2012-12-06T11:17:37-06:00 2012-01-31 990 2011-02-01 383244636 Covenant Retirement Communities of the Great Lakes Conference COVE 6167354541 2520 Lake Michigan Drive NW Grand Rapids MI 49504 Elizabeth Buikema 7738782294 2012-12-06 2011 2016-02-24 21:20:13Z Elizabeth Buikema c/o CRC - 5700 Old Orchard Rd Skokie IL 60077 12813481 0 2650 X www.covenantretirement.org X 1995 MI Care for senior adults. 21 17 242 144 0 0 36489 50889 11738487 12255211 354711 132081 328621 356596 12458308 12794777 0 0 0 0 4609647 4958535 0 0 75419 9569494 10126764 14179141 15085299 -1720833 -2290522 50341166 47515178 69017443 68477642 -18676277 -20962464 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 4578417 4964945 Residential Living: The number of persons who benefited from the services we provided for the year ended January 31, 2012 were as follows:There were a total of 214 residents, occupying 164 apartments at 01/31/2012. Residency for the fiscal year totaled 69,648 resident days. 2666553 3173811 Assisted Living: The number of persons who benefited from the services we provided for the year ended January 31, 2012 were as follows:There were a total of 63 assisted living residents at 01/31/2012. Assisted living residency for the fiscal year totaled 23,825 patient days. 3528628 4480551 Skilled Nursing: The number of persons who benefited from the services we provided for the year ended January 31, 2012 were as follows:There were a total of 25 skilled care patients at 01/31/2012.Skilled care residency for the fiscal year totaled 10,964 patient days. The organization was involved in various community benefits programwhich includes the following:- Staff members voluntered a total of 348 hours (equivalent to $26,950). This included the following: Off-site Blood Pressure Screening, as a CARF surveyor, various volunteer opportunities at Grand Valley State University, Brain Aerobics at Senior Center, mentored a Practician student enrolled in GRCC Gerontology program, community workshop "Brain Health" at a local church, served in a local school for the Kids Food Basket event and others.- Residents volunteered a total of 3,378 hours through the following organizations/events: Habitat for Humanity, local churches, mentoring local students through Kid's Hope USA, Kids Food Basket, Potter's House, Homeland Security Department's Terrorism and Security Training, Feed America project through Plymouth Arms Food Panty, Second Blessings Thrift Shop and others.- Provided student internship program for Grand Valley Gerontologystudents (equivalent to $2,550.00)- Provided space for meetings and events for small groups (under 35people) to large groups (75+ people) such as the various Camera Clubs, Parkinsons group, Widowed Group, Boes and other piano schools, Business Networking Group, American Cancer Society, Covenant Enabling Residences, Grand Rapids Chamber of Commerce, Walker Chamber of Commerce Church Circle, Grand Valley students, Area Agency on Aging, Swedish American Society, Antique Auto Club and others (equivalent to $333,000)- In-Kind Donations of 61 windows to Habitat for Humanity ($3,050 in estimated value)- Hosted small (under 35 people) to large (75+ people) scale communityevents such as "Painted Bowls for Soups On" event to benefit God's Kitchen, Presentations/Lectures on different topics (Senior Scams, Shingles, Therapy Management, Alzheimer's Disease, Wellness and Weight Loss after 50, Heart Health, Protect your Precious Gift of Sight, Bladder Health, Optimal Brain Health), Parkinsons' Support, Blood Drive, Widowed Persons' Group, Angel Tree, Bridal Show, different Drama Club presetnations, National Senior Health and Fitness and Warner Sallman display for the Grand Rapids' Artprize. (equivalent to $738,000) 10773598 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 45 0 1 242 1 0 0 0 0 0 1 1 0 0 0 0 X 21 17 0 1 0 0 1 0 1 1 1 1 0 1 1 1 1 1 1 0 0 0 X Elizabeth Buikema 7738782294 C/O CRC 5700 Old Orchard Rd Skokie IL 60077 X Jon P Aagaard MD 1.00 X 0 0 0 Curtis B Anderson 1.00 X 0 0 0 Rev Richard B Berry 1.00 X 0 0 0 Wendell Danielson 1.00 X 0 0 0 Rev Harvey Drake 1.00 X 0 0 0 James Elving 1.00 X 0 0 0 Marc E Espinosa 1.00 X 0 0 0 Lorene G Flewellen 1.00 X 0 0 0 Rhoda Friesen 1.00 X 0 0 0 Mary Miller 1.00 X 0 0 0 Cletus J Moll 1.00 X 0 0 0 Joyce Peterson 1.00 X 0 0 0 Norton Richards 1.00 X 0 0 0 Walter Schiller 1.00 X 0 0 0 Marlene Stante 1.00 X 0 0 0 Jean A Stebinger 1.00 X 0 0 0 Robert K Johnston 1.00 X 0 0 0 David A Dwight 1.00 X 0 848677 95681 Rick K Fisk 1.00 X X 0 897465 84268 Scott MacDonald 1.00 X 0 0 0 Gary Walter 1.00 X 0 151985 115788 Steven P Anderson 1.00 X 0 252774 70881 Elizabeth B Buikema 1.00 X 0 358640 55395 Moraine M Byrne 1.00 X 0 202945 47866 Terri S Cunliffe 1.00 X 0 350896 72409 John R Harriff 1.00 X 0 273526 47657 David G Erickson 1.00 X 0 226176 40285 Kathleen Jenkins 1.00 X 0 176448 70348 Richard D Kline 40.00 X 119313 0 34164 119313 3739532 734742 1 0 1 0 Aegis Therapies Inc Mail Drop 2761 - 10001 Fianna Way Fort Smith AR 72919 Therapy Services 607127 Sodexo Inc & Affiliates 4880 Paysphere Circle Chicago IL 60674 Dining Services 309439 2 18740 32149 50889 Routine Services 623000 7620925 7620925 Entrance Fee 623000 1945513 1945513 Ancillary Services 623000 1938717 1938717 Medicare/Medicaid 623000 650306 650306 Meals 623000 99750 99750 12255211 67364 67364 7499 -7499 -7499 -7499 64717 0 64717 64717 64717 11205 18740 11205 0 Support Services 623000 327361 327361 Services to Residents 623000 18185 18185 18549 18549 364095 12794777 12619306 0 124582 3942796 2976010 950877 15909 110717 87282 23059 376 580022 482725 97290 7 325000 226552 97231 1217 104187 104067 120 48905 48905 21285 21285 1479828 1159080 320312 436 283305 283305 641092 525348 115394 350 127998 62 127936 693169 693169 13640 5923 7717 25086 4947 20139 2740587 1938143 767364 35080 1499533 1060854 419869 18810 172441 172441 Dining Services 589373 589373 Related Party Payments 553063 60 552973 30 Resident Care 444691 444691 Admin & General 185492 163804 21688 503089 139067 360818 3204 15085299 10773598 4236282 75419 24159 18830 3672105 1867481 40592 43607 1011629 1068268 1879 3154 118266 87982 47813613 11275121 37591554 36538492 5672995 5571674 357839 545014 1850148 1770676 50341166 47515178 617254 623671 9858439 9612642 45351146 45088938 51574 106694 13139030 13045697 69017443 68477642 X -18770651 -21061172 94374 98708 -18676277 -20962464 50341166 47515178 X -2290522 4334 X 0 1 1 X 0 X 72426 34671 122087 36489 50889 316562 10111455 10572695 11442695 11738487 12255211 56120543 10183881 10607366 11564782 11774976 12306100 56437105 0 0 0 56437105 486411 47742 767460 354711 132081 1788405 486411 47742 767460 354711 132081 1788405 10670292 10655108 12332242 12129687 12438181 58225510 0.96930 0.95990 0.03070 0.04010 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 791493 791493 43757708 8883580 34874128 3086570 2347668 738902 177842 43873 133969 36538492 Deferred Revenue Subject to Refund 4998657 Refundable Contract Liabilities 3309621 Accrued Taxes & Employee Benefits 44263 Inter-company Advance Accounts 4640867 Other Liabilities 52289 13045697 12794777 15085299 -2290522 4334 4334 -2286188 Part IV, Line 2b: Part IV, line 2b: 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. Description of Uncertain Tax Positions Under FIN 48: Part X: A FIN 48 footnote was not included in the consolidated audited financial statements of Covenant Retirement Communities, Inc. and affiliates. A FIN 48 analysis was completed for Covenant Retirement Communities, Inc. and affiliates and it did not have a material impact on the financial position or results of operations. Part XI, Line 8 - Other Adjustments: Change in Temporarily Restricted Net Assets not included on Income Stmnt 4,334. Benevolence Gala 29945 18740 11205 200 4424 2519 4062 29945 18740 11205 200 4424 2519 4062 11205 0 X 1 1 0 1 0 0 0 0 0 1 0 David A Dwight 0 505032 0 0 0 343645 0 67314 0 28367 0 944358 0 0 Rick K Fisk 0 401500 0 109285 0 386680 0 67384 0 23717 0 988566 0 18009 Gary Walter 0 151985 0 0 0 0 0 27623 0 88165 0 267773 0 0 Steven P Anderson 0 146862 0 21837 0 84075 0 52698 0 24166 0 329638 0 5634 Elizabeth B Buikema 0 213636 0 38071 0 106933 0 34666 0 23948 0 417254 0 10768 Moraine M Byrne 0 160778 0 21538 0 20629 0 33590 0 17108 0 253643 0 8210 Terri S Cunliffe 0 169582 0 29138 0 152176 0 57714 0 17075 0 425685 0 0 John R Harriff 0 128946 0 15355 0 129225 0 37805 0 16193 0 327524 0 0 David G Erickson 0 149595 0 32240 0 44341 0 20060 0 23450 0 269686 0 0 Kathleen Jenkins 0 80036 0 7500 0 88912 0 52257 0 20314 0 249019 0 11125 Richard D Kline 99202 0 12434 0 7677 0 16082 0 20881 0 156276 0 0 0 Part I, Line 1a Health club dues paid for one (1) senior-level employee. This is treated as a taxable benefit. 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 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 - $78,250.81 Rick Fisk - $62,656.27 Elizabeth Buikema - $22,523.08 Steven P. Anderson - $19,775.86 John R. Harriff - $21,225.06 Terri Cunliffe - $18,594.60 David Erickson - $20,085.18 Kathleen Jenkins - $11,814.81 Moraine Byrne - $17,884.00 Richard Kline - $14,979.00 Pension Restoration Plan As certain individuals' pension benefits may be limited by tax code maximums on both eligible compensation and benefits, Covenant Ministries of Benevolence (CMB) provides a Pension Restoration Plan which entitles the individuals listed below to a pension benefit based on total cash compensation. David A. Dwight - $6,814 Rick K. Fisk - $25,517 Part I, Line 7 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. Supplemental Information Part III 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 2011 relate to the achievement of targets for the fiscal year ended 1/31/2011. Part II, Column B (iii): Other Reportable Compensation - During the 2010 calendar year, Covenant Ministries of Benevolence (CMB) discontinued its sponsorship of a particular deferred benefit program that included employer contributions to split dollar life insurance arrangements for certain employees, including some individuals whose compensation is disclosed on this Form 990 Part VII and in Schedule J. While the sponsorship and employer contributions to the split dollar life insurance arrangements were discontinued in 2010, federal tax law rules prevented CMB from transferring the insurance policies to the affected employees, and fully terminating these arrangements, for 12 months following the Board action to end its sponsorship and contributions. As a result, affected employees were taxed on the value of those split dollar life insurance policies in 2011, when the policies or the value of them was actually transferred to the employees. Although these benefits were earned over many years of employment, the full value of the benefits must be treated as taxable compensation in the year that the employee receives the policy or the benefit. In prior years, the premiums paid for the life insurance arrangements were reported in Part II Column B(iii) as non-taxable benefits in the years they were paid. The portions of reportable compensation that were due to this acceleration treatment are as follows: David Dwight - $283,443.23 Rick Fisk - $274,538.58 Elizabeth Buikema - $75,181.58 Steven P. Anderson - $67,348.01 John R. Harriff - $92,164.41 Terri Cunliffe - $119,770.13 David Erickson - $19,001.89 Kathleen Jenkins - $45,430.60 Part II, Column C: Deferred compensation includes an estimate of the contribution made to an employer sponsored defined benefit pension plan. Part II, Column D: Nontaxable benefits include health insurance premiums paid by the employer and employee. Mission Statement: Form 990 - Part III - Line 1 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 Retirement Communities of the Great Lakes provided $49,099 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 3 Covenant Retirement Communities of the Great Lakes Conference delegated control over management duties to Covenant Retirement Communities, Inc. (CRC), its parent organization. Form 990, Part VI, Section A, line 6 The sole member is Covenant Retirement Communties, Inc. (CRC). Form 990, Part VI, Section A, line 7b S 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 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. Covenant 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 18 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 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. Contact Info for Directors & Officers: Form 990 - Part VI - Line 9 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. Related Organization: Form 990 - Part VII - Section A Officers and Directors devote less than 1 hour per week to related organizations except for those individuals that are employees of Covenant Retirement Communities, Inc. (CRC). Those that are employed by CRC devote approximately 40 hours per week to CRC. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Change in Temporarily Restricted Net Assets not included on Income Stmnt 4,334. Total to Form 990, Part XI, Line 5: 4,334. 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 Cardiovascular Performance Group LLC 5145 N California Avenue Chicago IL 60625 203587272 Management Services IL N/A N/A 0 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 Covenant Trust Company 5215 Old Orchard Road Suite 725 Skokie IL 60077 363583163 Financial Services IL N/A C Swedish Covenant Management Services Inc (SCMS) 5145 North California Avenue Chicago IL 60625 364073303 Physician Practice Management IL N/A C Swedish Covenant Managed Care Alliance (SCMCA) 2740 West Foster Avenue Suite 409 Chicago IL 60625 364118659 Physician - Hospital Organization IL N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 Covenant Retirement Communities Inc O 2539233