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COVENANT LIVING OF GOLDEN VALLEY: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
COVENANT LIVING OF GOLDEN VALLEY (EIN 41-0841150)
Tax period
2016-02-01 to 2017-01-31
Filed
2017-11-08
IRS object ID
201743129349301324
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)
Return2017-11-08T10:29:44-06:00ReturnTs
Tax Period End2017-01-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2016-02-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN410841150EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Colonial Acres Home IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOLOBusinessNameControlTxt
Phone6125466125PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15800 St Croix AveAddressLine1Txt
CityMinneapolisCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55422ZIPCd

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 Tm09:28:20IPTm
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 Line15700 Old Orchard RoadAddressLine1Txt
CitySkokieCityNm
State AbbreviationILStateAbbreviationCd
ZIP60077ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$19,414,709GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption2650GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.covenantretirement.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1959FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionCare for senior adults.ActivityOrMissionDesc
Voting Members Governing Body20VotingMembersGoverningBodyCnt
Voting Members Independent17VotingMembersIndependentCnt
Total Employee376TotalEmployeeCnt
Total Volunteers276TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$363,481PYContributionsGrantsAmt
CY Contributions Grants$166,690CYContributionsGrantsAmt
PY Program Service Revenue$18,240,948PYProgramServiceRevenueAmt
CY Program Service Revenue$18,253,406CYProgramServiceRevenueAmt
PY Investment Income$393,128PYInvestmentIncomeAmt
CY Investment Income$443,950CYInvestmentIncomeAmt
PY Other Revenue$249,858PYOtherRevenueAmt
CY Other Revenue$224,759CYOtherRevenueAmt
PY Total Revenue$19,247,415PYTotalRevenueAmt
CY Total Revenue$19,088,805CYTotalRevenueAmt
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$9,470,313PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$9,575,301CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$74,514CYTotalFundraisingExpenseAmt
PY Other Expenses$12,077,301PYOtherExpensesAmt
CY Other Expenses$13,126,250CYOtherExpensesAmt
PY Total Expenses$21,547,614PYTotalExpensesAmt
CY Total Expenses$22,701,551CYTotalExpensesAmt
PY Revenues Less Expenses-$2,300,199PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$3,612,746CYRevenuesLessExpensesAmt
Total Assets BOY$43,688,151TotalAssetsBOYAmt
Total Assets EOY$43,438,721TotalAssetsEOYAmt
Total Liabilities BOY$66,075,971TotalLiabilitiesBOYAmt
Total Liabilities EOY$69,443,309TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$22,387,820NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$26,004,588NetAssetsOrFundBalancesEOYAmt
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$6,296,295ExpenseAmt
Revenue$6,941,319RevenueAmt
DescResidential Living: The number of persons who benefited from the services we provided for the year ended January 31, 2017 were as follows:There were a total of 230 residents, occupying 178 apartments at 01/31/2017. Residency for the fiscal year totaled 80,243 resident days.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$2,623,463ExpenseAmt
Revenue$3,182,191RevenueAmt
DescAssisted Living: The number of persons who benefited from the services we provided for the year ended January 31, 2017 were as follows:There were a total of 50 assisted living residents at 01/31/2017. Assisted living residency for the fiscal year totaled 19,873 patient days.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$7,645,856ExpenseAmt
Revenue$8,365,944RevenueAmt
DescSkilled Nursing: The number of persons who benefited from the services we provided for the year ended January 31, 2017 were as follows:There were a total of 74 skilled care patients at 01/31/2017.Skilled care residency for the fiscal year totaled 26,180 patient days.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
DescThe organization was involved in various community benefits projects that include the following:- Staff members volunteered a total of 31 hours of their time to various activities/events in the community (equivalent to $1,663)- Residents volunteered a total of 3,500 hours to the community by serving in local churches, schools, library, food drives and feeding programs, tutoring programs, sewing and knitting projects for various ministries and others. - Provided space usage for small (under 35 people) to large groups (75+ people) for various community events such Clergy Appreciation Breakfast, Halloween Event, Jazz Piano concert, various presentations/topics and others (equivalent to $366,845)- Monetary Donations to various individuals and organizations including the Alzheimer's Association, PRISM, local churches and others ($6,347 in total)- In-kind Donation to various individuals and organizations including the local food pantries, local churches, Salvation Army and others ($930 in estimated value)Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$16,565,614TotalProgramServiceExpensesAmt
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 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 ActivitiesYes (1)FundraisingActivitiesInd
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 OrgYes (1)TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document63IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee376EmployeeCnt
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 Members20GoverningBodyVotingMembersCnt
Independent Voting Member17IndependentVotingMemberCnt
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 Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
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 RoadAddressLine1Txt
CitySkokieCityNm
State AbbreviationILStateAbbreviationCd
ZIP60077ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Jon P Aagaard MD
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
Rev Harvey Drake
Director1.001.00Yes (X)$0$0$0
Mark C Eastburg
Director/Chair1.001.00Yes (X)$0$0$0
James Elving
Director1.001.00Yes (X)$0$0$0
Marc E Espinosa
Director/Vice Chair1.001.00Yes (X)$0$0$0
Carol A Findling
Director1.001.00Yes (X)$0$0$0
Lorene G Flewellen
Director1.001.00Yes (X)$0$0$0
Rhoda Friesen
Director1.001.00Yes (X)$0$0$0
Thomas F Heywood
Director1.001.00Yes (X)$0$0$0
Donald Hodgkinson
Director1.001.00Yes (X)$0$0$0
Kathy Holmgren
Director1.001.00Yes (X)$0$0$0
Jody Holt
Director/Secretary1.001.00Yes (X)$0$0$0
Scott Macdonald
Director1.001.00Yes (X)$0$0$0
Matthew 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
Anne Vining
Director1.001.00Yes (X)$0$0$0
David A Dwight
Ex-Officio1.0040.00Yes (X)$0$629,581$22,698
Jennifer Larson
Ex-Officio1.001.00Yes (X)$0$0$0
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)
Joshua Anderson
Assoc VP/Asst Secretary1.0040.00$0$216,126$48,796Yes (X)
Thomas Freudenstein
Sales Director40.000.00$108,814$0$0Yes (X)
Todd Carsen
Admin-Healthcare40.000.00$108,856$0$10,119Yes (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$217,670TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,671,741TotReportableCompRltdOrgAmt
Total Other Compensation$654,014TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
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
AJW Contracting Inc
11428 293rd AvenuePrincetonMN55371Flooring and Cabinets$848,996
Sodexo Inc & Affiliates
4880 Paysphere CircleChicagoIL60674Dining Services$429,622
Seitz Bros Inc
8608 Xylon Avenue NorthBrooklyn ParkMN55445Plumbing$293,765
Nordic Services Inc
11965 Larc Industrial Blvd Suite 6BurnsvilleMN55337A/C and Heating$255,392
Mary Nell Zellner
522 Hackmore DriveSt PaulMN55123Consullting Services$215,488
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
Fundraising$56,966FundraisingAmt
All Other Contributions$109,724AllOtherContributionsAmt
Total Contributions$166,690TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Routine Services623000$13,614,779$13,614,779
Entrance Fee623000$1,982,806$1,982,806
Ancillary Services623000$1,887,610$1,887,610
Medicare/Medicaid623000$679,613$679,613
Meals623000$88,598$88,598
FieldValueIRS element (for citing)
Total Program Service Revenue$18,253,406TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$730,870TotalRevenueColumnAmt
Exclusion$730,870ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$11,040RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$22,329RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$11,289RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$11,289TotalRevenueColumnAmt
Exclusion-$11,289ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$2,790SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$289,710OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$2,790SecuritiesAmt
Other-$289,710OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$286,920TotalRevenueColumnAmt
Exclusion-$286,920ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$13,865FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$56,966ContriRptFundraisingEventAmt
Fundraising Direct Expenses$13,865FundraisingDirectExpensesAmt

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$138,703$138,703
Services to Residents623000$15,253$15,253

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$82,092TotalRevenueColumnAmt
Related Or Exempt Func Income$82,092RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$236,048OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$19,088,805TotalRevenueColumnAmt
Related Or Exempt Func Income$18,489,454RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$432,661ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,845,892TotalAmt
Program Services$6,729,731ProgramServicesAmt
Management And General$1,113,262ManagementAndGeneralAmt
Fundraising$2,899FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$219,960TotalAmt
Program Services$177,659ProgramServicesAmt
Management And General$42,012ManagementAndGeneralAmt
Fundraising$289FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$915,821TotalAmt
Program Services$779,520ProgramServicesAmt
Management And General$136,200ManagementAndGeneralAmt
Fundraising$101FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$593,628TotalAmt
Program Services$509,122ProgramServicesAmt
Management And General$84,284ManagementAndGeneralAmt
Fundraising$222FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$112,210TotalAmt
Program Services$112,210ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$38,742TotalAmt
Management And General$38,742ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$9,288TotalAmt
Management And General$9,288ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,684,635TotalAmt
Program Services$1,200,468ProgramServicesAmt
Management And General$484,131ManagementAndGeneralAmt
Fundraising$36FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$342,951TotalAmt
Program Services$592ProgramServicesAmt
Management And General$342,359ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$875,240TotalAmt
Program Services$720,825ProgramServicesAmt
Management And General$154,025ManagementAndGeneralAmt
Fundraising$390FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$817,134TotalAmt
Management And General$817,134ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$875,676TotalAmt
Program Services$875,676ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$41,598TotalAmt
Program Services$16,396ProgramServicesAmt
Management And General$25,202ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$33,389TotalAmt
Program Services$6,901ProgramServicesAmt
Management And General$26,488ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,252,816TotalAmt
Program Services$1,615,945ProgramServicesAmt
Management And General$608,260ManagementAndGeneralAmt
Fundraising$28,611FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,842,095TotalAmt
Program Services$2,039,248ProgramServicesAmt
Management And General$767,366ManagementAndGeneralAmt
Fundraising$35,481FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$254,532TotalAmt
Program Services$254,532ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmtProgram ServicesProgramServicesAmt
Related Party Activity$1,065,972$1,059,538$6,434
Dining Services$780,840$780,840
Resident Care$555,633$555,633
Admin & General$265,197$239,535$25,662

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$278,302TotalAmt
Program Services$164,654ProgramServicesAmt
Management And General$113,597ManagementAndGeneralAmt
Fundraising$51FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$22,701,551TotalAmt
Program Services$16,565,614ProgramServicesAmt
Management And General$6,061,423ManagementAndGeneralAmt
Fundraising$74,514FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$114,471BOYAmt
EOY$5,908EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$135,859BOYAmt
EOY$81,006EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$251,149BOYAmt
EOY$264,936EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,854,248BOYAmt
EOY$2,297,297EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$59,092BOYAmt
EOY$100,299EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$63,320,996LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$33,033,307LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$31,189,255BOYAmt
EOY$30,287,689EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$7,610,552BOYAmt
EOY$8,224,679EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$1,820,570BOYAmt
EOY$2,100,697EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$652,955BOYAmt
EOY$76,210EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$43,688,151BOYAmt
EOY$43,438,721EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,070,921BOYAmt
EOY$1,021,140EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$8,019,155BOYAmt
EOY$8,336,063EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$32,338,650BOYAmt
EOY$31,729,207EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$57,976BOYAmt
EOY$52,865EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$24,589,269BOYAmt
EOY$28,304,034EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$66,075,971BOYAmt
EOY$69,443,309EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$22,612,966BOYAmt
EOY-$26,225,712EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$225,146BOYAmt
EOY$221,124EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$22,387,820BOYAmt
EOY-$26,004,588EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$43,688,151BOYAmt
EOY$43,438,721EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$3,612,746ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$4,022OtherChangesInNetAssetsAmt
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$581,692CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$223,512CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$299,736CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$363,481CurrentTaxYearMinus1YearAmt
Current Tax Year$166,690CurrentTaxYearAmt
Total$1,635,111TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$15,696,836CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$16,502,268CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$17,168,341CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$18,240,948CurrentTaxYearMinus1YearAmt
Current Tax Year$18,253,406CurrentTaxYearAmt
Total$85,861,799TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$16,278,528CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$16,725,780CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$17,468,077CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$18,604,429CurrentTaxYearMinus1YearAmt
Current Tax Year$18,420,096CurrentTaxYearAmt
Total$87,496,910TotalAmt

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$87,496,910PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$620,495CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$622,648CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$236,238CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$393,128CurrentTaxYearMinus1YearAmt
Current Tax Year$443,950CurrentTaxYearAmt
Total$2,316,459TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$620,495CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$622,648CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$236,238CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$393,128CurrentTaxYearMinus1YearAmt
Current Tax Year$443,950CurrentTaxYearAmt
Total$2,316,459TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$16,899,023CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$17,348,428CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$17,704,315CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$18,997,557CurrentTaxYearMinus1YearAmt
Current Tax Year$18,864,046CurrentTaxYearAmt
Total$89,813,369TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.97420PublicSupportCY509Pct
Public Support PY5090.97270PublicSupportPY509Pct
Investment Income CY0.02580InvestmentIncomeCYPct
Investment Income PY0.02730InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

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

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$551,033OtherCostOrOtherBasisAmt
Book Value$551,033BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$48,942,753OtherCostOrOtherBasisAmt
Depreciation$27,078,861DepreciationAmt
Book Value$21,863,892BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,191,730OtherCostOrOtherBasisAmt
Depreciation$5,704,835DepreciationAmt
Book Value$7,486,895BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$635,480OtherCostOrOtherBasisAmt
Depreciation$249,611DepreciationAmt
Book Value$385,869BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$30,287,689TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
Deferred Revenue Subject to Refund$4,379,628
Refundable Contract Liabilities$4,844,171
Accrued Taxes & Employee Benefits$56,867
Inter-company Advance Accounts$18,930,795
Other Liabilities$92,573
FieldValueIRS element (for citing)
Total Liability$28,304,034TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart IV, Line 2b:FormAndLineReferenceDesc
ExplanationResident Entrance Fee Account: Prospective residents pay an application fee deposit which is carried in an escrow account. At move in, the deposit is applied against the total entrance fee amount and the remainder of the money is collected and put in this account. At the end of the month the resident has moved in, all money is transferred out of the escrow account. Resident Trust Fund at the Skilled Nursing Facility: Per state regulations, an account is made available to SNF residents wishing to deposit personal needs funds that they can access as needed. Interest is paid on any balance exceeding $49.ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1Annual Benefit EventEvent1Nm
Gross Receipts Event1$35,364GrossReceiptsEvent1Amt
Charitable Contri Event1$22,253CharitableContriEvent1Amt
Gross Revenue Event1$13,111GrossRevenueEvent1Amt
Rent Facility Costs Event1$650RentFacilityCostsEvent1Amt
Food And Beverage Event1$3,891FoodAndBeverageEvent1Amt
Entertainment Event1$1,603EntertainmentEvent1Amt
Other Direct Expenses Event1$6,967OtherDirectExpensesEvent1Amt
Event2Benevolent Care Matching Fund DriveEvent2Nm
Gross Receipts Event2$35,467GrossReceiptsEvent2Amt
Charitable Contri Event2$34,713CharitableContriEvent2Amt
Gross Revenue Event2$754GrossRevenueEvent2Amt
Other Direct Expenses Event2$754OtherDirectExpensesEvent2Amt
Gross Receipts Total$70,831GrossReceiptsTotalAmt
Charitable Contributions Tot$56,966CharitableContributionsTotAmt
Gross Revenue Total Events$13,865GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$650RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$3,891FoodAndBeverageTotalEventsAmt
Entertainment Total Events$1,603EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$7,721OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$13,865DirectExpenseSummaryEventsAmt
Net Income Summary$0NetIncomeSummaryAmt

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 (7 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
Joshua Anderson
Assoc VP/Asst Secretary$0$164,113$0$22,680$0$29,333$0$22,074$0$29,767$0$267,967$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 4bLine 4b: Executive 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 Joshua Anderson - $19,783 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 (13 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(CRC), Colonial Acres Home, Inc. provided $2,051,762 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 issue 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 3Colonial Acres Home, Inc. delegated control over management duties to Covenant Retirement Communities, Inc. (CRC).
Form 990, Part VI, Section A, line 6The sole member 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 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 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 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 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 Info for Directors & 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 ARelated Organizations 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 XI, line 9:Change in Temporarily Restricted Net Assets not included on Income Stmnt -4,022.

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/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 AvenueHamiltonBDInsuranceBDN/AC0
Covenant Trust Company
Financial ServicesN/AC08303 West Higgins Road 6th FloorChicagoIL60631363583163IL
Swedish Covenant Management Services Inc (SCMS)
Physician Practice ManagementN/AC05145 North California AvenueChicagoIL60625364073303IL
Swedish Covenant Managed Care Alliance (SCMCA)
Physician - Hospital OrganizationN/AC02740 West Foster Avenue Suite 409ChicagoIL60625364118659IL
St Francis Health Care Ltd
Independent Group of PhysiciansN/AC02740 West Foster Avenue 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 OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmt
Covenant Retirement Communities Inc
Q$1,614,816
Covenant Retirement Communities Inc
P$532,255
Covenant Retirement Communities Inc
A$900
Covenant Trust Company
P$6,434