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BENEDICTINE LIVING COMMUNITY OF SPOONER: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
BENEDICTINE LIVING COMMUNITY OF SPOONER (EIN 45-0700468)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-02-13
IRS object ID
201420449349301957
Schema version
2012v2.0
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)
Timestamp2014-02-13T13:03:57-08:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN450700468EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BENEDICTINE LIVING COMMUNITY OF SPOONERBusinessNameLine1
Business Name Line2dba BENEDICTINE LIVING CENTER OF SPOONERBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlBENENameControl
Phone7636891162Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11995 E RUM RIVER DRIVE SAddressLine1
CityCAMBRIDGECity
StateMNState
ZIP Code55008ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKEVIN RYMANOWSKIName
TitleCFOTitle
Date Signed2014-02-13DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonPETER LEERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11995 E RUM RIVER DRIVE SAddressLine1
CityCAMBRIDGECity
StateMNState
ZIP Code55008ZIPCode
FieldValueIRS element (for citing)
Gross Receipts4970342GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.bhshealth.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2011YearFormation
State Legal DomicileMNStateLegalDomicile
Activity Or Mission DescriptionOur mission is to witness to God's love by providing compassionate, quality care with special concern for the underserved and those in need.ActivityOrMissionDescription
Nbr Voting Members Governing Body3NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees108TotalNbrEmployees
Total Nbr Volunteers85TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year8965ContributionsGrantsPriorYear
Contributions Grants Current Year3743ContributionsGrantsCurrentYear
Program Service Revenue Prior Year6124807ProgramServiceRevenuePriorYear
Program Service Revenue CY4965925ProgramServiceRevenueCY
Investment Income Prior Year5InvestmentIncomePriorYear
Investment Income Current Year674InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year6133777TotalRevenuePriorYear
Total Revenue Current Year4970342TotalRevenueCurrentYear
Grants And Similar Amnts CY30396GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year3779393SalariesEtcPriorYear
Salaries Etc Current Year3455319SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2587146OtherExpensePriorYear
Other Expenses Current Year2366201OtherExpensesCurrentYear
Total Expenses Prior Year6366539TotalExpensesPriorYear
Total Expenses Current Year5851916TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-232762RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-881574RevenuesLessExpensesCY
Total Assets BOY852952TotalAssetsBOY
Total Assets EOY858057TotalAssetsEOY
Total Liabilities BOY1020157TotalLiabilitiesBOY
Total Liabilities EOY1871344TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-167205NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-1013287NetAssetsOrFundBalancesEOY
Mission DescriptionBenedictine Living Community of Spooner is a Catholic organization entrusted with advancing the health care ministry of the Benedictine Sisters of Duluth, Minnesota. Our mission is to witness to God's love by providing compassionate, quality care with special concern for the underserved and those in need.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense5250123Expense
Grants30396Grants
Revenue4965925Revenue
DescriptionOperation of BLC - Spooner, is a 90 bed skilled nursing facility in Spooner, Wisconsin.The facility had a 77% occupancy and served 134 individualus during the fiscal yearending 6/30/13.Description
Total Program Service Expense5250123TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingtrueCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109613NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingfalseComplianceWithBackupWitholding
Number Of Employees108NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members3NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledMNStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonKEVIN RYMANOWSKI CFONamePerson
Telephone Number7636891162TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11995 E RUM RIVER DRIVE SAddressLine1
CityCAMBRIDGECity
StateMNState
ZIP Code55008ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (5 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
KEVIN RYMANOWSKI
CFO OF BHS0.0040.00XX030794163553
STEVE CHIES
SVP OF BHS0.0040.00XX032706463085
DALE THOMPSON
CEO OF BHS0.0040.00XX0832055123739
PETER LEER
CEO / ADMIN.40.000.00X0482786083
LEONARD MEYSEMBOURG
CEO / ADMIN.40.000.00X05054411368
FieldValueIRS element (for citing)
Total Reportable Comp Frm Rltd Orgs1565882TotalReportableCompFrmRltdOrgs
Total Other Compensation267828TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SUNDANCE REHABILITATION
6549 PAYSPHERE CIRCLECHICAGOIL60674THERAPY302825
BENEDICTINE HEALTH SYSTEM
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008MANAGING SERVICES355927
AVIANDS
1751 W COUNTY ROAD BROSEVILLEMN55113DIETARY SERVICES307932
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K
All Other Contributions3743AllOtherContributions
Total Contributions3743TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionRESIDENT SERVICESDescription
Business Code623000BusinessCode
Total Revenue Column4965925TotalRevenueColumn
Related Or Exempt Function Income4965925RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue4965925TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column74TotalRevenueColumn
Exclusion$74ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other600Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other600Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column600TotalRevenueColumn
Exclusion$600ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column4970342TotalRevenueColumn
Related Or Exempt Function Income4965925RelatedOrExemptFunctionIncome
Exclusion$674ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total30396Total
Program Services30396ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2838214Total
Program Services2750749ProgramServices
Management And General87465ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total42049Total
Program Services39316ProgramServices
Management And General2733ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total325634Total
Program Services304468ProgramServices
Management And General21166ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total249422Total
Program Services233210ProgramServices
Management And General16212ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total355927Total
Management And General355927ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total10535Total
Management And General10535ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total3211Total
Management And General3211ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total871380Total
Program Services871380ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total2621Total
Program Services2621ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total27454Total
Management And General27454ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total73608Total
Management And General73608ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total232328Total
Program Services232328ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total8871Total
Program Services6413ProgramServices
Management And General2458ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total517Total
Program Services21ProgramServices
Management And General496ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total15504Total
Program Services15504ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total70446Total
Program Services70446ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
FOOD6742967429
BAD DEBTS8296682966
SURCHARGE (BED TAX)178500178500
Medical Supply Expense301726301726

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total63178Total
Program Services62650ProgramServices
Management And General528ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total5851916Total
Program Services5250123ProgramServices
Management And General601793ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY145221BOY
EOY75907EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY600051BOY
EOY708852EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY32916BOY
EOY5382EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis83129LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec27854LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY57887BOY
EOY55275EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY16877BOY
EOY12641EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY852952BOY
EOY858057EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY916201BOY
EOY1609163EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY16877BOY
EOY12641EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY87079BOY
EOY249540EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1020157BOY
EOY1871344EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-167205BOY
EOY-1039264EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY25977EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-167205BOY
EOY-1013287EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY852952BOY
EOY858057EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-881574ReconcilationRevenueExpenses
Reconcilation Other Changes35492ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year8965CurrentTaxYearMinus1Year
Current Tax Year3743CurrentTaxYear
Total12708Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year6124807CurrentTaxYearMinus1Year
Current Tax Year4965925CurrentTaxYear
Total11090732Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year6133772CurrentTaxYearMinus1Year
Current Tax Year4969668CurrentTaxYear
Total11103440Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50911103440PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year5CurrentTaxYearMinus1Year
Current Tax Year74CurrentTaxYear
Total79Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year5CurrentTaxYearMinus1Year
Current Tax Year74CurrentTaxYear
Total79Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Total0Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year6133777CurrentTaxYearMinus1Year
Current Tax Year4969742CurrentTaxYear
Total11103519Total
FieldValueIRS element (for citing)
First5 Years509XFirst5Years509
Public Support Percentage5090.00000PublicSupportPercentage509
Investment Income Percentage0.00000InvestmentIncomePercentage

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FStrueIncludedOnFS
Explanation In Part XIIIXExplanationInPartXIII

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis35360OtherCostOrOtherBasis
Depreciation12032Depreciation
Book Value23328BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis38255OtherCostOrOtherBasis
Depreciation15822Depreciation
Book Value22433BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis9514OtherCostOrOtherBasis
Book Value9514BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings55275TotalOfBookValueLandBuildings
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part XPart X : FIN48 FootnoteTax Exempt StatusBHS has been determined to qualify as a tax-exempt charitable, educational, and scientific organization under Section 501 (c)(3) of the Internal Revenue Code and also has been determined to be exempt from state income tax. The Organization follows the accounting standard for contingencies in evaluating the accounting for uncertainty in income taxes recognized in an entity's financial statements. The standard prescribes recognition and measurement of tax provisions taken or expected to be taken on a tax return that are not certain to be realized. The Organization income tax returns are subject to review and examination by federal, state, and local authorities. The Organization is not aware of any activities that would jeopardize its tax-exempt status. The Organization is not aware of any activities that are subject to tax on unrelated business income or excise or other taxes. The tax returns for the fiscal years 2010 to 2012 are open to examination by federal, local, and state authorities.
Part IV, Line 2bPart IV, Line 2b: Explanation of escrow account liabilityCARETAKER OF RESIDENT FUNDS

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedfalseRecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1BENEDICTINE HEALTH SYSTEMBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11995 E RUM RIVER DRIVE SAddressLine1
CityCAMBRIDGECity
StateMNState
ZIP Code55008ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient411531892EINOfRecipient
IRC Section501 (C) 3IRCSection
Amount Of Cash Grant30396AmountOfCashGrant
Amount Of Non Cash Assistance0AmountOfNonCashAssistance
Purpose Of GrantCAPITAL FUND / SUPPORTPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)

TitleTitleComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
STEVE CHIES
SVP OF BHS2481634114637755517111137439014951711
KEVIN RYMANOWSKI
CFO OF BHS2386434011229186418152173837149441815
DALE THOMPSON
CEO OF BHS56181810193616830110871715022955794108717

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSch J, Part III, Additional InformationIdentifier
Return ReferencePart III, Additional InformationReturnReference
ExplanationDALE THOMPSON CEO, STEVE CHIES VP, AND KEVIN RYMANOWSKI CFO OF BENEDICTINE HEALTH SYSTEM 41-1531892 SHARE THEIR TIME BETWEEN THE REPORTING ORGANIZATION AND RELATED ORGANIZATIONS.CEO LEN MEYSEMBOURG SALARY FROM CALANDER YEAR 2011 - IS 6 MONTHS OF PERIOD COMPANY WAS OPERATING. THE CEO IS COMPENSATED BY BENEDICTINE HEALTH SYSTEM, A RELATED ORGANIZATION. THIS ORGANIZATION USES THE FOLLOWING TO SET CEO / ADMINISTRATIVE COMPENSATIONS:1. COMPENSATION COMMITTEE2. INDEPENDENT COMPENSATION CONSULTANT3. WRITTEN EMPLOYMENT CONTRACT4. COMPENSATION SURVEY OR STUDY5. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
OFFICER COMPENSATIONDALE THOMPSON CEO, STEVE CHIES VP, AND KEVIN RYMANOWSKI CFO OF BENEDICTINE HEALTH SYSTEM 41-1531892 SHARE THEIR TIME BETWEEN THE REPORTING ORGANIZATION AND THE FOLLOWING RELATED ORGANIZATIONS.ARROWHEAD SENIOR LIVING COMMUNITY41-1978619BENEDICTINE CARE CENTERS41-1907571BENEDICTINE HEALTH CENTER41-1381401BENEDICTINE HEALTH SYSTEM 41-1531892BENEDICTINE HEALTH SYSTEM FOUNDATION41-1513014BENEDICTINE LIVING COMMUNITIES41-1639687BENEDICTINE LIVING COMMUNITIES -BISMARCK INC.26-4376543BENEDICTINE LIVING COMMUNITY OF MORA27-4219119BENEDICTINE LIVING COMMUNITY OF NEW LONDON27-4218436BENEDICTINE LIVING COMMUNITY OF SPOONER45-0700468BENEDICTINE LIVING COMMUNITY OF ST. PETER86-1113231BENEDICTINE LIVING COMMUNITY OF WINSTED27-4219293BENEDICTINE SENIOR LIVING COMMUNITY OF ST PETER27-2716531BRIDGES CARE COMMUNITY26-2620983CERENITY SENIOR CARE36-3517696CERENITY CARE CENTER - WHITE BEAR LAKE41-1983267CITY OF LAKES CARE CENTER41-1985663ELLENDALE EVERGREEN PLACE, INC41-1796445LIVING COMMUNITY OF ST. JOSEPH41-2011661MADONNA MEADOWS OF ROCHESTER47-0855891MADONNA TOWERS OF ROCHESTER, INC41-1809914NAZARETH LIVING CENTER43-1450394ROSEWOOD COURT41-2011389SAINT ANNE OF WINONA41-0850791ST. GERTRUDE'S HEALTH CENTER41-1848720STEELE COUNTY COMMUNITIES FOR A LIFETIME INC27-0705237STEEPLE POINTE SENIOR LIVING COMMUNITY41-1852273TEKAWITHA NURSING CENTER, INC41-1809912VILLA ST. BENEDICT36-4343235VILLA ST. VINCENT 41-1352227BLC OF RED WING 45-4929398BLC OF WAHPETON 45-4274091CRS OF WISCONSIN 39-0982340
Form 990, Part XII, Line 2: Change of Oversight or Selection ProcessThe Benedictine Health System Audit / Finance Committee oversees the selection of the independent auditor and oversees the annual Consolidated Audit of Benedictine Health System and Affiliates which includes the Organization.Form 990, Part XII, Line 2c
Other Changes In Net Assets Or Fund Balances - Other Increaseschange in Net Assets of Temp Restricted Contributions = $35492Form 990, Part XI, Line 9
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableNOT AVAILABLE TO PUBLICForm 990, Part VI, Line 19
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsThis Corporation shall not enter into any contract or transaction with (a) its Director or officer or a member of the family of a Director or an officer; (b) a director or officer of a related organization (within the meaning of Minnesota Statutes, section 317A.011, Subd. 18) or a member of the family of a director or officer of a related organization; or (c) an organization in or of which this Corporation's Director or officer is a director, officer or legal representative or has a material financial interest; unless the material facts as to the contract or transaction and as to the director's or officer's interest are fully disclosed or known to the Board of Directors, and the Board of Directors authorizes, approves, or ratifies the contract or transaction in good faith by the affirmative vote (without counting any interested Director) of a majority of the entire Board of Directors, at a meeting at which there is a quorum without counting any interested Director. For purposes of these Bylaws, "member of the family" of a director or officer shall mean a spouse, parent, child, spouse of a child, brother, sister, or spouse of a brother or sister, of the director or officer. Failure to comply with the provisions of this section shall not invalidate any contract or transaction to which this Corporation is a party. The provisions of this section shall not apply to any contracts or transaction between or among BHS and its Subsidiaries.Form 990, Part VI, Line 12c
Form 990, Part VI, Line 11b: Form 990 Review ProcessAN ELECTRONIC COPY OF THE FORM 990 WAS DISTRIBUTED PRIOR TO FILING.Form 990, Part VI, Line 11b
Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or ShareholdersBenedictine Health System has certain Reserved Powers relating to the activities of the Corporation as set out in the Corporation's By-Laws. In addition, in keeping with the Corporation's mission "to assist and coordinate activities of facilities for health care, education, and care for the aged and social services in accordance with the charitable works tradition of the Roman Catholic Church", all activities of the Corporation are required to be carried out in accordance with the charisms of the Benedictine Sisters Benevolent Association ("BSBA"), a civil law corporation for the Sisters of St. Benedict of St. Scholastica Monastery located in Duluth, Minnesota.Form 990, Part VI, Line 7b
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyEach Director of the Corporation is appointed by Benedictine Health System.Form 990, Part VI, Line 7a
Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderBenedictine Health System, a Minnesota nonprofit corporation, is the sole member of the Corporation.Form 990, Part VI, Line 6
Form 990, Part VI, Line 3: Description of Delegated Duties to Management CompanyThe Corporation contracts with Benedictine Health System, a related organization, for Management Services. Benedictine Health System employed the Administrator/CEO of the CorporationForm 990, Part VI, Line 3

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (32 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
VILLA ST BENEDICT
1995 E RUM RIVER DIRVE SCAMBRIDGEMN55008364343235NURSING HOMEMN501 (C) 39BHSfalse
VILLA ST VINCENT
1995 E RUM RIVER DIRVE SCAMBRIDGEMN55008411352227NURSING HOMEMN501 (C) 39BHSfalse
STEELE COUNTY COMMUNITIES
1995 E RUM RIVER DIRVE SCAMBRIDGEMN55008270705237NURSING HOMEMN501 (C) 39BHSfalse
ROSEWOOD COURT
1995 E RUM RIVER DIRVE SCAMBRIDGEMN55008412011389NURSING HOMEMN501 (C) 39BHSfalse
NAZARETH LIVING CENTER
1995 E RUM RIVER DIRVE SCAMBRIDGEMN55008431450394NURSING HOMEMO501 (C) 311 TYPE IBHSfalse
MADONNA MEADOWS
1995 E RUM RIVER DIRVE SCAMBRIDGEMN55008470855891ASSISTED LIVINGMN501 (C) 39BHSfalse
ELLENDALE EVERGREEN PLACE
1995 E RUM RIVER DIRVE SCAMBRIDGEMN55008411796445NURSING HOMEMN501 (C) 39BHSfalse
CATHOLIC RESIDENTIAL SERVICES
1995 E RUM RIVER DIRVE SCAMBRIDGEMN55008390982340NURSING HOMEWI501 (C) 39BHSfalse
BSLC OF ST PETER
1995 E RUM RIVER DIRVE SCAMBRIDGEMN55008272716531ASSISTED LIVINGMN501 (C) 39BHSfalse
BRIDGES CARE COMMUNITY
1995 E RUM RIVER DIRVE SCAMBRIDGEMN55008262620983NURSING HOMEMN501 (C) 39BHSfalse
BLC OF RED WING
1995 E RUM RIVER DIRVE SCAMBRIDGEMN55008454929398NURSING HOMEMN501 (C) 39BHSfalse
BLC OF WAPHETON
1995 E RUM RIVER DIRVE SCAMBRIDGEMN55008454274091NURSING HOMEMN501 (C) 39BHSfalse
BLC OF BISMARCK
1995 E RUM RIVER DIRVE SCAMBRIDGEMN55008264376543NURSING HOMEMN501 (C) 39BHSfalse
CITY OF LAKES CARE CENTER
1995 E RUM RIVER DIRVE SCAMBRIDGEMN55008411985663NURSING HOMEMN501 (C) 39BHSfalse
BENEDICTINE LIVING COMMUNITY OF WINSTED
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008274219293NURSING HOMEMN501 (C) 39BHSfalse
BENEDICTINE LIVING COMMUNITY OF NEW LOND
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008274218436NURSING HOMEMN501 (C) 39BHSfalse
BENEDICTINE LIVING COMMUNITY OF MORA
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008274219119NURSING HOMEMN501 (C) 39BHSfalse
ARROWHEAD SENIOR LIV COM
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008411978619NURSING HOMEMN501 (C) 39BHSfalse
Tekakwitha Living Center
1995 E RUM RIVER DIRVE SCAMBRIDGEMN55008411809912NURSING HOMEMN501 (C) 39BHSfalse
St Gertrudes Health & Rehab
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008411848720NURSING HOMEMN501 (C) 39BHSfalse
Saint Anne of Winona
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008410850791NURSING HOMEMN501 (C) 39BHSfalse
Madonna Towers of Rochester
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008411809914NURSING HOMEMN501 (C) 39BHSfalse
Living Community of St Joseph
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008412011661NURSING HOMEMN501 (C) 39BHSfalse
BHS FOUNDATION
503 E THIRD ST SUITE 400DULUTHMN55008411513014FUND DEVELOPMENTMN501 (C) 39BHSfalse
Cerenity Care Cen- White Bear Lake
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008411983267NURSING HOMEMN501 (C) 39BHSfalse
Cerenity Senior Care
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008363517696NURSING HOMEMN501 (C) 39BHSfalse
STEEPLE POINTE SEN LIV COMM
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008411852273NURSING HOMEMN501 (C) 39BHSfalse
Benedictine Living Com of St Peter
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008861113231NURSING HOMEMN501 (C) 39BHSfalse
Benedictine Living Communities
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008411639687NURSING HOMEMN501 (C) 39BHSfalse
BENEDICTINE CARE CENTERS
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008411907571NURSING HOMEMN501 (C) 39BHSfalse
BENEDICTINE HEALTH CENTER
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008411381401NURSING HOMEMN501 (C) 39BHSfalse
BENEDICTINE HEALTH SYSTEM
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008411531892SUPPORTING ORG.MN501 (C) 311 TYPE IIIfalseN/A
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg