2014-11-17T15:36:58-06:00 2013-12-31 381357951 PLANTE & MORAN PLLC 65 EAST STATE ST STE 600 COLUMBUS OH 43215 990 2013-01-01 311510768 SARAH MOORE HEALTH CARE CENTER INC SARA 7403629641 26 N UNION STREET DELAWARE OH 43015 ROBERT B STILLMAN CURRENT CFO & TREASURER, OPRS 7403629641 2014-11-13 1 BERNIE OSTROWSKI P00366367 6148493000 2013 2015-11-30 17:44:51Z ROBERT B STILLMAN 1001 KINGSMILL PARKWAY COLUMBUS OH 43229 4984523 0 X SARAHMOOREHOME.COM X 1997 OH SARAH MOORE HEALTH CENTER, INC. OPERATES A 32 BED SKILLED NURSING HOME FACILITY AND A 44 BED ASSISTED LIVING FACILITY. 9 9 177 12 0 0 34641 3424 4716993 4464296 27370 143292 0 0 4779004 4611012 0 0 0 0 2701565 2530096 0 0 0 2257087 2380924 4958652 4911020 -179648 -300008 10897633 11723496 14961188 9247459 -4063555 2476037 SARAH MOORE IS COMMITTED TO PRESERVING THE DIGNITY AND PRIDE OF OUR RESIDENTS WHILE PROVIDING THEM WITH COMFORTABLE AND SAFE HOUSING WITH LOVING, PERSONAL CARE AND COMPASSION. 0 0 4333923 0 4550961 PROVIDED SKILLED CARE AND ASSISTED LIVING. 4333923 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 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 0 0 177 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 OH X ROBERT B STILLMAN 6148887800 1001 KINGSMILL PARKWAY COLUMBUS OH 43229 DEBORAH MARTIN CHAIRMAN 1.00 0.00 X X 0 0 0 TIM CHESSER VICE CHAIRMAN 1.00 0.00 X X 0 0 0 CHESTER HAMMOND BOARD TREASURER 1.00 0.00 X X 0 0 0 GERRY EDMONDS BOARD SECRETARY 1.00 0.00 X X 0 0 0 DON CHENOWETH BOARD MEMBER 1.00 0.00 X 0 0 0 BILL WILLIAMS BOARD MEMBER 1.00 0.00 X 0 0 0 MARY LOU WALDRON BOARD MEMBER 1.00 0.00 X 0 0 0 DARLENE BARNES BOARD MEMBER 1.00 0.00 X 0 0 0 MARILYN SHEETS BOARD MEMBER 1.00 0.00 X 0 0 0 TERRY HILL BOARD MEMBER (PART YEAR) 1.00 0.00 X 0 0 0 KATHIE WILL ADMINISTRATOR 50.00 10.00 X 138254 39088 0 138254 39088 0 1 0 1 0 FUNCTIONAL PATHWAYS 614 MABRY HOOD RD NW KNOXVILLE TN 37932 THERAPY 245169 1 3424 3424 NURSING HOME/ASSISTED 623000 4464296 4464296 4464296 56627 56627 460176 373511 86665 86665 86665 4611012 4550961 0 56627 138254 138254 2180912 1970835 210077 38775 38775 172155 172155 34658 34658 8840 8840 451298 451298 1698 1698 103576 103576 10540 10540 485801 485801 6673 6673 1581 1581 349670 349670 298389 298389 61200 61200 BAD DEBT 276519 276519 FOOD 122882 122882 MEDICAL SUPPLIES 89795 89795 REPAIRS & MAINTENANCE 77804 77804 4911020 4333923 577097 0 51300 138300 511087 582291 4915 4915 22603 9746 12317200 3218005 8350347 9099195 1799954 1726190 157427 162859 10897633 11723496 372687 435699 8006801 7850000 6581700 961760 14961188 9247459 X -4063555 2476037 -4063555 2476037 10897633 11723496 X -300008 152667 6686933 X 0 1 X 1 0 X 1143955 62185 6689 34641 3424 1250894 3474902 4350702 4668827 4716993 4464296 21675720 4618857 4412887 4675516 4751634 4467720 22926614 0 0 0 22926614 1635 28799 25876 18810 56627 131747 1635 28799 25876 18810 56627 131747 4620492 4441686 4701392 4770444 4524347 23058361 0.99430 0.99570 0.00570 0.00430 X 428317 428317 10612946 2306929 8306017 1102098 793593 308505 173839 117483 56356 9099195 INTEREST RATE SWAP LIABILITY 961760 961760 X PART X, LINE 2: NO PROVISION HAS BEEN MADE FOR INCOME TAXES SINCE THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER CODE SECTION 501(C)(3) AND IS CLASSIFIED AS OTHER THAN A PRIVATE FOUNDATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE ORGANIZATION, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2013, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE ORGANIZATION IS NOT CURRENTLY UNDER EXAMINATION BY THE INTERNAL REVENUE SERVICE OR ANY STATE OR LOCAL TAX AUTHORITIES. THE ORGANIZATION'S FEDERAL TAX RETURNS FOR THE YEARS ENDED PRIOR TO DECEMBER 31, 2010 ARE NO LONGER SUBJECT TO EXAMINATION. 0 0 0 0 0 0 0 0 0 KATHIE WILL ADMINISTRATOR 138254 39088 0 0 0 0 0 0 0 0 138254 39088 0 0 A COUNTY OF DELAWARE 316400065 245872AH9 2007-09-13 8905000 REFURBISH/ADD BEDS 0 0 0 A 8905000 203000 5649000 2009 1 0 1 1 A 0 0 0 0 0 0 1 A 0 0 0 0 1 1 0 0 0 0 0 A 1 FORM 990, PART VI, SECTION B, LINE 11 ON AUGUST 21, 2014, THE REPORTING ORGANIZATION HAD BEEN ACQUIRED BY OPRS COMMUNITIES AND THE BOARD OF THE REPORTING ENTITY HAD BEEN DISSOLVED. HOWEVER THE FORM 990 WAS REVIEWED BY THE CFO/TREASURER OF OPRS COMMUNITIES. OPRS COMMUNITIES HAS IMPLEMENTED A PROCESS, GOING FORWARD, WHICH INCLUDES A DETAIL REVIEW OF THE FORM 990 BY A DESIGNATED BOARD MEMBER, AND THEN THE RELEASE OF THE FORM 990 TO THE OPRS COMMUNITIES BOARD FOR THEIR REVIEW. THE CEO AND CFO OF OPRS COMMUNITIES HAS APPROVED THIS PROCESS. FORM 990, PART VI, SECTION B, LINE 12C IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, ALL INTERESTED PERSONS (DIRECTOR, OFFICER, ETC.) MUST DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST/CONFLICT AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST/CONFLICT AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. IN ADDITION, EACH INTERESTED PERSON SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS READ, UNDERSTANDS, AND IS IN COMPLIANCE WITH THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 ALTHOUGH A POLICY IS NOT YET IN PLACE FOR THE REVIEW OF OFFICER COMPENSATION, THE BOARD HAS BEEN INFORMED OF SUCH PRACTICES AND IS WORKING TOWARDS DEVELOPING A POLICY, WHICH WOULD INCLUDE INDEPENDENT APPROVAL, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DECISION-MAKING PROCESS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF SWAP AGREEMENT 946,902. TRANSFER OF NET ASSETS FROM SARAH MOORE HOME 5,740,031. SARAH MOORE HOME INC 47 EAST WILLIAMS ST DELAWARE OH 43015 314379575 ASSISTED LIVING OH 501(C)(3) 509(A)(1) SARAH MOORE HEALTH CARE CENTER INC 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 SARAH MOORE HOME INC S 5866313 BOOK VALUE