TY 2012 Form 990 Schedule O

efile Public Visual Render ObjectId: 201411359349303901 - Submission: 2014-05-15 TIN: 41-1531892

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization

BENEDICTINE HEALTH SYSTEM

Employer identification number

41-1531892

Identifier	Return Reference	Explanation
	OFFICER COMPENSATION	DALE THOMPSON CEO 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 2c	Form 990, Part XII, Line 2: Change of Oversight or Selection Process	The 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 XI, Line 9	Other Changes In Net Assets Or Fund Balances - Other Decreases	Intercompany transfer BHSF 41-1513014 = -$1204084
Form 990, Part XI, Line 9	Other Changes In Net Assets Or Fund Balances - Other Increases	Insurance Surplus Distribution = $21974
Form 990, Part XI, Line 9	Other Changes In Net Assets Or Fund Balances - Other Increases	Change in Permanetnly restricted NA = $4458
Form 990, Part XI, Line 9	Other Changes In Net Assets Or Fund Balances - Other Increases	change in Net Assets of Temp Restricted Contributions = $765423
Form 990, Part VI, Line 19	Form 990, Part VI, Line 19: Other Organization Documents Publicly Available	NOT AVAILABLE TO PUBLIC
Form 990, Part VI, Line 15b	Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees	Compensation for the organization's CEO and other key employees of the organization is determined by the Compensation Committee of the Board of Directors. This Committee is comprised entirely of independent directors. The Compensation Committee reviews data on compensation provided to individuals holding comparable positions in comparable organizations in order to establish a reasonable compensation range. The data is collected and reviewed with the Compensation Committee by an independent consultant. Based on the market data and in light of any specific individual qualifications, the Compensation Committee determines compensation. The deliberations and determinations of the Compensation Committee are recorded contemporaneously and provided to the governing body for review.
Form 990, Part VI, Line 12c	Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts	This 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 11b	Form 990, Part VI, Line 11b: Form 990 Review Process	AN ELECTRONIC COPY OF THE FORM 990 WAS DISTRIBUTED PRIOR TO FILING.
Form 990, Part VI, Line 7b	Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders	BSBA HAS CERTAIN "RESERVED POWERS" OVER BHS TO ENSURE ALL ACTIVITIES ARE CARRIED OUT IN ACCORDANCE WITH THE CHARISMS OF THE BSBA AND THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES.
Form 990, Part VI, Line 7a	Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body	BENEDICTINE SISTERS BENEVOLENT ASSOCIATION (BSBA) - A CIVIL LAW CORPORATION FOR THE SISTERS OF ST. BENEDICT OF ST. SCHOLASTICA MONASTERY, DULUTH MN - APPOINTS UP TO 30% OF THE BOARD MEMBERS. ESSENTIA HEALTH, - A MN NON-PROFIT ORGANIZATION - HAS THE AUTHORITY TO APPOINT AT LEAST 20% OF THE BOARD MEMBERS
Form 990, Part VI, Line 1a	Form 990, Part VI, Line 1a: Explanation of Delegated Broad Authority to Committee	The Executive Committee (comprised of the Chair, Vice-Chair, Prioress, Board Secretary, and the Chairs of the standing committees) is authorized to act on behalf of the board in the interval between meetings of the board, provided, however, that it may not determine matters of policy without prior specific authorization of the board.

Identifier

Return Reference

Explanation

OFFICER COMPENSATION

DALE THOMPSON CEO 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 2c

Form 990, Part XII, Line 2: Change of Oversight or Selection Process

The 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 XI, Line 9

Other Changes In Net Assets Or Fund Balances - Other Decreases

Intercompany transfer BHSF 41-1513014 = -$1204084

Form 990, Part XI, Line 9

Other Changes In Net Assets Or Fund Balances - Other Increases

Insurance Surplus Distribution = $21974

Form 990, Part XI, Line 9

Other Changes In Net Assets Or Fund Balances - Other Increases

Change in Permanetnly restricted NA = $4458

Form 990, Part XI, Line 9

Other Changes In Net Assets Or Fund Balances - Other Increases

change in Net Assets of Temp Restricted Contributions = $765423

Form 990, Part VI, Line 19

Form 990, Part VI, Line 19: Other Organization Documents Publicly Available

NOT AVAILABLE TO PUBLIC

Form 990, Part VI, Line 15b

Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees

Compensation for the organization's CEO and other key employees of the organization is determined by the Compensation Committee of the Board of Directors. This Committee is comprised entirely of independent directors. The Compensation Committee reviews data on compensation provided to individuals holding comparable positions in comparable organizations in order to establish a reasonable compensation range. The data is collected and reviewed with the Compensation Committee by an independent consultant. Based on the market data and in light of any specific individual qualifications, the Compensation Committee determines compensation. The deliberations and determinations of the Compensation Committee are recorded contemporaneously and provided to the governing body for review.

Form 990, Part VI, Line 12c

Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts

This 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 11b

Form 990, Part VI, Line 11b: Form 990 Review Process

AN ELECTRONIC COPY OF THE FORM 990 WAS DISTRIBUTED PRIOR TO FILING.

Form 990, Part VI, Line 7b

Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders

BSBA HAS CERTAIN "RESERVED POWERS" OVER BHS TO ENSURE ALL ACTIVITIES ARE CARRIED OUT IN ACCORDANCE WITH THE CHARISMS OF THE BSBA AND THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES.

Form 990, Part VI, Line 7a

Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body

BENEDICTINE SISTERS BENEVOLENT ASSOCIATION (BSBA) - A CIVIL LAW CORPORATION FOR THE SISTERS OF ST. BENEDICT OF ST. SCHOLASTICA MONASTERY, DULUTH MN - APPOINTS UP TO 30% OF THE BOARD MEMBERS. ESSENTIA HEALTH, - A MN NON-PROFIT ORGANIZATION - HAS THE AUTHORITY TO APPOINT AT LEAST 20% OF THE BOARD MEMBERS

Form 990, Part VI, Line 1a

Form 990, Part VI, Line 1a: Explanation of Delegated Broad Authority to Committee

The Executive Committee (comprised of the Chair, Vice-Chair, Prioress, Board Secretary, and the Chairs of the standing committees) is authorized to act on behalf of the board in the interval between meetings of the board, provided, however, that it may not determine matters of policy without prior specific authorization of the board.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2012

Software ID:	12000229
Software Version:	2012v2.0