2012-04-03T14:49:04-05:00 2010-12-31 PLANTE & MORAN PLLC 1111 SUPERIOR AVE SUITE 1250 CLEVELAND OH 441142533 990 2010-01-01 610654635 MADONNA MANOR INC MADO 8593413981 2344 AMSTERDAM RD VILLA HILLS KY 41017 MARK MULLAHY 8593413981 2012-03-29 1 2165231010 2010 2016-02-24 21:20:13Z X MARK MULLAHY 2344 AMSTERDAM RD VILLA HILLS KY 41017 5808847 0 X WWW.MADONNAMANOR.ORG X 1964 KY MADONNA MANOR IS A CATHOLIC HEALTHCARE FACILITY FOR SENIOR ADULTS DEVOTED TO PROVIDING A HOME WITHIN A SPIRITUAL ATMOSPHERE. FAITHFUL TO THE SPIRIT OF ST. FRANCIS OF ASSISI AND THE SISTERS OF ST. FRANCIS OF SYLVANIA, OHIO, THE VALUES OF REVERENCE, SERVICE, AND STEWARDSHIP GUIDE STAFF AND VOLUNTEERS IN PROVIDING SERVICES AND ACTIVITIES, WHICH FOSTER THE DIGNITY AND INDIVIDUALITY OF EACH PERSON. 9 6 95 25 0 0 472949 169680 3602148 3361976 79675 443612 5429 23113 4160201 3998381 0 0 0 0 2171594 2183848 0 0 59238 1101093 1350566 3272687 3534414 887514 463967 12358513 42942940 2627383 34109535 9731130 8833405 X MADONNA MANOR IS A CATHOLIC HEALTHCARE FACILITY FOR SENIOR ADULTS DEVOTED TO PROVIDING A HOME WITHIN A SPIRITUAL ATMOSPHERE. FAITHFUL TO THE SPIRIT OF ST. FRANCIS OF ASSISI AND THE SISTERS OF ST. FRANCIS OF SYLVANIA, OHIO, THE VALUES OF REVERENCE, SERVICE, AND STEWARDSHIP GUIDE STAFF AND VOLUNTEERS IN PROVIDING SERVICES AND ACTIVITIES, WHICH FOSTER THE DIGNITY AND INDIVIDUALITY OF EACH PERSON. 0 0 2048677 3126638 MADONNA MANOR IS A CCRC PROVIDING SERVICES TO MEET THE APPROPRIATE SPIRITUAL NEEDS TO THOSE ENTRUSTED IN OUR PERSONAL CARE AND NURSING UNIT. IN 2010, WE HAD 35 LICENSED SKILLED NURSING BEDS AND 25 LICENSED PERSONAL CARE BEDS. ALL RESIDENTS ARE OFFERED SOCIAL SERVICES AND THE OPPORTUNITY TO PARTICIPATE IN PROGRAM AND SPIRITUAL ACTIVITIES. SOCIAL SERVICES: THESE SERVICES ARE OFFERED TO BOTH THE RESIDENT AND THE FAMILY. ALL FAMILIES HAVE SOME INTERACTION WITH THE SOCIAL SERVICES THROUGH THE ADMISSION PROCESS, CARE CONFERENCES AND AS NEEDED. RESIDENTS ARE VISITED ON A REGLUAR BASIS TO INSURE ALL CONCERNS AND/OR NEEDS ARE BEING ADDRESSED.ACTIVITIES: PARTICIPATION IN ACTVITIES AVERAGE ABOUT 30% OF OUR NURSING RESIDENTS AND 50% OF OUR PERSONAL CARE RESIDENTS PARTICIPATE IN GROUP ACTIVITIES, ABOUT 25% NURSING AND 40% PERSONAL CARE IN THE SMALL GROUP ACTIVITIES. ALL RESIDENTS ARE VISITED WEEKLY BY THE ACTIVITY, SOCIAL SERVICES AND/OR PASTORAL MINISTRY STAFF MEMBERS AND RESIDENTS WITH LIMITED ABILITIES ARE VISITED DAILY.SPIRITUAL: ALL RESIDENTS ARE INVITED TO PARTICIPATE IN THE VARIOUS SERVICES DURING THE WEEK WITH ABOUT 50% PARTICIPATION FROM THE LICENSED NURSING AND 60% PARTICIPATION FROM THE LICENSED PERSONAL CARE ON A WEEKLY BASIS. FAMILIES ARE ALWAYS WELCOME AND MANY PARTICIPATE IN THE LITURGIES. 154202 235338 MADONNA MANOR IS A CCRC PROVIDING SERVICES TO MEET THE APPROPRIATE LEVEL OF CARE TO MEET THE PHYSICAL, SOCIAL, INTELLECTUAL, EMOTIONAL AND SPRITUAL NEEDS TO THOSE ENTRUSTED IN OUR CARE LIVING INDEPENDENTLY.ACTIVITIES: PARTICIPATION INCREASED THIS YEAR TO AN AVERAGE OF 45-50%. THIS IS DUE TO THE FOCUS PROVIDED BY ONE ACTIVITY STAFF PERSON. THERE HAS BEEN AN INCREASE IN ACTIVITIES OFFERED AS WELL AS A PERSONAL INVITATION TO EACH EVENT/ACTIVITY. MANY RESIDENTS CONTINUE TO BE ACTIVE IN THE COMMUNITY AT LARGE THROUGH A VARIETY OF ORGANIZATIONS AND ACTIVITIES AND SEVERAL SERVE AS VOLUNTEERS FOR MADONNA MANOR. SPIRITUAL: ALL RESIDENTS ARE INVITED TO PARTCIPATE IN THE VARIOUS SERVICES DURING THE WEEK WITH ABOUT 70% PARTICIPATION ON A WEEKLY BASIS. 2202879 1 1 0 0 0 0 0 0 1 1 1 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 22 0 1 95 1 0 0 0 0 0 0 0 0 0 0 X 9 6 0 0 0 0 1 1 1 1 1 1 0 1 1 1 1 1 1 1 0 0 X SAMANTHA BELL CONTROLLER 8593413981 2344 AMSTERDAM RD VILLA HILLS KY 41017 JOHN NIENABER 1.00 X X 0 0 0 JOE NADER 1.00 X X 0 0 0 EVA BALLARD 1.00 X X 0 0 0 DAVID ADAMS 1.00 X 0 0 0 RICK RYAN 1.00 X 0 289722 60293 WILLIAM WATERS 1.00 X 0 622280 257170 SISTER CAROLYN GIERA 1.00 X 0 0 0 MICHAEL ROHMILLER 1.00 X 0 0 0 MARIANN DUNN 40.00 X X 66602 0 146 JERRY WHITE 1.00 X 0 0 0 66602 912002 317609 0 0 1 0 0 17075 152605 169680 NURSING/PERSONAL CARE 623000 3126638 3126638 INDEPENDENT LIVING 623000 235338 235338 3361976 478312 478312 1770285 1804985 -34700 -34700 -34700 2880 17075 5481 -2601 -2601 2493 2493 2493 MISC. REVENUE 623000 23221 23221 23221 3998381 3361976 0 466725 66748 66748 1600434 1283618 283174 33642 129134 99433 24489 5212 269598 208986 49657 10955 117934 90809 22365 4760 18429 18429 64540 64540 46989 46989 208245 113207 91059 3979 138166 138166 8658 8658 10645 10645 276955 276955 158651 158651 32856 32856 FOOD 162495 162495 CONTRACTED LABOR 126934 126934 PROVISION FOR BAD DEBTS 39000 39000 LEGEND DRUGS 31182 31182 FRANCHISE TAXES 17349 17349 9472 8782 690 3534414 2202879 1272297 59238 335873 1054794 701693 1770237 532682 576227 26016 22800 22106905 483313 6585760 21623592 3345072 17036622 469792 442292 361625 416376 12358513 42942940 1251666 3644498 224210 18480 28440000 1151507 2006557 2627383 34109535 X 8912755 8015030 818375 818375 9731130 8833405 12358513 42942940 X 463967 -1361692 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2292199 13565354 15857553 2035932 273614 17347 2292199 2739287 -684627 18728 2035932 0.62000 0.38000 0 0 2335000 2335000 1376054 403912 972142 259755 79401 180354 18136096 18136096 21623592 BOARD DESIGNATED FUNDS 1508255 F RESTRICTED FUNDS 948067 F PUBLICLY TRADED INVESTMENTS 1179069 F TRUSTEE-HELD FUNDS 13401231 F 17036622 SECURITY DEPOSITS 47483 DUE TO AFFILIATED ENTITY 681074 DERIVATIVE LIABILITY 1278000 2006557 3998381 3534414 463967 -84694 -1276998 -1361692 -897725 3888074 -84694 -84694 3972768 30735 -5122 25613 3998381 3507799 5122 5122 3502677 30735 1002 31737 3534414 Description of Intended Use of Endowment Funds: Part V, Line 4: THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS IS TO SUPPORT CHARITABLE CARE WITHIN THE SKILLED NURSING AND ASSISTED LIVING AREAS. Part XI, Line 8 - Other Adjustments: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -1,278,000. NET ASSET ADJUSTMENT 1,002. Part XII, Line 2d - Other Adjustments: NET UNREALIZED LOSSES ON INVESTMENTS -84,694. Part XII, Line 4b - Other Adjustments: AWARDS DINNER FUNDRAISING EXPENSES (RECLASS TO REVENUE PER 990) -5,122. Part XIII, Line 2d - Other Adjustments: DIRECT FUNDRAISING EXPENSES 5,122. Part XIII, Line 4b - Other Adjustments: NET ASSET ADJUSTMENT 1,002. APPLAUDS AWARD DINNER 17075 17075 3222 1900 17075 17075 3222 1900 5122 -5122 X 0 0 0 0 0 0 0 0 0 RICK RYAN 0 288625 0 0 0 1097 0 23465 0 36828 0 350015 0 0 WILLIAM WATERS 0 327564 0 0 0 294716 0 223632 0 33538 0 879450 0 0 KENTUCKY ECONOMIC DEVELOPMENT FINANCE AUTHORITY 2010-01-05 28440000 CONSTRUCTION AND FURNISHING A 106,000 SQ. FT. AL, AL MEMORY, AND NF 0 0 0 28440000 473770 558576 14979252 498917 13460747 0 0 1 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 0 0 Form 990, Part VI, Section A, line 6 FRANCISCAN LIVING COMMUNITIES IS THE SOLE MEMBER OF FRANCISCAN CARE CENTER, SYLVANIA Form 990, Part VI, Section A, line 7a FRANCISCAN LIVING COMMUNITIES, AS THE SOLE MEMBER OF THE ORGANIZATION, HAS RESERVED POWERS TO ELECT THE TRUSTEES OF THE ORGANIZATION, AND TO ELECT AND REMOVE THE CHAIRPERSON AND PRESIDENT/CEO OF FRANCISCAN CARE CENTER, SYLVANIA Form 990, Part VI, Section A, line 7b FRANCISCAN LIVING COMMUNITIES HAS THE RESERVED POWER TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF FRANCISCAN CARE CENTER, SYLVANIA Form 990, Part VI, Section B, line 11 A COPY OF FORM 990 WAS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY AND WAS REVIEWED BY THE BOARD OF DIRECTORS BEFORE FILING. Form 990, Part VI, Section B, line 12c THE ORGANIZATION PROVIDES AN ANNUAL QUESTIONNAIRE TO ALL BOARD MEMBERS WHICH REQUIRES DISCLOSURE OF ANY CONFLICTS OF INTEREST THE BOARD MEMBER MAY HAVE WITH THE ORGANIZATION. THIS IS REVIEWED BY THE ORGANIZATION AND REPORTED TO THE BOARD OF TRUSTEES. Form 990, Part VI, Section B, line 15a THE PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S EXECUTIVE DIRECTOR IS DONE BY THE BOARD OF DIRECTORS. IN SETTING THE WAGES, THE BOARD COMPARES VARIOUS SALARIES FROM LIKE POSITIONS IN SIMILAR ORGANIZATIONS. THE BOARD REVIEWS AND APPROVES THE SALARY ON AN ANNUAL BASIS AND DOCUMENTS IN BOARD MEETING MINUTES. Form 990, Part VI, Section C, line 18 THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. Form 990, Part VI, Section C, line 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized losses on investments: -84,694. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -1,278,000. NET ASSET ADJUSTMENT 1,002. Total to Form 990, Part XI, Line 5: -1,361,692. AUDIT OVERSIGHT FORM 990, PAGE 11, PART XI, LINE 2C THE PROCESS FOR THE SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. BOARD MEMBER ADDRESSES FORM 990, PAGE 6, PART VI, SECTION A, LINE 11 NAME: WILLIAM WATERS ADDRESS: 6832 CONVENT BLVD. SYLVANIA, OHIO 43560 NAME: RICK RYAN ADDRESS: 6832 CONVENT BLVD. SYLVANIA, OHIO 43560 PUBLIC CHARITY STATUS FORM 990, SCHEDULE R, PART II, COLUMN E THE PUBLIC CHARITY STATUS OF THE SISTERS OF ST. FRANCIS OF SYLVANIA, A RELATED PARTY, IS NOT APPLICABLE. THE ORGANIZATION IS CONSIDERED A CHURCH AND RECEIVED THE EXEMPT CODE STATUS OF 501(C)(3) AUTOMATICALLY. AMENDED RETURN FORM 990, PAGE 4, PART IV, LINE 24A RETURN IS BEING AMENDED TO INCLUDE INFORMATION RELATING TO TAX-EXEMPT BONDS AS SHOWN ON SCHEDULE K. FRANCISCAN SERVICES CORPORATION 6832 CONVENT BLVD SYLVANIA OH 43560 341412964 CHURCH ORGANIZATION OH 501(C)(3) LINE 1 (SCH. A) N/A 0 FRANCISCAN LIVING COMMUNITIES 6832 CONVENT BLVD SYLVANIA OH 43560 341892096 MANAGEMENT SUPPORT OH 501(C)(3) LINE 11 (SCH. A) FRANCISCAN SERVICES CORP 1 SISTERS OF ST FRANCIS OF SYLVANIA 6832 CONVENT BLVD SYLVANIA OH 43560 344450609 RELIGIOUS OH 501(C)(3) N/A N/A 0 THE COMMONS OF PROVIDENCE 5000 PROVIDENCE DRIVE SANDUSKY OH 44870 341826097 ASSISTED LIVING OH 501(C)(3) LINE 9 (SCH. A) FRANCISCAN LIVING COMMUNITIES 1 PROVIDENCE RESIDENTIAL COMMUNITY CORP 5055 PROVIDENCE DRIVE SANDUSKY OH 44870 341896807 INDEPENDENT LIVING OH 501(C)(3) LINE 9 (SCH. A) FRANCISCAN LIVING COMMUNITIES 1 PROVIDENCE CARE CENTERS 2025 HAYES AVENUE SANDUSKY OH 44870 341826099 FINANCIAL SUPPORT OH 501(C)3 LINE 11 (SCH. A) FRANCISCAN LIVING COMMUNITIES 1 PROVIDENCE CARE CENTER 2025 HAYES AVENUE SANDUSKY OH 44870 341658625 LONG TERM CARE FACILITY OH 501(C)3 LINE 9 (SCH. A) FRANCISCAN LIVING COMMUNITIES 1 BURLESON ST JOSEPH HEALTH CARE CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742759890 HEALTHCARE TX 501(C)3 LINE 3 (SCH. A) ST JOSEPH SERVICES CORPORATION 1 BURLESON ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN TX 77802 742913931 NURSING CARE TX 501(C)3 LINE 9 (SCH. A) ST JOSEPH SERVICES CORPORATION 1 FRANCISCAN CARE CENTER SYLVANIA 4111 HOLLAND SYLVANIA RD TOLEDO OH 43623 341931806 LONG TERM CARE FACILITY OH 501(C)3 LINE 9 (SCH. A) FRANCISCAN LIVING COMMUNITIES 1 FRANCISCAN PROPERTIES INC 6832 CONVENT BLVD SYLVANIA OH 43560 341412966 RESIDENTIAL HOUSING OH 501(C)3 LINE 9 (SCH. A) FRANCISCAN LIVING COMMUNITIES 1 FRANCISCAN SERVICES CORP SELF INSURANCE TRUST 6832 CONVENT BLVD SYLVANIA OH 43560 346895492 SELF INSURANCE TRUST OH 501(C)3 LINE 11 (SCH. A) FRANCISCAN SERVICES CORP 1 FRANCISCAN SHELTERS 6832 CONVENT BLVD SYLVANIA OH 43560 341612437 DOMESTIC VIOLENCE SHELTER OH 501(C)3 LINE 1 (SCH. A) FRANCISCAN SERVICES CORP 1 MADISON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742761145 HEALTHCARE TX 501(C)3 LINE 3 (SCH. A) ST JOSEPH SERVICES CORPORATION 1 ROSARY CARE CENTER 6832 CONVENT BLVD SYLVANIA OH 43560 341931795 LONG TERM CARE FACILITY OH 501(C)3 LINE 11 (SCH. A) FRANCISCAN LIVING COMMUNITIES 1 SOPHIA CENTER 6832 CONVENT BLVD SYLVANIA OH 43560 341761656 OUTPATIENT MENTAL HEALTH OH 501(C)3 LINE 9 (SCH. A) FRANCISCAN SERVICES CORP 1 ST CLARE COMMONS 6832 CONVENT BLVD SYLVANIA OH 43560 270163752 LONG TERM CARE FACILITY OH 501(C)3 LINE 9 (SCH. A) FRANCISCAN LIVING COMMUNITIES 1 ST JOSEPH FOUNDATION 2801 FRANCISCAN DRIVE BRYAN TX 77802 742351158 CHARITABLE FUNDRAISING TX 501(C)3 LINE 11 (SCH. A) ST JOSEPH SERVICES CORPORATION 1 ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN TX 77802 742847594 NURSING CARE TX 501(C)3 LINE 9 (SCH. A) ST JOSEPH SERVICES CORPORATION 1 ST JOSEPH PHYSICIAN ASSOCIATES 2801 FRANCISCAN DRIVE BRYAN TX 77802 203159302 PHYSICIAN PRACTICE TX 501(C)3 LINE 3 (SCH. A) ST JOSEPH SERVICES CORPORATION 1 ST JOSEPH REGIONAL HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 741282696 HEALTHCARE TX 501(C)3 LINE 3 (SCH. A) ST JOSEPH SERVICES CORPORATION 1 ST JOSEPH SERVICES CORPORATION 2801 FRANCISCAN DRIVE BRYAN TX 77802 742455161 GOVERNANCE TX 501(C)3 LINE 11 (SCH. A) FRANCISCAN SERVICES CORP 1 ST LEONARD 8100 CLYO RD CENTERVILLE OH 45458 341940863 CONTINUING CARE RETIREMENT COMMUNITY OH 501(C)3 LINE 9 (SCH. A) FRANCISCAN LIVING COMMUNITIES 1 ST LEONARD FOUNDATION 8100 CLYO RD CENTERVILLE OH 45458 320102715 CHARITABLE FUNDRAISING OH 501(C)3 LINE 7 (SCH. A) FRANCISCAN LIVING COMMUNITIES 1 TRINITY CARE CENTER 400 E SAYLES BRENHAM TX 77833 742663229 LONG TERM CARE FACILITY TX 501(C)3 LINE 9 (SCH. A) TRINITY HEALTH SERVICES CORP 1 TRINITY COMMUNITY MEDICAL CENTER 700 MEDICAL PARKWAY BRENHAM TX 77833 742519752 HOSPITAL TX 501(C)3 LINE 3 (SCH. A) TRINITY HEALTH SERVICES CORP 1 TRINITY HEALTH SERVICES CORP 700 MEDICAL PARKWAY BRENHAM TX 77833 742605157 HOLDING COMPANY TX 501(C)3 LINE 11 (SCH.A) FRANCISCAN SERVICES CORP 1 TRINITY HEALTH SERVICES FOUNDATION 700 MEDICAL PARKWAY BRENHAM TX 77833 742460815 CHARITABLE FUNDRAISING TX 501(C)3 LINE 7 (SCH. A) TRINITY HEALTH SERVICES CORP 1 ST LEONARD CENTER LIMITED PARTNERSHIP 88 E BROAD STREET STE 1800 COLUMBUS OH 43215 311481761 LOW INCOME RENTAL OH 0 1 ALLIANCE HEALTH PROVIDERS OF BRAZOS VALLEY 2801 FRANCISCAN DRIVE BRYAN TX 77802 742466914 PHYSICIAN HOSPITAL ORGANIZATION TX N/A C TAU ENTERPRISES 2801 FRANCISCAN DRIVE BRYAN TX 77802 742544009 OFFICE BUILDING RENTAL TX N/A C ST JOSEPH PHYSICIAN ALLIANCE 2801 FRANCISCAN DRIVE BRYAN TX 77802 742764039 COORD EMPL INSUR TX N/A C ST LEONARD CENTER 1 INC 8100 CLYO RD CENTERVILLE OH 45458 311481764 LOW INCOME RENTAL OH N/A C 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0