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ObjectId: 201641329349303109 - Submission: 2016-05-11
TIN: 27-4219119
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Information about Schedule R (Form 990) and its instructions is at
www.irs.gov/form990
.
OMB No. 1545-0047
20
14
Open to Public Inspection
Name of the organization
BENEDICTINE LIVING COMMUNITY OF MORA
dba ST CLARE LIVING COMMUNITY OF MORA
Employer identification number
27-4219119
Part I
Identification of Disregarded Entities
Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Total income
(e)
End-of-year assets
(f)
Direct controlling
entity
Part II
Identification of Related Tax-Exempt Organizations
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))
(f)
Direct controlling
entity
(g)
Section 512(b)(13) controlled entity?
Yes
No
(1)
BENEDICTINE HEALTH SYSTEM
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
41-1531892
SUPPORTIN ORG
MN
501 (C) 3
11, TYPE III
N/A
No
(2)
BENEDICTINE HEALTH CENTER
1995 E RUM RIVER DRIVE S
CAMRIDGE
,
MN
55008
41-1381401
NURSING HOME
MN
501 (C) 3
9
BHS
No
(3)
BENEDICTINE CARE CENTERS
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
41-1907571
NURSING HOME
MN
501 (C) 3
9
BHS
No
(4)
Benedictine Living Communities
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
41-1639687
NURSING HOME
MN
501 (C) 3
9
BHS
No
(5)
Benedictine Living Com of St Peter
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
86-1113231
NURSING HOME
MN
501 (C) 3
9
BHS
No
(6)
STEEPLE POINTE SEN LIV COMM
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
41-1852273
ASSISTED LIVING
MN
501 (C) 3
9
BHS
No
(7)
Cerenity Senior Care
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
36-3517696
NURSING HOME
MN
501 (C) 3
9
NA
No
(8)
Cerenity Care Cen- White Bear Lake
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
41-1983267
NURSING HOME
MN
501 (C) 3
9
NA
No
(9)
BHS FOUNDATION
503 E THIRD ST SUITE 400
DULUTH
,
MN
55805
41-1513014
FUND DEVELOPMENT
MN
501 (C) 3
9
BHS
No
(10)
Living Community of St Joseph
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
41-2011661
NURSING HOME
MN
501 (C) 3
9
BHS
No
(11)
Madonna Towers of Rochester
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
41-1809914
NURSING HOME
MN
501 (C) 3
9
BHS
No
(12)
Saint Anne of Winona
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
41-0850791
NURSING HOME
MN
501 (C) 3
9
BHS
No
(13)
St Gertrudes Health & Rehab
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
41-1848720
NURSING HOME
MN
501 (C) 3
9
BHS
No
(14)
Tekakwitha Living Center
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
41-1809912
NURSING HOME
MN
501 (C) 3
9
BHS
No
(15)
ARROWHEAD SENIOR LIV COM
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
41-1978619
NURSING HOME
MN
501 (C) 3
9
BHS
No
(16)
BENEDICTINE LIVING COMM OF NEW LONDON
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
27-4218436
NURSING HOME
MN
501 (C) 3
9
BHS
No
(17)
BENEDICTINE LIVING COMM OF SPOONER
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
45-0700468
NURSING HOME
MN
501 (C) 3
9
BHS
No
(18)
BENEDICTINE LIVING COMMUNITY OF WINSTED
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
27-4219293
NURSING HOME
MN
501 (C) 3
9
BHS
No
(19)
BLC OF BISMARCK
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
26-4376543
NURSING HOME
MN
501 (C) 3
9
BHS
No
(20)
BENEDICTINE HEALTH CENTER
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
41-1381401
NURSING HOME
MN
501 (C) 3
9
BHS
No
(21)
BLC OF WAHPETON
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
45-4274091
ASSISTED LIVING
MN
501 (C) 3
9
BHS
No
(22)
BLC OF RED WING
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
45-4929398
NURSING HOME
MN
501 (C) 3
9
BHS
No
(23)
BRIDGE CARE COMMUNITY
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
26-2620983
NURSING HOME
MN
501 (C) 3
9
BHS
No
(24)
BSLC OF ST PETER
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
27-2716531
ASSSITED LIVING
MN
501 (C) 3
9
BHS
No
(25)
CATHOLIC RESIDENTIAL SERVICES
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
39-0982340
NURSING HOME
WI
501 (C) 3
9
BHS
No
(26)
ELLENDALE EVERGREEN PLACE
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
41-1796445
NURSING HOME
MN
501 (C) 3
9
BHS
No
(27)
MADONNA MEADOWS
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
47-0855891
ASSISTED LIVING
MN
501 (C) 3
9
BHS
No
(28)
NAZARETH LIVING CENTER
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
43-1450394
NURSING HOME
MO
501 (C) 3
9
NA
No
(29)
ROSEWOOD COURT
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
41-2011389
NURSING HOME
MN
501 (C) 3
9
BHS
No
(30)
STEELE COUNTY COMMUNITIES
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
27-0705237
NURSING HOME
MN
501 (C) 3
9
NA
No
(31)
VILLA ST VINCENT
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
41-1352227
NURSING HOME
MN
501 (C) 3
9
BHS
No
(32)
VILLA ST BENEDICT
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
36-4343235
NURSING HOME
MN
501 (C) 3
9
BHS
No
(33)
LIVING SERVICES FOUNDATION
900 LONG LAKE RD STE 130
NEW BRIGHTON
,
MN
55112
41-1936717
SUPPORTING ORG.
MN
501 (C) 3
11 TYPE III
N/A
No
(34)
BLC OF FRIDLEY
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
46-2904490
NURSING HOME
MN
501 (C) 3
9
BHS
No
(35)
REGINA SENIOR LIVING
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
46-3700475
NURSING HOME
MN
501 (C) 3
9
BHS
No
(36)
BLC OF BYRON
1995 E RUM RIVER DRIVE S
CAMBRIDGE
,
MN
55008
47-1538777
NURSING HOME
MN
501 (C) 3
9
BHS
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2014
Page 2
Schedule R (Form 990) 2014
Page
2
Part III
Identification of Related Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes
No
Schedule R (Form 990) 2014
Page 3
Schedule R (Form 990) 2014
Page
3
Part V
Transactions With Related Organizations
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note.
Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1
During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a
Receipt of
(i)
interest,
(ii)
annuities,
(iii)
royalties, or
(iv)
rent from a controlled entity
.....................
1a
No
b
Gift, grant, or capital contribution to related organization(s)
............................
1b
Yes
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
Yes
d
Loans or loan guarantees to or for related organization(s)
............................
1d
No
e
Loans or loan guarantees by related organization(s)
............................
1e
Yes
f
Dividends from related organization(s)
............................
1f
No
g
Sale of assets to related organization(s)
............................
1g
No
h
Purchase of assets from related organization(s)
............................
1h
No
i
Exchange of assets with related organization(s)
............................
1i
No
j
Lease of facilities, equipment, or other assets to related organization(s)
.......................
1j
No
k
Lease of facilities, equipment, or other assets from related organization(s)
......................
1k
No
l
Performance of services or membership or fundraising solicitations for related organization(s)
.....................
1l
No
m
Performance of services or membership or fundraising solicitations by related organization(s)
.................
1m
Yes
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
...................
1n
No
o
Sharing of paid employees with related organization(s)
............................
1o
Yes
p
Reimbursement paid to related organization(s) for expenses
............................
1p
No
q
Reimbursement paid by related organization(s) for expenses
............................
1q
No
r
Other transfer of cash or property to related organization(s)
............................
1r
No
s
Other transfer of cash or property from related organization(s)
............................
1s
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
Schedule R (Form 990) 2014
Page 4
Schedule R (Form 990) 2014
Page
4
Part VI
Unrelated Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)
(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income
(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Yes
No
Schedule R (Form 990) 2014
Page 5
Schedule R (Form 990) 2014
Page
5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference
Explanation
Schedule R (Form 990) 2014
Additional Data
Software ID:
14000265
Software Version:
2014v6.0