2013-11-15T08:12:15-06:00 2012-12-31 381357951 PLANTE & MORAN PLLC 1111 SUPERIOR AVENUE SUITE 1250 CLEVELAND OH 44114 990 2012-01-01 341940863 STLEONARD STLE 9374330480 8100 CLYO ROAD CENTERVILLE OH 45458 EMILY MOORE 9374397159 2013-11-13 1 JEREMY S HERMAN P00745789 2165231010 2012 2016-02-25 16:41:14Z TIMOTHY DRESSMAN 8100 CLYO ROAD CENTERVILLE OH 45458 40682739 0 0928 X WWW.STLEONARD.NET X 2000 OH RESPONDING TO THE GOSPEL OF JESUS, ST. LEONARD ASSISTS SENIORS OF ALL FAITHS TO ACHIEVE THEIR HIGHEST LEVEL OF INDEPENDENT BY OPERATING A CONTINUING CARE RETIREMENT COMMUNITY LOCATED ON APPROXIMATELY 240 ACRES IN CENTERVILLE, OHIO. 11 9 589 480 69894 -96192 1068421 250004 20227623 25375750 1847494 974104 380630 484547 23524168 27084405 0 0 0 0 10830608 12986137 0 0 0 8494230 12487253 19324838 25473390 4199330 1611015 82056082 81550562 64290343 62173859 17765739 19376703 RESPONDING TO THE GOSPEL OF JESUS, ST. LEONARD ASSISTS SENIORS OF ALL FAITHS TO ACHIEVE THEIR HIGHEST LEVEL OF INDEPENDENCE BY OPERATING A CONTINUING CARE RETIREMENT COMMUNITY LOCATED ON APPROXIMATELY 240 ACRES IN CENTERVILLE, OHIO. 0 0 18850310 25781236 ST. LEONARD IS COMPRISED OF A 150 BED LICENSED SKILLED NURSING CENTER, 125 LICENSED ASSISTED LIVING UNITS, 250 COTTAGE AND GARDEN HOMES, AND 70 APARTMENTS LOCATED IN CENTERVILLE, OHIO. SPECIALIZED UNITS EXIST FOR DEMENTIA CLIENTS IN THE ASSISTED LIVING AREA, THE ADULT DAY CARE AREA, AND THE HEALTH CARE CENTER. 18850310 1 1 0 1 0 0 0 0 0 0 1 1 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 0 0 0 1 28 0 1 589 1 1 1 0 0 0 0 0 0 0 0 0 X 11 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 OH X EMILY MOORE 9374397159 8100 CLYO ROAD CENTERVILLE OH 45458 X TIMOTHY DRESSMAN 40.00 1.00 X X 194519 0 42128 GARY SCANLON 1.00 X X 0 0 0 MARTIN P SLOAN CPA 1.00 X X 0 0 0 DANIEL W DITTMAN 1.00 X X 0 0 0 PATRICIA MARTIN RD-PHD 1.00 X X 0 0 0 REV TERRENCE HAMILTON 1.00 X 0 0 0 DR DON R JUSZCZYK 1.00 X 0 0 0 PATRICIA L IOAS CPA CMA 1.00 X 0 0 0 RICK RYAN 1.00 40.00 X 0 347637 43887 RICK CARLILE 1.00 X 0 0 0 JASON MCCLELLAN 1.00 X 0 0 0 SYLVIA CLASEN 40.00 1.00 X 123578 0 36861 AILEEN JONES 40.00 X 112344 0 11455 430441 347637 134331 3 0 1 0 FUNCTIONAL PATHWAYS 614 MABRY HOOD RD SUITE 301 KNOXVILLE TN 37932 THERAPY SERVICES 1257172 CORNA KOKOSING L-3320 COLUMBUS OH 43260 CONSTRUCTION - NEW BLDG 642337 BEEBER'S PHARMACY 1600 RIVERCENTER II 100 E RIVERCENT COVINGTON KY 45458 PHARMACEUTICAL SVCS 431131 3 220490 29514 250004 NET PATIENT REVENUE 623000 20179121 20179121 ASST. LIVING RENT 623990 3589446 3589446 AMORT. ENTRANCE FEES 623990 1281183 1281183 APPLICATION FEES 623990 326000 326000 25375750 510091 510091 14062347 13596772 1562 465575 -1562 464013 464013 NET INSURANCE PROCEEDS 524298 331250 331250 WELLNESS AND DAY SPA 812900 63691 63691 MANAGEMENT FEES 623990 38431 38431 51175 35805 6203 9167 484547 27084405 25781236 69894 983271 520884 385454 135430 9719045 7192093 2526952 501364 371009 130355 1512090 1118947 393143 732754 542238 190516 31151 23052 8099 2290400 1694896 595504 67311 49810 17501 1282213 948838 333375 221144 163646 57498 1211238 896316 314922 146332 108286 38046 21211 15697 5514 2339908 1731532 608376 2663889 1971278 692611 99326 73501 25825 MEDICAL SUPPLIES 1264605 935808 328797 BED TAX 629647 465939 163708 PROVISION FOR BAD DEBTS 159832 118276 41556 DUES & SUBSCRIPTIONS 37622 27840 9782 21424 15854 5570 25473390 18850310 6623080 0 2600 2880 2535933 3480223 1292785 2267555 2608096 2469517 25898 20875 96390 121935 74387810 21195168 51791350 53192642 11595258 12424283 9335591 4704645 2772181 2866007 82056082 81550562 4879555 2985253 14065 11313 40869565 40349142 18527158 18828151 64290343 62173859 X 17765739 19376703 17765739 19376703 82056082 81550562 1611015 64545 -64596 0 X X 0 1 X 1 0 X 149585 122804 329405 549125 29514 1180433 17886259 17676784 19843457 20227623 25375750 101009873 18035844 17799588 20172862 20776748 25405264 102190306 0 0 0 102190306 605256 507829 673827 600404 510091 2897407 605256 507829 673827 600404 510091 2897407 514872 510046 -7340 380630 550663 1948871 19155972 18817463 20839349 21757782 26466018 107036584 0.95470 0.95130 0.02710 0.02960 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1516 1516 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: PERCENTAGE OF DUES PAID TO THE OHIO HEALTH CARE ASSOCIATION THAT WAS USED FOR LOBBYING IN 2012 WAS 18.41 PERCENT. THIS PERCENTAGE INCLUDES THE DUES PAID TO AMERICAN HEALTH CARE ASSOCIATION THROUGH THE OHIO HEALTH CARE ASSOCIATION. 1221379 1221379 56095814 14940799 41155015 5710123 2316224 3393899 11349879 3938145 7411734 10615 10615 53192642 TRUSTEE HELD FUNDS 4704645 F 4704645 THIRD PARTY REIMBURSEMENT CONTRACTS 128178 REFUNDABLE ENTRANCE FEES 15763343 NONREFUNDABLE ENTRANCE FEES 2718823 INSURANCE CLAIMS RESERVE 155886 DUE TO AFFILIATES 61921 18828151 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THERE ARE NO MATERIAL UNRECORDED TAX LIABILITIES AT DECEMBER 31, 2012 OR 2011. 0 1 0 0 0 0 0 0 0 TIMOTHY DRESSMAN 194519 0 0 0 0 0 13000 0 29128 0 236647 0 0 0 RICK RYAN 0 313233 0 0 0 34404 0 22490 0 21397 0 391524 0 0 SYLVIA CLASEN 123578 0 0 0 0 0 22500 0 14361 0 160439 0 0 0 PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATE IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN UNDER SECTION 457(F). CURRENT YEAR PAYMENTS, REPORTED IN PART II, COLUMN (B)(III), ARE SUMMARIZED BELOW: RICK RYAN $33,737 A COUNTY OF MONTGOMERY OHIO 316000172 61351QAC3 2010-06-30 40672000 HEALTHCARE AND MULTIFAMILY HOUSING IMPROVEMENT AND REFUNDING 0 0 0 A 40672000 3193691 671040 12402167 813454 6480305 14809695 2011 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 1 0 0 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 FRANCISCAN LIVING COMMUNITIES IS THE SOLE MEMBER OF ST. LEONARD. FORM 990, PART VI, SECTION A, LINE 7A FRANCISCAN LIVING COMMUNITIES, AS THE SOLE MEMBER OF THE ORGANIZATION, HAS THE RESERVED POWERS TO ELECT THE TRUSTEES OF THE ORGANZIATION, AND ELECT AND REMOVE THE CHAIRPERSON AND PRESIDENT/CEO OF ST. LEONARD. FORM 990, PART VI, SECTION A, LINE 7B FRANCISCAN LIVING COMMUNITIES HAS THE RESERVED POWER TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF ST. LEONARD. 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 AN ELECTRONIC 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 EVERY YEAR, EACH BOARD MEMBER, DEPARTMENT DIRECTOR, AND KEY EMPLOYEE IS GIVEN A QUESTIONNAIRE TO BE FILLED OUT AND SENT TO THE EXECUTIVE DIRECTOR. THE FORM IS REVIEWED AND ACTIONS ARE TAKEN IF A CONFLICT IS IDENTIFIED. A "DESIGNATED PERSON" MEANS ANY MEMBER OF THE BOARD OF THE CORPORATION, ANY MEMBER OF A COMMITTEE OF THE CORPORATION THAT IS AUTHORIZED TO APPROVE TRANSACTIONS OR ASSERT CLAIMS ON BEHALF OF THE CORPORATION, ANY OFFICER OF THE CORPORATION, AND ANY EMPLOYEE OR AGENT OF THE CORPORATION WHO IS AUTHORIZED TO APPROVE TRANSACTIONS OF ASSERT CLAIMS ON BEHALF OF THE CORPORATION. ANY DESIGNATED PERSON WHO HAS A CONFLICT OF INTEREST SHALL DISCLOSE THE CONFLICT OF INTEREST WHEN IT ARISES, AND BEFORE ACTION ON THE TRANSACTION OR CLAIM IN QUESTION. CONFLICTS OF INTEREST INVOLVING THE PRESIDENT OR MEMBERS OF THE BOARD OF THE CORPORATION SHALL BE REPORTED TO THE BOARD, AND CONFLICTS OF INTEREST CONCERNING OTHER DESIGNATED PERSONS SHALL BE REPORTED TO THE PRESIDENT, IN WHICH CASE THE PRESIDENT WILL MAKE THE CONFLICT OF INTEREST KNOWN TO THE BOARD AND ANY APPLICABLE COMMITTEE AT THE NEXT REGULARLY SCHEDULED MEETING. A DESIGNATED PERSON WHO HAS A CONFLICT OF INTEREST ARISING OUT OF OR RELATED TO A TRANSACTION OR CLAIM SHALL BE EXCUSED FROM THE BOARD OR COMMITTEE MEETING BEFORE ANY DELIBERATIONS OR VOTING CONCERNING THE AUTHORIZATION OF THE TRANSACTION OR ASSERTION OF THE CLAIM. FORM 990, PART VI, SECTION B, LINE 15 THE HR DIRECTOR IS IN CHARGE OF COMPARING THE DATA FOR THE EXECUTIVE DIRECTOR USING A BOOK THAT CONTAINS SALARY SURVEYS. THE COMPARISON IS THEN REVIEWED BY THE BOARD AND ACCEPTED OR REJECTED. THE DELIBERATIONS ARE RECORDED IN THE MINUTES OF THE BOARD OF TRUSTEES EXECUTIVE COMMITTEE THAT IS RESPONSIBLE FOR OVERSEEING FULL DISCLOSURE OF EXECUTIVE COMPENSATION. THE EXECUTIVE COMMITTEE SHALL ANUALLY REVIEW AND APPROVE ELEMENTS OF EXECUTIVE COMPENSATION IN A MANNER THAT IS DESIGNED TO COMPLY WITH REGULATIONS GOVERNING THE IRS'S INTERMEDIATE SANCTIONS PROVISION. FORM 990, PART VI, SECTION C, LINE 19 THE DOCUMENTS CAN BE REVIEWED BY REQUESTING AN APPOINTMENT WITH TIMOTHY DRESSMAN AT 8100 CLYO ROAD OR BY CALLING 937-439-7120. FORM 990, PART VII, AVERAGE HOURS PER WEEK RICK RYAN IS AN OFFICER OF THE PARENT ORGANIZATION. ONE OF THE RESPONSIBILITIES OF HIS POSITION IS TO SERVE AS OFFICER FOR MANY OF THE SUBSIDIARY ORGANIZATIONS. THE AVERAGE WORK WEEK FOR HIM IS 40+ HOURS. THIS TIME IS ALLOCATED TO HIS POSITIONS WITH THE VARIOUS SUBSIDIARIES AS WELL AS HIS RESPONSIBILITIES TO THE PARENT ORGANIZATION. IT IS ESTIMATED THAT HE DEDICATES AT LEAST ONE HOUR PER WEEK TO HIS RESPONSIBILITIES AS AN OFFICER OF THE SUBORDINATE ORGANIZATIONS. FORM 990, PART XII, LINE 2C THE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT HAS NOT CHANGED ITS OVERSIGHT PROCESS OR SELECTION PROCESS FROM THE PRIOR YEAR. JOSEPH BERNADINE RESIDENCE LLC 8400 ST FRANCIS DRIVE CENTERVILLE OH 45458 461614594 LOW INCOME RENTAL RESIDENTIAL OH 0 0 ST LEONARD ST JOSEPH SERVICES CORPORATION 2801 FRANCISCAN DRIVE BRYAN TX 77802 742455161 GOVERNANCE TX 501(C)(3) LINE 11A, I SYLVANIA FRANCISCAN HEALTH 0 ST JOSEPH REGIONAL HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 741282696 HEALTH CARE TX 501(C)(3) LINE 3 ST JOSEPH SERVICES CORPORATION 0 BURLESON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742759890 HEALTH CARE TX 501(C)(3) LINE 3 ST JOSEPH SERVICES CORPORATION 0 MADISON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742761145 HEALTH CARE TX 501(C)(3) LINE 3 ST JOSEPH SERVICES CORPORATION 0 ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN TX 77802 742847594 NURSING CARE TX 501(C)(3) LINE 9 ST JOSEPH SERVICES CORPORATION 0 BURLESON ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN TX 77802 742913931 NURSING CARE TX 501(C)(3) LINE 9 ST JOSEPH SERVICES CORPORATION 0 ST JOSEPH FOUNDATION 2801 FRANCISCAN DRIVE BRYAN TX 77802 742351158 FUNDRAISING TX 501(C)(3) LINE 11A, I ST JOSEPH SERVICES CORPORATION 0 ST JOSEPH PHYSICIAN ASSOCIATES 2801 FRANCISCAN DRIVE BRYAN TX 77802 203159302 PHYSICIAN PRACTICE TX 501(C)(3) LINE 3 ST JOSEPH SERVICES CORPORATION 0 SOPHIA CENTER 6832 CONVENT BLVD SYLVANIA OH 43560 341761656 MENTAL HEALTH OH 501(C)(3) LINE 9 SYLVANIA FRANCISCAN HEALTH 0 SISTERS OF ST FRANCIS 6832 CONVENT BLVD SYLVANIA OH 43560 344450609 RELIGIOUS OH 501(C)(3) LINE 1 N/A 0 SYLVANIA FRANCISCAN HEALTH 3231 CENTRAL PARK WEST SUITE 106 TOLEDO OH 43617 341412964 CHURCH ORG OH 501(C)(3) LINE 1 N/A 0 FRANCISCAN LIVING COMMUNITIES 5942 RENAISSANCE PLACE SUITE A TOLEDO OH 43623 341892096 MANAGEMENT SUPPORT OH 501(C)(3) LINE 11A, I SYLVANIA FRANCISCAN HEALTH 0 ST LEONARD FOUNDATION 8100 CLYO ROAD CENTERVILLE OH 45458 320102715 FUNDRAISING OH 501(C)(3) LINE 7 ST LEONARD 1 PROVIDENCE CARE CENTER 2025 HAYES ROAD SANDUSKY OH 44870 341658625 LONG TERM CARE FACILITY OH 501(C)(3) LINE 9 FRANCISCAN LIVING COMMUNITIES 0 THE COMMONS OF PROVIDENCE 5000 PROVIDENCE DRIVE SANDUSKY OH 44870 341826097 ASSISTED LIVING FACILITY OH 501(C)(3) LINE 9 PROVIDENCE CARE CENTERS 0 PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION 5055 PROVIDENCE DRIVE SANDUSKY OH 44870 341896807 INDEPENDENT LIVING FACILITY OH 501(C)(3) LINE 9 PROVIDENCE CARE CENTERS 0 PROVIDENCE CARE CENTERS 2025 HAYES ROAD SANDUSKY OH 44870 341826099 FINANCIAL SUPPORT OH 501(C)(3) LINE 7 PROVIDENCE CARE CENTERS 0 FRANCISCAN CARE CENTER 4111 HOLLAND SYLVANIA ROAD TOLEDO OH 43623 341931806 LONG TERM CARE FACILITY OH 501(C)(3) LINE 9 FRANCISCAN LIVING COMMUNITIES 0 ST CLARE COMMONS 5942 RENAISSANCE PLACE SUITE A TOLEDO OH 43623 270163752 LONG TERM CARE FACILITY OH 501(C)(3) LINE 9 FRANCISCAN LIVING COMMUNITIES 0 ROSARY CARE CENTER 6832 CONVENT BLVD SYLVANIA OH 43560 341931795 LONG TERM CARE FACILITY OH 501(C)(3) LINE 9 SYLVANIA FRANCISCAN HEALTH 0 FRANCISCAN PROPERTIES INC 6600 CONVENT ROAD SYLVANIA OH 43560 341412966 SENIOR HOUSING OH 501(C)(3) LINE 9 FRANCISCAN LIVING COMMUNITIES 0 TRINITY HOSPITAL TWIN CITY 819 NORTH FIRST STREET DENNISON OH 44621 275401105 HEALTH CARE OH 501(C)(3) LINE 3 SYLVANIA FRANCISCAN HEALTH 0 FRANCISCAN SERVICES SELF INSURANCE TRUST FUND (DSLVD IN 2012) 6832 CONVENT BLVD SYLVANIA OH 43560 346895492 SELF INSURANCE TRUST OH 501(C)(3) LINE 11A, I SYLVANIA FRANCISCAN HEALTH 0 SYLVANIA FRANCISCAN HEALTH FOUNDATION 3231 CENTRAL PARK WEST SUITE 106 TOLEDO OH 43617 455357161 FUNDRAISING OH 501(C)(3) LINE 7 SYLVANIA FRANCISCAN HEALTH 0 MADONNA MANOR 2344 AMSTERDAM ROAD VILLA HILLS KY 41017 610654635 LONG TERM CARE FACILITY KY 501(C)(3) LINE 9 FRANCISCAN LIVING COMMUNITIES 0 FRANCISCAN SHELTERS 6832 CONVENT BLVD SYLVANIA OH 43560 341612437 DOMESTIC VIOLENCE SHELTER OH 501(C)(3) LINE 7 SYLVANIA FRANCISCAN HEALTH 0 ST JOSEPH REGIONAL HEALTH PARTNERS 2801 FRANCISCAN DRIVE BRYAN TX 77802 454088170 PHYSICIAN SUPPORT TX 501(C)(3) LINE 3 ST JOSEPH SERVICES CORPORATION 0 ST LEONARD LIMITED PARTNERSHIP 88 EAST BROAD STREET SUITE 1800 CENTERVILLE OH 45458 311481761 LOW INCOME RENTAL RESIDENTIAL OH ST LEONARD EXCLUDED 0 1 ALLIANCE HEALTH PROVIDERS OF BRAZOS VALLEY 2801 FRANCISCAN DRIVE BRYAN TX 77802 742466914 PHYSICIAN HOSPITAL ORGANIZATION TX ST JOSEPH SERVICE CORPORATION C 0 TAU ENTERPRISES (DISSOLVED IN 2012) 2801 FRANCISCAN DRIVE BRYAN TX 77802 742544009 OFFICE BUILDING RENTAL TX ST JOSEPH SERVICE CORPORATION C 0 ST LEONARD CENTER 1 INC 8100 CLYO ROAD CENTERVILLE OH 45458 311481764 LOW INCOME RENTAL RESIDENTIAL OH ST LEONARD C -894 -4701 1.00000 1 JOSEPH BERNADINE RESIDENCE LLC 8400 ST FRANCIS DRIVE CENTERVILLE OH 45458 461614594 LOW INCOME RENTAL RESIDENTIAL OH ST LEONARD C 0 SFH ASSURANCE LTD SUITE 6 GRAND PAVILION COMMERICAL GRAND CAYMAN KY1- CJ 981056892 INSURANCE CJ SYLVANIA FRANCISCAN HEALTH C 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 ST LEONARD FOUNDATION C 220490 ST LEONARD FOUNDATION Q 592141