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CITY OF LAKES CARE CENTER: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
CITY OF LAKES CARE CENTER (EIN 41-1985663)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-13
IRS object ID
201131339349302823
Schema version
2009v1.7
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)
Timestamp2011-05-13T11:16:01-07:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN411985663EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CITY OF LAKES CARE CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCITYNameControl
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
TitleTreasurerTitle
Date Signed2011-05-12DateSigned
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDAVID BRENNANNameOfPrincipalOfficerPerson

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 Receipts10999044GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Group Exemption Number0928GroupExemptionNumber
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2000YearFormation
State Legal DomicileMNStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HOUSING AND NURSING CARE TO THE ELDERLY AND TO ASSIST AND COORDINATE ACTIVITIES OF FACILITIES FOR HEALTH CARE, SOCIAL SERVICES, EDUCATION AND RESEARCH IN ACCORDANCE WITH THE CHARITABLE WORKS TRADITION OF THE ROMAN CATHOLIC CHURCH.ActivityOrMissionDescription
Nbr Voting Members Governing Body3NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees153TotalNbrEmployees
Total Nbr Volunteers90TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Current Year5008ContributionsGrantsCurrentYear
Program Service Revenue Prior Year10841812ProgramServiceRevenuePriorYear
Program Service Revenue CY10984203ProgramServiceRevenueCY
Investment Income Prior Year14106InvestmentIncomePriorYear
Investment Income Current Year9833InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year10855918TotalRevenuePriorYear
Total Revenue Current Year10999044TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year6022279SalariesEtcPriorYear
Salaries Etc Current Year6103291SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year34261TotalFundrsngExpCurrentYear
Other Expense Prior Year3562545OtherExpensePriorYear
Other Expenses Current Year3748120OtherExpensesCurrentYear
Total Expenses Prior Year9584824TotalExpensesPriorYear
Total Expenses Current Year9851411TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1271094RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1147633RevenuesLessExpensesCY
Total Assets BOY8173221TotalAssetsBOY
Total Assets EOY8686250TotalAssetsEOY
Total Liabilities BOY5194697TotalLiabilitiesBOY
Total Liabilities EOY4568298TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY2978524NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY4117952NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE HOUSING AND NURSING CARE TO THE ELDERLY AND TO ASSIST AND COORDINATE ACTIVITIES OF FACILITIES FOR HEALTH CARE, SOCIAL SERVICES, EDUCATION AND RESEARCH IN ACCORDANCE WITH THE CHARITABLE WORKS TRADITION OF THE ROMAN CATHOLIC CHURCH.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense8663904Expense
Revenue10984203Revenue
DescriptionOperation of Benedictine Health Center - Minnapolis, is a 110 bed long-term care in Minneapolis, Minnesota which provides skilled nursing care to the elderly.The facility had a 86% occupancy and served 185 individuals during the fiscal year ending 6/30/10.Description
Total Program Service Expense8663904TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
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 OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
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
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109622NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees153NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
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
Nbr Voting Governing Body Members3NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
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
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledMNStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonBENEDICTINE HEALTH SYSTEMNamePerson
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 (4 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployee
STEVE CHIES
Vice President1.00XX030564158143
KEVIN RYMANOWSKI
Treasurer1.00XX025629052559
DAVID BRENNAN
CEO / ADMIN40.00012799125134X
DALE THOMPSON
President1.00XX0574547109001
FieldValueIRS element (for citing)
Total Reportable Comp Frm Rltd Orgs1264469TotalReportableCompFrmRltdOrgs
Total Other Compensation244837TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
BENEDICTINE HEALTH SYSTEM
1995 E RUM RIVER DRIVE SCAMBRIDGEMN55008MANAGING COMPANY723807
AVIANDS
1751 W COUNTY RD BROSEVILLEMN55113DIETARY SERVICES310147
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Government Grants5008GovernmentGrants
Total Contributions5008TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionRESIDENT SERVICESDescription
Business Code623000BusinessCode
Total Revenue Column10984203TotalRevenueColumn
Related Or Exempt Function Income10984203RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue10984203TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column9833TotalRevenueColumn
Exclusion$9,833ExclusionAmount

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

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

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 Column10999044TotalRevenueColumn
Related Or Exempt Function Income10984203RelatedOrExemptFunctionIncome
Exclusion$9,833ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

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)
Total4934943Total
Program Services4628855ProgramServices
Management And General277793ManagementAndGeneral
Fundraising28295Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total69233Total
Program Services64733ProgramServices
Management And General4154ManagementAndGeneral
Fundraising346Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total696893Total
Program Services651595ProgramServices
Management And General41814ManagementAndGeneral
Fundraising3484Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total402222Total
Program Services376078ProgramServices
Management And General24133ManagementAndGeneral
Fundraising2011Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total723808Total
Management And General723808ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total5492Total
Management And General5492ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total6643Total
Management And General6643ManagementAndGeneral

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)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total782896Total
Program Services755636ProgramServices
Management And General27260ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total487668Total
Program Services487668ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total11464Total
Program Services7511ProgramServices
Management And General3828ManagementAndGeneral
Fundraising125Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total12947Total
Program Services7641ProgramServices
Management And General5306ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total215646Total
Program Services215646ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total81683Total
Program Services81683ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
SURCHARGE309650309650
PURCHASED SERVICES578801578801
PROFESSIONAL FEES8066580665
FOOD236186236186
EQUIPMENT REPAIRS715575387917678

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total143014Total
Program Services127677ProgramServices
Management And General15337ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total9851411Total
Program Services8663904ProgramServices
Management And General1153246ManagementAndGeneral
Fundraising34261Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1056911BOY
EOY1754276EOY

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)
BOY1581725BOY
EOY1514574EOY

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)
BOY15567BOY
EOY9863EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis5617547LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1317769LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY4414871BOY
EOY4299778EOY

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)
BOY175196BOY
EOY163769EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY928951BOY
EOY943990EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY8173221BOY
EOY8686250EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1239080BOY
EOY783672EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY3954773BOY
EOY3783735EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY844BOY
EOY891EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY5194697BOY
EOY4568298EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2978524BOY
EOY4102699EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY15253EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2978524BOY
EOY4117952EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8173221BOY
EOY8686250EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1880CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1809CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7692CurrentTaxYearMinus2Years
Current Tax Year5008CurrentTaxYear
Total16389Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10483973CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10438264CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10435164CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10841812CurrentTaxYearMinus1Year
Current Tax Year10984203CurrentTaxYear
Total53183416Total

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 Minus4 Years10485853CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10440073CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10442856CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10841812CurrentTaxYearMinus1Year
Current Tax Year10989211CurrentTaxYear
Total53199805Total

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 Total50953199805PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years26969CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years53837CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years38244CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14106CurrentTaxYearMinus1Year
Current Tax Year9833CurrentTaxYear
Total142989Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years26969CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years53837CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years38244CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14106CurrentTaxYearMinus1Year
Current Tax Year9833CurrentTaxYear
Total142989Total

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)
Total53342794Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99730PublicSupportPercentage509
Prior Year Support Percentage0.99720PriorYearSupportPercentage
Investment Income Percentage0.00270InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00280PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis316295OtherCostOrOtherBasis
Book Value316295BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis4351983OtherCostOrOtherBasis
Book Value4351983BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis949269OtherCostOrOtherBasis
Book Value949269BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Depreciation1317769Depreciation
Book Value-1317769BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings4299778TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
Rounding2
DEBT SERVICE RESERVE FUND408733
BOND FUND AND ESCROW DEPOISTS535255
FieldValueIRS element (for citing)
Total Book Value Other Assets943990TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionASSET RETIREMENTDescription
Amount$891Amount
FieldValueIRS element (for citing)
Total Of Amounts891TotalOfAmounts

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
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 (4 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
STEVE CHIES
225504477213241649290885336378449290
KEVIN RYMANOWSKI
1920324434819910358021675730884935802
DAVID BRENNAN
1090741092079972489124315312524891
DALE THOMPSON
451359123188946751432668354894675

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Series 2004 A Health Care Facilities Rev BondsBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN416005375IssuerEIN
CUSIP Number60374QAD6CUSIPNumber
Date Issued2004-11-01DateIssued
Issue Price4735000IssuePrice
Description Of PurposeSEE SCH ODescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds4737453TotalProceeds
Amount In Reserve Fund429737AmountInReserveFund
Issuance Costs From Proceeds192716IssuanceCostsFromProceeds
Capital Expenditures4115000CapitalExpenditures
Year Of Subst Completion2004YearOfSubstCompletion
Current RefundingfalseCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Bond Counsel Routinely EngagedtrueBondCounselRoutinelyEngaged
Post Issuance Compliance ProcdrstruePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuefalseVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC
Regulatory Safe Harbor SatisfiedfalseRegulatorySafeHarborSatisfied
Exception To RebatefalseExceptionToRebate

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
KEVIN RYMANOWSKI
DIR. OF BHS723807MANAGING COMPANYfalse
STEVE CHIES
DIR. OF BHS723807MANAGING COMPANYfalse
DALE THOMPSON
PRES. OF RELATED ORG.723807MANAGING COMPANYfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableNOT AVALIVABLE TO PUBLIC
Form 990, Part VI, Line 15bForm 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesThe CEO of BHC-Minneapolis is employed by Benedictine Health System, the manager of BHC-M and, his/her salary is set by Benedictine Health System. BHS sets compensation for the CEO at the median for comparable organizations. Data regarding comparable organizations is obtained from an independent compensation consultant at the time of hire and is periodically refreshed to ensure continued consistency with market comparables. Records documenting the compensation process are maintained by the manager's human resource department. Compensation for other key employees is set by the CEO in consultation with the manager based on the same philosophy.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsPERIODIC AUDITS OF TRANSACTIONS TO ENSURE THAT CONFILICTS OF INTEREST DO NOT EXIST.
Form 990, Part VI, Line 11Form 990, Part VI, Line 11: Form 990 Review ProcessAN ELECTONIC COPY OF THE FORM 990 WAS DISTRIBUTED PRIOR TO FILING.
Form 990, Part VI, Line 7aForm 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 6Form 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 3Form 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 Corporation
Form 990, Part VI, Line 2Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, EtAll directors are employees of Benedictine Health System

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (15 entries)

EINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNA
ARROWHEAD SENIOR LIV COM
411978619NURSING HOMEMN501 (C) 3YESN/A
Tekakwitha Living Center
411809912NURSING HOMEMN501 (C) 3YESN/A
St Gertrudes Health & Rehab
411848720NURSING HOMEMN501 (C) 3YESN/A
Saint Anne of Winona
410850791NURSING HOMEMN501 (C) 3YESN/A
Madonna Towers of Rochester
411809914NURSING HOMEMN501 (C) 3YESN/A
Living Community of St Joseph
412011661NURSING HOMEMN501 (C) 3YESN/A
BHS FOUNDATION
411513014SUPPORTING ORGMN501 (C) 3YESN/A
Cerenity Care Cen- White Bear Lake
411983267NURSING HOMEMN501 (C) 3YESN/A
Cerenity Senior Care
363517696NURSING HOMEMN501 (C) 3YESN/A
Benedictine Senior Liv at Steeple Point
411852273NURSING HOMEMN501 (C) 3YESN/A
Benedictine Living Com of St Peter
861113231NURSING HOMEMN501 (C) 3YESN/A
Benedictine Living Communities
411639687NURSING HOMEMN501 (C) 3YESN/A
BENEDICTINE CARE CENTERS
411907571NURSING HOMEMN501 (C) 3YESN/A
BENEDICTINE HEALTH CENTER
411381401NURSING HOMEMN501 (C) 3YESN/A
BENEDICTINE HEALTH SYSTEM
411531892SUPPORTIN ORGMN501 (C) 3YESN/A
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
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 OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
BENEDICTINE HEALTH SYSTEM
q21516
BENEDICTINE HEALTH SYSTEM
n185900
BENEDICTINE HEALTH SYSTEM
l559512