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COVENANT PLACE OF LENEXA INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
COVENANT PLACE OF LENEXA INC (EIN 45-2693240)
Tax period
2016-02-01 to 2017-01-31
Filed
2017-11-08
IRS object ID
201703129349301545
Schema version
2016v3.0
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)
Return2017-11-08T10:29:43-06:00ReturnTs
Tax Period End2017-01-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2016-02-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN452693240EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Covenant Place of Lenexa IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOVEBusinessNameControlTxt
Phone7738782294PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15700 Old Orchard RoadAddressLine1Txt
CitySkokieCityNm
State AbbreviationILStateAbbreviationCd
ZIP60077ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJody HoltPersonNm
Person TitleVP of Finance/CFOPersonTitleTxt
Phone7738782294PhoneNum
Signature2017-11-08SignatureDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address69.8.120.204IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-11-08IPDt
IP Tm10:24:59IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id475448EDD106694E6004F08D4B312B5174DD2527AtSubmissionCreationDeviceId
At Submission Filing Device Id475448EDD106694E6004F08D4B312B5174DD2527AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2018-03-14 21:41:22ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJody HoltPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1c/o CRC - 5700 Old Orchard RdAddressLine1Txt
CitySkokieCityNm
State AbbreviationILStateAbbreviationCd
ZIP60077ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$5,529,741GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption2650GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.covenantretirement.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2011FormationYr
Legal Domicile StateKSLegalDomicileStateCd
Activity Or MissionCare for senior adultsActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee119TotalEmployeeCnt
Total Volunteers7TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$252PYContributionsGrantsAmt
CY Contributions Grants$862CYContributionsGrantsAmt
PY Program Service Revenue$6,173,964PYProgramServiceRevenueAmt
CY Program Service Revenue$5,464,287CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$35,834PYOtherRevenueAmt
CY Other Revenue$64,592CYOtherRevenueAmt
PY Total Revenue$6,210,050PYTotalRevenueAmt
CY Total Revenue$5,529,741CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$2,371,192PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$2,604,310CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$3,384,405PYOtherExpensesAmt
CY Other Expenses$3,580,507CYOtherExpensesAmt
PY Total Expenses$5,755,597PYTotalExpensesAmt
CY Total Expenses$6,184,817CYTotalExpensesAmt
PY Revenues Less Expenses$454,453PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$655,076CYRevenuesLessExpensesAmt
Total Assets BOY$18,165,543TotalAssetsBOYAmt
Total Assets EOY$17,135,649TotalAssetsEOYAmt
Total Liabilities BOY$18,503,394TotalLiabilitiesBOYAmt
Total Liabilities EOY$18,128,576TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$337,851NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$992,927NetAssetsOrFundBalancesEOYAmt
MissionAs a ministry of the Evangelical Covenant Church, Covenant Place of Lenexa 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$4,526,029ExpenseAmt
Revenue$5,528,879RevenueAmt
DescThe number of persons who benefited from the services we providedduring the year were as follows:- Residential Living: There were a total of 44 residents, occupying 42 apartments at 01/31/2017. Residency for the fiscal year totaled 15,906 resident days.- Assisted Living: There were a total of 31 residents at 01/31/2017. Assisted living residency for the fiscal year totaled 10,422 resident days.- Skilled Nursing: There were a total of 31 residents at 01/31/2017. Skilled care residency for the fiscal year totaled 9,275 resident days.Desc
Total Program Service Expenses$4,526,029TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
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 Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
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 Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document34IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee119EmployeeCnt
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
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Form8899 Filedind0Form8899Filedind
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
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 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 CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
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 Line15700 Old Orchard RoadAddressLine1Txt
CitySkokieCityNm
State AbbreviationILStateAbbreviationCd
ZIP60077ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Rev Garth Bolinder
Director1.000.00Yes (X)$0$0$0
Janet Creaney
Director1.000.00Yes (X)$0$0$0
Marc Espinosa
Director1.000.00Yes (X)$0$0$0
Donald Holt
Director1.000.00Yes (X)$0$0$0
Mary Palmer
Director/Chair1.000.00Yes (X)$0$0$0
Walter Schiller
Director1.000.00Yes (X)$0$0$0
David A Dwight
Ex-Officio1.0040.00Yes (X)$0$629,581$22,698
Gary Walter
Ex-Officio1.0040.00Yes (X)$0$166,203$111,795
Terri S Cunliffe
Ex-Officio/President1.0040.00Yes (X)$0$502,850$84,235Yes (X)
Elizabeth B Buikema
Senior VP/CFO/Treasurer1.0040.00$0$330,207$63,644Yes (X)
David G Erickson
VP/Asst Secretary1.0040.00$0$278,833$52,881Yes (X)
Peter Carlson
Asst Legal Counsel/Asst Secretary1.0040.00$0$90,079$17,698Yes (X)
Rick K Fisk
Former Ex-Officio/President0.0040.00$0$547,941$259,846Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,545,694TotReportableCompRltdOrgAmt
Total Other Compensation$612,797TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Pivotal Health Care LLC
11827 W 112th St Suite 103Overland ParkKS66210Management Services$251,419
Summit Care Inc
6830 W 121st St Suite 103Overland ParkKS66210Therapy Services$187,426
Husch Blackwell LLP
235 E High StreetJefferson CityMO65102Legal Services$107,514
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
All Other Contributions$862AllOtherContributionsAmt
Total Contributions$862TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Routine Services623000$3,882,074$3,882,074
Medicare/Medicaid623000$936,106$936,106
Ancillary Services623000$640,098$640,098
Meals623000$6,009$6,009
FieldValueIRS element (for citing)
Total Program Service Revenue$5,464,287TotalProgramServiceRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescSupport ServicesDesc
Business623000BusinessCd
Total Revenue Column$22,568TotalRevenueColumnAmt
Related Or Exempt Func Income$22,568RelatedOrExemptFuncIncomeAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$42,024TotalRevenueColumnAmt
Related Or Exempt Func Income$42,024RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$64,592OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,529,741TotalRevenueColumnAmt
Related Or Exempt Func Income$5,528,879RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,199,037TotalAmt
Program Services$1,946,600ProgramServicesAmt
Management And General$252,437ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$223,693TotalAmt
Program Services$112,249ProgramServicesAmt
Management And General$111,444ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$181,580TotalAmt
Program Services$132,553ProgramServicesAmt
Management And General$49,027ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$12,000TotalAmt
Program Services$12,000ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$197,312TotalAmt
Management And General$197,312ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$456,553TotalAmt
Program Services$328,218ProgramServicesAmt
Management And General$128,335ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$84,322TotalAmt
Management And General$84,322ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$256,398TotalAmt
Program Services$223,769ProgramServicesAmt
Management And General$32,629ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$777TotalAmt
Management And General$777ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$232,842TotalAmt
Program Services$232,842ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$5,917TotalAmt
Program Services$528ProgramServicesAmt
Management And General$5,389ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,199TotalAmt
Management And General$1,199ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$662,039TotalAmt
Program Services$483,288ProgramServicesAmt
Management And General$178,751ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$627,886TotalAmt
Program Services$458,357ProgramServicesAmt
Management And General$169,529ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$56,748TotalAmt
Program Services$56,748ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Dining Services$287,588$287,588
Related Party Payments$278,956$278,956
Admin & General$120,080$14,792$105,288
Resident Care$76,767$76,767

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$223,123TotalAmt
Program Services$159,730ProgramServicesAmt
Management And General$63,393ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$6,184,817TotalAmt
Program Services$4,526,029ProgramServicesAmt
Management And General$1,658,788ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,470,720BOYAmt
EOY$1,423,965EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$14,625BOYAmt
EOY$14,936EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$620,604BOYAmt
EOY$374,477EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$23,174BOYAmt
EOY$31,256EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$17,428,408LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,137,393LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$15,887,190BOYAmt
EOY$15,291,015EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$149,230BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$18,165,543BOYAmt
EOY$17,135,649EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$356,089BOYAmt
EOY$409,895EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$13,054,550BOYAmt
EOY$12,650,185EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,092,755BOYAmt
EOY$5,068,496EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$18,503,394BOYAmt
EOY$18,128,576EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$337,851BOYAmt
EOY-$992,927EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$337,851BOYAmt
EOY-$992,927EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$18,165,543BOYAmt
EOY$17,135,649EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$655,076ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
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$750CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$252CurrentTaxYearMinus1YearAmt
Current Tax Year$862CurrentTaxYearAmt
Total$1,871TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$2,220,714CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,860,953CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,173,964CurrentTaxYearMinus1YearAmt
Current Tax Year$5,464,287CurrentTaxYearAmt
Total$19,719,918TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$2,221,464CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,860,960CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,174,216CurrentTaxYearMinus1YearAmt
Current Tax Year$5,465,149CurrentTaxYearAmt
Total$19,721,789TotalAmt

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$19,721,789PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$64CurrentTaxYearMinus2YearsAmt
Total$64TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$64CurrentTaxYearMinus2YearsAmt
Total$64TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$2,221,464CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,861,024CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,174,216CurrentTaxYearMinus1YearAmt
Current Tax Year$5,465,149CurrentTaxYearAmt
Total$19,721,853TotalAmt
FieldValueIRS element (for citing)
Public Support CY5091.00000PublicSupportCY509Pct
Public Support PY5091.00000PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,015,158OtherCostOrOtherBasisAmt
Book Value$1,015,158BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,642,598OtherCostOrOtherBasisAmt
Depreciation$1,464,434DepreciationAmt
Book Value$13,178,164BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,190,845OtherCostOrOtherBasisAmt
Depreciation$479,378DepreciationAmt
Book Value$711,467BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$579,807OtherCostOrOtherBasisAmt
Depreciation$193,581DepreciationAmt
Book Value$386,226BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$15,291,015TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Notes Payable$5,000,000
Other Liabilities$68,496
FieldValueIRS element (for citing)
Total Liability$5,068,496TotalLiabilityAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
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 PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 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
Ex-Officio$0$503,437$0$0$0$126,144$0$7,950$0$25,192$0$662,723$0$0
Gary Walter
Ex-Officio$0$166,203$0$0$0$0$0$24,931$0$86,864$0$277,998$0$0
Terri S Cunliffe
Ex-Officio/President$0$392,000$0$44,510$0$66,340$0$65,703$0$21,879$0$590,432$0$0
Elizabeth B Buikema
Senior VP/CFO/Treasurer$0$248,387$0$40,586$0$41,234$0$36,737$0$30,576$0$397,520$0$0
David G Erickson
VP/Asst Secretary$0$217,505$0$17,861$0$43,467$0$27,940$0$31,264$0$338,037$0$0
Rick K Fisk
Former Ex-Officio/President$0$286,625$0$134,971$0$126,345$0$254,610$0$5,508$0$808,059$0$0

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 - $28,787 Terri Cunliffe - $45,986 David Dwight - $67,225 David Erickson - $27,994 Rick Fisk - $18,600
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 2016 relate to the achievement of targets for the fiscal year ended 1/31/2016.
Part II, Column D:Nontaxable benefits include health insurance premiums paid by the employer and employee.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 - Part III - Line 1As a ministry of the Evangelical Covenant Church, Covenant Place of Lenexa 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. 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.
Form 990, Part VI, Section A, line 3Covenant Place of Lenexa, Inc. delegated control over management duties to Pivotal Health Care.
Form 990, Part VI, Section A, line 6The sole member is Covenant Retirement Services, Inc. (CRS). The sole member of CRS 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 CRS, 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 Services, Inc. (CRS) 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 CRS policy is distributed to CRS board members and officers. They are asked to sign acknowledging receipt of the policy and to disclose if they have any conflict of interests. If someone is absent from the meeting or fails to return the acknowledgment, there is a follow-up with the individual until the signed acknowledgment is provided. In addition to the above, a separate and more comprehensive questionnaire is sent to the board members, officers, key employees and other interested persons. The completed questionnaires are reviewed by CRS'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 15Covenant 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 CRS 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 CRS accounting department at 773-878-5744.
Form 990 - Part VII - Section A Column BOfficers 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.

Schedule R IRS990ScheduleR

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 12a, I0Swedish Covenant Hospital
Swedish Covenant Hospital
5145 North California AvenueChicagoIL60625362179813HospitalIL501(c)(3)Line 30Covenant Ministries of Benevolence
Swedish Covenant Hospital Foundation (SCHF)
5145 North California AvenueChicagoIL60625205055155Support of Swedish Covenant HospitalIL501(c)(3)Line 70Swedish Covenant Hospital
SC Insurance Company
6970 E Chauncey Lane Suite 100PhoenixAZ85054273312053InsuranceAZ501(c)(3)Line 12a, I0Swedish 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/CountryCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile Foreign CountryLegalDomicileForeignCountryCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdLegal Domicile StateLegalDomicileStateCd
Covenant International Insurance Company Ltd
Crawford House 50 Cedar AvenueHamiltonBD000000000InsuranceBDN/AC0
Covenant Trust Company
363583163Financial ServicesN/AC08303 West Higgins Road 6th FloorChicagoIL60631IL
Swedish Covenant Management Services Inc (SCMS)
364073303Physician Practice ManagementN/AC05145 North California AvenueChicagoIL60625IL
Swedish Covenant Managed Care Alliance (SCMCA)
364118659Physician - Hospital OrganizationN/AC02740 West Foster Avenue Suite 409ChicagoIL60625IL
St Francis Health Care Ltd
363208131Independent Group of PhysiciansN/AC02740 West Foster Avenue Suite 002ChicagoIL60625IL
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
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 Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd