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COVENANT HOME: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
COVENANT HOME (EIN 36-2643638)
Tax period
2016-02-01 to 2017-01-31
Filed
2017-11-08
IRS object ID
201733129349301658
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)
EIN362643638EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Covenant Home IllinoisBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOVEBusinessNameControlTxt
Phone8474806380PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12625 Techny RoadAddressLine1Txt
CityNorthbrookCityNm
State AbbreviationILStateAbbreviationCd
ZIP600625900ZIPCd

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 Tm09:56:00IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id475448EDD106694E6004F08D4B312B5174DD2527AtSubmissionCreationDeviceId
At Submission Filing Device Id475448EDD106694E6004F08D4B312B5174DD2527AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

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$18,874,054GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption2650GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.covenantretirement.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1962FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionCare for senior adults.ActivityOrMissionDesc
Voting Members Governing Body20VotingMembersGoverningBodyCnt
Voting Members Independent17VotingMembersIndependentCnt
Total Employee359TotalEmployeeCnt
Total Volunteers37TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$324,186PYContributionsGrantsAmt
CY Contributions Grants$533,325CYContributionsGrantsAmt
PY Program Service Revenue$14,677,630PYProgramServiceRevenueAmt
CY Program Service Revenue$15,290,753CYProgramServiceRevenueAmt
PY Investment Income$1,145,210PYInvestmentIncomeAmt
CY Investment Income$2,668,510CYInvestmentIncomeAmt
PY Other Revenue$212,414PYOtherRevenueAmt
CY Other Revenue$305,363CYOtherRevenueAmt
PY Total Revenue$16,359,440PYTotalRevenueAmt
CY Total Revenue$18,797,951CYTotalRevenueAmt
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$3,801,072PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$3,853,678CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$155,077CYTotalFundraisingExpenseAmt
PY Other Expenses$13,146,140PYOtherExpensesAmt
CY Other Expenses$12,678,567CYOtherExpensesAmt
PY Total Expenses$16,947,212PYTotalExpensesAmt
CY Total Expenses$16,532,245CYTotalExpensesAmt
PY Revenues Less Expenses-$587,772PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,265,706CYRevenuesLessExpensesAmt
Total Assets BOY$130,249,706TotalAssetsBOYAmt
Total Assets EOY$119,813,078TotalAssetsEOYAmt
Total Liabilities BOY$121,335,797TotalLiabilitiesBOYAmt
Total Liabilities EOY$108,621,920TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$8,913,909NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$11,191,158NetAssetsOrFundBalancesEOYAmt
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$10,724,344ExpenseAmt
Revenue$15,616,224RevenueAmt
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 419 residents, occupying 335 apartments at 01/31/17. Residency for the fiscal year totaled 155,113 resident 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 30 hours of their time to Northbrook Chamber of Commerce (equivalent to $10,500)- Residents volunteered 7,564 hours of their time various areas/groups in the community. - Provided space usage for small groups (under 35 people) to large groups (75+ participants) which includes dance and music recitals for various groups, Parkinson's Support Group, and Northbrook YMCA (equivalent to $264,500)- Monetary Donations to Northfield Township Food Pantry, Northbrook Police and Fire Departments, Northbrook Chamber of Commerce, Northbrook Library, and Swedish Covenant Hospital Foundation($14,830 in total)- In-Kind Donations to Habitat for Humanity (estimated value of $10,340)- Hosted small to large scale community events for different groups such as Citizens' Forums, concerts and music recitals as well as other forms of performance arts for different groups, various lectures and presentations, Veterans Day Program, the Holly Fair, Health Fair and others (equivalent to $1,223,000)Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$10,724,344TotalProgramServiceExpensesAmt
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 SecYes (1)ReportInvestmentsOtherSecInd
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 Document40IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee359EmployeeCnt
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 OtherYes (1)CompensationProcessOtherInd
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)
Phone7738782295PhoneNum

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 (33 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest 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)
Neil E Warnygora
Executive Director40.000.00$205,131$0$23,709Yes (X)
Constance Branstrom
Healthcare Sales40.000.00$104,300$0$16,033Yes (X)
Jonathan F Kaspar
Admin-Healthcare40.000.00$111,720$0$30,436Yes (X)
Audrey Friedland
Director of Nursing40.000.00$106,477$0$24,878Yes (X)
Latosha D Rivers
Dir. Of Financial Mgmt40.000.00$102,406$0$6,961Yes (X)
Eugenia Tan
Staff RN40.000.00$105,169$0$3,388Yes (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$735,203TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,671,741TotReportableCompRltdOrgAmt
Total Other Compensation$749,300TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
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
Healthpro Rehabilitation
634 Academy DriveNorthbrookIL60062Social Services Consulting$740,067
Sodexo Inc & Affiliates
4880 Paysphere CircleChicagoIL60674Dining Services$495,447
Jack Thomas Inc
38665 North AnderleLake VillaIL60046Construction Services$409,701
Incredible Builders
5200 Prairie Stone ParkwayHoffman EstatesIL60192Refurbishment$394,581
Murphy Paving and Sealcoating
16W235 83rd Street Suite DBurr RidgeIL60527Asphalt and Concrete Work$245,500
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
Fundraising$76,179FundraisingAmt
All Other Contributions$457,146AllOtherContributionsAmt
Total Contributions$533,325TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Routine Services623000$9,220,232$9,220,232
Entrance Fee623000$5,632,254$5,632,254
Ancillary Services623000$249,468$249,468
Meals623000$188,799$188,799
FieldValueIRS element (for citing)
Total Program Service Revenue$15,290,753TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,220,158TotalRevenueColumnAmt
Exclusion$2,220,158ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$17,500RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$37,608RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$20,108RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$20,108TotalRevenueColumnAmt
Exclusion-$20,108ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$475,466SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$27,114OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$475,466SecuritiesAmt
Other-$27,114OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$448,352TotalRevenueColumnAmt
Exclusion$448,352ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$11,381FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$76,179ContriRptFundraisingEventAmt
Fundraising Direct Expenses$11,381FundraisingDirectExpensesAmt

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$189,272$189,272
Services to Residents623000$38,570$38,570

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$97,629TotalRevenueColumnAmt
Related Or Exempt Func Income$97,629RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$325,471OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$18,797,951TotalRevenueColumnAmt
Related Or Exempt Func Income$15,616,224RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$2,648,402ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$224,683TotalAmt
Management And General$224,683ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,839,984TotalAmt
Program Services$2,188,885ProgramServicesAmt
Management And General$633,465ManagementAndGeneralAmt
Fundraising$17,634FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$98,417TotalAmt
Program Services$69,554ProgramServicesAmt
Management And General$28,561ManagementAndGeneralAmt
Fundraising$302FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$481,700TotalAmt
Program Services$344,307ProgramServicesAmt
Management And General$136,544ManagementAndGeneralAmt
Fundraising$849FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$208,894TotalAmt
Program Services$158,043ProgramServicesAmt
Management And General$49,501ManagementAndGeneralAmt
Fundraising$1,350FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$44,748TotalAmt
Program Services$44,748ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$35,877TotalAmt
Management And General$35,877ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$5,052TotalAmt
Management And General$5,052ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$690,964TotalAmt
Program Services$690,798ProgramServicesAmt
Fundraising$166FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$172,133TotalAmt
Program Services$250ProgramServicesAmt
Management And General$171,883ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$456,974TotalAmt
Program Services$333,867ProgramServicesAmt
Management And General$120,289ManagementAndGeneralAmt
Fundraising$2,818FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$433,791TotalAmt
Program Services$550ProgramServicesAmt
Management And General$433,241ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$749,099TotalAmt
Program Services$749,099ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$43,978TotalAmt
Program Services$29,348ProgramServicesAmt
Management And General$14,597ManagementAndGeneralAmt
Fundraising$33FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$25,503TotalAmt
Program Services$1,249ProgramServicesAmt
Management And General$24,254ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,230,098TotalAmt
Program Services$1,441,982ProgramServicesAmt
Management And General$758,233ManagementAndGeneralAmt
Fundraising$29,883FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$5,007,808TotalAmt
Program Services$3,244,393ProgramServicesAmt
Management And General$1,702,655ManagementAndGeneralAmt
Fundraising$60,760FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$212,958TotalAmt
Program Services$212,958ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmtProgram ServicesProgramServicesAmt
Related Party Activity$1,271,970$1,239,828$32,142
Dining Services$749,143$749,143
Resident Care$363,627$363,627
Admin & General$78,671$40,080$38,591

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$106,173TotalAmt
Program Services$62,952ProgramServicesAmt
Management And General$34,081ManagementAndGeneralAmt
Fundraising$9,140FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$16,532,245TotalAmt
Program Services$10,724,344ProgramServicesAmt
Management And General$5,652,824ManagementAndGeneralAmt
Fundraising$155,077FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$13,540BOYAmt
EOY$7,435EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$5,000BOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$122,672BOYAmt
EOY$83,238EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,037,760BOYAmt
EOY$598,177EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$12,269BOYAmt
EOY$40,859EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$106,360,222LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$38,419,590LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$70,382,578BOYAmt
EOY$67,940,632EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$44,307,020BOYAmt
EOY$35,910,931EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$11,508,254BOYAmt
EOY$12,124,405EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,860,613BOYAmt
EOY$3,107,401EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$130,249,706BOYAmt
EOY$119,813,078EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$688,042BOYAmt
EOY$661,775EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$23,463,091BOYAmt
EOY$26,020,145EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$57,115,392BOYAmt
EOY$44,576,566EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$129,750BOYAmt
EOY$142,800EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$39,939,522BOYAmt
EOY$37,220,634EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$121,335,797BOYAmt
EOY$108,621,920EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$8,838,302BOYAmt
EOY$11,104,008EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$75,607BOYAmt
EOY$87,150EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$8,913,909BOYAmt
EOY$11,191,158EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$130,249,706BOYAmt
EOY$119,813,078EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$2,265,706ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$11,543OtherChangesInNetAssetsAmt
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$45,029CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$815,453CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$373,195CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$324,186CurrentTaxYearMinus1YearAmt
Current Tax Year$533,325CurrentTaxYearAmt
Total$2,091,188TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,824,523CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,385,563CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,026,387CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$14,677,630CurrentTaxYearMinus1YearAmt
Current Tax Year$15,290,753CurrentTaxYearAmt
Total$61,204,856TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,869,552CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,201,016CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,399,582CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$15,001,816CurrentTaxYearMinus1YearAmt
Current Tax Year$15,824,078CurrentTaxYearAmt
Total$63,296,044TotalAmt

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$63,296,044PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,602,151CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,173,947CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,002,521CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,145,210CurrentTaxYearMinus1YearAmt
Current Tax Year$2,668,510CurrentTaxYearAmt
Total$8,592,339TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,602,151CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,173,947CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,002,521CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,145,210CurrentTaxYearMinus1YearAmt
Current Tax Year$2,668,510CurrentTaxYearAmt
Total$8,592,339TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,471,703CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$13,374,963CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$12,402,103CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$16,147,026CurrentTaxYearMinus1YearAmt
Current Tax Year$18,492,588CurrentTaxYearAmt
Total$71,888,383TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.88050PublicSupportCY509Pct
Public Support PY5090.89680PublicSupportPY509Pct
Investment Income CY0.11950InvestmentIncomeCYPct
Investment Income PY0.10320InvestmentIncomePYPct
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$450,291OtherCostOrOtherBasisAmt
Book Value$450,291BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$79,460,024OtherCostOrOtherBasisAmt
Depreciation$26,066,641DepreciationAmt
Book Value$53,393,383BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$17,536,822OtherCostOrOtherBasisAmt
Depreciation$8,642,985DepreciationAmt
Book Value$8,893,837BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,913,085OtherCostOrOtherBasisAmt
Depreciation$3,709,964DepreciationAmt
Book Value$5,203,121BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$67,940,632TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (5 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
Mortgages$82,691F
Domestic Equity$3,459,731F
International Equity$3,371,330F
Hedge Funds & Derivatives$3,863,723F
Private Equity$1,346,930F
FieldValueIRS element (for citing)
Total Book Value Securities$12,124,405TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
Deferred Revenue Subject to Refund$17,617,024
Refundable Contract Liabilities$18,658,273
Other Liabilities$945,337
FieldValueIRS element (for citing)
Total Liability$37,220,634TotalLiabilityAmt

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.ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1Benefit GalaEvent1Nm
Gross Receipts Event1$87,560GrossReceiptsEvent1Amt
Charitable Contri Event1$76,179CharitableContriEvent1Amt
Gross Revenue Event1$11,381GrossRevenueEvent1Amt
Food And Beverage Event1$4,544FoodAndBeverageEvent1Amt
Entertainment Event1$650EntertainmentEvent1Amt
Other Direct Expenses Event1$6,187OtherDirectExpensesEvent1Amt
Gross Receipts Total$87,560GrossReceiptsTotalAmt
Charitable Contributions Tot$76,179CharitableContributionsTotAmt
Gross Revenue Total Events$11,381GrossRevenueTotalEventsAmt
Food And Beverage Total Events$4,544FoodAndBeverageTotalEventsAmt
Entertainment Total Events$650EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$6,187OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$11,381DirectExpenseSummaryEventsAmt
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 (8 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
Neil E Warnygora
Executive Director$153,877$0$10,452$0$40,802$0$5,751$0$21,924$0$232,806$0$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 Joshua Anderson - $19,783 Rick Fisk - $18,600 Neil Warnygora - $20,375
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), Covenant Home provided $134,424 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 Home delegated control over management duties to Covenant Retirement Communities, Inc. (CRC), its parent organization.
Form 990, Part VI, Section A, line 6The sole member is Covenant Retirement Communties, 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 Covenant Retirement Communities, Inc. (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 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 & 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 XI, line 9:Change in Temporarily Restricted Net Assets not included on Income Stmnt 11,543.

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 Franscis Health Care Ltd
Independent Group of PhysiciansN/AC02740 West Foster Avenue Suite 002chicagoID60625363208131IL
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 OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmt
Covenant Retirement Communities Inc
Q$1,073,302
Covenant Trust Company
P$32,142