2014-12-11T13:02:40-06:00 2014-01-31 990 2013-02-01 363478388 Covenant Retirement Communities Inc COVE 7738782294 5700 Old Orchard Rd Skokie IL 60077 Elizabeth Buikema VP of Finance/CFO 7738782294 2014-12-11 2013 2015-11-30 17:44:51Z Elizabeth Buikema c/o CRC 5700 Old Orchard Rd Skokie IL 60077 44736737 0 2650 X www.covenantretirement.org X 1980 IL Care for senior adults. 21 17 112 17 0 0 16894 0 19025018 21176552 16551319 23081157 1326901 150830 36920132 44408539 12550 11701 0 0 7716962 8115312 0 0 454846 21453520 15574309 29183032 23701322 7737100 20707217 127258395 111415110 113395186 76782041 13863209 34633069 X As 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) 0 0 20802674 11701 18326391 The number of persons residing at the continuing care retirement communities, operated by Covenant Retirement Communities, Inc. (CRC), who benefited from the services we provided for the year ended January 31, 2014 were as follows:Residential & Catered Living: There were a total of 3,386 residents, occupying 2,605 apartments at 01/31/2014. Residency for the fiscal year totaled 1,198,117 resident days.Assisted Living: There were a total of 644 assisted living residents at 01/31/2014. Assisted living residency for the fiscal year totaled 230,967 patient days.Skilled Nursing: There were a total of 700 skilled care patients at 01/31/2014. Skilled care residency for the fiscal year totaled 259,739 patient days. 1347367 3010701 Estates of Windsor Park:The number of persons who benefited from the services we provided for the year ended January 31, 2014 were as follows:There were a total of 89 residents, occupying 60 apartments at 01/31/2014. Residency for the fiscal year totaled 33,397 resident days. - Monetary Donations to a various organizations/events such asEvangelical Covenant Church, Covenant Village of Turlock, Covenant Harbor and Swedish Covenant Hospital (total of $11,701) 22150041 1 0 0 0 0 0 0 0 1 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 1 0 1 65 0 1 112 1 0 1 BD 0 0 0 0 0 0 0 0 X 21 17 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X Elizabeth Buikema 7738782294 C/O CRC 5700 Old Orchard Rd Skokie IL 60077 X Jon P Aagaard MD Director 1.00 1.00 X 0 0 0 Rev Richard B Berry Director 1.00 1.00 X 0 0 0 Pamela Christensen Director 1.00 1.00 X 0 0 0 Kara E Davis MD Director 1.00 1.00 X 0 0 0 Rev Harvey Drake Director 1.00 1.00 X 0 0 0 Mark C Eastburg Director 1.00 1.00 X 0 0 0 James Elving Director 1.00 1.00 X 0 0 0 Marc E Espinosa Director 1.00 1.00 X 0 0 0 Carol A Findling Director 1.00 1.00 X 0 0 0 Lorene G Flewellen Director 1.00 1.00 X 0 0 0 Rhoda Friesen Director 1.00 1.00 X 0 0 0 Thomas F Heywood Director 1.00 1.00 X 0 0 0 Donald Hodgkinson Director 1.00 1.00 X 0 0 0 Kathy Holmgren Director 1.00 1.00 X 0 0 0 Jody Holt Director 1.00 1.00 X 0 0 0 Cletus J Moll Director 1.00 1.00 X 0 0 0 Marlene Stante Director 1.00 1.00 X 0 0 0 Anne Vining Director 1.00 1.00 X 0 0 0 David A Dwight Ex-Officio 1.00 40.00 X 0 829154 35518 Rick K Fisk Ex-Officio/President 40.00 1.00 X X 0 591314 20510 Scott Macdonald Ex-Officio 1.00 1.00 X 0 0 0 Gary Walter Ex-Officio 1.00 40.00 X 0 148198 108038 Terri S Cunliffe EVP of Oper/Asst Sec 40.00 1.00 X 291900 0 46580 Elizabeth B Buikema Senior VP/CFO/Treasurer 40.00 1.00 X 286641 0 51818 David G Erickson VP/Asst Secretary 40.00 1.00 X 216079 0 44087 Kathleen Jenkins Dir Admin Srvcs/Asst Secretary 40.00 1.00 X 139833 0 16572 Sneha Patel Chief Information Officer 40.00 1.00 X 182728 0 37308 Thomas V Pluta AVP-Strategic Fin Planning 40.00 1.00 X 177274 0 25042 Randal Gross VP-Facilities Mngt 40.00 1.00 X 181513 0 34419 Elizabeth A Malzahn Nat. Dir. - Healthcare 40.00 1.00 X 144617 0 20141 Robert J Wall Dir. - IT Infrastructure 40.00 1.00 X 147896 0 26030 1768481 1568666 466063 24 0 1 0 Moving Station LLC 100 N LaSalle Street Suite 300 Chicago IL 60602 Home Purchase Program 355980 Erickson Papanek Peterson Rose 1625 Shermer Road Northbrook IL 60062 Legal Consultants 342843 MRC Development LLC 11827 W 112th Street Suite 103 Overland Park KS 66210 Consultants 303320 Plante & Moran PLLC 2155 Point Blvd Suite 200 Elgin IL 60123 Financial Auditing 187500 MD Reynolds Consulting 1719 Chardonnay Lane Brentwood CA 94513 Consultants 140000 8 Management Fees 561000 18185433 18185433 Routine Services 623000 2119970 2119970 Entrance Fee 623000 868502 868502 Ancillary Service 623000 2647 2647 21176552 18827859 18827859 318488 328198 -9710 -9710 -9710 4151297 102001 0 0 4151297 102001 4253298 4253298 Support Services 623000 2534 2534 Services to Residents 623000 1424 1424 156582 156582 160540 44408539 21337092 0 23071447 11701 11701 1082113 1082113 5339859 5082445 119586 137828 299542 289148 3761 6633 972370 918944 13153 40273 421428 402962 8265 10201 50121 50121 296436 295666 770 12518 11233 1285 410952 410952 1069455 1054316 496 14643 55194 55194 498490 473838 20575 4077 4064103 4064103 279788 279788 892222 858886 33336 63553 61003 1538 1012 3704369 3328097 309212 67060 2638311 2316633 270368 51310 78132 78132 Related Party Activity 375480 250872 124608 0 Taxes 350575 128164 222411 Resident Care Services 193384 193384 Admin & General 151277 151277 389949 301069 407 88473 23701322 22150041 1096435 454846 4115085 8432414 468962 274263 19814 21451 614398 873876 7500 0 3747281 4130738 48127088 13983377 33524466 34143711 32007451 13008854 3201966 12971455 49551472 37558348 127258395 111415110 10154029 11011271 10121029 9513614 37810712 18987350 414080 414080 54895336 36855726 113395186 76782041 X 9026948 29610760 378714 379987 4457547 4642322 13863209 34633069 127258395 111415110 X 20707217 62643 X 0 1 X 1 0 X X X 0 0 0 Colonial Acres Home Inc 418041150 9 1 1 1 0 Bethany Covenant Home 410706103 9 1 1 1 0 Covenant Village of Florida 521115870 9 1 1 1 0 Covenant Home Illinois 362643638 9 1 1 1 0 Covenant Healthcare Centers Inc 521115873 9 1 1 1 0 The Holmstad 362835154 9 1 1 1 0 Covenant Home of Chicago 363095932 9 1 1 1 0 Covenant Home Inc Connecticut 131740015 9 1 1 1 0 Covenant Retirement Communities West 953472345 9 1 1 1 0 Covenant Village of Colorado 841084331 9 1 1 1 0 Windsor Park 363385581 9 1 1 1 0 Covenant Retirement Communities of the Great Lakes Conference 383244636 9 1 1 1 0 Covenant Home Services 260744025 9 1 1 1 0 Covenant Retirement Services 272480652 11 1 1 1 0 14 0 0 1 X 4450347 214023 -22048 4642322 4007505 463870 -21028 4450347 3904764 123480 -20739 4007505 3478405 446318 -19959 3904764 2752445 752986 -27026 3478405 0 0 9201158 9201158 24437158 5704563 18732595 11580182 8209707 3370475 2908590 69107 2839483 34143711 Mortgages 1516770 F Domestic Equity 2220517 F International Equity 3202550 F Hedge Funds & Derivatives 3929515 F Private Equity 1946175 F International Real Estate 155928 F 12971455 Unamortized Debt & Related Expenses 254271 Other Investments 21122318 Inter-company Advance Accounts 16181759 37558348 Refundable Contract Liabilities 2599421 Accrued Taxes & Employee Benefits 577097 Other Liabilities 33679208 36855726 X Part IV, Line 2b: Explanation: Resident 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. Part V, Line 4: The Brandel Endowment Fund is used for resident care at one of the CRC campuses. Part X, Line 2: A FIN 48 footnote was included in the consolidated audited financial statements of Covenant Retirement Communities, Inc. and affiliates which states: "Accounting principles generally accepted in the United States of America require management to evaluate tax positions taken by the Retirement Communities and recognize a tax liability if the Retirement Communities have taken an uncertain position that more likely than not would not be sustained upon examination by the IRS or other applicable taxing authorities. Management has analyzed the tax positions taken by the Retirement Communities and has concluded that as of January 31, 2014, there are no uncertain positions taken or expected to be taken that would require recognition of a liability or disclosure in the consolidated financial statements. The Retirement communities are subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. The Retirement Communities believe they are no longer subject to U.S. federal, state, and local, or non-U.S. income tax examinations by tax authorities for years before 2011." 1 Swedish Covenant Hospital 5145 N California Ave Chicago IL 60625 501(c)(3) 5000 Benefit Gala 1 Part I, Line 2: Grants and donation requests and proposals are brought to Covenant Retirement Communities'(CRC) management. The management then brings requests and proposals deemed appropriate to the CRC Board for approval, if significant. A check goes out after the appropriate level of approval is received. X X 1 1 0 1 0 0 0 0 0 1 0 David A Dwight Ex-Officio 0 515357 0 0 0 313797 0 7650 0 27868 0 864672 0 13274 Rick K Fisk Ex-Officio/President 0 432480 0 56263 0 102571 0 9286 0 21145 0 621745 0 0 Gary Walter Ex-Officio 0 148198 0 0 0 0 0 22230 0 85808 0 256236 0 0 Terri S Cunliffe EVP of Oper/Asst Sec 229480 0 17400 0 45020 0 29700 0 19309 0 340909 0 0 0 Elizabeth B Buikema Senior VP/CFO/Treasurer 228915 0 23750 0 33976 0 28600 0 26551 0 341792 0 0 0 David G Erickson VP/Asst Secretary 167268 0 21600 0 27211 0 21569 0 27995 0 265643 0 0 0 Kathleen Jenkins Dir Admin Srvcs/Asst Secretary 87263 0 7500 0 45070 0 3447 0 15636 0 158916 0 13817 0 Sneha Patel Chief Information Officer 145594 0 5000 0 32134 0 18034 0 21527 0 222289 0 11726 0 Thomas V Pluta AVP-Strategic Fin Planning 133201 0 7500 0 36573 0 17867 0 12755 0 207896 0 0 0 Randal Gross VP-Facilities Mngt 135105 0 13300 0 33108 0 18289 0 20366 0 220168 0 0 0 Elizabeth A Malzahn Nat. Dir. - Healthcare 122783 0 4000 0 17834 0 4262 0 16959 0 165838 0 0 0 Robert J Wall Dir. - IT Infrastructure 113322 0 7000 0 27574 0 15787 0 13194 0 176877 0 1530 0 Part I, Line 1a The following are available benefits and are treated as taxable compensation: - Travel for companion paid for two (2) senior-level employees. - Health club dues paid for six (6) senior-level employees. Part I, Line 3 See Schedule O explanation for Form 990 Part VI Section B Line 15 for the methods used to determine CEO compensation. Part I, Line 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 Compensation Committee of CMB's Board 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 following listed individuals participated in the Executive Benefit Plan: David Dwight - $64,611 Rick Fisk - $54,257 Terri Cunliffe - $25,682 Elizabeth Buikema - $25,464 David Erickson - $21,995 Kathleen Jenkins - $ 9,837 Sneha Patel - $16,019 Thomas Pluta - $19,007 Randal Gross - $18,832 Robert Wall - $15,777 Part I, Line 7 The following applies to certain individuals listed on Part VII whose compensation is paid from related organizations: The Executive Compensation Committee (the "Committee") follows a prescribed method for calculating bonuses. 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. Refer to additional information on the Committee included in Schedule O. Part II Column B (i): Base compensation for certain individuals may include payments from deferred compensation plans. Part II, Column B (ii): Bonus and incentive compensation - Certain key persons employed by CRC are eligible for incentive compensation as determined by the CRC Board Compensation Committee. Incentives paid in 2013 relate to the achievement of targets for the fiscal year ended 1/31/2013. Part II, Column D: Nontaxable benefits include health insurance premiums paid by the employer and employee. A Illinois Finance Authority 861091967 000000000 2011-12-14 59165000 See Part VI 0 0 0 B Colorado Health Facilities Authority 840752932 196474ZS9 2005-08-05 149845454 See Part VI 0 0 0 C Colorado Health Facilities Authority 840752932 19648AZM0 2012-09-06 154966180 See Part VI 0 0 0 D Colorado Health Facilities Authority 840752932 19648AJ30 2013-07-31 39480962 See Part VI 0 0 0 A 2145000 59167012 800459 6400943 51963598 2012 1 0 1 1 B 27865000 149290577 12249560 2429078 134547402 2009 0 0 1 1 C 2880000 155089193 15048709 2447778 18756044 117591400 1245262 1 0 0 1 D 37485609 1959535 788403 12123763 22613908 0 0 0 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 0 C 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 0 D 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 1 1 0 0 0 0 B 0 0 0 1 0 0 0 0 0 C 0 1 0 0 0 0 0 0 0 D 0 1 0 0 0 0 0 0 0 A 0 B 0 C 0 Date Rebate Computation Performed Issuer Name: Illinois Finance Authority Date the Rebate Computation was Performed: 12/31/2012 Issuer Name: Colorado Health Facilities Authority Date the Rebate Computation was Performed: 12/31/2010 Part I, Row A, Column F Borrowings were used, along with other funds, to (1) retire $53,285,000 of other variable rate debt recorded on the balance sheets of wholly owned subsidiaries of CRC (2) to pay debt issuance costs of $800,459 and (3) to fund capital projects of $6,401,003 for certain wholly owned subsidiaries of CRC. Part I, Row B, Column F Borrowings were used to (1) construct and equip residential living buildings for six wholly owned subsidiaries of CRC (2) to pay debt issuance costs of $2,429,078 and to fund required bond reserves. Part I, Row C, Column F Borrowings were used, along with other funds, to (1) retire $131,220,000 of previously issued debt recorded on the balance sheets of wholly owned subsidiaries of CRC (2) to pay debt issuance costs of $2,447,778 and (3) construct and equip residential and healthcare facilities for certain wholly owned subsidiaries of CRC Part I, Row D, Column F Borrowings are for the construction of a residential living towncenter, to fund routine capital and to pay debt issuance costs of $788,403. Part I, Row A-2, Column F Borrowings are for the construction of a residential living towncenter, to fund routine capital and to pay debt issuance costs of $406,244. Part II, Line 3, Column A The amount in Line 3 does not equal the amount in Part I, Row A, Col E because of investment earnings on reserves. Part II Line 3 Column B The amount in Line 3 does not equal the amount in Part I, Row B, Col E because CRC redeemed and retired $12,650,000 of the 2005 Bonds, which reduced the amount required to be held in the debt service reserve fund. The amount in excess of the reserve fund requirement was used to redeem and retire a portion of the 2005 Bonds. Additionally, investment earnings on the reserve fund were transferred to the bond sinking fund and bond interest fund to pay principal and interest on the 2005 Bonds. Part II Line 3 Column C The amount in Line 3 does not equal the amount in Part I, Row C, Col E because of unrealized investment losses on reserves. Part II, Line 3, Column D The amount in Line 3 does not equal the amount in Part I, Row D, Col E because of unrealized investment earnings/losses on reserves Part V CRC does not have a established written procedures regarding corrective action, but CRC has adequate practices in place to prevent a need for corrective action. CRC is working on developing written procedures. Part II Line 16 Column C, D, A-2 The final allocation of proceeds to wholly owned subsidiaries of CRC has not been made as of January 31, 2014. Part III, Line 9 & Part IV, Line 7 & Part V CRC does not have established written procedures but is in the process of developing documentation. Part IV, Line 2a, Column C, D, A-2 A rebate calculation has not been completed as it is not due. Part II, Line 3, Column A-2 The amount in Line 3 does not equal the amount in Part I, Row A-2, Col E because of unrealized investment earnings/losses on reserves. A California Statewide Communities Development Authority 680164610 13080SAU8 2013-07-31 20251431 See Part VI 0 0 0 A 20147876 1298275 406244 4107977 14335380 0 0 0 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 0 0 0 0 0 0 0 Grant Erickson See Part V 342873 See Part V 0 Sch L Part IV (b) and (d) a) Name of Person: Grant Ericksonb) Relationship Between Interested Person and Organization: Familymember of David Erickson (Vice President & Assistant Secretary)c) Amount of Transaction: $342,843d) Description of Transaction: Partner in a law firm that provideslegal counsel to the organization. Form 990 - Part III - Line 1 As 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. 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. CRC, Inc. is organized and operated for the benefit of, and to plan and support the charitable purposes of, several continuing care retirement communities, all nonprofit organizations, consisting of residential living, assisted living facilities, and skilled nursing homes, as well as other senior services organizations and services. In addition to the program service accomplishments of each organization, Covenant Retirement Communities, Inc., provided $5,598,763 of free or discounted services to those residents unable to pay all or a portion of their charges, and who meet certain eligibility requirements. Form 990, Part VI, Section A, line 6 The members are the individual members of the Board of Benevolence. Form 990, Part VI, Section A, line 7a The individual members of the Board of Benevolence elect the CRC Board of Directors. Form 990, Part VI, Section A, line 7b S 2.4 of Bylaws include reserved powers to the 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 11 Management Review: The draft Form 990 was reviewed by multiple levels of management including the President of CRC, the Vice President of Finance/CFO and the Vice President of Legal Affairs. Board Review: Prior to filing, key provisions of the Form were discussed 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 12c Covenant 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 15 CRC's 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 18 A 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 19 The 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 VII - Section A Column B 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 1,273. Change in Permanently Restricted Net Assets not included on Income Stmnt 184,775. Adj to URNA for Adoption of Accounting Pronouncement -123,405. Estates of Windsor Park 5700 Old Orchard Road Skokie IL 60077 363478388 Residential Senior Services IL 3206306 26433117 N/A Evangelical Covenant Church 8303 West Higgins Road Chicago IL 60631 362167730 Church IL 501(c)(3) Line 1 N/A 0 Swedish Covenant Faculty Group (SCFG) 5145 North California Avenue Chicago IL 60625 363686216 Patient Treatment/Education IL 501(c)(3) Line 11a, I Swedish Covenant Hospital 0 Swedish Covenant Hospital 5145 North California Avenue Chicago IL 60625 362179813 Hospital IL 501(c)(3) Line 3 Covenant Ministries of Benevolence 0 Swedish Covenant Hospital Foundation (SCHF) 5145 North California Avenue Chicago IL 60625 205055155 Supporting Organization of SCH IL 501(c)(3) Line 7 Swedish Covenant Hospital 0 SC Insurance Company 6970 E Chauncey Lane Suite 100 Phoenix AZ 85054 273312053 Insurance AZ 501(c)(3) Line 11a, I Swedish Covenant Hospital 0 Coast Asset Management LLC 2450 Colorado Ave Suite 100 E Tower Santa Monica CA 90404 954763400 Hedge Fund Investment CA N/A N/A 0 0 Covenant Village of Portland LP 420 NE Mason St Portland OR 97211 364356838 Assisted Living Community OR N/A N/A 0 0 Swedish Covenant Surgery LLC 5215 N California Avenue Chicago IL 60625 272485300 Outpatient Medical Services IL N/A N/A 0 0 Covenant International Insurance Company Ltd Crawford House 50 Cedar Avenue Hamilton BD Insurance BD N/A 0.50000 0 Covenant Trust Company 5215 Old Orchard Road Suite 725 Skokie IL 60077 363583163 Financial Services IL N/A C 0 Swedish Covenant Management Services Inc (SCMS) 5145 North California Avenue Chicago IL 60625 364073303 Physician Practice Management IL N/A C 0 Swedish Covenant Managed Care Alliance (SCMCA) 2740 West Foster Avenue Suite 409 Chicago IL 60625 364118659 Physician - Hospital Organization IL N/A C 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 1 Colonial Acres Home Inc Q 677792 Colonial Acres Home Inc A 392091 Covenant Village of Florida P 991480 Covenant Village of Florida A 449126 Windsor Park Q 4366860 Windsor Park A 736696 Covenant Village of Colorado P 753473 Covenant Village of Colorado A 47689 Covenant Home Illinois Q 1293019 Covenant Home Illinois P 50445 The Holmstad Q 3349188 The Holmstad A 225283 Covenant Healthcare Centers Q 2643927 Covenant Healthcare Centers P 552636 Covenant Home of Chicago Q 75755 Covenant Home of Chicago A 121140 Covenanat Home Inc P 2505069 Covenanat Home Inc A 330245 Covenant Retirement Communities West P 1528552 Covenant Retirement Communities West Q 7457004 Covenant Retirement Communities of the Great Lakes Conference Q 46705 Covenant Retirement Communities of the Great Lakes Conference A 146289 Covenant Retirement Services Inc P 637455 Covenant Retirement Services Inc A 128887 Covenant Home Services P 340160 Covenant Home Services A 505361 Covenant Ministries of Benevolence M 2072250 Covenant Ministries of Benevolence L 80600 Covenant Ministries of Benevolence Q 105498 Covenant Ministries of Benevolence P 2461984 Covenant Ministries of Benevolence S 14442026 Covenant Housing Corporation P 75000