2025-11-12T13:48:23-06:00 2024-12-31 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2024-01-01 341193296 OTTERBEIN PORTAGE VALLEY INC OTTE 4198337000 20311 PEMBERVILLE ROAD PEMBERVILLE OH 43450 J CHRISTOPHER GREEN CFO 5139335400 2025-11-12 1 0 AMBER HAMILTON P01251012 3149254300 2025-11-12 2024 2025-03-06 01:10:19Z J CHRISTOPHER GREEN 3855 LOWER MARKET STREET SUITE 300 LEBANON OH 45036 21885807 0 X OTTERBEIN.ORG/FIND-A-LOCATION/PEMBERVILLE X 1975 OH CONTINUING CARE RETIREMENT COMMUNITY THAT PROVIDES HOUSING AND SERVICES FOR OLDER ADULTS. 11 8 342 61 0 0 437275 79535 13728719 14910611 232873 565519 236099 379244 14634966 15934909 0 0 0 0 5850600 6033892 0 0 0 8633709 9794392 14484309 15828284 150657 106625 46614785 48334262 30077783 30824231 16537002 17510031 INSPIRED BY FAITH, WE STRIVE TO ENRICH INDIVIDUAL LIFE JOURNEYS FOR ALL. 0 0 13686316 0 15740666 OTTERBEIN PORTAGE VALLEY, INC. PROVIDES A CONTINUUM OF CARE INCLUDINGINDEPENDENT LIVING, ASSISTED LIVING, NURSING CARE, AND DEMENTIA CARE.REHABILITATION, SOCIAL SERVICES AND CHAPLAINCY SERVICES ARE AVAILABLETO ALL RESIDENTS.LOCAL GROUPS SUCH AS THE VETERANS, CHURCH CIRCLES, COMMUNITY CIVICGROUPS AND A HOST OF OTHERS USE OTTERBEIN AS A MEETING PLACE. INADDITION OTTERBEIN PROVIDES SPECIAL PROGRAMS AND EVENTS FOR THECOMMUNITY ON AN ONGOING BASIS. 0 0 0 GENEROUS DONORS HAVE ESTABLISHED A BENEVOLENT CARE FUND WHICH OFFERS ASSISTANCE TO RESIDENTS WHO CANNOT PAY THE FULL COST OF CARE. OTTERBEIN'S RICH HERITAGE HAS EARNED US A SOLID REPUTATION AS A TRUSTED AND VALUABLE RESOURCE. BY PROVIDING INFORMATION AND SERVICES ON AGING ISSUES WE CONTINUE TO SERVE RESIDENTS, THEIR FAMILIES, AND THE SURROUNDING COMMUNITIES. OTTERBEIN RESIDENTS AND STAFF VOLUNTEER THEIR TIME AND TALENTS AT OTTERBEIN PORTAGE VALLEY RETIREMENT LIVING COMMUNITY BUT ALSO FOR A NUMBER OF ORGANIZATIONS AND CAUSES IN THE GREATER COMMUNITY. 0 0 -830055 THE ORGANIZATION PROVIDES NURSING CARE TO RESIDENTS UNDER THE MEDICAID PROGRAM FOR WHICH THE COSTS TO PROVIDE SUCH CARE EXCEEDS REIMBURSEMENT. THE ORGANIZATION FUNDS THIS DIFFERENCE THROUGH ITS OPERATIONS. THE SHORTFALL IS NETTED WITH PROGRAM SERVICE REVENUE. 13686316 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 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 X 0 0 342 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X J CHRISTOPHER GREEN 5139335400 3855 LOWER MARKET STREET SUITE 300 LEBANON OH 45036 DANIEL BARBEE VICE CHAIR 1.00 0.00 X X 0 0 0 JAMES C GREEN CFO/TREASURER 2.00 38.00 X X 0 437456 24430 JASON MILLER VP SR - LSC 2.00 38.00 X X 0 484061 26770 JILL WILSON PRESIDENT/CEO 2.00 38.00 X X 0 725335 22531 JUDY BENEDICT DIRECTOR 1.00 0.00 X 0 0 0 SUE DONALDSON RESIDENT DIRECTOR (TERM ENDED) 1.00 0.00 X 0 0 0 KATIE MCKIBBEN SECRETARY 1.00 0.00 X X 0 0 0 MARILYN BOWLUS DIRECTOR 1.00 0.00 X 0 0 0 MIKE GODFREY DIRECTOR 1.00 0.00 X 0 0 0 NORRIS HINDS RESIDENT DIRECTOR 1.00 0.00 X 0 0 0 TOM KYLLO CHAIR 1.00 0.00 X X 0 0 0 WILLIAM BROWNSON BOARD CHAIR OF OTTERBEIN 1.00 8.00 X 0 0 0 JESSICA KIRKENDALL EXECUTIVE DIRECTOR 40.00 0.00 X 135155 0 3713 CATHERINE CHIOVARO VP - WORKFORCE MANAGEMENT 2.00 38.00 X 0 366772 25912 DANIEL ARNOLD VP - NEIGHBORHOODS 2.00 38.00 X 0 253155 23475 GARY HORNING VP - MKTG - COMMUNICATIONS 2.00 38.00 X 0 293395 24644 MARY SIMPSON VP - CLINICAL QUALITY 2.00 38.00 X 0 289427 50010 PAMELA RICHMOND VP CHIEF STRATEGY/DEV 2.00 38.00 X 0 340696 43791 135155 3190297 245276 2 0 1 0 0 75 79460 79535 RESIDENTIAL REVENUE & FEES 623000 14903690 14903690 DEPARTMENTAL REVENUE 623000 6921 6921 14910611 417305 417305 1217 1217 6096172 5949175 146997 146997 146997 195 1723 -1528 -1528 DIETARY 623000 199623 199623 MISCELLANEOUS 623000 82510 82510 UTILITIES 623000 27812 27812 70827 70827 380772 15934909 14910611 0 944763 138868 138868 4638391 4417696 220695 912922 844211 68711 343711 317841 25870 3842 3842 11825 11825 49040 49040 1472122 1446339 25783 371750 371750 1529178 1475077 54101 152868 8740 144128 1188969 1158934 30035 47561 42720 4841 995764 970610 25154 1847105 1800445 46660 224211 218547 5664 CORPORATE SERVICE FEES 878484 878484 REFUNDABLE LIFE USE FEE 649882 649882 BED DEBT 159724 159724 UNRECOVERED COST BASIS 76742 74803 1939 135325 100747 34578 15828284 13686316 2141968 0 20969 28146 967555 1253245 31969 31969 59918 79981 49776657 22424478 27960395 27352179 17439718 19472010 51000 51000 83261 65732 46614785 48334262 1011759 1515021 619676 507975 11919400 18918568 20969 28147 16505979 9854520 30077783 30824231 X 15986888 16940022 550114 570009 16537002 17510031 46614785 48334262 X 106625 838954 27450 X X 0 1 X 1 0 X 55583 479485 414688 437275 79535 1466566 10424243 10753267 12278864 13728719 14910611 62095704 1038 215099 177177 226277 298262 917853 10480864 11447851 12870729 14392271 15288408 64480123 54824 130142 61029 68369 71445 385809 0 54824 130142 61029 68369 71445 385809 64094314 397548 398785 236782 351700 418522 1803337 397548 398785 236782 351700 418522 1803337 214968 39398 56877 12497 82510 406250 11093380 11886034 13164388 14756468 15789440 66689710 0.96110 0.95130 0.02700 0.02920 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: BEAUTY AND BARBER - 2020 AMOUNT: $ 7,503. HOUSEKEEPING - 2020 AMOUNT: $ -19. MISC - 2020 AMOUNT: $ 47,476. 2021 AMOUNT: $ 39,398. 2022 AMOUNT: $ 56,877. 2023 AMOUNT: $ 12,497. 2024 AMOUNT: $ 82,510. DIETARY - 2020 AMOUNT: $ 148,148. PLANT GROUNDS MAINT - 2020 AMOUNT: $ 11,860. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 151422 151422 39675608 15884227 23791381 2564442 2124973 439469 6992196 4415278 2576918 392989 392989 27352179 REFUNDABLE ADVANCE DEPOSITS 7556967 SPLIT INTEREST AGREEMENT 73661 INTERCOMPANY PAYABLE 2155194 OPERATING LEASE LIABILITY 68698 9854520 X PART IV, LINE 2B: RESIDENT FUNDS ARE DEPOSITS HELD UNDER A FIDUCIARY RESPONSIBILITY AND ARE REQUIRED BY STATE REGULATION. PART X, LINE 2: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE CONSOLIDATED FINANCIAL STATEMENTS. 0 1 0 0 0 0 0 0 0 JILL WILSON PRESIDENT/CEO 0 482796 0 123797 0 118742 0 19450 0 3081 0 747866 0 0 JASON MILLER VP SR - LSC 0 358556 0 58834 0 66671 0 12369 0 14401 0 510831 0 0 JAMES C GREEN CFO/TREASURER 0 324852 0 50849 0 61755 0 13264 0 11166 0 461886 0 0 CATHERINE CHIOVARO VP - WORKFORCE MANAGEMENT 0 287034 0 79738 0 0 0 11511 0 14401 0 392684 0 0 PAMELA RICHMOND VP CHIEF STRATEGY/DEV 0 291357 0 46863 0 2476 0 29390 0 14401 0 384487 0 0 MARY SIMPSON VP - CLINICAL QUALITY 0 246114 0 41072 0 2241 0 35609 0 14401 0 339437 0 0 GARY HORNING VP - MKTG - COMMUNICATIONS 0 248199 0 41321 0 3875 0 10243 0 14401 0 318039 0 0 DANIEL ARNOLD VP - NEIGHBORHOODS 0 220328 0 31677 0 1150 0 9074 0 14401 0 276630 0 0 PART I, LINE 3 THE PARENT ORGANIZATION, OTTERBEIN HOMES INC., USES THE FOLLOWING METHODS TO ESTABLISH COMPENSATION FOR THE CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B 457(F) CONTRIBUTIONS: JILL WILSON - $118,300 JASON MILLER $65,358.75 CHRIS GREEN $58,766 PAMELA RICHMOND $22,207.52 MARY SIMPSON $25,445.78 FROM 990, PAGE 5, PART V, LINE 1A THE PARENT COMPANY, OTTERBEIN HOMES, (FEIN 31-0549058) PROCESSES ACCOUNTS PAYABLE PAYMENTS FOR ALL RELATED ENTITIES. AS A RESULT, THE ORGANIZATION IS UNABLE TO DETERMINE THE NUMBER OF 1099S NOR INDEPENDENT CONTRACTORS PAID OVER $100K FOR SERVICES BY ENTITY. AS A RESULT, ALL 1099S AND INDEPENDENT CONTRACTORS PAID OVER $100K ARE ISSUED AND REPORTED OUT OF THE PARENT COMPANY. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE IS AUTHORIZED TO ACT FOR THE BOARD OF DIRECTORS BETWEEN REGULAR AND/OR CALLED SESSIONS OF THE BOARD. THE EXECUTIVE COMMITTEE HAS AUTHORITY TO MAKE ALL DECISIONS WITHOUT HAVING TO WAIT AND BRING THE ACTION TO THE FULL BOARD. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS OTTERBEIN LSC, LLC. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OF THE BOARD OF DIRECTORS SHALL BE ELECTED BY THE MEMBER OF THE CORPORATION UPON NOMINATION BY THE CORPORATION'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING CORPORATE POWERS AND ACTIONS MAY ONLY BE TAKEN WITH THE APPROVAL OF THE MEMBER AFTER GIVING CONSIDERATION TO THE CONCERNS OF THE BOARD OF DIRECTORS: 1. THE DETERMINATION AND ADOPTION OF THE CORPORATION'S ANNUAL OPERATING AND CAPITAL BUDGETS. 2. THE EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF $25,000 3. DETERMINING CORPORATION ADMINISTRATIVE AND OPERATING STAFF COMPENSATION AND BENEFITS. 4. DETERMINING ALL BUILDING PROGRAMS AND THE MAKING OF CERTIFICATE OF NEED APPLICATIONS 5. DETERMINING TO ADD OR TERMINATE ANY SERVICES 6. THE EXECUTION OF ANY CONTRACT OR AGREEMENT FOR FINANCIAL COMMITMENTS IN EXCESS OF THAT APPROVED IN THE ANNUAL BUDGET 7. THE APPOINTMENT OF AUDITORS AND LEGAL COUNSEL 8. EMPLOYING, EVALUATING, DISCIPLINING OR DISCHARGING THE PRESIDENT AND/OR TREASURER OF THE CORPORATION 9. THE ADOPTION OF LONG-RANGE PLANS AND MANAGEMENT OBJECTIVES, INCLUDING THE EXECUTION OF ANY AGREEMENT WITH CONSORTIUMS, ALLIANCES OR OTHER ORGANIZATIONS. 10. TAKING MEMBERSHIP IN OR JOINING ANY ORGANIZATION 11. THE SALE, LEASE, MORTGAGING, ENCUMBERING. LEASE OR OTHER DISPOSITION OF ANY REAL PROPERTY OR ANY PERSONAL PROPERTY OF A VALUE IN EXCESS OF $10,000 12. THE MANAGEMENT AND ADMINISTRATION OF ALL LEGAL MATTERS INVOLVING THE CORPORATION 13. THE MANAGEMENT AND ADMINISTRATION OF ALL INSURANCE FOR THE CORPORATION 14. THE ESTABLISHMENT OF UNIFORM EMPLOYMENT PRACTICES AND POLICIES 15. THE DEVELOPMENT AND IMPLEMENTATION OF MARKETING, PUBLIC RELATIONS AND FUNDRAISING EFFORTS ON BEHALF OF THE CORPORATION WITHOUT PRIOR NOTIFICATION TO AND APPROVAL FROM AN OFFICER OF THE MEMBER UNLESS APPROVED IN THE ANNUAL BUDGET 16. THE ASSUMPTION OR ISSUANCE OF ANY LONG-TERM OR SHORT-TERM DEBT IN EXCESS OF AN AMOUNT DETERMINED FROM TIME TO TIME BY THE MEMBER 17. THE APPROVAL OF ANY VOLUNTARY MERGER OR CONSOLIDATION OF THE CORPORATION OF THE SALE, ASSIGNMENT, MORTGAGING, ENCUMBERING, PLEDGING, LEASING OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR THE TRANSFER OF CONTROL OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM IS PROVIDED AND REVIEWED BY THE CHIEF FINANACIAL OFFICER BEFORE THE FORM IS FILED. A COMPLETE COPY OF THE 990 IS ALSO PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C IN ACCORDANCE WITH THE BY-LAWS, ANY POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY BOARD MEMBER, CORPORATE EXECUTIVE, EXECUTIVE DIRECTOR, OR ADMINISTRATIVE STAFF MEMBER, OR COMMITTEE MEMBERS, WHO ARE NOT MEMBERS OF THE BOARD OF TRUSTEES OF OTTERBEIN HOMES SHALL BE DISCLOSED TO THE BOARD AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST BECOMES RELEVANT TO A MATTER OF BOARD ACTION. FORM 990, PART VI, SECTION B, LINE 15A THE INDEPENDENT EXECUTIVE COMMITTEE OF THE OTTERBEIN HOMES BOARD OF TRUSTEES HAS THE RESPONSIBILITY FOR DETERMINING THE ANNUAL COMPENSATION FOR THE OFFICERS BY THE USE OF INDUSTRY SPECIFIC DATA SUCH AS SALARY SURVEYS FROM LEADING AGE AND LEADING AGE OHIO. THE SALARIES OF THE KEY EMPLOYEES ARE DETERMINED BY THE OFFICERS USING INDUSTRY COMPARATIVE DATA SUCH AS SALARY SURVEYS FROM LEADING AGE AND LEADING AGE OHIO. THE DELIBERATIONS AND DECISIONS REGARDING COMPENSATION ARE DOCUMENTED. THIS PROCESS WAS LAST PERFORMED IN 2024. FORM 990, PART VI, SECTION C, LINE 19 THE ANNUAL REPORT IS PROVIDED TO THE PUBLIC WHICH INCLUDES THE AUDITED FINANCIAL STATEMENT SUMMARY. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENT -13,769. CHANGE IN MINIMUM PENSION LIABILITY 41,219. FORM 990, PAGE 12, PART XII, LINE 2C THERE HAS BEEN NO CHANGE TO THE SELECTION OR OVERSIGHT PROCESS. FORM 990, PART X, PAGE 11, LINE 20 - TAX EXEMPT BOND LIABILITIES THE PARENT COMPANY, OTTERBEIN HOMES, HAS ALLOCATED A PORTION OF THE TAX EXEMPT BONDS THAT WERE ISSUED TO THE PARENT COMPANY. THE DETAILS OF THE TAX EXEMPT BONDS ISSUED TO OTTERBEIN HOMES ARE CONTAINED ON THE SCHEDULE K THAT IS FILED WITH THE FORM 990 FOR THE PARENT COMPANY (FEIN 31-0549058). THERE IS NO SCHEDULE K FOR THIS TAX RETURN. THIS TREATMENT IS CONSISTENT WITH PRIOR YEARS. OTTERBEIN PORTAGE VALLEY LLC 3855 LOWER MARKET STREET SUITE 300 LEBANON OH 45036 270512972 REAL ESTATE HOLDING COMPANY OH 151422 OTTERBEIN PORTAGE VALLEY OTTERBEIN HOMES 3855 LOWER MARKET STREET SUITE 300 LEBANON OH 45036 310549058 PARENT - RETIREMENT LIVING COMMUNITIES OH 501(C)(3) LINE 10 N/A 0 OTTERBEIN AT GRANVILLE 2158 COLUMBUS ROAD GRANVILLE OH 43023 311657346 RETIREMENT LIVING COMMUNITY OH 501(C)(3) LINE 10 OTTERBEIN HOMES 0 OTTERBEIN LEBANON 585 NORTH STATE ROUTE 741 LEBANON OH 45036 311743874 RETIREMENT LIVING COMMUNITY OH 501(C)(3) LINE 10 OTTERBEIN HOMES 0 THE FRANKLIN UNITED METHODIST HOME INC 1070 WEST JEFFERSON STREET FRANKLIN IN 46131 350988712 RETIREMENT LIVING COMMUNITY IN 501(C)(3) LINE 10 OTTERBEIN HOMES 0 NORTH SHORE RETIREMENT COMMUNITY 9400 NORTHSHORE BLVD LAKESIDE OH 43440 341743836 RETIREMENT LIVING COMMUNITY OH 501(C)(3) LINE 10 OTTERBEIN HOMES 0 OTTERBEIN ST MARYS 11230 STATE ROUTE 364 ST MARYS OH 45885 341940880 RETIREMENT LIVING COMMUNITY OH 501(C)(3) LINE 10 OTTERBEIN HOMES 0 OTTERBEIN CRIDERSVILLE 100 RED OAK DRIVE CRIDERSVILLE OH 45806 341940884 RETIREMENT LIVING COMMUNITY OH 501(C)(3) LINE 10 OTTERBEIN HOMES 0 SUNSET RETIREMENT COMMUNITIES INC 4040 INDIAN ROAD TOLEDO OH 43606 344428230 RETIREMENT LIVING COMMUNITY OH 501(C)(3) LINE 10 OTTERBEIN HOMES 0 OTTERBEIN GREEN HILLS INC 6557 US HIGHWAY 68 S WEST LIBERTY OH 43357 341137582 RETIREMENT LIVING COMMUNITY OH 501(C)(3) LINE 10 OTTERBEIN HOMES 0 WEST LIBERTY GARDEN APARTMENTS INC 6557 US HIGHWAY 68 S WEST LIBERTY OH 43357 341325781 SUPPORTING ORGANIZATION OH 501(C)(3) LINE 12B, II OTTERBEIN HOMES 0 WEST LIBERTY HOMES INC 6557 US HIGHWAY 68 S WEST LIBERTY OH 43357 346708015 RETIREMENT LIVING COMMUNITY OH 501(C)(3) LINE 10 OTTERBEIN HOMES 0 OTTERBEIN GREEN HILLS FOUNDATION INC 6557 US HIGHWAY 68 S WEST LIBERTY OH 43357 272566073 SUPPORTING ORGANIZATION OH 501(C)(3) LINE 12B, II OTTERBEIN HOMES 0 0 0 0 0 1 0 0 0 0 0 0 1 0 1 1 1 0 0 0