. SEE SCHEDULE R FOR INFORMATION ON RELATED ORGANIZATIONS.
FORM 990, PART IX, LINE 11GPURHCASED SERVICES: PROGRAM SERVICE EXPENSES 1,571,825. MANAGEMENT AND GENERAL EXPENSES 44,085. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,615,910.
FORM 990, PART XI, LINE 9:CHANGE IN INVESTMENT IN FOUNDATION -7,000.
FORM 990, PART XII, LINE 2C:THE BENEDICTINE HEALTH SYSTEM AUDIT/ FINANCE COMMITTEE OVERSEES THE SELECTION OF THE INDEPENDENT AUDITOR AND OVERSEES THE ANNUAL CONSOLIDATED AUDIT OF BENEDICTINE HEALTH SYSTEM AND AFFILIATES WHICH INCLUDES THE ORGANIZATION.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1PARK PLACE SENIOR LIVING LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line16499 UNIVERSITY AVE NE SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55432ZIPCd
FieldValueIRS element (for citing)
EIN384050146EIN
Primary ActivitiesASSISTED LIVINGPrimaryActivitiesTxt
Legal Domicile StateMNLegalDomicileStateCd
Total Income$0TotalIncomeAmt
End Of Year Assets$0EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1KODA LIVING COMMUNITYBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (31 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
CERENITY CARE CENTER - WHITE BEAR LAKE
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411983267NURSING HOMEMN501(C)(3)LINE 10N/A0
BENEDICTINE HEALTH SYSTEM
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411531892SUPPORTING ORGANIZATIONMN501(C)(3)LINE 10N/A0
VILLA ST BENEDICT
1920 MAPLE AVENUELISLEIL60532364343235NURSING HOMEMN501(C)(3)LINE 10N/A0
NAZARETH LIVING CENTER
2 NAZARETH LANEST LOUISMO63129431450394NURSING FACILITYMN501(C)(3)LINE 10N/A0
CERENITY SENIOR CARE
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411983267NURSING HOMEMN501(C)(3)LINE 10N/A0
BLC OF ST PETER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432861113231NURSING HOMEMN501(C)(3)LINE 10Yes (1)BHS
BLC - WINSTED
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432274219293NURSING HOMEMN501(C)(3)LINE 10Yes (1)BHS
BLC - WAHPETON
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432454274091ASSISTED LIVINGMN501(C)(3)LINE 10Yes (1)BHS
BLC - RED WING
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432454929398NURSING HOMEMN501(C)(3)LINE 10Yes (1)BHS
BLC - NEW LONDON
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432274218436NURSING HOMEMN501(C)(3)LINE 10Yes (1)BHS
BLC - BYRON
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432471538777ASSISTED LIVINGMN501(C)(3)LINE 10Yes (1)BHS
BLC - BISMARCK
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432264376543ASSISTED LIVINGMN501(C)(3)LINE 10Yes (1)BHS
BENEDICTINE LIVING COMMUNITIES
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411639687NURSING HOMESMN501(C)(3)LINE 10Yes (1)BHS
BENEDICTINE HEALTH CENTER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411381401NURSING HOMEMN501(C)(3)LINE 10Yes (1)BHS
BENEDICTINE CARE CENTERS
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411907571NURSING HOMESMN501(C)(3)LINE 10Yes (1)BHS
BRIDGES CARE CENTER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432262620983ASSISTED LIVINGMN501(C)(3)LINE 10Yes (1)BHS
MADONNA TOWERS OF ROCHESTER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411809914NURSING HOMEMN501(C)(3)LINE 10Yes (1)BHS
BSLC - ST PETER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432272716531NURSING HOMEMN501(C)(3)LINE 10Yes (1)BHS
STEEPLE POINTE SEN LIVING COMMUNITY
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411852273ASSISTED LIVINGMN501(C)(3)LINE 10Yes (1)BHS
ST GERTRUDE'S HEALTH CENTER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411848720NURSING HOMEMN501(C)(3)LINE 10Yes (1)BHS
SAINT ANNE OF WINONA
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432410850791NURSING HOMEMN501(C)(3)LINE 10Yes (1)BHS
ROSEWOOD COURT
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432412011389ASSISTED LIVINGMN501(C)(3)LINE 10Yes (1)BHS
REGINA SENIOR LIVING
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432463700475NURSING HOMEMN501(C)(3)LINE 10Yes (1)BHS
MADONNA MEADOWS OF ROCHESTER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432470855891ASSISTED LIVINGMN501(C)(3)LINE 10Yes (1)BHS
LIVING COMMUNITY OF ST JOSEPH
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432412011661NURSING HOMEMN501(C)(3)LINE 10Yes (1)BHS
ELLENDALE EVERGREEN PLACE
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411796445ASSISTED LIVINGMN501(C)(3)LINE 10Yes (1)BHS
CITY OF LAKES CARE CENTER
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411985663NURSING HOMEMN501(C)(3)LINE 10Yes (1)BHS
BENEDICTINE HEALTH SYSTEM FOUNDATION
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411513014FUND DEVELOPMENTMN501(C)(3)LINE 10Yes (1)BHS
ARROWHEAD SENIOR LIVING COMMUNITIES
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411978619NURSING HOMEMN501(C)(3)LINE 10Yes (1)BHS
CATHOLIC RESIDENTIAL SERVICES
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432390982340NURSING HOMEWI501(C)(3)LINE 10Yes (1)BHS
VILLA ST VINCENT
6499 UNIVERSITY AVENUE NE SUITE 300MINNEAPOLISMN55432411352227NURSING HOMEMN501(C)(3)LINE 10Yes (1)BHS

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1BENEDICTINE GROUP SELF-INSURANCE ASSOCIATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line16499 UNIVERSITY AVE NE SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55432ZIPCd
FieldValueIRS element (for citing)
EIN411548753EIN
Primary ActivitiesWORKERS' COMPENSATION PROGRAMPrimaryActivitiesTxt
Legal Domicile StateMNLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeSEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd