2022-05-16T14:57:54-05:00 2021-06-30 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2020-07-01 310538523 OHIO LIVING QUAKER HEIGHTS OHIO 6148887800 514 W HIGH STREET PO BOX 677 WAYNESVILLE OH 45068 ROBERT B STILLMAN CFO/TREASURER 6148887800 2022-05-12 1 ROBERT STILLMAN 999009999 AMY CIMINELLO P00796388 6148493000 2022-05-12 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z LAURENCE C GUMINA 9200 WORTHINGTON RD WESTERVILLE OH 43082 7882619 0 X SEE SCHEDULE O X 1904 OH OUR MISSION IS TO PROVIDE OLDER ADULTS WITH CARING AND QUALITY SERVICES TOWARD ENHANCEMENT OF PHYSICAL, MENTAL AND SPIRITUAL WELL-BEING CONSISTENT WITH THE CHRISTIAN GOSPEL. OHIO LIVING IS DEDICATED TO LIVING OUR MISSION AND KEEPING THE PROMISES WE MAKE TO THOSE FOR WHOM WE PROVIDE CARE. OHIO LIVING IS COMMITTED TO INCLUSIVENESS, A HIGH ETHICAL STANDARD, RESPECT AND RESPONSIVENESS, ALL OF WHICH ESTABLISHES OHIO LIVING AS AN INTEGRAL PART OF THE LARGER COMMUNITY. SINCE INCEPTION, WE HAVE ADHERED TO THE PROMISE THAT NO OHIO LIVING RESIDENTS WILL BE ASKED TO LEAVE BECAUSE THEY EXHAUST PERSONAL FUNDS, THROUGH NO FAULT OF THEIR OWN, TO PAY FOR THEIR HOUSING OR CARE. 7 4 0 4 0 0 0 496547 7990142 7157988 2245 -67917 16265 18876 8008652 7605494 0 0 0 0 2200645 2190439 0 0 0 5891246 6046843 8091891 8237282 -83239 -631788 10630047 10489487 10011677 9914985 618370 574502 X TO PROVIDE OLDER ADULTS WITH CARING AND QUALITY SERVICES TOWARD THE ENHANCEMENT OF PHYSICAL, MENTAL AND SPIRITUAL WELL BEING CONSISTENT WITH THE CHRISTIAN GOSPEL. 0 0 7353573 0 7157988 OHIO LIVING QUAKER HEIGHTS PROVIDES THE FOLLOWING SERVICES TO THE RESIDENTS AT THE FACILITY:NURSING HOME CARE FOR ELDERLY - NURSING HOME OPERATED IN ACCORDANCE WITH MEDICARE/MEDICAID REGULATIONS CONSISTING OF 70 BEDS.ASSISTED LIVING CARE FOR ELDERLY - 60 UNIT ASSISTED LIVING FACILITY OPERATED IN ACCORDANCE WITH MEDICARE/MEDICAID REGULATIONS. 7353573 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 7 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X ROBERT B STILLMAN 6148887800 9200 WORTHINGTON ROAD SUITE 300 WESTERVILLE OH 43082 LAURENCE C GUMINA CHIEF EXECUTIVE OFFICER 1.00 39.00 X X 0 657840 11900 LESLIE BELFANCE DIVISION EXECUTIVE OF COMMUNITIES 6.00 34.00 X 0 170892 16126 SANDY ADAM DIRECTOR/VICE CHAIR 2.00 6.00 X X 0 0 0 TERRY WHITE DIRECTOR/ASSISTANT TREASURER 2.00 6.00 X X 0 0 0 DONALD EDWARDS DIRECTOR/CHAIR 2.00 6.00 X X 0 0 0 JAMES JOYCE DIRECTOR/ASSISTANT SECRETARY 2.00 6.00 X X 0 0 0 DANIEL O'CONNER CHIEF OPERATING OFFICER THRU 09/20 1.00 39.00 X 0 409283 15404 ROBERT STILLMAN CHIEF FINANCIAL OFFICER/TREASURER 1.00 39.00 X 0 382533 17258 DANA ULLOM-VUCELICH CHIEF HUMAN RESOURCES OFFICER 1.00 39.00 X 0 295852 9983 CONNIE TOSTEVIN CHIEF NURSING OFFICER THRU 02/21 1.00 39.00 X 0 276259 9749 JOYCE MILLER CHIEF INFO OFFICER THRU 08/20 1.00 39.00 X 0 239205 11201 MICHAELLA REES CHIEF BRAND & GROWTH OFFICER 1.00 39.00 X 0 209371 1777 MARK ROBERTS CHIEF EXEC OF PROJECT DEVELOPMENT 1.00 39.00 X 0 148246 13600 DANIEL HOLSTEIN CORP EXECUTIVE OF FINANCE 1.00 39.00 X 0 150029 9205 JEAN MORGAN CORPORATE MANAGER OF MEMORY CARE 1.00 39.00 X 0 134566 12480 0 3074076 128683 0 0 1 0 INTELYCARE INC PO BOX 200413 PITTSBURGH PA 152510413 MEDICAL STAFFING 1075845 HEALTHCARE SERVICES GROUP PO BOX 829677 PHILADELPHIA PA 191829677 DIETARY AND HOUSEKEEPING SERVICES 864125 ENCOMPASS CARE INC 1100 SHAWNEE ROAD LIMA OH 458053529 HEALTHCARE STAFFING 433789 AVENTUS DEVELOPMENT GROUP LLC 967 HILL STREET CINCINNATI OH 45202 CONSTRUCTION SERVICES 312185 BUCKINGHAM DOOLITTLE & BURROUGHS LLC PO BOX 78000 DETROIT MI 482781184 LEGAL SERVICES 168495 5 496547 496547 RESIDENT/RENT REVENUE 623000 7157988 7157988 7157988 1088 1088 208120 277125 -69005 -69005 -69005 BEAUTY/BARBER SHOP 900099 14707 14707 4169 4169 18876 7605494 7157988 0 -49041 X 91176 91176 1770223 1632456 137767 5437 679 4758 177943 22233 155710 145660 123835 21825 115756 115756 12700 12700 2852285 2852285 7435 7435 575129 102656 472473 39820 39820 419185 419185 19280 19280 1674 1674 545833 545833 308324 308324 MEDICAL SUPPLIES/DRUGS 543577 543577 FRANCHISE FEES 340837 340837 BAD DEBT 263142 263142 1866 1866 8237282 7353573 883709 0 60493 61091 761602 738884 201767 235606 8396213 790729 7821708 7605484 234418 234418 1550059 1614004 10630047 10489487 452480 567083 9523605 9333336 35592 14566 10011677 9914985 X 618370 574502 618370 574502 10630047 10489487 X -631788 587920 X X 0 1 X 1 1 0 X 51015 0 0 0 496547 547562 7721739 7732164 3811596 7990142 7157988 34413629 7772754 7732164 3811596 7990142 7654535 34961191 0 0 0 34961191 2419 168 22566 2245 1088 28486 2419 168 22566 2245 1088 28486 11310 16265 18876 46451 7775173 7732332 3845472 8008652 7674499 35036128 0.99790 0.99830 0.00080 0.00100 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 790000 790000 6955049 643342 6311707 516323 116884 399439 134841 30503 104338 7605484 RESERVE REPLACEMENT 777850 RESIDUAL RECEIPTS 319538 RESIDENT FUNDS HELD BY QUAKER HEIGHTS 9001 DEPOSITS 1000 OPERATING RIGHTS - SKILLED NURSING FACILITY 910000 INTERZONE -403385 1614004 DEPOSITS 14566 14566 0 1 0 0 0 0 0 0 0 LAURENCE C GUMINA CHIEF EXECUTIVE OFFICER 0 657150 0 0 0 690 0 3825 0 8075 0 669740 0 0 DANIEL O'CONNER CHIEF OPERATING OFFICER THRU 09/20 0 368715 0 0 0 40568 0 2795 0 12609 0 424687 0 0 ROBERT STILLMAN CHIEF FINANCIAL OFFICER/TREASURER 0 381843 0 0 0 690 0 2394 0 14864 0 399791 0 0 DANA ULLOM-VUCELICH CHIEF HUMAN RESOURCES OFFICER 0 294773 0 0 0 1079 0 1908 0 8075 0 305835 0 0 CONNIE TOSTEVIN CHIEF NURSING OFFICER THRU 02/21 0 274298 0 0 0 1961 0 1674 0 8075 0 286008 0 0 JOYCE MILLER CHIEF INFO OFFICER THRU 08/20 0 238276 0 0 0 929 0 1701 0 9500 0 250406 0 0 MICHAELLA REES CHIEF BRAND & GROWTH OFFICER 0 209147 0 0 0 224 0 1301 0 476 0 211148 0 0 LESLIE BELFANCE DIVISION EXECUTIVE OF COMMUNITIES 0 169951 0 0 0 941 0 1320 0 14806 0 187018 0 0 MARK ROBERTS CHIEF EXEC OF PROJECT DEVELOPMENT 0 146709 0 0 0 1537 0 1136 0 12464 0 161846 0 0 DANIEL HOLSTEIN CORP EXECUTIVE OF FINANCE 0 149238 0 0 0 791 0 1132 0 8073 0 159234 0 0 PART I, LINE 3: OHIO LIVING FOUNDATION RELIED ON A RELATED ORGANIZATION (OHIO LIVING) THAT USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -FORM 990 OF OTHER ORGANIZATIONS -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B: DURING THE CURRENT YEAR, OHIO LIVING MADE NO CONTRIBUTIONS TO A 457(F) NONQUALIFIED DEFERRED COMPENSATION PLAN. THE 457(F) NONQUALIFIED DEFERRED COMPENSATION PLAN IS AVAILABLE TO KEY EMPLOYEES OF THE ORGANIZATION, AS DEFINED BY THE ORGANIZATION AND NOT PART VII OF THE FORM 990. THE 457(F) NONQUALIFIED DEFERRED COMPENSATION PLAN WILL VEST 100% AFTER 3 FISCAL YEARS OF CONTINUED EMPLOYMENT HAVE CONCLUDED; OTHERWISE, AMOUNTS ARE FORFEITED. FORM 990, PART VI, SECTION A, LINE 6 OHIO LIVING COMMUNITIES IS THE SOLE MEMBER OF OHIO LIVING QUAKER HEIGHTS AND SHALL HAVE AND EXERCISE ALL OF THE RIGHTS AND PRIVILEGES OF MEMBERS OF A NONPROFIT CORPORATION CONFERRED UNDER THE LAWS OF THE STATE OF OHIO. FORM 990, PART VI, SECTION A, LINE 7A DIRECTORS OF OHIO LIVING QUAKER HEIGHTS WILL BE APPOINTED BY THE SOLE MEMBER, OHIO LIVING COMMUNITIES, THROUGH ITS BOARD OF DIRECTORS, AT THE ANNUAL MEETING OF THE SOLE MEMBER. NOMINEES TO THE BOARD OF DIRECTORS OF OHIO LIVING QUAKER HEIGHTS WILL BE SELECTED AND APPOINTED BY THE OHIO LIVING COMMUNITIES BOARD OF DIRECTORS BASED UPON THEIR ABILITY TO CONTRIBUTE IN TERMS OF EXPERTISE AND TIME AND THEIR COMMITMENT TO THE OHIO LIVING MISSION STATEMENT. FORM 990, PART VI, SECTION A, LINE 7B DIRECTORS OF OHIO LIVING QUAKER HEIGHTS WILL BE APPOINTED BY THE SOLE MEMBER, OHIO LIVING COMMUNITIES, THROUGH ITS BOARD OF DIRECTORS, AT THE ANNUAL MEETING OF THE SOLE MEMBER. NOMINEES TO THE BOARD OF DIRECTORS OF OHIO LIVING QUAKER HEIGHTS WILL BE SELECTED AND APPOINTED BY OHIO LIVING BASED UPON THEIR ABILITY TO CONTRIBUTE IN TERMS OF EXPERTISE AND TIME AND THEIR COMMITMENT TO THE OHIO LIVING MISSION STATEMENT. FORM 990, PART VI, SECTION B, LINE 11B AFTER MANAGEMENT PERFORMS A DETAILED REVIEW OF THE DRAFT 990, THE ORGANIZATION DELEGATES THE REVIEW OF THE 990 TO A BOARD MEMBER WITH SUFFICIENT EXPERIENCE TO EVALUATE THE CONTENT CONTAINED THEREIN. THE MEMBER THEN REPORTS HIS/HER REVIEW FINDINGS TO THE BOARD AND FINANCE COMMITTEE. A DRAFT OF THE FORM 990 IS POSTED TO THE ONLINE BOARD PORTAL AND EACH BOARD MEMBER IS GRANTED ACCESS TO REVIEW AND COMMENT. THE FINAL ISSUED FORM 990 IS ALSO POSTED TO THE BOARD PORTAL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, ALL INTERESTED PERSONS (DIRECTOR, OFFICER, ETC.) MUST DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST/CONFLICT AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST/CONFLICT AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON BY THE REMAINING BOARD MEMBERS. IN ADDITION, EACH INTERESTED PERSON SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS READ, UNDERSTANDS, AND IS IN COMPLIANCE WITH THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE CHIEF HUMAN RESOURCES OFFICER OF OHIO LIVING, A RELATED ENTITY, IN CONJUNCTION WITH THE OHIO LIVING EXECUTIVE COMPENSATION AND EVALUATION COMMITTEE (ECEC) OF THE BOARD OVERSEE THE COMPENSATION OF THE EXECUTIVE LEADERSHIP PERSONNEL. THE ECEC IS COMPRISED OF KEY BOARD MEMBERS WHO INCLUDE THE BOARD CHAIR FROM EACH SUBSIDIARY BOARD, THE BOARD CHAIR FROM THE OHIO LIVING PARENT BOARD, THE FINANCE, AUDIT, ETHICS & COMPLIANCE COMMITTEE CHAIR AND THE HUMAN RESOURCES COMMITTEE CHAIR. THE ECEC IS GOVERNED BY A CHARTER AND MEETS REGULARLY. RESOURCES USED BY THE ECEC INCLUDE MARKET SURVEYS AVAILABLE THROUGH HEALTHCARE, LONG-TERM CARE, HOSPICE AND HOME HEALTH DATA COLLECTION CLEARINGHOUSES, CONSULTANTS SUCH AS AON HEWITT AND OTHER AVAILABLE RESOURCES THAT ARE IN COMPLIANCE WITH ANTI-TRUST REGULATIONS. DECISIONS INVOLVING EXECUTIVE LEADERSHIP PAY ARE DISCUSSED AND APPROVED DURING EXECUTIVE SESSIONS OF THE OHIO LIVING PARENT BOARD MEETINGS. THIS PROCESS IS UPDATED ANNUALLY AND REVIEWED THROUGHOUT THE YEAR DURING QUARTERLY MEETINGS. THE CEO, EXECUTIVE OFFICERS AND KEY EMPLOYEES ARE PAID FROM AND RECEIVE W-2'S FROM OHIO LIVING, AND ARE SUBJECT TO THE ABOVE PROCESS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,553,120. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,553,120. THERAPY/MEDICAL/DRUG SERVICES: PROGRAM SERVICE EXPENSES 269,376. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 269,376. OTHER FEES: PROGRAM SERVICE EXPENSES 29,789. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,789. FORM 990, PART XI, LINE 9: NON-OPERATING INTEREST AND DIVIDENDS 345. BOOK ENTRY TO CLOSE OUT CUMULATIVE INTERCOMPANY ACCOUNTS TO NET ASSETS 600,965. NON-OPERATING EXPENSES -13,390. FORM 990, PART XII, LINE 3B: THE REQUIRED SINGLE AUDIT AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 HAS NOT YET BEEN COMPLETED. PLANS HAVE BEEN MADE TO HAVE THE REQUIRED SINGLE AUDIT COMPLETED BY THE EXTENDED DUE DATE AS ESTABLISHED IN OMB M-20-26. FORM 990, PAGE 1, LINE J: WEBSITE: WWW.OHIOLIVING.ORG/COMMUNITIES/OHIO-LIVING-QUAKER-HEIGHTS QUAKER HEIGHTS LLC 514 W HIGH STREET WAYNESVILLE OH 45068 310538523 PROPERTY HOLDING COMPANY OH 0 0 OHIO LIVING QUAKER HEIGHTS QUAKER HEIGHTS FOUNDATION 514 W HIGH STREET WAYNESVILLE OH 45068 311575048 TO SUPPORT ACTIVITIES OF QUAKER HEIGHTS CARE COMMUNITY OH 501(C)(3) LINE 12A, I OHIO LIVING QUAKER HEIGHTS 0 OHIO LIVING FOUNDATION 9200 WORTHINGTON ROAD SUITE 300 WESTERVILLE OH 43082 311166164 SUPPORT OH 501(C)(3) LINE 12B, II OHIO LIVING 1 OHIO LIVING COMMUNITIES 9200 WORTHINGTON ROAD SUITE 300 WESTERVILLE OH 43082 344429863 ADULT CARE OH 501(C)(3) LINE 10 OHIO LIVING 1 OHIO LIVING HOLDINGS 9200 WORTHINGTON ROAD SUITE 300 WESTERVILLE OH 43082 272564811 ADULT CARE OH 501(C)(3) LINE 10 OHIO LIVING 1 OHIO LIVING SARAH MOORE 26 N UNION STREET DELAWARE OH 43015 311510768 SKILLED CARE/ASSISTED LIVING OH 501(C)(3) LINE 10 OHIO LIVING COMMUNITIES 1 OHIO LIVING 9200 WORTHINGTON ROAD SUITE 300 WESTERVILLE OH 43082 311340918 MANAGEMENT OH 501(C)(3) LINE 12B, II N/A 0 OHIO PRESBYTERIAN RETIREMENT SERVICES DEVELOPMENT CORPORATION 9200 WORTHINGTON ROAD SUITE 300 WESTERVILLE OH 43082 311166160 INACTIVE OH N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 OHIO LIVING COMMUNITIES Q 4598006 CASH TRANSFER OHIO LIVING COMMUNITIES R 7096803 CASH TRANSFER OHIO LIVING COMMUNITIES O 2190439 CASH TRANSFER