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OTTERBEIN NORTH SHORE: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
OTTERBEIN NORTH SHORE (EIN 34-1743836)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-14
IRS object ID
201333189349306063
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-14T15:46:19-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN410746749EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11 BRONZE POINTEAddressLine1
CityBELLEVILLECity
StateILState
ZIP Code62226ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN341743836EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1NORTH SHORE RETIREMENT COMMUNITYBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlNORTNameControl
Phone4197988203Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line19400 NORTH SHORE BLVDAddressLine1
CityLAKESIDECity
StateOHState
ZIP Code43440ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJ CHRISTOPHER GREENName
TitleCFOTitle
Phone4197988203Phone
Date Signed2013-11-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameCHAD KUNZEName
PTINP00639380PTIN
Phone6182331200Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJ CHRISTOPHER GREENNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1580 N SR 741AddressLine1
CityLEBANONCity
StateOHState
ZIP Code45036ZIPCode
FieldValueIRS element (for citing)
Gross Receipts4406029GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.OTTERBEIN.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1993YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionOTTERBEIN NORTH SHORE IS A CONTIUING CARE RETIREMENT COMMUNITY THAT PROVIDES HOUSING AND SERVICES FOR OLDER ADULTS. GENEROUS DONATIONS HAVE ESTABLISHED A BENEVOLENT CARE FUND WICH OFFERS ASSISTANCE TO RESIDENTS WHO CANNOT PAY THE FULL COST OF CARE. OTTERBEIN'S RICH HERITAGE HAS EARNED A SOLID REPUTATION AS A TRUSTED AND VALUABLE RESOURCE. BY PROVIDING INFOMRATION 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 TO OTTERBEIN NORTH SHORE RETIREMENT LIVING COMMUNITY BUT ALSO FOR A NUMBER OF ORGANIZATIONS AND CAUSES IN THE GREATER COMMUNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members19NbrIndependentVotingMembers
Total Nbr Employees86TotalNbrEmployees
Total Nbr Volunteers15TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year88703ContributionsGrantsPriorYear
Contributions Grants Current Year193936ContributionsGrantsCurrentYear
Program Service Revenue Prior Year4031329ProgramServiceRevenuePriorYear
Program Service Revenue CY4170597ProgramServiceRevenueCY
Investment Income Prior Year94016InvestmentIncomePriorYear
Investment Income Current Year41496InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year4214048TotalRevenuePriorYear
Total Revenue Current Year4406029TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year1587940SalariesEtcPriorYear
Salaries Etc Current Year1648356SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2574530OtherExpensePriorYear
Other Expenses Current Year2614469OtherExpensesCurrentYear
Total Expenses Prior Year4162470TotalExpensesPriorYear
Total Expenses Current Year4262825TotalExpensesCurrentYear
Revenues Less Expenses Prior Year51578RevenuesLessExpensesPriorYear
Revenues Less Expenses CY143204RevenuesLessExpensesCY
Total Assets BOY10392235TotalAssetsBOY
Total Assets EOY10742217TotalAssetsEOY
Total Liabilities BOY10005777TotalLiabilitiesBOY
Total Liabilities EOY10078310TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY386458NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY663907NetAssetsOrFundBalancesEOY
Mission DescriptionOUR MISSION - IN KEEPING WITH OUR UNITED METHODIST TRADITION WE SEEK TO ENHANCE THE QUALITY OF LIFE AND HOLISTIC GROWTH OF OLDER PERSONS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense3322462Expense
Revenue4170597Revenue
DescriptionOTTERBEIN NORTH SHORE PROVIDES A CONTINUUM OF CARE INCLUDING INDEPENDENT LIVING, ASSISTED LIVING, NURSING CARE, AND DEMENTIA CARE.REHABILITATION, SOCIAL SERVICES AND CHAPLAINCY SERVICES ARE AVAILABLE TO ALL RESIDENTS.LOCAL GROUPS SUCH AS THE VETERANS, CHURCH CIRCLES, COMMUNITY CIVIC GROUPS AND A HOST OF OTHERS USE OTTERBEIN AS A MEETING PLACE. IN ADDITION OTTERBEIN PROVIDES SPECIAL PROGRAMS AND EVENTS FOR THE COMMUNITY ON AN ONGOING BASIS.Description
Total Program Service Expense3322462TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109618NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees86NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members19NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledOHStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJ CHRISTOPHER GREENNamePerson
Telephone Number5139335400TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1580 NORTH SR 741AddressLine1
CityLEBANONCity
StateOHState
ZIP Code450368839ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per Week RelatedAverageHoursPerWeekRelatedOfficerOfficer
LYNN APP
DIRECTOR1.00X000
NEIL ALLEN
DIRECTOR1.00X000
CAROL EVERSON
DIRECTOR1.00X000
REV BRUCE BATCHELOR-GLADER
DIRECTOR (EX-OFFICIO)1.00X000
JAMES STOUFFER JR
DIRECTOR1.00X000
MILLARD MEAD
HONORARY BOARD MEMBER (NON-VOTING)1.00X000
DAVE GLASMIRE
RESIDENT RESPRESENTATIVE1.00X000
DICK HARTLEY
RESIDENT REPRESENTATIVE1.00X000
DON YAUSSY
RESIDENT REPRESENTATIVE1.00X000
HELEN ROFKAR
COMMITTEE MEMBER1.00X000
TIM TAYLOR
COMMITTEE MEMBER1.00X000
PHYLLIS LANE
COMMITTEE MEMBER1.00X000
MARY COFFEE
COMMITTEE MEMBER1.00X000
BARBARA STEPHENS-RICH
COMMITTEE MEMBER1.00X000
BETH MCKEE
COMMITTEE MEMBER1.00X000
BUD COX
COMMITTEE MEMBER1.00X000
JOHN ENGLEBECK
COMMITTEE MEMBER1.00X000
REV JUDY CLAYCOMB
COMMITTEE MEMBER (EX-OFFICIO)1.00X000
CAROL MORGAN
COMMITTEE MEMBER1.00X000
BOB METHENY
COMMITTEE MEMBER1.00X000
JILL HREBEN
PRESIDENT/CEO2.0003241031933738.00X
JAMES CHRIS GREEN
VP FINANCE/CFO2.000226879960238.00X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs550982TotalReportableCompFrmRltdOrgs
Total Other Compensation28939TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CONCEPT REHAB
7150 GRANITE CIRCLE SUITE 200TOLEDOOH43617THERAPY SERVICES255784
RICHARD R KNEISLEY
345 NORTH POPLAR STREETPORT CLINTONOH43452CONSTRUCTION SERVICES134125
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
All Other Contributions193936AllOtherContributions
Noncash Contributions40671NoncashContributions
Total Contributions193936TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
RESIDENTIAL SERVICE FE62300040675034067503
DEPARTMENTAL REVENUE623000103094103094
FieldValueIRS element (for citing)
Total Program Service Revenue4170597TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column39700TotalRevenueColumn
Exclusion$39,700ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other1796Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other1796Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1796TotalRevenueColumn
Exclusion$1,796ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column4406029TotalRevenueColumn
Related Or Exempt Function Income4170597RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$41,496ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1292097Total
Program Services1076769ProgramServices
Management And General215328ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total74844Total
Program Services62371ProgramServices
Management And General12473ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total176964Total
Program Services147473ProgramServices
Management And General29491ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total104451Total
Program Services87044ProgramServices
Management And General17407ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total668Total
Management And General668ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total8390Total
Management And General8390ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total539961Total
Program Services472424ProgramServices
Management And General67537ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total262380Total
Program Services251659ProgramServices
Management And General10721ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total6458Total
Program Services5382ProgramServices
Management And General1076ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total265904Total
Program Services255039ProgramServices
Management And General10865ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total429882Total
Program Services412317ProgramServices
Management And General17565ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total29922Total
Program Services28699ProgramServices
Management And General1223ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
NURSE AGENCY FEES279915279915
CORPORATE SERVICE FEES265861265861
REFUNDABLE LIFE USE FEE232195232195
OTHER ADMINISTRATION106743106743

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total186190Total
Program Services11175ProgramServices
Management And General175015ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total4262825Total
Program Services3322462ProgramServices
Management And General940363ManagementAndGeneral
Fundraising0Fundraising

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY301820BOY
EOY378941EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2218BOY
EOY6222EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY21382BOY
EOY15439EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis13800081LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec5053114LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY8832362BOY
EOY8746967EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY1294471EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY929064BOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY305389BOY
EOY300177EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY10392235BOY
EOY10742217EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY751455BOY
EOY787770EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY1242045BOY
EOY1392516EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY6627638BOY
EOY6155218EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1384639BOY
EOY1742806EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY10005777BOY
EOY10078310EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-3667399BOY
EOY467223EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY4047132BOY
EOY164976EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY6725BOY
EOY31708EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY386458BOY
EOY663907EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY10392235BOY
EOY10742217EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses143204ReconcilationRevenueExpenses
Reconciliation Unrealized Invest72095ReconciliationUnrealizedInvest
Reconcilation Other Changes62150ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years56758CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years120798CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years107932CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year88703CurrentTaxYearMinus1Year
Current Tax Year193936CurrentTaxYear
Total568127Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3696774CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3868134CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3700932CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4031329CurrentTaxYearMinus1Year
Current Tax Year4170597CurrentTaxYear
Total19467766Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3753532CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3988932CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3808864CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4120032CurrentTaxYearMinus1Year
Current Tax Year4364533CurrentTaxYear
Total20035893Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3510CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years41015CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1263CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1175CurrentTaxYearMinus1Year
Current Tax Year45606CurrentTaxYear
Total92569Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3510CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years41015CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1263CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1175CurrentTaxYearMinus1Year
Current Tax Year45606CurrentTaxYear
Total92569Total
FieldValueIRS element (for citing)
Public Support Total50919943324PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years-3845CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8031CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years71000CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year93966CurrentTaxYearMinus1Year
Current Tax Year39700CurrentTaxYear
Total208852Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years-3845CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8031CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years71000CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year93966CurrentTaxYearMinus1Year
Current Tax Year39700CurrentTaxYear
Total208852Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years46196CurrentTaxYearMinus3Years
Total46196Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3749687CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4043159CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3879864CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4213998CurrentTaxYearMinus1Year
Current Tax Year4404233CurrentTaxYear
Total20290941Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98290PublicSupportPercentage509
Prior Year Support Percentage0.97810PriorYearSupportPercentage
Investment Income Percentage0.01030InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.01520PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis574075OtherCostOrOtherBasis
Book Value574075BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis11575888OtherCostOrOtherBasis
Depreciation3948408Depreciation
Book Value7627480BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1449814OtherCostOrOtherBasis
Depreciation990000Depreciation
Book Value459814BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis200304OtherCostOrOtherBasis
Depreciation114706Depreciation
Book Value85598BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings8746967TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
REFUNDABLE PORTION OF REFUNDABLE LIFE USE FEES$225,875
SPLIT-INTEREST AGREEMENT$54,146
DEFERRED COST OF INTEREST RATE SWAP$248,783
INTERCOMPANY PAYABLE$1,214,002
FieldValueIRS element (for citing)
Total Of Amounts1742806TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X, LINE 2:ReturnReference
ExplanationTHE ORGANIZATIONS, EXCEPT FOR OTTERBEIN SERVICE CORPORATION, QUALIFY AS TAX-EXEMPT CORPORATIONS DESCRIBED IN SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THE ORGANIZATIONS ARE NOT SUBJECT TO FEDERAL INCOME TAXES UNDER SECTION 501 (C)(3) OF THE CODE. THE ORGANIZATIONS ARE CLASSIFIED AS PUBLICLY SUPPORTED CHARITABLE ORGANIZATIONS UNDER THE CODE AND CONTRIBUTIONS TO THE ORGANIZATIONS QUALIFY AS CHARITABLE TAX DEDUCTIONS FOR THE CONTRIBUTOR. THE ENTITY FILES AS A TAX-EXEMPT ORGANIZATION. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, ALL YEARS SINCE INCEPTION COULD BE SUBJECT TO REVIEW BY THE IRS. THE ORGANIZATIONS' 2011, 2010, AND 2009 TAX YEARS ARE OPEN FOR EXAMINATION BY THE IRS. OTTERBEIN SERVICE CORPORATION IS AN INACTIVE FOR-PROFIT CORPORATION, AND IS LIABLE FOR INCOME TAXES ON ITS TAXABLE INCOME.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
JILL HREBEN
PRESIDENT/CEO0324103000000019337034344000
JAMES CHRIS GREEN
VP FINANCE/CFO022687900000009602023648100

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTraded

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F99040671NoncashContribsRptdF990
Method Of Determining RevenuesMARKET VALUEMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Number Of8283 Received1NumberOf8283Received
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11THE FORM IS PROVIDED TO AND REVIEWED BY THE CHIEF FINANCIAL OFFICER DEFORE IT 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 12CIN 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 THE ANNUAL PROCEDURE OR WHEN THE INTEREST BECOMES RELEVANT TO A MATTER OF BOARD ACTION.
FORM 990, PART VI, SECTION B, LINE 15THE 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.
FORM 990, PART VI, SECTION C, LINE 18UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19UPON REQUEST.
FORM 990, PART XI, LINE 9:CHANGE IN FAIR VALUE OF SPLIT INTEREST AGREEMENT -24,470. RELATED PARTY TRANSFERS OF UNRESTRICTED NET ASSETS 52,546. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 81,502. CHANGE IN MINIMUM PENSION LIABILITY -47,428.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2CTHERE HAVE BEEN NO CHANGES IN THE OVERSIGHT OR THE SELECTION OF AN INDEPENDENT ACCOUTANT FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
OTTERBEIN HOMES
580 NORTH STATE ROUTE 741LEBANONOH45036310549058PARENTOH501(C)(3)LINE 9N/A0
OTTERBEIN CRIDERSVILLE
100 RED OAK DRIVECRIDERSVILLEOH45806341940884RETIREMENT LIVING COMMUNITYOH501(C)(3)LINE 9N/A0
OTTERBEIN PORTAGE VALLEY
20311 PEMBERVILLE ROADPEMBERVILLEOH43450341193296RETIREMENT LIVING COMMUNITYOH501(C)(3)LINE 9N/A0
OTTERBEIN ST MARYS
11230 STATE ROUTE 364ST MARYSOH45885341940880RETIREMENT LIVING COMMUNITYOH501(C)(3)LINE 9N/A0
OTTERBEIN LEBANON
585 NORTH STATE 741LEBANONOH45036311743874RETIREMENT LIVING COMMUNITYOH501(C)(3)LINE 9N/A0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg