2022-11-15T13:30:05-07:00 2021-12-31 990 2021-01-01 341040692 ST AUGUSTINE MANOR STAU 2166347400 7801 Detroit Avenue Cleveland OH 44102 Francis Huba CFO 2166347555 2022-03-30 1 11 0 AAL2 2021 2022-09-23 18:48:47Z Rick Meserini 7801 Detroit Avenue Cleveland OH 44131 40008569 0 X www.staugustinehealthministries.org X 1969 OH St. Augustine Manor dba St. Augustine Health Ministries provides skilled nursing and community based services including; an early education and child day care, assisted living, rehabilitation, long-term care, home delivered and congregate meals, home care and hospice care. 19 18 453 79 0 0 3346533 3309963 34603153 35965250 43367 60709 2543642 672647 40536695 40008569 0 0 0 0 26376117 25391067 0 0 142266 11689576 12740611 38065693 38131678 2471002 1876891 31210513 33180606 6724271 6402107 24486242 26778499 St. Augustine Health Ministries continues the healing ministry of Christ by promoting the quality of life and independence of each person entrusted to our care through a continuum of health care and related services to the chronically ill and aging of our community with special concern for the poor. We promote the sacredness of life in a community that celebrates purpose, individuality, companionship and well-being. 0 0 24118034 12586 25152830 Skilled Nursing Home Care: 234 bed skilled nursing facility with an in-house Pharmacy and on-site dialysis. The facility was last surveyed by the Ohio Department of Health in December 2019 and fared well receiving only 3 low level, low in scope and severity, citations. All patient floors were remodeled/renovated in 2015, including our 67 bed skilled care unit. A Respiratory Wing was added in 2018 and renovations to the rest of the building continue into 2020. We are a 4 star facility according to CMS ratings. We placed 41st on the Plain Dealer's top 50 work places for mid-sized companies, and were the only Skilled Nursing Facility to make the list. We specialize in Pulmonary Care, Rehabilitation, Cardio Vascular Diseases, Infectious Diseases, Wound Care, HIV Care, Respiratory and Clinically-Complex Nursing Care. We partnered with all major hospital systems in greater Cleveland ensuring seamless transitions to a sub-acute setting for patients who are followed by the system's attending physician. We had 358 new admissions in 2021. 6977865 0 7559393 Medicare-Certified Hospice: Community hospice services extending beyond Cuyahoga County into Summit, Medina and Lorain Counties, as well as a recently remodeled 30 bed inpatient facility with mostly private rooms. With an average daily census of over 92 patients, Holy Family Home/Hospice served over 551 patients in 2021 and provided nearly $1.44 million of free charity care. Holy Family Home has expanded its services to provide palliative care to the community through Holy Family Home Health Care. Holy Family Hospice systematically scores well on patient and family satisfaction surveys, as 92% of families who have used our services would recommend Holy Family Hospice to their friends and relatives. 2676244 0 3070998 Assisted Living Facility: St. Augustine Towers is a licensed residential care facility with 99 apartments, daily Mass in our chapel on site, and a capacity to serve 110 residents. The Towers focuses on their mission to serve the underserved and downtrodden populations in our communities. The Towers was well below average for the number of citations during a survey conducted by the Ohio Department of Health. The Towers had a perfect survey in 2021conducted by Western Reserve Area on Aging. The Towers has been a part of the Medicaid waiver program through WRAAA since 2007 serving an average of 18 residents a month under this program which allows a qualified AL waiver recipient to receive rent subsidies affording them an apartment and all offered amenities. The Towers also serves persons with a VA benefit earned during armed conflict for which the veteran or the spouse receives a monthly stipend that is used for rent. The Towers is contracted with the PACE program, a Medicaid waiver program that also subsidizes qualified AL waiver recipients to afford monthly rent and provides physician services and medical care allowing residents to age in place. Throughout 2021 we averaged 42 residents on the PACE program. Throughout the pandemic, the Towers were able to continue all life enrichment activities whilst mitigating the risk and spread of COVID-19 by strictly following CDC and ODH guidelines. Our 2021 occupancy of 94% is well above both national and state averages demonstrating our consistently high resident/family satisfaction despite the pandemic. 735822 0 854675 Home Health Care Agency and other programs. 735822 0 854675 34507965 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 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 0 1 0 0 0 1 102 0 1 453 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 19 18 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X X Francis S Huba 2166347400 7801 Detroit Avenue Cleveland OH 44102 Rick Meserini President/CEO Ex-Officio Board of Trustees 39 1 X 226360 0 38465 Patrick Gareau Ex-Officio of Board of Directors/Secretariat of Catholic Charities 1 39 X 0 224409 34136 Francis Huba CFO 39 1 X 187616 0 15713 Jorge Palma Licensed Practical Nurse 68 0 X 144127 0 31578 Colleen Wilson Director of Nursing 40 0 X 140317 0 19142 Kristin Graham Executive Director of Hospice and Home Health Care 40 0 X 123680 0 20184 Jennifer Thomas Licensed Practical Nurse 69 0 X 125104 0 12709 Elayne Newcomb Sr Administrator 40 0 X 103617 0 32482 The Most Reverend Edward C Malesic Board Member - Bishop of Diocese of Cleveland 1 0 X 0 0 0 Mark Seryak Board of Directors - Ex-Officio 1 0 X 0 0 0 J Thomas Hannon Honorary Trustee of Board of Directors 1 0 X 0 0 0 Janet Gosche Board of Directors Trustee Officer-Vice Chairperson 1 0 X 0 0 0 Linda Sheehan Board of Dircetors Trustee 1 0 X 0 0 0 Theresa Dawson Board of Directors Trustee 1 0 X 0 0 0 Edward Hack Board of Directors Trustee 1 0 X 0 0 0 John Faulstich Board of Directors Trustee Officer-Treasurer 1 0 X 0 0 0 Deborah Enty Board of Directors Trustee 1 0 X 0 0 0 Erik Huss Board of Directors Trustee 1 0 X 0 0 0 Karen McCarthy Board of Directors Trustee 1 0 X 0 0 0 Joseph Sciarrillo Board of Directors Trustee 1 0 X 0 0 0 Robert Pumphrey Board of Directors Trustee Officer-Secretary 1 0 X 0 0 0 Peter P Jancar Board of Directors Trustee 1 0 X 0 0 0 Damon Taseff Board of Directors Trustee Officer-Chair 1 0 X 0 0 0 Patricia Snowbrick Board of Directors Trustee 1 0 X 0 0 0 Marilyn Streeter Board of Directors Trustee 1 0 X 0 0 0 1050821 224409 204409 13 0 1 0 Gordon Food Service PO Box 88029 Chicago IL 606801029 Food Service 1146758 Intely Care Inc PO Box 200413 Pittsburgh PA 152510413 Staffing Nurses 774537 McKesson Medical-Surgical Supply Inc PO Box 630693 Cincinnati OH 45263 Medical Supplies 564176 Connect RN Inc PO Box 208685 Dallas TX 753208685 Staffing Nurses 436374 Medline Industries Inc PO Box 382075 Pittsburgh PA 152518075 Medical Supplies 260654 16 4484 0 0 1414704 12586 1878189 0 3309963 Nursing Home Care 623110 23949576 23949576 0 0 Hospice Care 623110 7362794 7362794 0 0 Assisted Living Care 623311 2972132 2972132 0 0 Home Health Care 621610 854675 854675 0 0 Child Care 624410 503923 503923 0 0 322150 322150 0 0 35965250 64136 0 0 64136 0 0 0 0 0 0 0 0 0 0 0 -3427 0 0 0 -3427 -3427 -3427 0 0 0 Coronavirus/Provider Relief Funds 623110 273000 273000 0 0 Insurance Settlement 623110 184449 184449 0 0 Dietary 722212 147029 147029 0 0 68169 68169 0 0 672647 40008569 36634470 0 64136 0 0 0 0 0 0 0 0 424905 0 424905 0 0 0 0 0 20276994 18023178 2160978 92838 582003 526430 51175 4398 2612800 2359167 234179 19454 1494365 1352286 130862 11217 315000 222429 92571 0 18673 0 18673 0 44603 0 44603 0 0 0 0 0 0 0 0 0 0 0 2518897 2484834 34063 0 132253 113379 15858 3016 548987 300205 239890 8892 265530 236983 26096 2451 0 0 0 0 2194155 2193080 1075 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1227394 1227394 0 0 364955 358436 6519 0 Medical Supplies 2140843 2140843 0 0 Raw Food and Supplies 1668801 1668801 0 0 Bad Debt 217800 217800 0 0 Bed Tax 1081282 1081282 0 0 1438 1438 0 0 38131678 34507965 3481447 142266 2121182 1575382 4267886 4647116 0 0 5780492 6827264 0 0 0 0 0 0 207076 166118 52437 84371 35094292 24324913 10172373 10769379 0 0 465182 501862 0 0 345000 345000 7798885 8264114 31210513 33180606 6142796 5949322 0 0 506529 386207 0 0 0 0 0 0 0 0 0 0 74946 66578 6724271 6402107 X 16869050 18921541 7617192 7856958 24486242 26778499 31210513 33180606 1876891 415366 0 0 0 0 X X 0 1 X 1 1 1 X 3313131 4251598 3334482 3346532 3309963 17555706 30773616 31924239 33515944 34875267 35965250 167054316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34086747 36175837 36850426 38221799 39275213 184610022 1428869 1776647 1623525 1476652 1414704 7720397 0 0 0 0 0 0 1428869 1776647 1623525 1476652 1414704 7720397 176889625 61845 56466 68194 43796 64136 294437 0 0 0 0 0 0 61845 56466 68194 43796 64136 294437 0 0 0 0 0 0 0 0 0 2271100 273000 2544100 34148592 36232303 36918620 40536695 39612349 187448559 0.94367 0.94194 0.00157 0.00163 X Schedule A, Part III, Line 12 St. Augustine received $273,000 from the Provider Relief Fund administered by the Department of Health and Human Services to provide support for coronavirus related expenses and lost revenue attributed to the COVID-19 pandemic. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 715182 7095 29585 0 0 0 751862 688532 2110 24540 0 0 0 715182 648039 3813 36680 0 0 0 688532 657383 13366 -22418 0 285 7 648039 630149 2835 24412 0 0 13 657383 0 1 0 0 1 1 0 0 0 0 20522531 12177023 8345508 0 4168 4168 0 0 13264761 11609353 1655408 0 1302832 534369 768463 10769379 Board Designated Funded Depreciation 1147411 Deposits Workers' Compensation 2809 Deferred Contributions 457B Plan 81468 Investments held in Perpetual Trust 6782426 Endowment Funds 250000 8264114 0 Security Deposits 66578 66578 X Schedule D, Part V, Line 4 Board Designated net assets consist of Board controlled investments that have been raised for the support of the Manor. Permanently restricted endowment funds represent funds which are restricted as to use in perpetuity. Endowment Funds are appropriated based on an approval process through the Board of Directors. Specific committees recommend amounts to be disbursed from the accumulated earnings of the endowment funds, which are then approved for appropriation by the Board of Directors. Schedule D, Part X, Line 2 St Augustine Manor adopted the accounting standard on accounting for uncertainty in income taxes, which addresses the determination of whether tax benefits claimed or expected to be claimed on a tax return should be recorded in the financial statements. Under this guidance, the Manor may recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by taxing authorities, based on the technical merits of the position. Examples of tax positions include the tax-exempt status of St. Augustine Manor and various positions related to the potential sources of unrelated business taxable income (UBIT). The tax benefits recognized in the financial statements from such a position are measured based on the largest benefit that has a greater that 50 percent likelihood of being realized upon ultimate settlement. The guidance on accounting for uncertainty in income taxes also addresses de-recognition, classification, interest and penalties in income taxes, and accounting in interim periods. At December 31, 2021, there were no unrecognized tax benefits identified or recorded as liabilities. 0 1 0 0 0 0 0 0 0 Patrick Gareau Ex-Officio of Board of Directors/Secretariat of Catholic Charities 0 224409 0 0 0 0 0 13726 0 20410 0 258545 0 0 Rick Meserini President/CEO Ex-Officio Board of Trustees 226360 0 0 0 0 0 9131 0 29334 0 264825 0 0 0 Francis Huba CFO 170539 0 0 0 17077 0 7325 0 8388 0 203329 0 0 0 Schedule J, Part I, Line 4 Highly paid individuals may participate in the Section 457 plan established, but not funded by the employer, to allow participants in the 401(k) retirement plan to substitute salary deferrals under the 401(k) that are retroactively denied when ERISA compliance testing is completed and low participation rates by lower paid employees is revealed. Frank Huba contributed $17,077 in 2021 to the Section 457 plan. Form 990, Part VI, Section A, Line 6 The Organization has 3 members: 1.)The Board of Directors jointly and collectively 2.)The Secretariat of Catholic Charities Corporation and 3.)The Roman Catholic Bishop of the Diocese of Cleveland. Form 990, Part VI, Section A, Line 7a The members can be elected by the Secretariat and the Bishop, or deferred to the nominating committee of the Board of Directors to make recommendations for new Board members. Form 990, Part VI, Section A, Line 7b The Bishop and the Secretariat must approve appointment of new members to the Board of Directors as well as annual operating and capital budgets. The entity cannot sell or acquire real property without the approval of the Bishop and the Secretariat, nor may it take on long-term debt without their approval. Form 990, Part VI, Section B, Line 11b The 2021 Form 990 was prepared in-house on the same basis, and using the guidance provided by an independent accounting firm. Prior to filling, Form 990 is reviewed by the Chief Financial Officer and the Chief Executive Officer. Form 990, Part VI, Section B, Line 12c All employees, including Officers, Directors, Trustees and Key employees are required to disclose interests that could give rise to conflict at the time of hire or appointment. They are then further instructed to notify the organization of any changes during their tenure that could be considered a conflict of interest. The disclosure must be signed by the employee and their supervisor. This is a required part of the annual employee evaluation process. Starting in 2014, annual disclosures of potential conflict of interest are required of Board members. No conflicts have been identified initially or subsequently. Form 990, Part VI, Section B, Line 15 The President/CEO's salary is set by the Secretariat of Catholic Charities Corporation within prescribed guidelines and is approved by the Bishop of the Diocese of Cleveland. All positions within the organization are scaled based on duties and responsibilities. Those scales are rated and evaluated by the Human Resources department using comparative salary and wage surveys from the not-for-profit Nursing Home Trade Association. Individual salaries are determined within the established pay range for each position. Form 990, Part VI, Section C, Line 19 The Organization makes its governing documents, conflict of interest policy and audited financial statements available to the public upon written request. Annual Form 990 is available through Guide Star. Form 990, Part XII, Line 2c The Organization has a committee that assumes responsibility for the oversight of the audit and selection of an Independent Accountant. This process has not changed during the year. Form 990, Part XII, Line 3a The organization expended over 1.7 million in Provider Relief Funds distributed by the Department of Health and Human Services for COVID-19 expenses in 2020 and 2021. However, the 2020 audit requirement was deferred to 2021 such that two years of SEFA's would be combined and reported in 2021 only. St Augustine Services Corporation 7801 Detroit Avenue Cleveland OH 44102 341609330 Medical Services OH 501(c)(3) Line 9 N/A 0 Catholic Charities Corporation 7911 Detroit Avenue Cleveland OH 44102 341318541 Social Services OH 501(c)(3) Line 11A, I N/A 0 Rose-Mary Center 19350 Euclid Avenue Euclid OH 44117 341267579 Disability Care OH 501(c)(3) Line 1 N/A 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 Form 8868, application for extension of time to file Form 990, was sent to the IRS on March 18, 2022 by certified mail. Form 8868 was received and date stamped by the IRS on April 7,2022. A letter of approval was received on June 13, 2022 from the IRS approving an automatic extension to file Form 990 until November 15, 2022. So this return is not late.