2021-05-17T09:49:48-05:00 2020-06-30 381357951 PLANTE & MORAN PLLC 250 S HIGH STREET SUITE 100 COLUMBUS OH 43215 990 2019-07-01 311534051 HOLZER SENIOR CARE CENTER HOLZ 7404465195 380 COLONIAL DRIVE BIDWELL OH 45614 MICHAEL HAYNES CFO 7404465195 2021-05-12 1 AMY CIMINELLO P00796388 6148493000 2021-05-07 2019 2022-09-23 18:48:47Z SEE SCHEDULE O MICHAEL CANADY 100 JACKSON PIKE GALLIPOLIS OH 45631 10746831 0 X WWW.HOLZER.ORG X 1996 OH HOLZER SENIOR CARE CENTER IS A SKILLED NURSING FACILITY FOR THE CARE AND TREATMENT OF THE SICK, DISABLED, AND INJURED, PROVIDING CARING AND QUALITY SERVICES TOWARD THE ENHANCEMENT OF PHYSICAL AND MENTAL WELL-BEING WITHOUT REGARD TO THE PERSON'S FINANCIAL RESOURCES. 16 0 262 0 0 0 0 0 9058517 10347408 885 719 117434 398704 9176836 10746831 0 0 0 0 5794463 5748945 0 0 0 4549383 4692606 10343846 10441551 -1167010 305280 15076953 14674145 8460298 7752210 6616655 6921935 X FRIENDLY VISITS, EXCELLENT CARE; EVERY PATIENT, EVERY TIME. 0 0 8450153 0 10628645 HOLZER SENIOR CARE CENTER IS A SEVENTY (70) BED FACILITY, GUIDED BY THE VISION OF QUALITY CARE AND OPTIMUM OUTCOME. IT IS COMMITTED TO IDENTIFY, UNDERSTAND AND RESPOND TO THE NEEDS OF THE RESIDENTS. HOLZER SENIOR CARE CENTER OFFERS:* A MEDICAL DIRECTOR* SKILLED NURSING CARE 24 HOURS PER DAY* REHABILITATION THERAPIES INCLUDING: PHYSICAL THERAPIES, OCCUPATIONAL THERAPIES, SPEECH THERAPY* SHORT AND LONG TERM PLACEMENT OF RESIDENTS* SOCIAL AND THERAPEUTIC ACTIVITIES* PROGRAM FOR HOSPICE PATIENTS* CHAPLAINCY SERVICES* DIETARY SERVICES WITH A QUALIFIED DIETITIAN* PERSONAL CARE (BEAUTICIAN & BARBER SERVICES)* ALL INCLUSIVE ROOM RATE* CABLE TVMEDICAL SUPPORT: HOLZER SENIOR CARE CENTER IS UNDER THE DIRECT SUPERVISION OF A MEDICAL DIRECTOR, WHO HELPS PROVIDE THE LATEST IN HIGH ACUITY CARE. RESIDENTS OF HOLZER SENIOR CARE CENTER MAY USE THE SERVICES OF THE CENTER'S MEDICAL DIRECTOR, OR CONTINUE UNDER THE DIRECT CARE OF THEIR OWN PHYSICIAN. A TRAINED STAFF, COMMITTED TO THE HIGHEST STANDARD IN CARING FOR THE RESIDENTS OF HOLZER SENIOR CARE CENTER IS ON DUTY TWENTY FOUR HOURS A DAY, EVERY DAY.REHABILITATION SERVICES: A COMPLETE RANGE OF REHABILITATION SERVICES IS OFFERED AT HOLZER SENIOR CARE CENTER, CONDUCTED BY REGISTERED THERAPISTS. PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES ARE AVAILABLE TO PROVIDE THE MOST THOROUGH REHABILITATION CARE TO RESIDENTS. A RESTORATIVE NURSING CARE PROGRAM IS AN ONGOING SERVICE TO THE CENTER RESIDENTS. THE WIDE RANGE OF SPECIALIZED THERAPY PROGRAMS ENABLES MANY RESIDENTS TO RESUME THEIR FORMER LIFESTYLES AS THEY BECOME MORE INDEPENDENT.NUTRITIONAL SERVICES: RESIDENTS AT HOLZER SENIOR CARE CENTER ENJOY NUTRITIONAL AND APPETIZING MEALS IN A COMFORTABLE AND ATTRACTIVE DINING SETTING. A REGISTERED DIETITIAN WHO SPECIALIZES IN MEETING EACH RESIDENT'S NEEDS PLANS THE MENUS. BED SIDE SERVICE IS AVAILABLE FOR THOSE RESIDENTS WHO ARE UNABLE TO GO TO THE DINING ROOM FOR THEIR MEALS. FAMILY AND FRIENDS WHO WISH TO DINE WITH THEIR LOVED ONES MAY ALSO PURCHASE A MEAL FOR A NOMINAL FEE.SOCIAL AND RECREATIONAL ACTIVITIES: THE OVERALL ACTIVITY PROGRAM AT HOLZER SENIOR CARE CENTER IS THERAPEUTICALLY DESIGNED BY A QUALIFIED AND EXPERIENCED ACTIVITIES COORDINATOR, WHO GIVES SPECIAL ATTENTION TO THE PHYSICAL, MENTAL, SPIRITUAL, AND SOCIAL NEEDS OF EACH RESIDENT. THERE IS SOMETHING FOR EVERYONE. AMONG THE MOST POPULAR EVENTS ARE THE GAMES, CRAFTS, SING-ALONGS, RELIGIOUS SERVICES, PICNICS, AND COMMUNITY OUTINGS. EACH RESIDENT IS ENCOURAGED TO PARTICIPATE IN WHATEVER ACTIVITIES PROVIDE THE MOST FULFILLMENT AND BEST SERVES HIS OR HER PERSONAL NEEDS.ACCOMMODATIONS: A COMFORTABLE HOME-LIKE SETTING CAN PLAY A MAJOR ROLE IN RESTORING HEALTH AND WELL-BEING. THE ROOMS AT HOLZER SENIOR CARE CENTER ARE SPACIOUS AND SUNNY WITH WINDOWS THAT BRING IN AN ABUNDANCE OF NATURAL LIGHT. RESIDENTS ARE ENCOURAGED TO DECORATE THEIR ROOMS WITH FAVORITE PERSONAL BELONGINGS, SUCH AS QUILTS, PILLOWS, AND PICTURES. THE ROOM RATE AT HOLZER SENIOR CARE CENTER IS AN ALL-INCLUSIVE RATE. NO ADDITIONAL CHARGES ARE MADE FOR PERSONAL GROOMING ITEMS OR LAUNDRY SERVICES. THE ATTRACTIVE SOLARIUM AREAS ARE ALWAYS AVAILABLE FOR THE ENJOYMENT OF THE RESIDENTS, THEIR FAMILIES AND FRIENDS. QUALITY OF LIFE: EVERY MEMBER OF THE STAFF AT HOLZER SENIOR CARE CENTER IS COMMITTED TO ADDRESSING AND MEETING THE NEEDS OF EACH RESIDENT ON A PERSONAL BASIS. THEY RESPECT EVERY RESIDENT'S RIGHT TO PRIVACY, DIGNITY AND TREATMENT AS AN INDIVIDUAL.DURING THE YEAR, HOLZER SENIOR CARE SERVED 146 PATIENTS FOR 23,041 RESIDENT DAYS AND ASSISTED LIVING SERVED 112 PATIENTS FOR 32,120 RESIDENT DAYS. 8450153 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 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 1 2 0 1 262 1 0 0 0 0 0 0 0 0 0 0 0 0 X 16 0 0 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X WILLIAM CRABTREE 7402880192 190 WATER ST SUITE 4 JACKSON OH 45640 DR PHIL LONG TRUSTEE 1.00 49.00 X 0 734673 0 DR MICHAEL CANADY CEO - HHS 1.00 49.00 X 0 648610 0 DR RODNEY STOUT TRUSTEE 1.00 49.00 X 0 454546 0 BRENT SAUNDERS CHAIRMAN HHS 1.00 49.00 X X 0 446228 1719 MICHAEL HAYNES CFO - HHS 1.00 49.00 X 0 374000 0 DR DANIELLE CAPPELLETTI TRUSTEE 1.00 49.00 X 0 354778 0 DR LANCE BROY TRUSTEE 1.00 49.00 X 0 341356 0 DR JARED SHEETS TRUSTEE 1.00 49.00 X 0 304622 0 DR RENUKA KANDULA TRUSTEE 1.00 49.00 X 0 265971 0 STEVE CHAPMAN TRUSTEE 1.00 3.00 X 0 24000 0 LARRY KIDD TREASURER 1.00 3.00 X X 0 24000 0 DANNY HOLSCHUH TRUSTEE 1.00 3.00 X 0 24000 0 GARY ROACH TRUSTEE 1.00 3.00 X 0 24000 0 PAUL REED TRUSTEE 1.00 3.00 X 0 24000 0 BOB GRILLO TRUSTEE 1.00 3.00 X 0 24000 0 BRAD MUNN TRUSTEE 1.00 3.00 X 0 24000 0 ROBBIE PUGH TRUSTEE 1.00 1.00 X 0 24000 0 TOM WISEMAN TRUSTEE 1.00 3.00 X 0 24000 0 0 4140784 1719 0 0 1 0 RELIANT REHABILITATION PO BOX 207773 DALLAS TX 75320 CONTRACT THERAPY 845499 SKILLED CARE PHARMACY 6175 HI-TEK COURT MASON OH 45040 PHARMACY SERVICES 225062 SHIFTWISE INC 200 SW MARKET ST SUITE 700 PORTLAND OR 97201 MEDICAL STAFFING 121004 3 PROGRAM SERVICES 623000 9545768 9545768 RESIDENT MEALS 623000 763140 763140 ADMISSION FEES 623000 38500 38500 10347408 719 719 COVID RELIEF FUNDS 623000 281237 281237 PHONE INCOME 623000 57478 57478 CABLE TV INCOME 623000 51851 51851 8138 8138 398704 10746831 10628645 0 118186 4038062 3607420 430642 1529681 1383704 145977 181202 170269 10933 1016104 399676 616428 199651 183191 16460 316083 296665 19418 198665 188732 9933 461691 438606 23085 THERAPY 834120 834120 FOOD 381492 358669 22823 MEDICAL SUPPLIES 361518 361518 0 FRANCHISE TAX/PROPERTY 360319 4367 355952 562963 223216 339747 10441551 8450153 1991398 0 1950 2089 678173 1230489 1131204 983043 10000 10000 366836 109495 15705245 9086265 7025559 6618980 246973 167567 4432080 4432080 1184178 1120402 15076953 14674145 1756363 3108745 99674 3813684 3304678 2890251 1239113 8460298 7752210 X 6616655 6921935 6616655 6921935 15076953 14674145 305280 0 X X 0 1 X 1 0 X 9356648 9114039 9678049 9058517 10628645 47835898 9356648 9114039 9678049 9058517 10628645 47835898 0 0 0 47835898 790 788 780 885 719 3962 790 788 780 885 719 3962 125836 124969 131851 117434 117467 617557 9483274 9239796 9810680 9176836 10746831 48457417 0.98720 0.98640 0.00010 0.00010 X 542107 542107 11631828 7163352 4468476 2687369 1794713 892656 843941 128200 715741 6618980 INTERCOMPANY RECEIVABLE 797136 ASSETS LIMITED AS TO USE 322266 DEPOSITS 1000 1120402 INTERCOMPANY PAYABLE 1239113 1239113 0 0 0 0 0 0 0 0 0 DR PHIL LONG TRUSTEE 0 734673 0 0 0 0 0 0 0 0 0 734673 0 0 DR MICHAEL CANADY CEO - HHS 0 590145 0 58465 0 0 0 0 0 0 0 648610 0 0 DR RODNEY STOUT TRUSTEE 0 420246 0 34300 0 0 0 0 0 0 0 454546 0 0 BRENT SAUNDERS CHAIRMAN HHS 0 405662 0 40566 0 0 0 0 0 1719 0 447947 0 0 MICHAEL HAYNES CFO - HHS 0 340000 0 34000 0 0 0 0 0 0 0 374000 0 0 DR DANIELLE CAPPELLETTI TRUSTEE 0 354778 0 0 0 0 0 0 0 0 0 354778 0 0 DR LANCE BROY TRUSTEE 0 341356 0 0 0 0 0 0 0 0 0 341356 0 0 DR JARED SHEETS TRUSTEE 0 304622 0 0 0 0 0 0 0 0 0 304622 0 0 DR RENUKA KANDULA TRUSTEE 0 265971 0 0 0 0 0 0 0 0 0 265971 0 0 PART I, LINE 3 COMPENSATION PAID TO THE ORGANIZATION'S CEO IS ESTABLISHED BY A RELATED ORGANIZATION, HOLZER HEALTH SYSTEM, AND INCLUDES USE OF AN INDEPENDENT COMPENSATION CONSULTANT AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION A, LINE 6 HOLZER HEALTH SYSTEM IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B HOLZER SENIOR CARE CENTER'S DECISIONS THAT ARE MADE BY THEIR BOARD OF DIRECTORS CAN BE OVERRULED BY HOLZER HEALTH SYSTEM'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE CONTROLLER AND THE CFO OF HOLZER HEALTH SYSTEM REVIEW FORM 990. A COPY WILL BE PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE COMPLETED ANNUALLY AND ARE REVIEWED BY THE CONFLICT OF INTEREST REVIEW COMMITTEE. MEMBERS OF THE BOARD ARE AWARE THAT THEY SHOULD DISCLOSE CONFLICTS WHEN THEY ARISE, AND MEMBERS ABSTAIN FROM PARTICIPATING IN DISCUSSIONS OR VOTING ON MATTERS WHERE A CONFLICT IS PRESENT. FORM 990, PART VI, SECTION B, LINE 15 THE HOLZER HEALTH SYSTEM BOARD APPROVES COMPENSATION OF THE CEO AND OTHER OFFICERS. THE BOARD UTILIZES WAGE RECOMMENDATIONS FROM AN UNRELATED CONSULTANT TO DETERMINE THE COMPENSATION. THE CEO MAY BE INVOLVED IN DETERMINING OTHER OFFICERS' COMPENSATION, HOWEVER THE ULTIMATE DECISION RESTS WITH THE BOARD. THE PROCESS WAS LAST UNDERTAKEN DURING 2019 AS THERE WERE NO EXECUTIVE COMPENSATION CHANGES NECESSARY IN 2020. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 2C: THE AUDIT OVERSIGHT PROCESS AND THE PROCESS OF SELECTION OF AN INDEPENDENT ACCOUNTANT HAVE NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PAGE 1, LINE C: DOING BUSINESS AS: HOLZER ASSISTED LIVING - GALLIPOLIS HOLZER ASSISTED LIVING - JACKSON HOLZER ASSISTED LIVING - GALLIPOLIS 300 BRIARWOOD DR GALLIPOLIS OH 45631 311534051 ASSISTED LIVING OH 2356690 5691289 HOLZER SENIOR CARE CENTER HOLZER ASSISTED LIVING - JACKSON 101 MARKHAM DRIVE JACKSON OH 45640 311534051 ASSISTED LIVING OH 1974840 4409320 HOLZER SENIOR CARE CENTER HOLZER HEALTH SYSTEM 100 JACKSON PIKE GALLIPOLIS OH 45631 311156690 MANAGEMENT SERVICES OH 501(C)(3) LINE 12A, I N/A 0 HOLZER HOSPITAL FOUNDATION 100 JACKSON PIKE GALLIPOLIS OH 45631 314379491 HEALTH CARE OH 501(C)(3) LINE 3 HOLZER HEALTH SYSTEM 1 HOLZER MEDICAL CENTER - JACKSON 100 JACKSON PIKE GALLIPOLIS OH 45631 311724085 HEALTH CARE OH 501(C)(3) LINE 3 HOLZER HEALTH SYSTEM 1 HOLZER HERITAGE FOUNDATION 100 JACKSON PIKE GALLIPOLIS OH 45631 310927482 CONTINUING ADVANCEMENT OF HEALTH AND MEDICAL CARE OH 501(C)(3) LINE 10 HOLZER HEALTH SYSTEM 1 HOLZER VANGUARD INC 100 JACKSON PIKE GALLIPOLIS OH 45631 311192567 STOCK HOLDING COMPANY OH N/A C 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0