2020-11-09T11:58:45-06:00 2019-12-31 HW&CO 23240 Chagrin Blvd Suite 700 Cleveland OH 441225450 990 2019-01-01 344451089 GOOD SHEPHERD HOME % CHRISTOPHER P WIDMAN GOOD 4199371801 725 COLUMBUS AVENUE FOSTORIA OH 44830 CHRISTOPHER P WIDMAN EXECUTIVE DIRECTOR 4199371801 2020-11-09 true Joseph C Sbrocco CPA P00069069 2168311200 2020-11-05 12.203.198.2 34122420203145000001 2020-11-09 P 9104146F9E2F60B966A7B3E9FD5356FC6ED031FF 0B9CEC56E7D7AED94D6C12A1AC71A259EF49A470 2019 2021-01-29 14:40:06Z CHRISTOPHER P WIDMAN 725 COLUMBUS AVENUE FOSTORIA OH 44830 13991203 false X WWW.GOODSHEPHERDHOME.COM X 1902 OH THE GOOD SHEPHERD HOME OPERATES A CHRISTIAN COMMUNITY FOR THE ELDERLY, CONSISTING OF A NURSING FACILITY AND ASSISTED LIVING FACILITY AND IS LICENSED AS A HOME FOR THE AGING. 12 12 238 90 0 112057 110316 13174295 13335979 137191 161854 379266 331613 13802809 13939762 0 0 0 0 7004464 7023857 0 0 0 5729922 6216165 12734386 13240022 1068423 699740 25570124 27207817 11358515 11797551 14211609 15410266 THE GOOD SHEPHERD HOME MAINTAINS AND OPERATES A CHRISTIAN RETIREMENT COMMUNITY FOR THE ELDERLY, CONSISTING OF A NURSING FACILITY AND ASSISTED LIVING FACILITY AND IS LICENSED AS A HOME FOR THE AGING IN THE STATE OF OHIO. THE GOOD SHEPHERD HOME'S MISSION STATEMENT: THIS ORGANIZATION, FOUNDED TO MINISTER TO THE NEEDS OF THE COMMUNITY, IS COMMITTED TO PROVIDING AN ATMOSPHERE THAT ENHANCES THE QUALITY OF LIFE OF OUR RESIDENTS AND FOCUSES ON THEIR INDIVIDUALITY WHILE MAINTAINING A CHRISTIAN ENVIRONMENT IN WHICH TO LIVE AND WORK. false false 12276249 13633123 THE GOOD SHEPHERD HOME WHICH IS A LICENSED HOME FOR THE AGING in OHIO, OPERATES A RETIREMENT COMMUNITY CONSISTING OF A 128-BED SKILLED NURSING FACILITY, A 54-UNIT ASSISTED LIVING APARTMENT FACILITY AND 30 INDEPENDENT LIVING UNITS. THE HOME PROVIDED 61,515 INPATIENT DAYS OF CARE IN 2019 IN ITS NURSING FACILITY. 12276249 true true false false false false false false false false true false false false true false false true false false false false false false false false false false false true true false false false false false false false false false false false false false false true true true true false false true 28 0 true 238 true false false false false false false false false false false false false X 12 12 false false false false true false false true true false false true true true true true true true false false OH X CHRISTOPHER P WIDMAN 4199371801 725 COLUMBUS AVENUE FOSTORIA OH 44830 CHRISTOPHER P WIDMAN EXECUTIVE DIRECTOR 40.0 10.0 X 208065 15000 28363 RHONDA SCHULTE TRUSTEE 1.0 0.0 X 0 0 0 JENNA IRWIN TRUSTEE 1.0 0.0 X 0 0 0 BARBARA WILCH TRUSTEE 1.0 0.0 X 0 0 0 JANE DELL TRUSTEE 1.0 0.0 X 0 0 0 THERESE CLOUSE VICE CHAIRPERSON 2.0 2.0 X X 0 0 0 JACK JOHNSON CHAIRPERSON 2.0 2.0 X X 0 0 0 JIM SCHRECK TREASURER 2.0 2.0 X X 0 0 0 STEVE WHITE TRUSTEE 1.0 0.0 X 0 0 0 PAUL HARRISON TRUSTEE 1.0 0.0 X 0 0 0 MIKE COROCORAN TRUSTEE 1.0 0.0 X 0 0 0 ALAN LEIBENGOOD SECRETARY 2.0 2.0 X X 0 0 0 BERNIE STEINMETZ TRUSTEE 1.0 0.0 X 0 0 0 208065 15000 28363 1 false true false CLOUSE CONSTRUCTION CORP 4382 WEST TOWNSHIP ROAD 90 NEW RIEGEL OH 44853 CONSTRUCTION SVCS 1792477 FUNCTIONAL PATHWAYS 4320 BRIDGETOWN RD CINCINNATI OH 45211 THERAPY SERVICES 697958 WITHERS DESIGN GROUP 1250 CHAMBERS RD 110 COLUMBUS OH 43212 ARCHITECT SERVICES 125944 ZOELLER LAWN PROPERTY MANAGEMENT 8146 US-224 NEW RIEGEL OH 44853 MAINTENANCE SERVICES 161028 4 110316 110316 RESIDENT SERVICE REVENUE 623000 13335979 13335979 13335979 161854 161854 0 0 85910 51441 34469 0 34469 34469 0 0 0 0 0 0 0 0 0 0 MISCELLANEOUS INCOME 900099 261420 261420 REIMBURSEMENT OF EXPENSES BY AFFILIATE 900099 35724 35724 297144 13939762 13633123 196323 0 0 0 0 236428 118214 118214 0 5426815 5308097 118718 61580 59117 2463 730902 701666 29236 568132 545407 22725 0 83148 83148 0 0 0 9279 9279 1086459 995814 90645 66466 66466 156239 91208 65031 110717 110717 0 395787 391970 3817 56853 56853 0 8292 8292 308724 308724 0 889173 817891 71282 145073 131166 13907 FOOD SUPPLIES 677301 677301 FRANCHISE FEE 605800 605800 REPAIRS AND MAINTENANCE 518763 480507 38256 MEDICAL SUPPLIES 447809 447809 650282 419696 230586 13240022 12276249 963773 0 143371 170886 122260 131351 0 0 1249875 1414774 0 0 0 0 0 0 0 0 115199 113259 32210953 12644557 18255893 19566396 3517393 3590775 213900 210951 1136682 1136682 0 0 815551 872743 25570124 27207817 1086400 1228203 0 0 821695 1494541 4180000 3835000 0 0 0 0 3616774 3355959 0 0 1653646 1883848 11358515 11797551 X 14130232 15309449 81377 100817 14211609 15410266 25570124 27207817 X 699740 521465 -22548 X false true X true false X 104504 85230 121641 112057 110316 533748 11884929 13215539 13204382 13174295 13335979 64815124 0 0 0 11989433 13300769 13326023 13286352 13446295 65348872 0 0 0 65348872 84474 122126 180881 137191 161854 686526 0 84474 122126 180881 137191 161854 686526 0 194467 241930 286099 414896 297144 1434536 12268374 13664825 13793003 13838439 13905293 67469934 0.96856 0.96957 0.01018 0.01065 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1535073 1535073 27374279 10362265 17012014 2539838 1819676 720162 761763 462616 299147 19566396 0 REFUNDABLE LIFE USE FEES 1383600 INTEREST RATE SWAP 340572 DEFERRED COMPENSATION OBLIGATI 159676 1883848 14480840 521465 28892 550357 13930483 9279 9279 13939762 13282184 51441 51441 13230743 9279 9279 13240022 SCHEDULE D, PART XI, #2D TOTAL OTHER REVENUE NOT REPORTED ON TAX Form 990: CHANGE IN FV OF INTEREST RATE SWAP <$ 36,989.> CHANGE IN FV OF BENEFICIAL INTEREST $ 19,440. TRANSFER TO AFFILIATE <$ 5,000.> RENTAL EXPENSES $ 51,441. ----------- $ 20,892. SCHEDULE D, PART XII, #2D TOTAL OTHER EXPENSES NOT REPORTED ON TAX FORM 990: RENTAL EXPENSES $ 51,441. ----------- $ 51,441. X X X X false true false false false false false false false CHRISTOPHER P WIDMAN EXECUTIVE DIRECTOR 208065 0 0 0 0 15000 28363 0 0 0 236428 15000 0 0 PART I, LINE 4B PARTICIPATION IN 457 PLAN: CHRISTOPHER P. WIDMAN $19,000 A CITY OF FOSTORIA OH 346400520 2016-09-30 5130000 REFUNDING OF PRIOR TAX-EXEMPT BOND false false false A 1295000 0 5130000 0 0 0 0 0 0 0 0 0 2006 true false true true A false false false false 0 true false false true A false false false false true true MORGAN STANLEY CAPIT 21.583 false false false 0 A true PAGE 6, PART VI, SECTION C, #19 DOCUMENTS AVAILABLE TO PUBLIC: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. PAGE 6, PART VI, SECTION B, #12C MONITOR AND ENFORCE CONFLICT OF INTEREST POLICY: THE ORGANIZATION'S BOARD REVIEWS THE CONFLICT OF INTEREST POLICY ANNUALLY AND REQUIRES ITS MEMBERS TO SIGN IT ANNUALLY. PAGE 6, PART VI, SECTION B, #11B FORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY OUR OUTSIDE ACCOUNTING FIRM AND THEN PROVIDED TO THE EXECUTIVE DIRECTOR, ACCOUNTING MANAGER AND FINANCE COMMITTEE FOR THEIR REVIEW. PRIOR TO THE FILING OF THE RETURN, THE FORM 990 IS SENT TO OUR BOARD OF DIRECTORS. PAGE 6, PART VI, SECTION B, #15A PROCESS FOR DETERMINING COMPENSATION: ON AN ANNUAL BASIS, THE BOARD OF DIRECTORS WILL DO THE FOLLOWING: A.) COMPLETE AN ANNUAL PERFORMANCE AND COMPENSATION ANALYSIS OF THE EXECUTIVE DIRECTOR. B.) THE PERSONNEL COMMITTEE OF THE BOARD WILL MEET WITH THE EXECUTIVE DIRECTOR ON AN ANNUAL BASIS TO REVIEW THEIR PERFORMANCE AND ESTABLISH ANY NEW GOALS NECESSARY. C.) THE EXECUTIVE DIRECTOR WILL ENSURE PARTICIPATION IN THE ANNUAL COMPENSATION SURVEY CONDUCTED BY LEADING AGE, LEADING AGE OHIO, OR THE BOARD AND ADMINISTRATOR. INFORMATION FROM THE SURVEYS WILL BE SHARED WITH THE CHAIR OF THE PERSONNEL COMMITTEE. D.) THE PERSONNEL COMMITTEE WILL REPORT TO THE FULL BOARD IN EXECUTIVE SESSION THEIR OBSERVATIONS AND RECOMMENDATION REGARDING THE EXECUTIVE DIRECTOR. E.) ALL BOARD MEMBERS WILL PARTICIPATE IN THE EVALUATION PROCESS. F.) THE BOARD WILL USE THE COMPENSATION SURVEYS AND OTHER RELATED DOCUMENTATION IN CONSULTATION WITH THE EXECUTIVE DIRECTOR TO SET APPROPRIATE COMPENSATION LEVELS FOR THE UPCOMING YEAR. IT IS THE INTENT OF THIS BOARD TO SET COMPENSATION AT A LEVEL IN EXCESS OF THE 50TH PERCENTILE OF THE SURVEYS OR ON PAR WITH LOCAL ORGANIZATIONS, WHICHEVER IS GREATER. FURTHERMORE, THE GENERAL PERFORMANCE OF THE HOME WILL BE A DETERMINING FACTOR IN THE FINAL WAGE CONSIDERATION. PAGE 6, PART VI, SECTION A, #6 & 7A MEMBER CLASSES: NUMBER AND QUALIFICATION OF MEMBERS: A.) THIS CORPORATION SHALL BE GOVERNED BY A TWELVE (12) MEMBER BOARD OF TRUSTEES, ELEVEN (11) OF WHOM SHALL BE ELECTED FROM AND BY THE MEMBERSHIP AND ONE (1) OF WHOM SHALL BE ELECTED BY THE NORTHERN OHIO DISTRICT OF THE CHURCH OF THE BRETHREN. AT NO TIME SHALL A SUFFICIENT NUMBER OF TRUSTEES RELATED AS (I) HUSBANDS AND WIVES (II) SIBLINGS OR (III) PARENT AND CHILD, CONSTITUTE THE QUORUM REQUIREMENT FOR CONDUCTING CORPORATE BUSINESS. B.) AT LEAST FOUR (4) MEMBERS OF THE BOARD OF TRUSTEES SHALL BE MEMBERS OF THE NORTHERN OHIO DISTRICT OF THE CHURCH OF THE BRETHREN. C.) AT LEAST SIX (6) MEMBERS OF THE BOARD OF TRUSTEES SHALL BE RESIDENTS WITHIN THE COMMUNITIES AND GEOGRAPHIC AREAS SERVED BY GOOD SHEPHERD HOME REGARDLESS OF CHURCH AFFILIATION. D.) ONE (1) MEMBER SHALL BE A RESIDENT LIVING WITHIN THE CAMPUS OF GOOD SHEPHERD HOME. E.) AT LEAST ONE (1) MEMBER WHO IS NOT A CHURCH OF THE BRETHREN MEMBER SHALL HAVE A NON-FOSTORIA 44830 ADDRESS. F.) EACH MEMBER OF THE BOARD OF TRUSTEES MUST BE A MEMBER. IN THE EVENT THE NORTHERN OHIO DISTRICT OF THE CHURCH OF THE BRETHREN ELECTS A BOARD MEMBER WHO IS NOT A CORPORATE MEMBER, THAT BOARD MEMBER SHALL AUTOMATICALLY BECOME A CORPORATE MEMBER. ELECTION OF MEMBERS: A.) MEMBERS SHALL BE ELECTED TO MEMBERSHIP AT THE ANNUAL MEETING OF THE MEMBERS OF THE CORPORATION. B.) AN AFFIRMATIVE VOTE OF A MAJORITY OF THE MEMBERS PRESENT SHALL BE REQUIRED FOR ELECTION. C.) THE BOARD OF TRUSTEES MAY ELECT QUALIFIED MEMBERS TO FILL VACANCIES THAT OCCUR BETWEEN ANNUAL MEETINGS TO ENSURE A MINIMUM OF TWELVE (12) MEMBERS. MEMBERSHIP STATUS: A MEMBER, ONCE ELECTED, SHALL RETAIN MEMBERSHIP STATUS WITH THE CORPORATION UNTIL HE/SHE DIES, RESIGNS OR IS REMOVED WITH OR WITHOUT CAUSE. THE BOARD OF TRUSTEES RETAINS THE RIGHT TO ESTABLISH TERMS AND/OR FEES FOR MEMBERSHIP. VOTING RIGHTS: EACH MEMBER SHALL BE ENTITLED TO ONE VOTE ON EACH MATTER SUBMITTED TO A VOTE OF THE MEMBERSHIP. THE VOTE OF THE MAJORITY OF THOSE MEMBERS PRESENT SHALL DECIDE ANY QUESTIONS BROUGHT BEFORE SUCH MEETING, UNLESS THE QUESTION IS ONE UPON WHICH, BY LAW, THE ARTICLES OF INCORPORATION OR THESE REGULATIONS REQUIRES A DIFFERENT VOTE, IN WHICH CASE SUCH EXPRESSED. PROVISION SHALL GOVERN AND CONTROL. PROXY VOTING SHALL NOT BE ALLOWED. REMOVAL OF MEMBERS: THE BOARD OF TRUSTEES MAY, BY AFFIRMATIVE VOTE OF A MAJORITY OF THE TRUSTEES, REMOVE A MEMBER WITH OR WITHOUT CAUSE. ANY MEMBER WHOSE REMOVAL HAS BEEN PROPOSED BY THE TRUSTEES SHALL BE GIVEN THE OPPORTUNITY TO BE HEARD AT THE ANNUAL MEETING OR A SPECIAL MEETING CALLED FOR THAT PURPOSE. PAGE 12, PART XI, #9 RECONCILIATION OF NET ASSETS: TOTAL OTHER CHANGES IN NET ASSETS OR FUND BALANCES: CHANGE IN FV OF INTEREST RATE SWAP <$ 36,988.> CHANGE IN FV OF BENEFICIAL INTEREST $ 18,283. CONTRIBUTION TO THE BENEFICIAL INTEREST $ 1,157. TRANSFER TO AFFILIATE <$ 5,000.> ------------ $ 22,548. BRETHREN HOLDINGS LLC 725 COLUMBUS AVENUE FOSTORIA OH 44830 830995120 HOLDING OH 0 30002 GOOD SHEPH H GOOD SHEPHERD HOUSING CORPORATION 725 COLUMBUS AVENUE FOSTORIA OH 44830 203170750 HUD 202 OH 501(c)(3) 10 NA false WESLEY VILLAGE INC 725 COLUMBUS AVENUE FOSTORIA OH 44830 341211001 RENTAL HOUSIN OH 501(C)(3) 7 GOOD SHEPH H true SENIOR PHARMACY SERVICES LTD 5155 NORTH HIGH STREET COLUMBUS OH 43214 454618459 PHARMACY OH NA RELATED 69944 364012 false 0 false 0.16667 WESLEY COMMONS LLC 725 COLUMBUS AVENUE FOSTORIA OH 44830 311579725 RENTAL OH NA RELATED 31553 1369187 false 0 false 0.99949 false false false true false false false false false false false false false true true false true true false WESLEY VILLAGE INC 1Q 102012 FMV WESLEY COMMONS LLC 1D 150803 FMV