2020-11-12T13:49:46-06:00 2019-12-31 381357951 PLANTE & MORAN PLLC 1111 SUPERIOR AVE SUITE 1250 CLEVELAND OH 44114 990 2019-01-01 341931795 ROSARY CARE CENTER ROSA 4198243669 6832 CONVENT BLVD SYLVANIA OH 43560 JASON PHILLIPS CEO/ADMINISTRATOR 4198243669 2020-11-11 1 JEREMY S HERMAN CPA P00745789 2165231010 2020-11-11 99.59.111.177 2020-11-11 15:31:27 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 2073614AB6CC048C75CA70E90B6FEBAC5ECCA686 2019 2021-01-29 14:40:06Z JASON PHILLIPS 6832 CONVENT BLVD SYLVANIA OH 43560 7606678 0 0928 X N/A X 2000 OH ROSARY CARE CENTER OPERATES A LICENSED NURSING FACILITY AND A LICENSED RESIDENTIAL CARE FACILITY. THE NURSING FACILITY IS OPEN TO BOTH RETIRED MEMBERS OF RELIGIOUS ORDERS AND RETIRED LAY PERSONS. THE RESIDENTIAL CARE FACILITY IS OCCUPIED BY RETIRED MEMBERS OF THE SISTERS OF ST. FRANCIS. ROSARY CARE CENTER PROVIDES SKILLED NURSING CARE AND PERSONAL CARE SERVICES IN BOTH FACILITIES TO SICK, INFIRM, CONVALESCENT AND AGED PATIENTS UNDER THE DIRECTION OF PHYSICIANS AND OTHER HEALTH CARE PROFESSIONALS.THE SISTERS OF ST. FRANCIS CONTROL ROSARY CARE CENTER THROUGH SYLVANIA FRANCISCAN MINISTRIES, AN OHIO NONPROFIT CORPORATION WHICH ACTS AS THE PARENT OF ROSARY CARE CENTER. THE CONGREGATIONAL MINISTER AND MEMBERS OF THE GENERAL COUNCIL ARE THE MEMBERS OF SYLVANIA FRANCISCAN MINISTRIES AND APPOINT SYLVANIA FRANCISCAN MINISTRIES BOARD OF TRUSTEES. 9 8 141 18 0 0 184549 585259 6714327 7021394 -29389 25 0 0 6869487 7606678 0 0 0 0 3906023 4059452 0 0 0 3174973 3353320 7080996 7412772 -211509 193906 6272956 6330594 4269115 4132847 2003841 2197747 X ROSARY CARE CENTER OPERATES A LICENSED NURSING FACILITY AND A LICENSED RESIDENTIAL CARE FACILITY. THE NURSING FACILITY IS OPEN TO BOTH RETIRED MEMBERS OF RELIGIOUS ORDERS AND RETIRED LAY PERSONS. THE RESIDENTIAL CARE FACILITY IS OCCUPIED BY RETIRED MEMBERS OF THE SISTERS OF ST. FRANCIS. ROSARY CARE CENTER PROVIDES SKILLED NURSING CARE AND PERSONAL CARE SERVICES IN BOTH FACILITIES TO SICK, INFIRM, CONVALESCENT AND AGED PATIENTS UNDER THE DIRECTION OF PHYSICIANS AND OTHER HEALTH CARE PROFESSIONALS.THE SISTERS OF ST. FRANCIS CONTROL ROSARY CARE CENTER THROUGH SYLVANIA FRANCISCAN MINISTRIES, AN OHIO NONPROFIT CORPORATION WHICH ACTS AS THE PARENT OF ROSARY CARE CENTER. THE CONGREGATIONAL MINISTER AND MEMBERS OF THE GENERAL COUNCIL ARE THE MEMBERS OF SYLVANIA FRANCISCAN MINISTRIES AND APPOINT SYLVANIA FRANCISCAN MINISTRIES BOARD OF TRUSTEES. 0 0 5916736 7021394 DELIVER HEALTH CARE SERVICES TO THE ELDERLY VOWED RELIGIOUS AND OTHERS IN NEED OF ASSISTED LIVING, LONG-TERM OR REHABILITATIVE SERVICES IN A MANNER THAT UPHOLDS THE MORAL, ETHICAL AND RELIGIOUS DOCTRINES AND TEACHINGS OF THE ROMAN CATHOLIC CHURCH. 145 INDIVIDUALS SERVED FOR A TOTAL OF 30,943 RESIDENTIAL DAYS OF CARE IN 2019. 5916736 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 14 0 1 141 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 8 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 OH X JASON PHILLIPS 4198243600 6832 CONVENT BLVD SYLVANIA OH 43560 GAYLE LAMPKOWSKI TREASURER 1.00 40.00 X X 0 181899 9299 SR RACHEL NIJAKOWSKI TRUSTEE 1.00 40.00 X 0 32000 15178 SR THERESA DARGA TRUSTEE 1.00 40.00 X 0 0 0 SR SHANNON SCHREIN TRUSTEE 1.00 40.00 X 0 0 0 JENI BELT TRUSTEE 1.00 1.00 X 0 0 0 JUDITH LANZINGER TRUSTEE (BEG. 08/17) 1.00 1.00 X 0 0 0 SR JOY BARKER TRUSTEE (BEG. 03/19) 1.00 1.00 X 0 0 0 SR VALERIE GRONDIN TRUSTEE (BEG. 03/19) 1.00 1.00 X 0 0 0 SR MARY JON WAGNER PRESIDENT AND CHAIRPERSON 1.00 40.00 X X 0 0 0 SR SHARON DERIVAN SECRETARY 1.00 20.00 X X 0 0 0 0 213899 24477 1 0 1 0 CONCEPT REHAB 7150 GRANITE CIRCLE 3200 TOLEDO OH 43617 REHABILITATION SERVICES 564143 CHI LIVING COMMUNITIES 5942 RENAISSANCE PLACE SUITE A TOLEDO OH 43623 MANAGEMENT SERVICES 239921 2 578679 6580 157800 585259 COMMERCIAL/PRIVATE/OTH 623000 4805576 4805576 MEDICARE AND MEDICAID 623000 2215818 2215818 7021394 25 0 25 25 25 7606678 7021394 0 25 3058722 2725779 332943 67548 60195 7353 693515 618026 75489 239667 213579 26088 255968 15442 240526 19025 19025 6190 6190 990 990 561527 561527 7972 7972 721496 597686 123810 70179 70179 657088 207472 449616 22059 20614 1445 139513 113411 26102 162731 132285 30446 85834 85834 FRANCHISE FEES 359694 359694 PROVISION FOR BAD DEBT 283054 283054 7412772 5916736 1496036 0 450 449 378309 365488 844779 711444 17664 11463 42474 47556 5054954 1508241 3666072 3546713 1021034 1016820 302174 630661 6272956 6330594 514487 577550 198971 162303 3505000 3345000 50657 47994 4269115 4132847 X 2003841 2197747 2003841 2197747 6272956 6330594 193906 0 X 0 0 0 X 963315 334226 879070 184549 585259 2946419 4963250 5436105 5324398 6714327 7021394 29459474 5926565 5770331 6203468 6898876 7606653 32405893 0 334543 793954 736425 1004789 496880 3366591 334543 793954 736425 1004789 496880 3366591 29039302 127405 127405 6053970 5770331 6203468 6898876 7606653 32533298 0.89260 0.90140 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 990 990 0 PART II-B, LINE 1: OHIO HEALTH CARE ASSOCIATION MEMBERSHIP DUES - 21.08% 4194083 835412 3358671 217098 171932 45166 643773 500897 142876 3546713 NON-PATIENT RECEIVABLE 588817 RESIDENT TRUST ACCOUNTS (CASH) 33359 ACCRUED Y-E PAYROLL DEDUCTIONS 8485 630661 RESIDENT TRUST ACCOUNTS (CASH) 33359 DUE TO AFFILIATES 14635 47994 0 0 0 0 0 0 0 0 0 GAYLE LAMPKOWSKI TREASURER 0 181899 0 0 0 0 0 7175 0 2124 0 191198 0 0 A CITY OF SYLVANIA OHIO HEALTH CARE REVENUE BONDS SERIES 2012 341931795 2012-03-28 4395000 CONSTRUCTION 0 0 0 A 1050000 4395000 169245 43949 101714 3994666 2013 0 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 1 0 0 0 0 0 A 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CITY OF SYLVANIA, OHIO HEALTH CARE REVENUE BONDS, SERIES 2012 DATE THE REBATE COMPUTATION WAS PERFORMED: 10/31/2018 X CONTRIBUTED RENT INCOME 1 157800 FMV 0 0 0 FORM 990, PART VI, SECTION A, LINE 3 THE BOARD CONTRACTS WITH A MANAGEMENT COMPANY, CHI LIVING COMMUNITIES, TO MANAGE DAILY OPERATIONS OF THE FACILITY. HOWEVER, THE BOARD STILL MAINTAINS ULTIMATE OVERSIGHT OF ROSARY CARE CENTER. THE COMPENSATION PAID FOR MANAGEMENT DUTIES DURING 2019 TOTALED $239,921. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERSHIP OF THE CORPORATION CONSISTS OF ONE (1) CLASS AND THE ONLY MEMBER OF THE CORPORATION SHALL BE SYLVANIA FRANCISCAN MINISTRIES, AN OHIO NON-PROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE RESERVED POWERS EXERCISABLE BY THE MEMBER ALONE - ACTION BY SYLVANIA FRANCISCAN MINISTRIES IN ITS CAPACITY AS SOLE MEMBER OF THE CORPORATION SHALL BE REQUIRED, AND SHALL BE SUFFICIENT TO ELECT THE TRUSTEES OF THE CORPORATION AS PROVIDED IN THE CODE OF REGULATIONS, AND TO REMOVE THEM AT WILL, WITH OR WITHOUT CAUSE AS PROVDED IN THE CODE OF REGULATIONS; AND TO ELECT AND REMOVE THE CHAIRPERSON AND THE PRESIDENT OF THE CORPORATION AS PROVIDED IN THE CODE OF REGULATIONS. FORM 990, PART VI, SECTION A, LINE 7B THE RESERVED POWERS EXERCISABLE BY THE MEMBER ALONE-ACTION BY THE MEMBER OF THE CORPORATION SHALL BE REQUIRED AND SHALL BE SUFFICIENT: A) TO ADOPT OR CHANGE THE PHILOSOPHY, OBJECTIVES, PURPOSES OR ETHICAL OR RELIGIOUS STANDARDS OF THE CORPORATION AND OF ORGANIZATIONS CONTROLLED BY THE CORPORATION; B)TO REMOVE THE TRUSTEES AT WILL, WITH OR WITHOUT CAUSE AS PROVIDED IN ARTICLE V, SECTION 2; C) TO ELECT, APPOINT AND REMOVE ANY OFFICER AND CHAIRPERSON OF ANY COMMITTEE OF THE CORPORATION; D) TO AMEND OR REPEAL THE ARTICLES OF INCORPORATION AND THE CODE OF REGULATIONS OF THE CORPORATION AS PROVIDED IN ARTICLE XII; E) TO DISSOLVE OR TERMINATE THE EXISTENCE OF THE CORPORATION OR TO REVOKE ANY PROCEEDING FOR ITS VOLUNTARY DISSOLUTION AND TO DETERMINE THE DISTRIBUTION OF ASSETS UPON ANY APPROVED DISSOLUTION OR TERMINATION IN ACCORDANCE WITH THE ARTICLES OF INCORPORATION; F) TO SATISFY ALL REQUIREMENTS APPLICABLE TO NONPROFIT CORPORATIONS UNDER STATE LAW; G) TO TAKE ANY ACTION NECESSARY TO CONFORM THE PURPOSES AND ACTIVITIES OF THE CORPORATION AND OF ORGANIZATIONS CONTROLLED BY THE CORPORATION WITH THE TRADITIONS, TEACHINGS AND CANON LAW OF THE ROMAN CATHOLIC CHURCH AS THEY MAY BE IN EFFECT FROM TIME TO TIME; H) TO APPROVE ANY TRANSACTION, AGREEMENT, ARRANGEMENT OR CLAIM TO WHICH THE CORPORATION IS A PARTY THAT INVOLVES A POTENTIAL CONFLICT OF INTEREST AS DEFINED IN ARTICLE IX; I) TO APPROVE ANY MERGER OR CONSOLIDATION OF THE CORPORATION AND ANY SALE OF SUBSTANTIALLY ALL OF ITS ASSETS; J) TO AUTHORIZE THE CREATION OF ANY SUBSIDIARY ORGANIZATION OR THE AFFILIATION OF THE CORPORATION WITH ANY OTHER ENTITY FOR THE PURPOSE OF THE JOINT CONDUCT OF BUSINESS OR OTHER PROGRAMS, WHETHER IN THE FORM OF PARTICIPATION IN A CORPORATION, PARTNERSHIP, JOINT VENTURE, CO TENANCY OR ANY OTHER FORM OF OWNERSHIP OR CONTROL; K)TO APPROVE THE CONVEYANCE OF REAL PROPERTY OR THE GRANTING OF MORTGAGES OR TRUST DEEDS OR THE CREATION OF OTHER LIENS UPON ANY REAL PROPERTY OWNED BY THE CORPORATION; L) TO APPROVE CONVEYING ANY TANGIBLE PERSONAL PROPERTY, INCURRING ANY DEBT OR SERIES OF DEBTS, GUARANTEEING OF ANY DEBT OR SERIES OF DEBTS, OR THE GRANTING OF ANY SECURITY INTEREST OR OTHER LIEN IN THE PROPERTY OF THE CORPORATION IN EXCESS OF THE AMOUNT PRESCRIBED FROM TIME TO TIME BY THE MEMBER; M) TO APPROVE ANY CAPITAL EXPENDITURE OR GRANT, OR SERIES OF CAPITAL EXPENDITURES OR GRANTS IN EXCESS OF THE AMOUNT PRESCRIBED FROM TIME TO TIME BY THE MEMBER; N) TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION AND RELATED ORGANIZATIONS; O) TO APPROVE THE ADDITION OR TERMINATION OF SERVICES; P) TO APPROVE THE CORPORATION'S AUDITOR; Q) TO APPROVE THE CORPORATION'S STRATEGIC PLAN; R) TO APPROVE THE POWER OF APPROVAL RESERVED BY THE CORPORATION OVER ACTIONS OF THE GOVERNING BODIES OF ITS SUBSIDIARY ORGANIZATIONS OR AFFILIATED ENTITIES; AND S) TO APPROVE ANY OTHER ACT FOR WHICH MEMBERSHIP APPROVAL IS REQUIRED UNDER APPLICABLE CANON OR CIVIL LAW, THE ARTICLES OF INCORPORATION, OR THIS CODE OF REGULATIONS. FORM 990, PART VI, SECTION B, LINE 11B THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE ORGANIZATION'S ACCOUNTING DEPARTMENT. THE GOVERNING BODY RECEIVES A COPY OF THE FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, FOR REVIEW AND APPROVAL PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE WRITTEN CONFLICT OF INTEREST POLICY IS REGULARLY AND CONSISTENTLY MONITORED AND COMPLIANCE ENFORCED BY THE CEO/ADMINISTRATOR. THE SCOPE OF THIS POLICY INCLUDES BOARD MEMBERS AND STAFF (DESIGNATED PERSONS). THE POLICY IS IN PLACE TO PREVENT DESIGNATED PERSONS FROM EXERTING INFLUENCE ON TRANSACTIONS, AGREEMENTS OR CLAIMS. A SELF-DISCLOSURE FROM COVERED PERSONS TO THE BOARD IS REQUIRED ON ANY POTENTIAL CONFLICT OF INTEREST. THE COVERED PERSONS ARE TO RECUSE FROM PARTICIPATING IN ANY DELIBERATION OR DECISIONS ON SUCH TRANSACTIONS. FORM 990, PART VI, SECTION B, LINE 15 THE ADMINISTRATOR'S COMPENSATION IS PAID BY CHI LIVING COMMUNITIES, THE MANAGEMENT COMPANY. CHI LIVING COMMUNITIES CONDUCTS THE ANNUAL EVALUATION OF THE ADMINISTRATOR/CEO OF ROSARY CARE CENTER TO DETERMINE THE ANNUAL COMPENSATION BASED ON PERFORMANCE AND COMPARISON TO OTHER SIMILAR ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS OF ROSARY CARE CENTER, ALONG WITH THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS, ARE MADE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. THE DOCUMENTS ARE LOCATED IN THE ADMINISTRATIVE OFFICES DURING REGULAR BUSINESS HOURS. FORM 990, SCHEDULE R, PART II THE RELATED TAX EXEMPT ORGANIZATIONS ARE ALL MEMBERS OF GROUP EXEMPTION # 0928. SYLVANIA FRANCISCAN MINISTRIES (SFM) 6832 CONVENT BLVD SYLVANIA OH 43560 473544114 RELIGIOUS OH 501(C)(3) LINE 1 SISTERS OF ST FRANCIS OF SYLVANIA OHIO INC 1 SISTERS OF ST FRANCIS FOUNDATION 6832 CONVENT BLVD SYLVANIA OH 43560 473539212 RELIGIOUS OH 501(C)(3) LINE 1 SISTERS OF ST FRANCIS OF SYLVANIA OHIO INC 1 LOURDES UNIVERSITY 6832 CONVENT BLVD SYLVANIA OH 43560 341226547 HIGHER EDUCATION OH 501(C)(3) LINE 2 SISTERS OF ST FRANCIS OF SYLVANIA OHIO INC 1 FRANCISCAN PROPERTIES INC 6832 CONVENT BLVD SYLVANIA OH 43560 341412966 SENIOR HOUSING OH 501(C)(3) LINE 10 SISTERS OF ST FRANCIS OF SYLVANIA OHIO INC 1 FRANCISCAN SHELTERS PO BOX 5930 TOLEDO OH 436130930 341612437 DOMESTIC VIOLENCE SHELTER OH 501(C)(3) LINE 7 SISTERS OF ST FRANCIS OF SYLVANIA OHIO INC 1 SOPHIA CENTER INC 6832 CONVENT BLVD SYLVANIA OH 43560 341761656 MENTAL HEALTH OH 501(C)(3) LINE 10 SISTERS OF ST FRANCIS OF SYLVANIA OHIO INC 1 0 0 1 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 SISTERS OF ST FRANCIS C 21999 ACTUAL AMOUNT RECEIVED SISTERS OF ST FRANCIS P 395379 ACTUAL AMOUNT PAID SISTERS OF ST FRANCIS L 734020 ACTUAL AMOUNT PAID SISTERS OF ST FRANCIS L 55295 ACTUAL AMOUNT PAID SISTERS OF ST FRANCIS K 157800 FMV SISTERS OF ST FRANCIS E 160000 AMOUNT GUARANTEED SISTERS OF ST FRANCIS O 75962 ACTUAL AMOUNT PAID SISTERS OF ST FRANCIS C 157800 AMOUNT DONATED BY RELATED ORG SISTERS OF ST FRANCIS C 134540 ACTUAL AMOUNT PAID SISTERS OF ST FRANCIS C 264340 AMOUNT DONATED BY RELATED ORG