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COVENANT LIVING WEST: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
COVENANT LIVING WEST (EIN 95-3472345)
Tax period
2017-02-01 to 2018-01-31
Filed
2018-12-15
IRS object ID
201803499349300405
Schema version
2017v2.3
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)
Return2018-12-15T19:01:16-06:00ReturnTs
Tax Period End2018-01-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2017-02-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN953472345EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Covenant Retirement Communities WestBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOVEBusinessNameControlTxt
Phone8056870701PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12550 Treasure DriveAddressLine1Txt
CitySanta BarbaraCityNm
State AbbreviationCAStateAbbreviationCd
ZIP931054892ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJody HoltPersonNm
Person TitleVP of Finance/CFOPersonTitleTxt
Phone7738782294PhoneNum
Signature2018-12-15SignatureDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address99.179.150.174IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-12-15IPDt
IP Tm18:59:44IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id0EB4CE1ACD44DB279B6C2D9A8476B20948576B96AtSubmissionCreationDeviceId
At Submission Filing Device IdD33FA7F254BC09848346BBAA17B51EB9116DA51EAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJody HoltPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line15700 Old Orchard RdAddressLine1Txt
CitySkokieCityNm
State AbbreviationILStateAbbreviationCd
ZIP60077ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$110,179,483GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption2650GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.covenantretirement.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1975FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionCare for Senior AdultsActivityOrMissionDesc
Voting Members Governing Body17VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee1341TotalEmployeeCnt
Total Volunteers178TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,651,781PYContributionsGrantsAmt
CY Contributions Grants$1,874,861CYContributionsGrantsAmt
PY Program Service Revenue$99,719,903PYProgramServiceRevenueAmt
CY Program Service Revenue$101,178,227CYProgramServiceRevenueAmt
PY Investment Income$5,858,496PYInvestmentIncomeAmt
CY Investment Income$4,376,992CYInvestmentIncomeAmt
PY Other Revenue$1,685,064PYOtherRevenueAmt
CY Other Revenue$1,939,389CYOtherRevenueAmt
PY Total Revenue$108,915,244PYTotalRevenueAmt
CY Total Revenue$109,369,469CYTotalRevenueAmt
PY Grants And Similar Paid$40,945PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$40,945CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$41,960,236PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$43,285,538CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$672,261CYTotalFundraisingExpenseAmt
PY Other Expenses$57,973,538PYOtherExpensesAmt
CY Other Expenses$60,416,162CYOtherExpensesAmt
PY Total Expenses$99,974,719PYTotalExpensesAmt
CY Total Expenses$103,742,645CYTotalExpensesAmt
PY Revenues Less Expenses$8,940,525PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,626,824CYRevenuesLessExpensesAmt
Total Assets BOY$345,711,181TotalAssetsBOYAmt
Total Assets EOY$352,660,172TotalAssetsEOYAmt
Total Liabilities BOY$216,516,517TotalLiabilitiesBOYAmt
Total Liabilities EOY$213,582,290TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$129,194,664NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$139,077,882NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionAs 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)MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$29,953,808ExpenseAmt
Grant$40,945GrantAmt
Revenue$46,097,649RevenueAmt
DescResidential Living:The number of persons who benefited from the services we provided for the year ended January 31, 2018 were as follows:There were 1,132 residents occupying 846 apartments as of 1/31/18. The residency for the fiscal year totaled 403,619 resident days.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$9,923,583ExpenseAmt
Revenue$13,954,492RevenueAmt
DescAssisted Living & Assisted Memory Support:The number of persons who benefited from the services we provided for the year ended January 31, 2018 were as follows:There were a total of 191 assisted living residents at 01/31/18. Assisted living residency for the fiscal year totaled 70,385 patient days.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$35,038,666ExpenseAmt
Revenue$43,101,347RevenueAmt
DescSkilled Nursing:The number of persons who benefited from the services we provided for the year ended January 31, 2018 were as follows:There were a total of 332 skilled care patients at 01/31/18.Skilled care residency for the fiscal year totaled 122,036 patient days.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$74,916,057TotalProgramServiceExpensesAmt
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
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
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 ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
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 With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgYes (1)TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document236IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1341EmployeeCnt
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 ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members17GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
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 Members0ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing AddressYes (1)OfficerMailingAddressInd
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 CEO0CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Jody HoltBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7738782294PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1C/O CRC 5700 Old Orchard RdAddressLine1Txt
CitySkokieCityNm
State AbbreviationILStateAbbreviationCd
ZIP60077ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Jon P Aagaard MD
Director1.001.00Yes (X)$0$0$0
Sarah Bentley
Director1.001.00Yes (X)$0$0$0
Pamela Christensen
Director1.001.00Yes (X)$0$0$0
Kara E Davis MD
Director1.001.00Yes (X)$0$0$0
Mark C Eastburg
Director/Chair1.001.00Yes (X)$0$0$0
Marc E Espinosa
Director/Vice Chair1.001.00Yes (X)$0$0$0
Donald Hodgkinson
Director1.001.00Yes (X)$0$0$0
Scott Macdonald
Director1.001.00Yes (X)$0$0$0
Mathew Manlove
Director1.001.00Yes (X)$0$0$0
Dale Glen Rinard
Director1.001.00Yes (X)$0$0$0
Marlene Stante
Director1.001.00Yes (X)$0$0$0
Andrew Vanover
Director1.001.00Yes (X)$0$0$0
Anne E Vining
Director1.001.00Yes (X)$0$0$0
Richard P Nelson
Ex-Officio1.001.00Yes (X)$0$0$0
Gary Walter
Ex-Officio1.001.00Yes (X)$0$0$0
David A Dwight
former Ex-Officio/President1.0040.00Yes (X)$0$512,941$43,574
Roger Oxendale
Ex-Officio1.0040.00Yes (X)$0$183,226$37,485Yes (X)
Terri S Cunliffe
President/Asst Secretary1.0040.00Yes (X)$0$544,189$86,739Yes (X)
Jody Holt
Senior VP/CFO/Treasurer/Asst Secretary1.0040.00Yes (X)$0$175,758$29,300Yes (X)
David G Erickson
Senior VP/General Councel/Asst Secretary1.0040.00$0$289,791$55,484Yes (X)
Rebekah Erickson
Asst Secretary1.0040.00$0$23,693$2,318Yes (X)
Elizabeth B Buikema
Senior VP/CFP/Treasurer1.0040.00$0$291,162$19,281Yes (X)
Richard Miller
Executive Director40.000.00$171,528$0$30,573Yes (X)
Bruce Erickson
Executive Director40.000.00$150,578$0$59,624Yes (X)
Robert Howell
Executive Director40.000.00$214,406$0$28,154Yes (X)
Charles Johnson
Executive Director40.000.00$148,562$0$19,537Yes (X)
Robert Mann
Director of Nursing40.000.00$110,308$0$16,285Yes (X)
Jay S Caddell
Admin-Healthcare40.000.00$140,271$0$4,226Yes (X)
Janice Connelly
Admin-Healthcare40.000.00$129,446$0$14,860Yes (X)
Deborah Noyes
Director of Human Resources40.000.00$113,193$0$22,546Yes (X)
Patricia Ratzlaff
Healthcare Adminitrator40.00$184,424$0$629Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,362,716TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,020,760TotReportableCompRltdOrgAmt
Total Other Compensation$470,615TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K9IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Sodexo Inc & Affiliates
4880 Paysphere CircleChicagoIL60674Dining Services$4,244,913
Bycor General Contractor
6490 Marindustry Pl Suite ASan DiegoCA92121Construction Services$2,194,934
Consonus Rehab
4560 SE International Way Suite 10MilwaukeeOR97222Therapy Services$1,453,142
Casa Construction Company Inc
3675 Montalvo WaySanta BarbaraCA93105Construction Services$562,358
Kitson Landscape Management
5787 Thornwood DriveGoletaCA93117Landscaping Services$438,144
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K54CntrctRcvdGreaterThan100KCnt
Fundraising$176,716FundraisingAmt
All Other Contributions$1,698,145AllOtherContributionsAmt
Total Contributions$1,874,861TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Routine Services623000$56,668,547$56,668,547
Medicare/Medicaid623000$17,135,580$17,135,580
Entrance Fees623000$15,244,860$15,244,860
Ancillary Services623000$11,446,933$11,446,933
Meals623000$682,307$682,307
FieldValueIRS element (for citing)
Total Program Service Revenue$101,178,227TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,378,543TotalRevenueColumnAmt
Exclusion$5,378,543ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$72,685RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$108,557RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$35,872RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$35,872TotalRevenueColumnAmt
Exclusion-$35,872ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities-$1,667,918SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$666,367SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$1,001,551SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$1,001,551TotalRevenueColumnAmt
Exclusion-$1,001,551ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$35,090FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$176,716ContriRptFundraisingEventAmt
Fundraising Direct Expenses$35,090FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Support Services623000$1,017,789$1,017,789
Services to Residents623000$129,843$129,843

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$827,629TotalRevenueColumnAmt
Related Or Exempt Func Income$827,629RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,975,261OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$109,369,469TotalRevenueColumnAmt
Related Or Exempt Func Income$103,153,488RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$4,341,120ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$40,945TotalAmt
Program Services$40,945ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$660,480TotalAmt
Management And General$660,480ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$34,162,228TotalAmt
Program Services$29,142,924ProgramServicesAmt
Management And General$4,825,591ManagementAndGeneralAmt
Fundraising$193,713FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$874,864TotalAmt
Program Services$706,496ProgramServicesAmt
Management And General$162,900ManagementAndGeneralAmt
Fundraising$5,468FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,936,149TotalAmt
Program Services$4,143,033ProgramServicesAmt
Management And General$771,384ManagementAndGeneralAmt
Fundraising$21,732FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,651,817TotalAmt
Program Services$2,210,653ProgramServicesAmt
Management And General$430,011ManagementAndGeneralAmt
Fundraising$11,153FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$539,655TotalAmt
Program Services$539,655ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$234,077TotalAmt
Management And General$234,077ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$56,196TotalAmt
Management And General$56,196ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$11,285,614TotalAmt
Program Services$9,430,275ProgramServicesAmt
Management And General$1,849,059ManagementAndGeneralAmt
Fundraising$6,280FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$329,900TotalAmt
Program Services$4,456ProgramServicesAmt
Management And General$325,444ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$4,229,981TotalAmt
Program Services$3,571,566ProgramServicesAmt
Management And General$652,079ManagementAndGeneralAmt
Fundraising$6,336FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$3,070,680TotalAmt
Program Services$2,781ProgramServicesAmt
Management And General$3,067,899ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$4,800,221TotalAmt
Program Services$4,800,221ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$260,029TotalAmt
Program Services$102,954ProgramServicesAmt
Management And General$156,241ManagementAndGeneralAmt
Fundraising$834FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$174,773TotalAmt
Program Services$13,953ProgramServicesAmt
Management And General$160,380ManagementAndGeneralAmt
Fundraising$440FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$4,417,797TotalAmt
Program Services$3,169,886ProgramServicesAmt
Management And General$1,192,805ManagementAndGeneralAmt
Fundraising$55,106FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$13,482,744TotalAmt
Program Services$9,677,178ProgramServicesAmt
Management And General$3,640,341ManagementAndGeneralAmt
Fundraising$165,225FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$846,494TotalAmt
Program Services$846,494ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Related Party Activity$8,084,159-$57,055$7,967,208$174,006
Dining Services$4,201,108$4,201,108
Resident Care$1,808,561$1,808,561
Admin & General$1,441,145$19,502$1,421,643

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,153,028TotalAmt
Program Services$540,471ProgramServicesAmt
Management And General$580,589ManagementAndGeneralAmt
Fundraising$31,968FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$103,742,645TotalAmt
Program Services$74,916,057ProgramServicesAmt
Management And General$28,154,327ManagementAndGeneralAmt
Fundraising$672,261FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$55,986BOYAmt
EOY$275,832EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$377,738BOYAmt
EOY$30,580EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,519,835BOYAmt
EOY$1,307,215EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$8,566,986BOYAmt
EOY$6,084,847EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$1BOYAmt
EOY$1EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$346,215BOYAmt
EOY$376,606EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$293,721,595LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$137,829,271LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$158,304,602BOYAmt
EOY$155,892,324EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$52,388,314BOYAmt
EOY$50,283,368EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$19,106,714BOYAmt
EOY$30,307,470EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$105,044,790BOYAmt
EOY$108,101,929EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$345,711,181BOYAmt
EOY$352,660,172EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$4,975,298BOYAmt
EOY$1,004,390EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$68,609,797BOYAmt
EOY$71,445,710EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$76,478,425BOYAmt
EOY$74,413,223EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$459,271BOYAmt
EOY$532,035EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$65,993,726BOYAmt
EOY$66,186,932EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$216,516,517BOYAmt
EOY$213,582,290EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$126,284,007BOYAmt
EOY$133,913,932EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,867,649BOYAmt
EOY$5,114,872EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$43,008BOYAmt
EOY$49,078EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$129,194,664BOYAmt
EOY$139,077,882EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$345,711,181BOYAmt
EOY$352,660,172EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$5,626,824ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$2,253,292OtherChangesInNetAssetsAmt
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 Minus4 Years$2,156,631CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,607,737CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,334,574CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,651,781CurrentTaxYearMinus1YearAmt
Current Tax Year$1,874,861CurrentTaxYearAmt
Total$9,625,584TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$72,906,463CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$83,959,676CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$97,214,521CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$99,719,903CurrentTaxYearMinus1YearAmt
Current Tax Year$101,178,227CurrentTaxYearAmt
Total$454,978,790TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$75,063,094CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$85,567,413CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$99,549,095CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$101,371,684CurrentTaxYearMinus1YearAmt
Current Tax Year$103,053,088CurrentTaxYearAmt
Total$464,604,374TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$464,604,374PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,728,694CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,444,981CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,447,255CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,858,496CurrentTaxYearMinus1YearAmt
Current Tax Year$6,380,094CurrentTaxYearAmt
Total$24,859,520TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,728,694CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,444,981CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,447,255CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,858,496CurrentTaxYearMinus1YearAmt
Current Tax Year$6,380,094CurrentTaxYearAmt
Total$24,859,520TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$79,791,788CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$90,012,394CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$102,996,350CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$107,230,180CurrentTaxYearMinus1YearAmt
Current Tax Year$109,433,182CurrentTaxYearAmt
Total$489,463,894TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.94920PublicSupportCY509Pct
Public Support PY5090.94830PublicSupportPY509Pct
Investment Income CY0.05080InvestmentIncomeCYPct
Investment Income PY0.05170InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

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

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$43,008BeginningYearBalanceAmt
Investment Earnings Or Losses$6,070InvestmentEarningsOrLossesAmt
End Year Balance$49,078EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$40,145BeginningYearBalanceAmt
Investment Earnings Or Losses$2,863InvestmentEarningsOrLossesAmt
End Year Balance$43,008EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$45,408BeginningYearBalanceAmt
Investment Earnings Or Losses-$5,263InvestmentEarningsOrLossesAmt
End Year Balance$40,145EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$44,590BeginningYearBalanceAmt
Investment Earnings Or Losses$818InvestmentEarningsOrLossesAmt
End Year Balance$45,408EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$44,515BeginningYearBalanceAmt
Investment Earnings Or Losses$75InvestmentEarningsOrLossesAmt
End Year Balance$44,590EndYearBalanceAmt
FieldValueIRS element (for citing)
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,608,401OtherCostOrOtherBasisAmt
Book Value$4,608,401BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$216,227,811OtherCostOrOtherBasisAmt
Depreciation$106,014,739DepreciationAmt
Book Value$110,213,072BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$62,495,187OtherCostOrOtherBasisAmt
Depreciation$28,910,975DepreciationAmt
Book Value$33,584,212BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,390,196OtherCostOrOtherBasisAmt
Depreciation$2,903,557DepreciationAmt
Book Value$7,486,639BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$155,892,324TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (6 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
Mortgages$145,265F
Domestic Equity$8,353,288F
International Equity$11,687,305F
Hedge Funds & Derivatives$6,154,541F
Private Equity$2,482,842F
Fixed Income$1,484,229F
FieldValueIRS element (for citing)
Total Book Value Securities$30,307,470TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
Deferred Marketing$18,744
Other Investments$3,307,769
Intercompany Advance Accounts$104,775,416
FieldValueIRS element (for citing)
Total Book Value Other Assets$108,101,929TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
Deferred Revenue Subject to Refund$36,345,360
Refundable Contract Liabilities$28,597,678
Accrued Taxes & Employee Benefits$83,122
Other Liabilities$1,160,772
FieldValueIRS element (for citing)
Total Liability$66,186,932TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart IV, Line 2b:FormAndLineReferenceDesc
ExplanationResident 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 Refund Account: The Samarkand is required by State regulations to maintain an entrance fee refund account to fund certain entrance fee refund.ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1CS Benefit DinnerEvent1Nm
Gross Receipts Event1$68,375GrossReceiptsEvent1Amt
Charitable Contri Event1$64,325CharitableContriEvent1Amt
Gross Revenue Event1$4,050GrossRevenueEvent1Amt
Food And Beverage Event1$3,035FoodAndBeverageEvent1Amt
Entertainment Event1$800EntertainmentEvent1Amt
Other Direct Expenses Event1$215OtherDirectExpensesEvent1Amt
Event2SAM Benefit DinnerEvent2Nm
Gross Receipts Event2$78,886GrossReceiptsEvent2Amt
Charitable Contri Event2$66,792CharitableContriEvent2Amt
Gross Revenue Event2$12,094GrossRevenueEvent2Amt
Food And Beverage Event2$4,480FoodAndBeverageEvent2Amt
Entertainment Event2$1,450EntertainmentEvent2Amt
Other Direct Expenses Event2$6,164OtherDirectExpensesEvent2Amt
Other Events Total2OtherEventsTotalCnt
Gross Receipts Other Events$64,545GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$45,599CharitableContriOtherEventsAmt
Gross Revenue Other Events$18,946GrossRevenueOtherEventsAmt
Food And Beverage Other Events$12,350FoodAndBeverageOtherEventsAmt
Entertainment Other Events$4,250EntertainmentOtherEventsAmt
Oth Direct Expnss Other Events$2,346OthDirectExpnssOtherEventsAmt
Gross Receipts Total$211,806GrossReceiptsTotalAmt
Charitable Contributions Tot$176,716CharitableContributionsTotAmt
Gross Revenue Total Events$35,090GrossRevenueTotalEventsAmt
Food And Beverage Total Events$19,865FoodAndBeverageTotalEventsAmt
Entertainment Total Events$6,500EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$8,725OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$35,090DirectExpenseSummaryEventsAmt
Net Income Summary$0NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

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

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeGood Neighbor FundGrantTypeTxt

Supplemental Information Detail SupplementalInformationDetail

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

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsYes (1)CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (1)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 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
David A Dwight
former Ex-Officio/President$0$230,697$0$0$0$282,244$0$30,657$0$15,193$0$558,791$0$0
Roger Oxendale
Ex-Officio$0$100,353$0$15,000$0$67,873$0$14,648$0$22,981$0$220,855$0$0
Terri S Cunliffe
President/Asst Secretary$0$455,990$0$23,520$0$64,679$0$65,450$0$25,139$0$634,778$0$0
Jody Holt
Senior VP/CFO/Treasurer/Asst Secreta$0$158,132$0$0$0$17,626$0$17,910$0$17,901$0$211,569$0$0
David G Erickson
Senior VP/General Councel/Asst Secre$0$239,455$0$0$0$50,336$0$28,904$0$35,396$0$354,091$0$0
Elizabeth B Buikema
Senior VP/CFP/Treasurer$0$19,574$0$25,947$0$245,641$0$9,158$0$10,246$0$310,566$0$0
Richard Miller
Executive Director$140,970$0$4,070$0$26,488$0$5,186$0$25,815$0$202,529$0$0$0
Bruce Erickson
Executive Director$96,708$0$0$0$53,870$0$45,429$0$14,572$0$210,579$0$0$0
Robert Howell
Executive Director$162,477$0$8,250$0$43,679$0$6,195$0$22,399$0$243,000$0$0$0
Charles Johnson
Executive Director$119,799$0$4,000$0$24,763$0$4,128$0$15,716$0$168,406$0$0$0
Patricia Ratzlaff
Healthcare Adminitrator$152,105$0$22,000$0$10,319$0$0$0$1,041$0$185,465$0$0$0

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 1aThe following modest benefits were treated as taxable compensation and were determined by the Executive Compensation Committee (of CRC's Board) to be reasonable: - Health club dues paid for three (3) senior-level employees.
Part I, Line 3See Schedule O explanation for Form 990 Part VI Section B Line 15 for the methods used to determine CEO compensation. The review and approval process is designed to satisfy and qualify for the rebuttable presumption of reasonableness under the Internal Revenue Code Section 4958.
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 Executive Compensation Committee of CMB's Board ("Committee") 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 Committee has determined that total compensation for each such executive is reasonable. Contributions were made to the deferred compensation plan for the following participants: Elizabeth Buikema - $5,766 Terri Cunliffe - $60,601 David Dwight - $22,395 David Erickson - $29,318 Rebekah Erickson - $2,133 Jody Holt- $22,773
Part I, Line 7The following applies to certain individuals listed on Part VII whose compensation is paid from related organizations: The Executive Compensation Committee (of CMB's board) follows a prescribed method for calculating incentive compensation awards. 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 or on factors that will assure that final incentive compensation awards are in the best interest of the organization and appropriately reflect the performance of the organization. Refer to additional information on the Committee included in Schedule O.
Part II, Column B (ii):Bonus and incentive compensation - Certain key persons employed by CRC and CMB are eligible for incentive compensation as determined by the Executive Compensation Committee of either the CRC or CMB's Board based on where these individuals are employed. Incentives paid in 2017 relate to the achievement of targets for the fiscal year ended 1/31/2017.
Part II, Column D:Nontaxable benefits include health insurance premiums paid by the employer and employee.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 - Part III - Line 1Mission Statement As a ministry of the Evangelical Covenant Church, Covenant Retirement Communities celebrate God's gift of life in Christian community. We follow the Great Commandment to love and serve God and one another as taught by Jesus Christ. That compels us to affirm the dignity of each person and to pursue excellence and financial integrity in all that we do. As we provide a broad range of resources, services and programs to enhance individual and community wellness, we collaborate with residents and families to achieve the best possible results. While seeking to foster independence, we respond to each individual's evolving needs in order to provide the security that assures peace of mind. In living out the mission, the community provides a complete continuum of care from residential living through skilled nursing. Such services are guided by a series of values and goals addressing resident needs, privacy, safety and dignity, including appropriate access to services. In carrying out the mission statement of Covenant Retirement Communities, Covenant Retirement Communties West provided $1,235,660 of free or discounted services to those residents unable to pay all or a portion of their charges, and who meet certain eligibility requirements.
Form 990 - Part IV - Line 24aTax-Exempt Bonds The 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 11bManagement Review: The draft Form 990 was reviewed by multiple levels of management including the Vice President of Finance/CFO and the Vice President of Legal Affairs. Board Review: Prior to filing, the 990 process was reviewed 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 18A 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 19The governing documents, conflict of interest policy and financial statements are available upon request by contacting the CRC accounting department at 773-878-5744.
Form 990 - Part VI - Line 9Contact Information for Directors and Officers All of the organization's directors and officers can be contacted at this address: Covenant Retirement Communities, Inc. - 5700 Old Orchard Road, Skokie, IL 60077.
Form 990 - Part VII - Section A Column BRelated Organization Officers and Directors devote approximately 1 hour per week to related organizations except for those individuals that are employees of these related organizations; those individuals devote approximately 40 hours to the organizations at which they are employed.
Form 990, Part IX, line 11gContracted Healthcare Services: Program service expenses 9,430,275. Management and general expenses 0. Fundraising expenses 0. Total expenses 9,430,275. Consultant Services: Program service expenses 0. Management and general expenses 1,849,059. Fundraising expenses 0. Total expenses 1,849,059. Payroll Services: Program service expenses 0. Management and general expenses 0. Fundraising expenses 6,280. Total expenses 6,280.
Form 990, Part XI, line 9:Change in Temporarily Restricted Net Assets not included on Income Stmnt 2,247,222. Change in Permanently Restricted Net Assets not included on Income Stmnt 6,070.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
The Samarkand
2550 Treasure DriveSanta BarbaraCA93105953472345Continuing Care Retirement CommunityCAN/A
Covenant Village of Turlock
2125 North Olive AveTurlockCA95380953472345Continuing Care Retirement CommunityCAN/A
Mount Miguel Covenant Village
325 Kempton StreetSpring ValleyCA91977953472345Continuing Care Retirement CommunityCAN/A
Covenant Shores
9150 Fortuna DriveMercer IslandWA98040953472345Continuing Care Retirement CommunityWAN/A
Brandel Manor
1801 North Olive AvenueTurlockCA95380953472345Continuing Care Retirement CommunityCAN/A

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
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 12b, II0Swedish Covenant Hospital
Swedish Covenant Hospital
5145 North California AvenueChicagoIL60625362179813HospitalIL501(c)(3)Line 30Covenant Ministries of Benevolence
Swedish Covenant Hospital Foundation (SCHF)
5145 North California AvenueChicagoIL60625205055155Support of Swedish Covenant HospitalIL501(c)(3)Line 70Swedish Covenant Hospital
SC Insurance Company
6970 E Chauncey Lane Suite 100PhoenixAZ85054273312053InsuranceAZ501(c)(3)Line 12b, II0Swedish Covenant Hospital

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Covenant Village of Portland LPBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1420 NE Mason StAddressLine1Txt
CityPortlandCityNm
State AbbreviationORStateAbbreviationCd
ZIP97211ZIPCd
FieldValueIRS element (for citing)
EIN364356838EIN
Primary ActivitiesAssisted Living CommunityPrimaryActivitiesTxt
Legal Domicile StateORLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Predominant Income TypeN/APredominantIncomeTypeTxt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile Foreign CountryLegalDomicileForeignCountryCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINLegal Domicile StateLegalDomicileStateCd
Covenant International Insurance Company Ltd
Crawford House 50 Cedar AveHamiltonBDInsuranceBDN/AC0
Covenant Trust Company
Financial ServicesN/AC08303 West Higgins Road 6th FloorChicagoIL60631363583163IL
Swedish Covenant Management Services Inc (SCMS)
Physician Practice ManagementN/AC05145 N California AvenueChicagoIL60625364073303IL
Swedish Covenant Managed Care Alliance (SCMCA)
Physician - Hospital OrganizationN/AC02740 W Foster Suite 409ChicagoIL60625364118659IL
St Francis Health Care Ltd
Independent Group of PhysiciansN/AC02740 W Foster Suite 002ChicagoIL60625363208131IL
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
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 Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmt
Covenant Retirement Communities Inc
A$2,064,450
Covenant Retirement Communities Inc
P$1,223,673
Covenant Trust Company
P$131,945