2011-11-14T09:30:10-06:00 2010-12-31 990 2010-01-01 341193296 OTTERBEIN PORTAGE VALLEY INC OTTE 4198337000 20311 PEMBERVILLE Road PEMBERVILLE OH 43450 J Christopher Green 5139335400 2011-10-18 2010 2016-03-07 17:11:31Z J CHRISTOPHER GREEN 580 N SR 741 Lebanon OH 45036 8095831 0 X WWW.OTTERBEIN.ORG X 1975 OH OTTERBEIN PORTAGE VALLEY, INC. IS A CONTINUING CARE RETIREMENT COMMUNITY THAT PROVIDES HOUSING AND SERVICES FOR OLDER ADULTS. 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 THE SURROUNDING COMMUNITIES. OTTERBEIN RESIDENTS AND STAFF VOLUNTEER THEIR TIME AND TALENTS AT OTTERBEIN portage valley, inc. BUT ALSO FOR A NUMBER OF ORGANIZATIONS AND CAUSES IN THE GREATER COMMUNITY. 19 16 184 52 0 0 52761 99779 7764545 7878186 39157 117866 17595 0 7874058 8095831 0 0 0 0 3259848 3383809 0 0 0 4381839 4393023 7641687 7776832 232371 318999 16073386 16050824 11240881 11555095 4832505 4495729 In keeping with the United Methodist tradition we seek to enhance the quality of life and holistic growth of older persons. 0 0 6594146 7878186 Otterbein Portage Valley, inc. 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. 6594146 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 27 0 1 184 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 19 16 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 OH X J CHRISTOPHER GREEN 5139335400 580 N SR 741 LEBANON OH 450368839 Larry Moore 1.00 X 0 0 0 Charles Shanfelt 1.00 X 0 0 0 Cheryl Conley 1.00 X 0 0 0 Paul Blausey 1.00 X 0 0 0 Joe Frederick 1.00 X 0 0 0 Glenn Maddy 1.00 X 0 0 0 Michael Moore 1.00 X 0 0 0 James Nofzinger 1.00 X 0 0 0 Ken Ault 1.00 X 0 0 0 Arlene Layman 1.00 X 0 0 0 Bernard Sanchez 1.00 X 0 0 0 Frank Stumpf 1.00 X 0 0 0 Thelma Thompson 1.00 X 0 0 0 Thomas Compton 1.00 X 0 0 0 J Douglas Ruck 1.00 X 0 0 0 Luann Snyder 1.00 X 0 0 0 Alice Davis 1.00 X 0 0 0 Jill Hreben 40.00 X 0 250908 17793 James Christopher Green 40.00 X 0 170383 13154 Donald Gilmore 40.00 X 0 126927 0 0 548218 30947 0 1 1 0 Concept Rehab Inc 7150 Granite Circle Toledo OH 43617 Therapy Services 440573 1 99779 2935 99779 Resident revenue & fee 623000 7748312 7748312 Departmental Revenue 623000 129874 129874 7878186 116019 116019 1847 1847 1847 1847 8095831 7878186 0 117866 2639233 2307141 332092 115530 100993 14537 225109 157652 67457 403937 377410 26527 14022 14022 11811 11811 780398 611548 168850 710219 702117 8102 16196 9439 6757 414908 408068 6840 859746 845573 14173 112353 110501 1852 Nurse Agency Fees/Contr 514059 514059 Intercompany Expense 466008 466008 Refundable Life Use Fee 232454 232454 Other Administration 215429 193807 21622 Dues, subscriptions, & 24687 3908 20779 20733 19476 1257 7776832 6594146 1182686 0 177041 446510 22200 476812 515080 36645 42258 18647 18572 24925015 12606628 12355341 12318387 1653120 1965780 1355780 722037 16073386 16050824 622869 1432272 789438 1094922 9109319 8155486 719255 872415 11240881 11555095 X -511911 -146329 5179216 4475858 165200 166200 4832505 4495729 16073386 16050824 X 318999 -655775 X X 0 1 1 X 0 X 82674 219716 71009 52761 99779 525939 9836109 8702508 7213621 7764545 7878186 41394969 9918783 8922224 7284630 7817306 7977965 41920908 4648 4508 5372 14528 0 4648 4508 5372 14528 41906380 86219 157103 3207 25664 116019 388212 86219 157103 3207 25664 116019 388212 10005002 9079327 7287837 7842970 8093984 42309120 0.99050 0.99290 0.00920 0.00690 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 151422 151422 18226932 7588760 10638172 4554696 3566143 988553 1991965 1451725 540240 12318387 Investments 1965780 F 1965780 Refundable portion of refundable life use fees 175044 split-interest agreement 69950 deferred cost of interest rate swap 627421 872415 8095831 7776832 318999 -655775 -655775 -336776 Description of Uncertain Tax Positions Under FIN 48: Part X: 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 tax under the 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 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 Organization's 2009, 2008, and 2007 tax years are open for examination by the IRS. Part XI, Line 8 - Other Adjustments: Change in fair value of interest rate swap change in value of split-interest agreement Change in unrealized gains/losses change in minimum pension liability reversal of intercompany notes 1 X X X X X 0 1 0 0 0 0 0 0 0 Jill Hreben 0 250908 0 0 0 0 0 0 0 17793 0 268701 0 0 James Christopher Green 0 170383 0 0 0 0 0 0 0 13154 0 183537 0 0 Donald Gilmore 0 0 0 0 0 126927 0 0 0 0 0 126927 0 0 Supplemental Information Part III Part 1, Line 4b: Donald Gilmore, former President/CEO, received other compensation through a Board approved supplemental retirement plan. X misc items 12 2935 market value 0 1 0 Form 990, Part VI, Section B, line 11 Form 990, Part VI, Section A, line 10: The 990's are prepared internally by a Senior Staff Accountant and the Controller. They are reviewed by the Chief Financial Officer and the external audit firm. The 990's are available for review by the Board subsequent to filing with the IRS. Form 990, Part VI, Section B, line 12c 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 Form 990, Part VI, Section B, line 15: The executive committee of the Otterbein Homes Board of Directors 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 18 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 CEO and CFO. Form 990, Part VI, Section C, line 19 The governing documents and conflict of interest policy are available upon request. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Change in fair value of interest rate swap -92585. change in value of split-interest agreement -21726. Change in unrealized gains/losses 45119. change in minimum pension liability -90079. reversal of intercompany notes -496504. Total to Form 990, Part XI, Line 5: -655775. Form 990, Page 12, Part XII, Line 2c: There have been no changes in the oversight or the selection of an independent accountant from the prior year. Otterbein Portage Valley LLC 580 N State Rt 741 Lebanon OH 45036 270512972 Real Estate Holding Company OH 151422 N/A Otterbein Homes 580 North State Route 741 Lebanon OH 45036 310549058 parent OH 501(c)3 509(a)(3) N/A 0 Otterbein Cridersville 100 Red Oak Drive Cridersville OH 45806 341940884 Retirement Living Community OH 501(c)3 509(a)(2) N/A 0 Otterbein North Shore 9400 North Shore Blvd Lakeside OH 43440 341743836 Retirement Living Community OH 501(c)3 509(a)(2) N/A 0 Otterbein St Marys 11230 State Route 364 St Marys OH 45885 341940880 Retirement Living Community OH 501(c)3 509(a)(2) N/A 0 Otterbein Lebanon 585 State Route 741 Lebanon OH 45036 311743874 Retirement Living Community OH 501(c)3 509(a)(2) N/A 0 Otterbein Leipsic 580 North State Route 741 Lebanon OH 45036 341940875 Retirement Living Community OH 501(c)3 509(a)(2) N/A 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 Otterbein Homes L 466008