2013-11-14T15:46:19-06:00 2012-12-31 410746749 CLIFTONLARSONALLEN LLP 1 BRONZE POINTE BELLEVILLE IL 62226 990 2012-01-01 310549058 OTTERBEIN HOMES OTTE 5139322020 580 NORTH STATE ROUTE 741 LEBANON OH 450368839 J CHRISTOPHER GREEN 5139335400 2013-11-14 1 JEFF PARKER P00970069 6182331200 2012 2016-02-25 16:41:14Z J CHRISTOPHER GREEN 580 NORTH SR 741 LEBANON OH 450368839 68542192 0 X WWW.OTTERBEIN.ORG X 1912 OH OTTERBEIN HOMES IS AN ORGANIZATION OF CONTINUING CARE RETREMENT COMMUNITIES THAT PROVIDE HOUSING AND SERVICES TO ELDERS. 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 SURROUNDING COMMUNITIES. OTTERBEIN RESIDENTS AND STAFF VOLUNTEER THEIR TIME AND TALENTS AT THE OTTERBEIN CAMPUSES BUT ALSO FOR A NUMBER OF ORGANIZATIONS AND CAUSES IN THE GREATER COMMUNITY. 29 29 772 35 190253 -53426 163156 232406 27068890 29594091 3462615 3237518 291680 269109 30986341 33333124 0 0 0 0 14984070 16558427 0 0 729956 13812161 14538053 28796231 31096480 2190110 2236644 110135315 117548976 67221696 68949071 42913619 48599905 OUR MISSION - IN KEEPING WITH OUR UNITED METHODIST TRADITION WE SEEKTO ENHANCE THE QUALITY OF LIFE AND HOLISTIC GROWTH OF OLDER PERSONS. 0 0 22957402 29594091 OTTERBEIN HOMES PROVIDES MANAGEMENT AND SUPPORT SERVICES FOR ITS FIVE CONTINUING CARE RETIREMENT COMMUNITIES, SMALL HOUSE NURSING HOME NEIGHBORHOODS THROUGHOUT OHIO AND A HOME HEALTH AGENCY. SOME OF THE MANAGEMENT SERVICES PROVIDED INCLUDE ADMINISTRATIVE, FINANCIAL, PURCHASING, HUMAN RESOURCES, MARKETING, AND DEVELOPMENT FOR THE RELATED TAX-EXEMPT ORGANIZATIONS. IN PROVIDING MANAGEMENT AND SUPPORT TO ITS COMMUNITIES OF LEBANON, CRIDERSVILLE, ST. MARY'S, PORTAGE VALLEY, NORTH SHORE, AND THE SMALL HOUSES AT PERRYSBURG, MONCLOVA, SPRINGBORO, MIDDLETOWN AND MAINEVILLE, OTTERBEIN SERVES OVER 3,000 PERSONS. 22957402 1 1 0 0 0 0 1 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 92 0 772 1 1 1 0 0 0 0 0 0 0 X 29 29 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 OH X J CHRISTOPHER GREEN 5139335400 580 NORTH SR 741 LEBANON OH 450368839 REV BRIAN BROWN 1.00 X 0 0 0 REV MARLA BROWN 1.00 X 0 0 0 BILL BROWNSON 1.00 X 0 0 0 REV GEORGE CAMPBELL 1.00 X 0 0 0 REV LEROY CHAMBLISS 1.00 X 0 0 0 ROGER CLARK 1.00 X 0 0 0 TOM COMPTON 1.00 X 0 0 0 JAMES DUNHAM 1.00 X 0 0 0 JIM FENTON JR 1.00 X 0 0 0 REV CYNDY GARN 1.00 X X 0 0 0 ROBERT GLASER 1.00 X 0 0 0 REV TOM HANOVER 1.00 X 0 0 0 CHARLES MAHAN 1.00 X X 0 0 0 MICHAEL MCCARTY 1.00 X 0 0 0 LEROY MCKAY 1.00 X 0 0 0 MEL MILLER 1.00 X 0 0 0 PAMELA NICKELL 1.00 X 0 0 0 ZAN PETRIE 1.00 X 0 0 0 GEORGE SEHI 1.00 X 0 0 0 TINA BASINGER 1.00 X 0 0 0 WILLIAM THORN 1.00 X 0 0 0 JOHN WASHBURN 1.00 X 0 0 0 STEPHEN WILSON 1.00 X X 0 0 0 JOE WOLF 1.00 X 0 0 0 DAVID WOODYARD 1.00 X 0 0 0 LYNN APP 1.00 X 0 0 0 JOE FREDERICK 1.00 X 0 0 0 PATTY CISCO 1.00 X 0 0 0 RUTH FLOYD 1.00 X 0 0 0 JILL HREBEN 38.00 2.00 X 324103 0 19337 JAMES C GREEN 38.00 2.00 X 226879 0 9602 GARY HORNING 40.00 X 201009 0 12764 LOIS MILLS 40.00 X 172526 0 11640 SUE MCCONN 40.00 X 177563 0 27257 PAMELA RICHMOND 40.00 X 155708 0 14727 SONDRA MARKER 40.00 X 133902 0 4865 1391690 0 100192 11 0 1 0 CONCEPT REHAB INC 7150 GRANITE CIRCLE SUITE 200 TOLEDO OH 43617 THERAPY SERVICES 1670492 DIGITEL COMMUNICATIONS 406 BLANKENBAKER PARKWAY SUITE 1 LOUISVILLE KY 40243 TECHNOLOGY SERVICES 306235 ESCO TECHNOLOGIES LLC 7372 LIBERTY ONE DRIVE LIBERTY TOWNSHIP OH 45044 TELEPHONE SERVICES 190546 GRAYDON HEAD & RITCHEY PO BOX 6464 CINCINNATI OH 452016464 LEGAL SERVICES 170095 B-1 TECHNOLOGIES 7723 TYLERS PLACE BLVD 324 WEST CHESTER OH 45069 TECHNOLOGY SERVICES 153930 9 170130 62276 5061 232406 MEDICARE/MEDICAID PAYMENTS 623000 17004003 17004003 SERVICE FEES 541900 11828625 11828625 DEPARTMENTAL SERVICES 623000 761463 761463 29594091 944001 944001 347115 83329 263786 263786 190253 73533 37392974 1394 35098371 2480 2294603 -1086 2293517 2293517 12350 170130 24888 -12538 -12538 OTHER INCOME 623000 17861 17861 17861 33333124 29594091 190253 3316374 1719916 1719916 11348543 10999019 349524 819666 689869 129797 1671203 1349347 253876 67980 999099 818779 154051 26269 64883 60757 4126 57893 57893 2171175 2171175 438290 306509 131781 3016589 2659678 290341 66570 256741 256741 1583368 1352997 230371 305245 231402 43538 30305 1092352 933421 158931 1687563 1442032 245531 193566 165403 28163 OTHER ADMINISTRATION 1585315 1541981 43334 CORPORATE SERVICE FEES 1487002 1487002 BAD DEBT 346049 346049 STAFF DEVELOPMENT 116256 110548 5708 135766 33732 97675 4359 31096480 22957402 7409122 729956 53455 2986249 2672709 1545107 2149765 232682 183731 50680182 11235327 40395766 39444855 50644168 57265168 325000 325000 14006343 15454293 110135315 117548976 10713536 11276470 32291922 31198918 24216238 26473683 67221696 68949071 X 48716699 54127483 -11272862 -11259594 5469782 5732016 42913619 48599905 110135315 117548976 X 2236644 4627486 -1177844 X X 0 1 X 1 0 X 364947 217962 1388157 163156 232406 2366628 10547394 18325253 23126500 27068889 29594091 108662127 10912341 18543215 24514657 27232045 29826497 111028755 16550 20406 12389 43720 27768 120833 0 16550 20406 12389 43720 27768 120833 110907922 1483970 1174737 1067119 1099387 1291116 6116329 1483970 1174737 1067119 1099387 1291116 6116329 28575 27588 33349 17861 107373 12396311 19746527 25609364 28364781 31135474 117252457 0.94590 0.93590 0.05220 0.06220 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2009 AMOUNT: $ 28,575. 2010 AMOUNT: $ 27,588. 2011 AMOUNT: $ 33,349. 2012 AMOUNT: $ 17,861. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 1 17.80 1 0 15133764 760932 432771 78923 16248544 14678280 601051 -107752 37815 15133764 14026059 284760 384474 17013 14678280 13222168 500699 303192 14026059 13249657 93616 -121105 13222168 0.01900 0.96760 0.01340 0 0 4567791 4567791 34369099 4748799 29620300 7561839 5224053 2337786 4181453 1262475 2918978 39444855 UNAMORTIZED FINANCE COST 994050 CIP 1859807 UNEXPECTED BOND PROCEED & SINKING FUND 526575 INVESTMENTS 6601962 OTHER PROPERTY 2414500 RESIDENT TRUST 21211 LAND HELD FOR RESALE 3036188 15454293 CAPITAL LEASE 2046968 SPLIT-INTEREST AGREEMENT 226123 DEFERRED COST OF INTEREST RATE SWAP 363567 RESIDENT TRUST 21211 INTERCOMPANY PAYABLES 23815814 26473683 X DESCRIPTION OF HOW ORGANIZATION REPORTS CONSERVATION EASEMENTS: PART II, LINE 9: THE CONSERVATION EASEMENT IS LOCATED AT SE CORNER OF THE INTERSECTION OF SR 741 AND SR 63 IN WARREN COUNTY, OHIO. IT IS IN PLACE TO PROTECT THE PHYSICAL, BIOLOGICAL AND CHEMICAL INTEGRITY OF THE LITTLE MIAMI RIVER WATERSHED AND IS UNDER THE ENFORCEMENT OF THE OHIO EPA. OTTERBEIN HOMES ENGAGEMENT THE FIRM OF JF NEW IN 2008 FOR MITIGATION AND MONITORING. DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ORGANIZATION HAS ADPOTED INVESTMENT AND SPENDING POLICIES FOR ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO PROGRAMS SUPPORTED BY ITS ENDOWMENT. ENDOWMENT ASSETS INCLUDE THOSE ASSETS OF DONOR-RESTRICTED FUNDS THA THE ORGANIZATION MUST HOLD IN PERPETUITY OR FOR A DONOR-SPECIFIED PERIOD. UNDER THIS POLICY, AS APPROVED BY THE BOARD OF TRUSTEES, THE ENDOWMENT ASSETS ARE INVESTED IN A MANNER THAT IS INTENDED TO PRESERVE AND GROW CAPITAL, STRIVE FOR CONSISTENT ABSOLUTE RETURNS, PRESERVE PURCHASING POWER BY STRIVING FOR LONG-TERM RETURNS WHICH EITHER MATCH OR EXCEED THE SET PAYOUT, FEES AND INFLATION WITHOUT PUTTING A PRINCIPAL VALUE AT IMPRUDENT RISK, AND DIVERSIFY INVESTMENTS CONSISTENT WITH COMMONLY ACCEPTED INDUSTRY STANDARD TO MINIMIZE THE RISK OF LARGE LOSSES. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ORGANIZATION QUALIFIES AS A TAX-EXEMPT CORPORATION DESCRIBED IN SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THE ORGANIZATION IS NOT SUBJECT TO FEDERAL INCOME TAXES UNDER SECTION 501 (C)(3) OF THE CODE. THE ORGANIZATION IS CLASSIFIED AS A PUBLICLY SUPPORTED CHARITABLE ORGANIZATION UNDER THE CODE AND CONTRIBUTIONS TO THE ORGANIZATION QUALIFIES AS A 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 2012, 2011, AND 2010 TAX YEARS ARE OPEN FOR EXAMINATION BY THE IRS. DILGARD TOURNAMENT (GOLF) 57685 45335 12350 24888 GALA 124795 124795 182480 170130 12350 24888 24888 -12538 1 X X X X 0 0 0 0 0 0 0 0 0 JILL HREBEN 324103 0 0 0 0 0 0 0 19337 0 343440 0 0 0 JAMES C GREEN 226879 0 0 0 0 0 0 0 9602 0 236481 0 0 0 GARY HORNING 201009 0 0 0 0 0 0 0 12764 0 213773 0 0 0 LOIS MILLS 172526 0 0 0 0 0 0 0 11640 0 184166 0 0 0 SUE MCCONN 177563 0 0 0 0 0 0 0 27257 0 204820 0 0 0 PAMELA RICHMOND 155708 0 0 0 0 0 0 0 14727 0 170435 0 0 0 A COUNTY OF WARREN OHIO 316000058 93515PAC1 2007-04-02 17605000 RENOVATION AND CONSTRUCTION 0 0 0 B COUNTY OF WARREN OHIO 316000058 93515PAF4 2009-07-16 20000000 CONSTRUCTION 0 0 0 A 1930000 17605000 383026 99627 17122347 2008 0 0 1 1 B 1020000 20000000 343899 231977 19424124 2010 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 0 0 1 1 1 DEUTSCHE BANK 2.900000000000 0 0 0 0 1 B 0 1 0 0 1 0 0 0 1 A 1 B 1 JILL HREBEN CEO/PRESIDENT OF OTTERBEIN HOMES & BOARD REPRESENTATIVE OF CCIC 653000 CARING COMMUNITES INSURANCE COMPANY (CCIC) - OTTERBEIN HOMES HAS A CLAIMS MADE POLICY FOR GENERAL LIABILITY INSURANCE. HS. HREBEN ALSO SERVES ON THE BOARD OF DIRECTORS OF CCIC. DURING 2012, OTTERBEIN HOMES PAID INSURANCE PREMIUMS TO CCIC TOTALING APPROXIMATELY $653,000. MS. HREBEN RECEIVES NO PERSONAL BENEFIT FROM THIS RELATIONSHIP. 0 FORM 990, PART VI, SECTION B, LINE 11 THE IRS FORM 990 IS PROVIDED TO AND REVIEWED BY THE OFFICERS AND BOARD OF DIRECTORS 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 15 AN AD HOC 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 19 THE ANNUAL REPORT IS PROVIDED TO THE PUBLIC WHICH INCLUDES THE AUDITED FINANCIAL STATEMENT SUMMARY AND IS CERTIFIED BY THE CHIEF EXECUTIVE OFFICER AND THE CHIEF FINANCIAL OFFICER. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 5,739. CHANGE IN FAIR VALUE OF SPLIT INTEREST AGREEMENT -16,290. CHANGE IN MINIMUM PENSION LIABILITY -1,030,706. TRANSFERS OF UNRESTRICTED NET ASSETS -101,208. RESTRICTED FUND ADJUSTMENTS -35,379. FORM 990, PART XII, LINE 2C THE SELECTION AND OVERSIGHT PROCESS HAS NOT CHANGED. OTTERBEIN PERRYSBURG LLC 580 N STATE ROUTE 741 LEBANON OH 45036 205493322 DEVELOP AND OPERATE SMALL HOUSE NEIGHHOODS - PROVIDING SKILLED NURSING CARE OH 4293652 6928670 OTTERBEIN HOMES OTTERBEIN MONCLOVA LLC 580 N STATE ROUTE 741 LEBANON OH 45036 205493287 DEVELOP AND OPERATE SMALL HOUSE NEIGHHOODS - PROVIDING SKILLED NURSING CARE OH 4219440 7906742 OTTERBEIN HOMES OTTERBEIN CLEARCREEK LLC 580 N STATE ROUTE 741 LEBANON OH 45036 260731207 DEVELOP AND OPERATE SMALL HOUSE NEIGHHOODS - PROVIDING SKILLED NURSING CARE OH 4266846 7495549 OTTERBEIN HOMES OTTERBEIN MIDDLETOWN LLC 580 N STATE ROUTE 741 LEBANON OH 45036 260731330 DEVELOP AND OPERATE SMALL HOUSE NEIGHHOODS - PROVIDING SKILLED NURSING CARE OH 5023857 7522181 OTTERBEIN HOMES OTTERBEIN HOLDING LLC 580 N STATE ROUTE 741 LEBANON OH 45036 205493357 REAL ESTATE HOLDING COMPANY OH 1890467 OTTERBEIN HOMES OTTERBEIN INDEPENDENT LIVING SERVICES LLC 580 N STATE ROUTE 741 LEBANON OH 45036 263554627 CLINIC OH 617334 82306 OTTERBEIN HOMES OTTERBEIN PROPERTIES LLC 580 N STATE ROUTE 741 LEBANON OH 45036 270543473 REAL ESTATE DEVELOPMENT OH OTTERBEIN HOMES OTTERBEIN HOME HEALTH 580 N STATE ROUTE 741 LEBANON OH 45036 271049483 HOME HEALTH SERVICES OH 952533 597219 OTTERBEIN HOMES OTTERBEIN MAINEVILLE LLC 580 N STATE ROUTE 741 LEBANON OH 45036 205952379 DEVELOP AND OPERATE SMALL HOUSE NEIGHHOODS - PROVIDING SKILLED NURSING CARE OH 4817062 8932655 OTTERBEIN HOMES OTTENBEIN ST MARYS 11230 STATE ROUTE 364 ST MARYS OH 45885 341940880 CONTINUING CARE RETIREMENT COMMUNITY OH 501(C)(3) LINE 9 OTTERBEIN HOMES 1 OTTERBEIN LEBANON 585 NORTH STATE ROUTE 741 LEBANON OH 45036 311743874 CONTINUING CARE RETIREMENT COMMUNITY OH 501(C)(3) LINE 9 OTTERBEIN HOMES 1 OTTERBEIN NORTH SHORE 9400 NORTH SHORE BLVD LAKESIDE OH 43440 341743836 CONTINUING CARE RETIREMENT COMMUNITY OH 501(C)(3) LINE 9 OTTERBEIN HOMES 1 OTTERBEIN PORTAGE VALLEY 20311 PEMBERVILLE ROAD PEMBERVILLE OH 43450 341193296 CONTINUING CARE RETIREMENT COMMUNITY OH 501(C)(3) LINE 9 OTTERBEIN HOMES 1 OTTERBEIN CRIDERSVILLE 100 RED OAK DRIVE CRIDERSVILLE OH 45806 341940884 CONTINUING CARE RETIREMENT COMMUNITY OH 501(C)(3) LINE 9 OTTERBEIN HOMES 1 OTTERBEIN SERVICES CORPORATION (INACTICE) 580 N STATE ROUTE 741 LEBANON OH 45036 311293054 INACTIVE OH OTTERBEIN HOMES C 1.00000 1 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 OTTERBEIN PERRYSBERG L 260229 PERCENTAGE OF REVENUE OTTERBEIN MONCLOVA L 256620 PERCENTAGE OF REVENUE OTTERBEIN CLEARCREEK L 261588 PERCENTAGE OF REVENUE OTTERBEIN MIDDLETOWN L 324576 PERCENTAGE OF REVENUE OTTERBEIN MAINEVILLE L 266304 PERCENTAGE OF REVENUE OTTERBEIN HOME HEALTH SERVICES L 56431 PERCENTAGE OF REVENUE OTTERBEIN INDEPENDENT LIVING SUPPORT SERVICES L 61254 PERCENTAGE OF REVENUE OTTERBEIN CRIDERSVILLE L 494795 PERCENTAGE OF REVENUE OTTERBEIN LEBANON L 2042957 PERCENTAGE OF REVENUE OTTERBEIN ST MARYS L 586327 PERCENTAGE OF REVENUE OTTERBEIN NORTH SHORE L 265861 PERCENTAGE OF REVENUE OTTERBEIN PORTAGE VALLEY L 511788