2020-11-03T16:34:10-06:00 2019-12-31 571184737 FABRIZIO & SHULTZ LLC 3620 N HIGH ST STE 309 COLUMBUS OH 43214 990 2019-01-01 341437965 ST FRANCIS HOME INC STFR 4194472723 182 ST FRANCIS AVE TIFFIN OH 44883 SISTER SARA ALDRIDGE CHAIRPERSON 4194472723 2020-10-20 RYAN E SHULTZ CPA P01318447 6142684400 2020-10-29 52.38.98.93 2020-11-03 16:34:10 CS P F1E2D6ADFA3461CCA4246B4825CA913809B82CD1 F4CAE1EF7454098FD4620A8685074F36D647BC8E 2019 2021-01-29 14:40:06Z SISTER SARA ALDRIDGE 200 ST FRANCIS AVE TIFFIN OH 44883 2990607 false X WWW.STFRANCISTIFFIN.ORG X 1961 OH TO PROVIDE FACILITIES FOR INDEPENDENT LIVING, CUSTODIAL CARE & INTERMEDIATE CARE FOR THE ELDERLY. X 5 5 229 55 0 374398 17342 10037301 1763721 4839 -2011650 499558 246868 10916096 16281 0 0 7118830 931827 0 0 4010100 708646 11128930 1640473 -212834 -1624192 5064327 1855963 1786346 185533 3277981 1670430 X TO PROVIDE FACILITIES FOR INDEPENDENT LIVING, CUSTODIAL CARE & INTERMEDIATE CARE FOR THE ELDERLY. false true 30183 37951 INDEPENDENT LIVING FACILITY FOR ELDERLY RESIDENTS WITH 31 UNITS OF APARTMENT-LIVING COMPLEX KNOWN AS ELIZABETH SCHAEFER APARTMENTS. 1168448 1725770 SKILLED NURSING FACILITY FOR THE ELDERLY. DURING THE YEAR, IT OPERATED WITH 132 SKILLED-NURSING BEDS AND 16 ASSISTED-LIVING BEDS. 1198631 true false false false false false false false false false false false false false false false false false false false false false false false false false false false false false false false false false false true false false false false false true false true true true false false true 23 0 229 true false false false false false false false false false false false false false false X 5 5 false true false false true true true true true false false true true true true true true true true false OH X SISTER SARA ALDRIDGE 4194472723 200 ST FRANCIS AVE TIFFIN OH 44883 X SISTER SARA ALDRIDGE CHAIRPERSON 1.00 40.00 X X 0 0 0 SISTER MYRA ARNONE BOARD MEMBER 1.00 40.00 X 0 0 0 SISTER LEANNE KERSCHNER TREASURER 1.00 40.00 X X 0 0 0 SISTER MARY KUHLMAN BOARD MEMBER 1.00 40.00 X 0 0 0 SISTER ROZANNE SWOPE V CHAIRPERSO 1.00 40.00 X X 0 0 0 false false false FABRIZIO CHIROPRACTIC & REHAB SERVIC 1560 W MARKET ST TIFFIN OH 44883 PHYSICAL & OCCU 108746 MEDICAL STAFFING NETWORK PO BOX 840292 DALLAS TX 752840292 STAFFING 101058 2 17342 17342 MEDICARE AND MEDICAID 623000 1141719 1141719 NURSING HOME REVENUE 623000 584051 584051 INDEPENDENT LIVING FEE 531110 37951 37951 1763721 4083 4083 9815 9815 9815 9815 249591 709002 229538 2744788 20053 -2035786 -2015733 -2015733 OTHER INCOME 181041 181041 MANAGEMENT FEE TO RELATIVES 47414 47414 OTHER MISC INCOME 4833 4833 3765 3765 237053 16281 -18724 17663 747659 747659 14049 14049 191804 191804 -21685 -21685 14336 14336 1303 1303 31947 31947 89164 89164 18896 18896 2374 2374 109538 109538 1697 1697 2519 2519 4997 4997 60150 60150 11305 11305 SUPPLIES 143910 133612 10298 FRANCHISE FEES 99453 99453 SUPPLIES - MEALS 56660 56660 EQUIPMENT, REPAIR, MAINTE 43703 43703 16694 7289 9405 1640473 1198631 441842 0 1650 1650 1707021 1717915 528745 136398 29373 91112 2051297 211675 443454 5064327 1855963 1099286 185533 687060 1786346 185533 X 2980383 1422832 297598 247598 3277981 1670430 5064327 1855963 -1624192 16641 X false false false X 739538 209167 236022 374398 17342 1576467 10437648 10469439 10544953 10455330 1997009 43904379 20632 40731 14479 16143 3765 95750 11197818 10719337 10795454 10845871 2018116 45576596 45576596 65757 79201 87150 70608 13898 316614 65757 79201 87150 70608 13898 316614 11263575 10798538 10882604 10916479 2032014 45893210 0.99310 0.99280 0.01000 0.01000 X DOMINIC FABRIZIO FORMER B MEMBER 108746 SEE BELOW false SCHEDULE L, PART V SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF PERSON: DOMINIC FABRIZIO (B) DESCRIPTION OF TRANSACTION: PURCHASED REHABILITATION SERVICES FROM FABRIZIO CHIROPRACTIC AND REHABILITATION SERVICES, INC. AT FAIR VALUE. ASSET SALE 2019-02-28 709002 BOOK VALUE 832533222 CSJI-TIFFIN INC 3700 E LINCOLN STREET WITCHITA KS 67218 false false false false SCHEDULE N ON FEBRUARY 28, 2019 ST. FRANCIS SENIOR MINISTRIES (SFSM) EXECUTED AN ASSET SALE IN WHICH ALL FIXED ASSETS WERE SOLD TO CSJ INITIATIVES, INC (CSJI). CSJI AND SFSM ENTERED INTO AN OPERATIONS TRANSFER AGREEMENT ON JANUARY 1, 2019. UPON CLOSING CSJI WAS TO DEFEASE THE BONDS PAYABLE TO THE COUNTY OF SENECA, HOSPITAL CARE FACILITIES REVENUE REFUNDING BONDS, SERIES 2005 AND ALL RESIDENT FUNDS AND DEPOSITS WERE TRANSFERRED TO CSJI. FORM 990, PAGE 2, PART III, LINE 3 ON FEBRUARY 28, 2019 ST. FRANCIS SENIOR MINISTIRES (SFSM) EXECUTED AN ASSET SALE IN WHICH ALL FIXED ASSETS WERE SOLD TO CSJ INITIATIVES, INC. CSJI AND SFSM ENTERED INTO AN OPERATIONS TRANSFER AGREEMENT ON JANUARY 1, 2019. FORM 990, PAGE 6, PART VI, LINE 3 THE ORGANIZATION WAS MANAGED BY CSJI-TIFFIN, INC FROM JANUARY - FEBRUARY OF 2019. DURING THAT TIME CSJI-TIFFIN, INC MANAGE AND OPERATE THE CAMPUS CONSISTENT WITH ALL APPLICABLE FEDERAL, STATE AND LOCAL LAWS, RULES AND REGULATIONS RELATED TO THE SERVICES PROVIDED IN THE CONTINUUM. SUPERVISE AND MANAGE THE DAY-TO-DAY OPERATION OF THE CAMPUS ON BEHALF OF THE OWNER. IMPLEMENT POLICIES AND PROCEDURES ESTABLISHED BY MANAGER AND APPROVED BY OWNER. FORM 990, PAGE 6, PART VI, LINE 6 THE SOLE CORPORATE MEMBERS OF THE ORGANIZATION ARE THE COMMUNITY MINISTER AND FOUR MEMBERS OF GENERAL COUNCIL OF THE SISTERS OF ST. FRANCIS OF PENANCE AND CHARITY OF TIFFIN, OHIO (SISTERS OF ST. FRANCIS). FORM 990, PAGE 6, PART VI, LINE 7A THE ORGANIZATION'S CHAIR OF THE BOARD IS ELECTED BY THE SISTERS OF ST. FRANCIS. FORM 990, PAGE 6, PART VI, LINE 7B THE ORGANIZATION'S ANNUAL BUDGET AND OTHER MAJOR DECISIONS REQUIRE AN APPROVAL FROM THE COMMUNITY MINISTER AND SISTERS OF ST. FRANCIS, SOLE MEMBERS OF ST. FRANCIS HOME, INC. FORM 990, PAGE 6, PART VI, LINE 11B EACH MEMBER OF THE BOARD RECEIVES AN ELECTRONIC COPY OF THE 990 FOR REVIEW. ANY QUESTIONS OR CONCERNS THAT ARISE FROM THE REVIEW OF THE 990 FROM THE BOARD WILL BE DISCUSSED AND RESOLVED APPROPRIATELY. FORM 990, PAGE 6, PART VI, LINE 12C OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS OF INTEREST ANNUALLY. THE GOVERNING BODY ADDRESSES THOSE CONFLICTS AS NEEDED. FORM 990, PAGE 6, PART VI, LINE 15A IN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS, A COMPARISON IS DONE TO SALARIES FOR COMPARABLE POSITIONS. SALARIES ARE REVIEWED AND APPROVED BY THE MEMBERS OF SISTERS OF ST. FRANCIS. FORM 990, PAGE 6, PART VI, LINE 15B CEO AND HUMAN RESOURCE DEPARTMENT REVIEW SALARIES OF ALL KEY EMPLOYEES ANNUALLY WITH COMPARABLE SALARY RANGE FOR OTHER FACILITIES IN THE REGION FORM 990, PAGE 6, PART VI, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE KEPT ON SITE AND MADE AVAILABLE FOR PUBLIC VIEWING UPON REQUEST. ST FRANCIS VILLAS INC 182 ST FRANCIS AVE TIFFIN OH 44883 341628903 OPERATION OH 501C3 10 SISTERS OF true ST FRANCIS SENIOR MINISTRIES DAY C 182 ST FRANCIS AVE TIFFIN OH 44883 203401507 PROVIDE DA OH 501C3 10 SISTERS OF true SISTERS OF ST FRANCIS 200 ST FRANCIS AVE TIFFIN OH 44883 344428986 SISTERS OF OH 501C3 1 SISTERS OF false FRIEDMAN VILLAGE AT ST FRANCIS 175 ST FRANCIS AVE TIFFIN OH 44883 264425817 PROVIDE IN OH 501C3 10 SISTERS OF true false false false false false false false false false false false false false true true false false false false ST FRANCIS VILLAS INC O 10614 FAIR MARKET VALUE FRIEDMAN VILLAGE AT ST FRANCIS O 22464 FAIR MARKET VALUE