2016-11-11T12:30:53-06:00 2015-12-31 381357951 PLANTE & MORAN PLLC 1111 SUPERIOR AVE SUITE 1250 CLEVELAND OH 44114 990 2015-01-01 341931795 ROSARY CARE CENTER ROSA 4198243669 6832 CONVENT BLVD SYLVANIA OH 43560 JASON PHILLIPS CEO/ADMINISTRATOR 4198243669 2016-11-10 1 JEREMY S HERMAN P00745789 2165231010 2015 2017-02-10 21:41:12Z JASON PHILLIPS 6832 CONVENT BLVD SYLVANIA OH 43560 6053970 0 0928 X N/A X 2000 OH ROSARY CARE CENTER OPERATES A LICENSED NURSING FACILITY AND A LICENSED RESIDENTIAL CARE FACILITY PROVIDING CARE PRIMARILY TO MEMBERS OF RELIGIOUS ORDERS. BOTH THE NURSING FACILITY AND THE RESIDENTIAL CARE FACILITY ARE PRIMARILY 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 MEMBERS OF RELIGIOUS ORDERS 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. 6 5 158 40 0 0 3089415 963315 4693939 4963250 0 0 112526 127405 7895880 6053970 0 0 0 0 2969964 3165573 0 0 0 2504825 2591244 5474789 5756817 2421091 297153 8782527 6856707 4712191 4641407 4070336 2215300 X ROSARY CARE CENTER OPERATES A LICENSED NURSING FACILITY AND A LICENSED RESIDENTIAL CARE FACILITY PROVIDING CARE PRIMARILY TO MEMBERS OF RELIGIOUS ORDERS. BOTH THE NURSING FACILITY AND THE RESIDENTIAL CARE FACILITY ARE PRIMARILY 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 MEMBERS OF RELIGIOUS ORDERS 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 4549213 4963250 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. 119 INDIVIDUALS SERVED FOR A TOTAL OF 30,110 RESIDENTIAL DAYS OF CARE IN 2015. 4549213 1 1 0 0 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 0 0 0 0 0 1 1 1 0 0 1 15 0 1 158 1 0 0 0 0 0 0 0 0 0 0 0 X 6 5 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 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 GAYLE LAMPKOWSKI TREASURER 1.00 40.00 X X 0 176215 8713 SR THERESA DARGA TRUSTEE 1.00 40.00 X 0 0 0 SR PATRICIA GARDNER TRUSTEE 1.00 40.00 X 0 0 0 SR RACHEL NIJAKOWSKI TRUSTEE 1.00 40.00 X 0 61085 17428 JENI BELT TRUSTEE 1.00 1.00 X 0 0 0 0 237300 26141 0 0 1 0 CONCEPT REHAB 7150 GRANITE CIRCLE 3200 TOLEDO OH 43617 REHABILITATION SERVICES 340563 1 954406 8909 963315 COMMERCIAL/PRIVATE/OTH 623000 3077196 3077196 MEDICARE AND MEDICAID 623000 1886054 1886054 4963250 MEAL INCOME 623000 127405 127405 127405 6053970 4963250 0 127405 2484196 2157709 326487 498826 425090 73736 182551 154749 27802 95527 21706 73821 1547 1547 12700 12700 340563 340563 1498 1498 762121 654911 107210 52808 52808 621467 221696 399771 14677 6718 7959 71227 55948 15279 206036 161839 44197 64287 64287 Franchise taxes 334786 334786 Provision for Bad Debts 12000 12000 5756817 4549213 1207604 0 3039800 408833 484443 895973 27628 27628 162025 143248 5360455 1240806 4247719 4119649 219280 161967 601632 1099409 8782527 6856707 429696 469769 4175000 4060000 107495 111638 4712191 4641407 X 4070336 2215300 4070336 2215300 8782527 6856707 X 297153 -2152189 X 0 0 0 X 3089415 963315 4052730 4693939 4963250 9657189 7783354 5926565 13709919 0 128009 334543 462552 128009 334543 462552 13247367 112526 127405 239931 7895880 6053970 13949850 0.94960 0.96950 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4148921 377086 3771835 354300 190631 163669 857234 673089 184145 4119649 DUE FROM AFFILIATES 5747 DEFERRED FINANCING FEES 89546 CERTIFICATE OF NEED - NET OF AMORTIZATION 1004116 1099409 DUE TO AFFILIATES 57334 Cost settlements payable 54304 111638 0 0 0 0 0 0 0 0 0 GAYLE LAMPKOWSKI TREASURER 0 176215 0 0 0 0 0 6933 0 1780 0 184928 0 0 A CITY OF SYLVANIA OHIO HEALTH CARE REVENUE BONDS SERIES 2012 341931795 2012-03-28 4395000 CONSTRUCTION 0 0 0 A 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 1 1 0 0 0 0 A 0 Form 990, Part VI, Section A, line 3 THE BOARD CONTRACTS WITH A RELATED ENTITY TO OPERATE DAILY MANAGEMENT DUTIES, HOWEVER THE BOARD STILL MAINTAINS ULTIMATE OVERSIGHT OF ROSARY CARE CENTER. THE COMPENSATION PAID FOR MANAGEMENT DUTIES DURING 2015 TOTALED $ 95,527. 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 11 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 FRANCISCAN LIVING COMMUNITIES, THE MANAGEMENT COMPANY. FRANCISCAN 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, Part XI, line 9: EQUITY TRANSFER TO RELATED ORGANIZATION -2,152,189. FORM 990, SCHEDULE R, PART II THE RELATED TAX EXEMPT ORGANIZATIONS ARE ALL MEMBERS OF GROUP EXEMPTION # 0928. SYLVANIA FRANCISCAN MINISTRIES 6832 CONVENT BLVD SYLVANIA OH 43560 473544114 RELIGIOUS OH 501(C)(3) LINE 1 SISTERS OF ST FRANCIS OF SYLVANIA OHIO INC 1 0 0 1 0 0 0 0 0 0 0 1 0 1 0 1 1 0 0 1 SISTERS OF ST FRANCIS C 954406 ACTUAL AMOUNT RECEIVED SISTERS OF ST FRANCIS K 157800 ACTUAL AMOUNT PAID SISTERS OF ST FRANCIS P 383889 ACTUAL AMOUNT PAID SISTERS OF ST FRANCIS S 2152187 ACTUAL AMOUNT PAID FRANCISCAN LIVING COMMUNITIES M 95527 ACTUAL AMOUNT PAID