2024-05-09T15:11:14-05:00 2023-06-30 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2022-07-01 310892356 FRIENDSHIP VILLAGE OF COLUMBUS OHIO INC FRIE 6148908282 5800 FOREST HILLS BLVD COLUMBUS OH 432312957 LISA BURKHART EXECUTIVE DIRECTOR 6148908282 2024-05-03 1 LISA BURKHART 999009999 0 AMY CIMINELLO P00796388 6148493000 2024-05-03 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z X WESTERWOOD LISA BURKHART 5800 FOREST HILLS BLVD COLUMBUS OH 432312957 23693584 0 X WWW.LIVEATWESTERWOOD.ORG X 1977 OH WE BRING MAINTENANCE-FREE LIVING AND PEACE OF MIND TO OVER 150 INDEPENDENT LIVING RESIDENTS. AS RESIDENTS NEED ADDITIONAL SERVICES, WE OFFER ASSISTED LIVING 24 HOUR DAILY ASSISTANCE AND A REHABILITATION CENTER WHICH PROVIDES SKILLED NURSING SERVICES ON A SHORT TERM OR LONG TERM BASIS. DESIGNED TO ENCOURAGE INTERACTION BETWEEN RESIDENTS, WESTERWOOD PROVIDES A CONTINUUM OF CARE OF OLDER ADULTS. 10 10 468 10 0 0 2105231 2883605 18436959 20440896 726922 114680 11642 1000 21280754 23440181 27000 33330 0 0 10284395 9688141 0 0 19300 9606187 12207184 19917582 21928655 1363172 1511526 26297233 28086467 31699342 31753532 -5402109 -3667065 X TO PROMOTE INDEPENDENCE, WELLNESS AND COMMUNITY FOR OLDER ADULTS IN AN ACTIVE AND FRIENDLY CONTINUING-CARE ENVIRONMENT. 0 0 19517997 33330 20440896 PROVIDING HOME AND CARE FOR OVER 330 SENIOR RESIDENTS IN A HIGHLY LABOR INTENSIVE ENVIRONMENT. UNDERWRITING SALARIES AND BENEFITS FOR NURSING, COMMUNITY LIFE, FOOD SERVICE, HOUSEKEEPING, MAINTENANCE, CHAPLAINCY, AND ADMINISTRATIVE STAFF IS OUR LARGEST BUT MOST VALUABLE EXPENSE. OUR STAFF IS 24/7, COVERING MULTIPLE SHIFTS AND HAVING A WIDE RANGE OF COMPETENCIES. THE WORK THAT IS DONE CAN BE REPETITIVE AND VERY DIFFICULT, SO KEEPING AND CULTIVATING A QUALITY WORK FORCE IS A CHALLENGING NECESSITY. INVESTING IN THIS QUALITY STAFF ENSURES THE PHYSICAL, SPIRITUAL, SOCIAL, EMOTIONAL AND INTELLECTUAL WELLNESS OF OUR RESIDENTS. OUR STAFFING RATIOS ARE VERY HIGH COMPARED TO OTHER CARE FACILITIES AND PROMOTING THIS TIMELY AND CONSISTENT CARE IS AT THE HEART OF OUR MISSION. PHYSICAL WELLNESS OF OUR RESIDENTS IS OUR THERAPY. 19517997 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 468 0 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X LAURA CHANAK 6145680507 5800 FOREST HILLS BOULEVARD COLUMBUS OH 43231 ELEANOR BIDDULPH PRESIDENT 10.00 X X 0 0 0 CHRIS DIEBEL VICE PRESIDENT 5.00 X X 0 0 0 SUZANNE SCRUTTON SECRETARY 3.00 X X 0 0 0 JOHN LINDAMAN TREASURER 3.00 X X 0 0 0 DICK MAXWELL RESIDENT TRUSTEE 2.00 X 0 0 0 FRED HELZER RESIDENT TRUSTEE 2.00 X 0 0 0 JEFF FIVECOAT BOARD MEMBER 2.00 X 0 0 0 BRIAN HORNE BOARD MEMBER 2.00 X 0 0 0 ANNE STOCKTON BOARD MEMBER 2.00 X 0 0 0 JACK ANDERSON BOARD MEMBER 2.00 X 0 0 0 LISA BURKHART EXECUTIVE DIRECTOR 45.00 X 219900 0 0 LAURA CHANAK DIRECTOR OF ACCOUNTING 45.00 X 106961 0 0 AUBREY ELEY ADMINSTRATOR 45.00 X 139173 0 0 VALERIE MCCONNELL DIRECTOR OF NURSING 45.00 X 133656 0 0 DICKSON APPIAH BAAH LPN CHARGE NURSE REHAB CENTER 36.00 X 114032 0 0 CAROL GILBERT DIRECTOR OF ASSISTED LIVING 45.00 X 104990 0 0 818712 0 0 6 0 1 0 CURA HOSPITALITY LLC PO BOX 743676 ATLANTA GA 30374 DINING SERVICES CONTRACT 1909939 GUILD CONSTRUCTION 4694 CEMETERY RD UNIT HILLIARD OH 43026 CONTRACTOR FOR APARTMENT RENOVATION 1167047 HEALTHPRO HERITAGE LLC PO BOX 69268 BALTIMORE MD 212649268 CONTRACT THERAPY SERVICE 1109114 BUCKEYE COUNTERTOP SOLUTIONS LLC 1410 N HAGUE AVE COLUMBUS OH 43204 CONTRACTOR FOR APARTMENT RENOVATION 866952 RUFFIN ROOFING 464 E MAIN ST COLUMBUS OH 43215 REPAIRS 743255 13 2543644 339961 2883605 APTS./SKILLED NURSING 623000 20440896 20440896 20440896 344448 344448 23635 133295 120108 -133295 -96473 -229768 -229768 INSURANCE REFUND 900099 1000 1000 1000 23440181 20440896 0 115680 X 33330 33330 326861 326861 7770372 7366040 386124 18208 93852 78873 14979 895801 763756 132045 601255 544988 55175 1092 104800 104800 44180 44180 90188 90188 4736 4736 3649407 3262414 386993 337971 337971 2487545 2201094 286451 1729166 1545737 183429 21395 19202 2193 2213 2213 762247 686022 76225 1983067 1785057 198010 303336 273002 30334 FRANCHISE TAXES 363621 363621 PROVISION FOR BAD DEBTS 198256 198256 RECRUITING AND TRAINING 81786 16173 65613 RESIDENT ACTIVITIES 35179 35179 8091 7282 809 21928655 19517997 2391358 19300 1000 1000 656813 705378 1094385 927246 73993 88755 82306 59841 61911762 40896412 20812442 21015350 1747669 1483567 1681726 996726 146899 2808604 26297233 28086467 2209956 2506907 5903616 6923635 19478110 18780378 4107660 3542612 31699342 31753532 X -5626829 -4081781 224720 414716 -5402109 -3667065 26297233 28086467 X 1511526 217119 6399 X 0 1 X 1 0 X 136439 103337 722668 2105231 2883605 5951280 18010222 18198903 17427575 18436959 20440896 92514555 18146661 18302240 18150243 20542190 23324501 98465835 6894 6894 2444 1500 3000 20732 0 6894 6894 2444 1500 3000 20732 98445103 79095 529210 103748 68814 344448 1125315 79095 529210 103748 68814 344448 1125315 53925 41463 39554 11642 1000 147584 18279681 18872913 18293545 20622646 23669949 99738734 0.98700 0.98880 0.01130 0.00950 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2890 2890 0 PART II-B, LINE 1: MEMBERSHIP DUES IN THE AMOUNT OF $17,000 WERE PAID TO LEADING AGE (11.1% RELATED TO LOBBYING), AND MEMBERSHIP DUES IN THE AMOUNT OF $5,819.03 TO OCHA (17.23% RELATED TO LOBBYING). 181032 225742 9143 138367 259264 177807 143502 11340 128937 181032 202755 115329 11399 128878 177807 167583 125509 7069 83268 202755 0.17000 0.00000 0.83000 0 0 527425 527425 50107546 33085776 17021770 5023502 3284482 1739020 6253289 4526154 1727135 21015350 ASSETS LIMITED AS TO USE HELD BY TR 112413 UNEMPLOYMENT COMP DEPOSIT 35750 CASH SURRENDER VALUE LIFE INSURANCE 2543644 BOARD DESIGNATED INVESTMENTS 116797 2808604 FUTURE SERVICE OBLIGATION 3542612 3542612 23722106 217119 6399 223518 23498588 4736 -63143 -58407 23440181 21987062 96473 96473 21890589 4736 33330 38066 21928655 PART V, LINE 4: PHILANTHROPIC PURPOSES TO BENEFIT THE COMMUNITY AND THE RESIDENTS, STAFF SCHOLARSHIPS, IMPROVEMENT OF CAMPUS, EDUCATIONAL PROGRAMS. REPORTING UPDATED TO INCLUDE YEARS ENDOWMENT EXISTED. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF BENEFICIAL INTEREST TRUST 6,399. PART XI, LINE 4B - OTHER ADJUSTMENTS: HARDSHIP DISCOUNTS 33,330. LOSS ON DISPOSAL OF ASSET -96,473. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF ASSET 96,473. PART XII, LINE 4B - OTHER ADJUSTMENTS: HARDSHIP DISCOUNTS 33,330. 1 HARDSHIP DISCOUNTS 1 0 33330 PART I, LINE 2: TO PROVIDE FINANCIAL ASSISTANCE TO RESIDENTS WHO HAVE DEVELOPED A FINANCIAL NEED DUE TO UNFORESEEN OR UNCONTROLLABLE CIRCUMSTANCES. PROCEDURE: -EACH APPLICANT MUST SUBMIT A CURRENT FINANCIAL STATEMENT SHOWING ASSETS AND MONTHLY INCOME. -EACH APPLICATION WILL BE REVIEWED BY THE EXECUTIVE DIRECTOR AND A COMMITTEE OF THE BOARD OF TRUSTEES FOR APPROVAL UNDER THE GUIDELINES ADOPTED BY THE BOARD OF TRUSTEES. GUIDELINES: LEVEL OF FINANCIAL STANDING FOR DISCOUNT CONSIDERATION: A. ASSETS SINGLE PERSON: NOT MORE THAN $5,000 COUPLE: NOT MORE THAN $8,000 B. MONTHLY INCOME EACH PERSON: THE INCOME LEVEL AT WHICH FRIENDSHIP VILLAGE OF COLUMBUS WILL CONSIDER APPLICATIONS FOR HARDSHIP DISCOUNT IS DETERMINED BY WHETHER THE RESIDENT'S MONTHLY INCOME IS LESS THAN THE SUM OF THE FOLLOWING MONTHLY EXPENSE. 1. CHARGE FOR THE STANDARD SERVICE FEE PLUS 2. CHARGES FOR TWO EXTRA MEALS PER DAY PLUS 3. MEDICAL EXPENSE NOT COVERED BY MEDICARE OR INSURANCE OVER $35/MONTH PLUS 4. AN ALLOWANCE OF ONE HUNDRED DOLLARS ($100) PER MONTH FOR INCIDENTALS C. BECAUSE OF THE EFFECT UPON OTHER RESIDENTS WHERE HARDSHIP DISCOUNT IS GRANTED THE FOLLOWING WILL BE USED IN CONSIDERING AN APPLICATION FOR DISCOUNT: 1. NO RESIDENT MAY WILLINGLY AND KNOWINGLY GIVE, TRANSFER OR CONVEY HIS/HER ASSETS OR PLEDGE THE INCOME THEREFROM TO ANY PERSON (I.E. RELATIVE BY BLOOD OR MARRIAGE, FRIEND OR INSTITUTION) DURING THE PERIOD OF TIME OF RESIDENCY AT FRIENDSHIP VILLAGE OF COLUMBUS. 2. THE EXECUTIVE DIRECTOR MAY, AT HIS DISCRETION, REQUIRE OF THE RESIDENT AN ACCOUNTING OF ASSETS STATED ON THE ENTRANCE APPLICATION IN ORDER TO DETERMINE THAT NO DELIBERATE DIVESTITURE HAS TAKEN PLACE. 3. IF DELIBERATE FALSIFICATION OF THE ENTRANCE APPLICATION OR DELIBERATE DIVESTITURE OF ASSETS HAS BEEN MADE, THE BOARD OF TRUSTEES MAY TERMINATE THE RESIDENCY AGREEMENT OF THAT RESIDENT FOR FAILURE TO MAKE ALL OR ANY PART OF THE PAYMENTS AS OUTLINED IN THE RESIDENCY AGREEMENT. 4. IF THE RESIDENT IS RESIDING IN A ONE OR TWO BEDROOM APARTMENT, THEY WILL BE REQUIRED TO RELOCATE TO AN ALCOVE UNIT WHEN ONE IS AVAILABLE. THE MOVE WILL TAKE PLACE WITHIN 90 DAYS OF THE HARDSHIP APPROVAL DATE. THE TRANSFER WILL BE IN ACCORDANCE WITH THE INTERNAL TRANSFER POLICY (OTHER THAN THE ENTRANCE FEE REFUND WILL BE PROVIDED THE RESIDENT AT THE TIME OF TRANSFER). D. REVIEW: 1. THE ADMINISTRATION MAY, AT ITS DISCRETION, REQUEST A REVISED CONFIDENTIAL FINANCIAL STATEMENT FROM ANY RESIDENT RECEIVING FINANCIAL ASSISTANCE WHEN IT IS FELT THERE IS A SIGNIFICANT CHANGE IN THEIR FINANCIAL STATUS. 2. A CURRENT CONFIDENTIAL FINANCIAL STATEMENT ON A FORM FURNISHED BY FRIENDSHIP VILLAGE OF COLUMBUS MUST BE RE-SUBMITTED IN THE MONTH OF JULY EACH YEAR FOR ALL RESIDENTS NEEDING CONTINUED FINANCIAL ASSISTANCE. E. EMERGENCY CLAUSE: 1. THE BOARD OF TRUSTEES AUTHORIZES THE EXECUTIVE DIRECTOR TO GRANT UP TO A $150 ONE TIME DISCOUNT ON AN EMERGENCY BASIS WITHOUT BOARD APPROVAL PROVIDING THE APPLICANT MEETS THE ABOVE FINANCIAL GUIDELINES. 2. THE BOARD OF TRUSTEES AUTHORIZES THE EXECUTIVE DIRECTOR TO APPROVE DEFERRED PAYMENT OF MONTHLY SERVICE FEE FOR A PERIOD OF TIME UP TO 90 DAYS IN ORDER FOR A RESIDENT TO MAKE ADJUSTMENTS IN PERSONAL FINANCES TO BE ABLE TO MEET THE MONTHLY SERVICE PAYMENT. FURTHER AUTHORIZED DEFERRED PAYMENT OF MONTHLY SERVICE FEES MUST BE APPROVED BY THE BOARD OF TRUSTEES. X X 0 0 0 0 0 0 0 1 0 LISA BURKHART EXECUTIVE DIRECTOR 180608 0 39292 0 0 0 0 0 0 0 219900 0 0 0 PART I, LINE 7 THE BOARD OF FRIENDSHIP VILLAGE OF COLUMBUS REVIEWS A SCORECARD FOR ALL OFFICERS, THE RESULTS OF WHICH DETERMINE THE AMOUNT OF THE BONUS AN INDIVIDUAL IS ABLE TO RECEIVE. A HEALTH CARE FACILITIES REVENUE REFUNDING BONDS SERIES 2016A 2016-03-01 11901000 IMPROVEMENT OF EXISITING FACILITIES 0 0 0 B HEALTH CARE FACILITIES REVENUE BONDS SERIES B 2016-03-01 10975000 IMPROVEMENT OF EXISITING FACILITIES 0 0 0 A 11901000 1 0 0 1 B 10975000 1 0 0 0 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 0 0 A 0 B 0 FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR. AN ELECTRONIC COPY OF THE FORM IS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING, ALONG WITH A SUMMARY OF THE INCREASED FILING REQUIREMENTS BEGINNING IN 2008. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEMBER IS REQUIRED TO SIGN A CONFLICT OF INTEREST POLICY AGREEMENT UPON ACCEPTANCE OF THE POSITION AS WELL AS ON AN ANNUAL BASIS AFTERWARD. ANNUALLY AT THE JUNE BOARD MEETING, THE POLICY IS REVIEWED BY THE PRESIDENT AND DISCLOSURE SHEETS ARE SIGNED BY EACH TRUSTEE AND KEPT ON FILE IN THE ADMINISTRATIVE FILE. IF NEW CONFLICTS ARISE, THE CONFLICT IS DISCLOSED IMMEDIATELY TO THE BOARD FOR DISCUSSION AT THE MONTHLY BOARD MEETING AND THE BOARD MEMBER WITH A CONFLICT OF INTEREST WOULD ABSTAIN FROM VOTING IN ANY RELATED MATTER. FORM 990, PART VI, SECTION B, LINE 15 MANAGEMENT PREPARES AND/OR REVIEWS THE ANNUAL PERFORMANCE REVIEW IN EACH INSTANCE FRIENDSHIP VILLAGE OF COLUMBUS HIRES A NEW EXECUTIVE DIRECTOR, DIRECTOR OF ACCOUNTING, OR ADMINISTRATIVE MEMBER. COMPENSATION FOR SIMILAR POSITIONS IS COMPILED AND COMPARED ON A REGIONAL AND NATIONAL LEVEL THROUGH AOPHA'S SALARY SURVEY TO MAINTAIN COMPETITIVE SALARIES WITHIN THE INDUSTRY. FORM 990, PART VI, SECTION C, LINE 18 FORM 990 AND FORM 1023 ARE AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 BOOKS ARE KEPT IN THE RESIDENT LIBRARY, ADMINISTRATIVE OFFICE, AND FRIENDSHIP VILLAGE'S SYSTEMS NETWORK. FORM 990, PART IX, LINE 11G CONSULTING FEES: PROGRAM SERVICE EXPENSES 587,784. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 587,784. CONTRACTED PERSONNEL: PROGRAM SERVICE EXPENSES 2,670,537. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,670,537. PAYROLL PROCESSING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 36,850. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 36,850. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 4,093. MANAGEMENT AND GENERAL EXPENSES 350,143. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 354,236. FORM 990, PART XI, LINE 9: CHANGES IN BENEFICIAL INTEREST IN TRUST 6,399. FORM 990, PAGE 1, SECTION B: AMENDED RETURN: AN ERROR IN COMPENSATION WAS DISCOVERED AFTER THE ORIGINAL RETURN WAS FILED. THE CHANGED IMPACTED FORM 990, PART VII AND SCHEDULE J, PART II.