2019-11-14T08:36:51-06:00 2018-12-31 340677006 MALONEY NOVOTNY LLC 1111 SUPERIOR AVE SUITE 700 CLEVELAND OH 441142540 990 2018-01-01 340714765 SISTERS OF ST JOSEPH OF ST MARK SIST 2165317426 21800 CHARDON ROAD EUCLID OH 44117 MOTHER M RAPHAEL GREGG PRESIDENT 2165317426 2019-11-07 1 CHRISTOPHER B ANDERSON P00226559 2163630100 209.116.109.2 2019-11-07 13:54:56 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 0B316B399EFEFC22F92101C2AC7A3AB7697B62CF 2018 2020-04-17 16:48:07Z MOTHER M RAPHAEL GREGG 21800 CHARDON ROAD EUCLID OH 44117 8350580 0 X N/A X 1971 OH 99 BED NURSING HOME LICENSED BY THE STATE OF OHIO. THE NURSING HOME IS A SKILLED NURSING FACILITY OPERATED BY THE SISTERS OF ST. JOSEPH OF ST. MARK FOR THE CARE OF THE ELDERLY. 1 1 305 23 0 0 2000100 58929 8228694 7946503 24 30 112 345118 10228930 8350580 0 0 0 0 4714418 4714488 0 0 0 4020263 4275771 8734681 8990259 1494249 -639679 4266504 3416657 1377354 1167186 2889150 2249471 99 BED NURSING HOME LICENSED BY THE STATE OF OHIO. THE NURSING HOME IS A SKILLED NURSING FACILITY OPERATED BY THE SISTERS OF ST JOSEPH OF ST MARK FOR THE CARE OF THE ELDERLY. THE SISTERS ARE OF A RELIGIOUS ORDER. 0 0 8551703 8291621 LICENSED NURSING HOME THAT CARES FOR THE ELDERLY, FRAIL AND SICKRESIDENTS. IT IS A 24-HOUR, 365-DAY OPERATION THAT IS OPERATED BYTHE SISTERS OF ST. JOSEPH OF ST. MARK, WHICH IS A RELIGIOUS ORDEROF SISTERS. THE SERVICES THEY PROVIDE INCLUDE BUT ARE NOT LIMITEDTO PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, SKILLEDNURSING CARE, DIETARY MEALS, ACTIVITIES, HOUSEKEEPING AND LAUNDRY. 8551703 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 6 0 1 305 1 0 0 0 0 0 0 0 0 0 0 0 0 X 1 1 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X MOTHER M RAPHAEL GREGG 2165317426 21800 CHARDON ROAD EUCLID OH 44117 X MOTHER M RAPHAEL GREGG PRESIDENT 60.00 X X 0 0 0 E TIMOTHY HOLZHEIMER ASST. TREASURER 2.00 X 0 0 0 0 0 0 0 0 0 0 ABSOLUTE REHABILITATION 339 EAST MAPLE ST NORTH CANTON OH 44720 PHYSICAL THERAPY 557950 GORDON FOOD SERVICE DEPT CH 10490 PALATINE IL 43271 FOOD AND SUPPLIES 264921 GENERATIONS HEALTHCARE MGMT 2 BEREA COMMONS BEREA OH 44017 MANAGEMENT SVCS 249626 MEDLINE INDUSTRIES INC 6780 MAYFIELD RD WADSWORTH OH 44281 MEDICAL PRODUCTS&SVCS. 185595 ABSOLUTE PHARMACY 339 E MAPLE ST NORTH CANTON OH 44720 PHARMACY SERVICES 147828 6 58929 58929 MEDICAID 623000 3929065 3929065 MEDICARE 623000 1929022 1929022 SELF PAY 623000 1633262 1633262 MANAGED CARE 623000 287368 287368 HOSPICE 623000 167786 167786 7946503 30 30 DEBT FORGIVENESS 900099 214870 214870 CONTRACTOR SETTLEMENT 900099 130248 130248 345118 8350580 8291621 0 30 3859876 3651139 208737 518185 487094 31091 336427 316241 20186 252146 237017 15129 157878 148405 9473 37593 35337 2256 11723 11020 703 44669 41989 2680 59800 56212 3588 1083667 1019862 63805 5470 5142 328 24043 19715 4328 109798 103210 6588 CONTRACTED SERVICES 750666 706272 44394 SUPPLIES 683239 665909 17330 FRANCHISE PERMIT FEE 461086 461086 0 ANCILLARY SERVICES 136412 133888 2524 457581 452165 5416 8990259 8551703 438556 0 2421645 1538767 1741667 1793461 15337 9477 208350 133398 87855 74952 4266504 3416657 1377354 1167186 1377354 1167186 X 2889150 2249471 2889150 2249471 4266504 3416657 -639679 0 X 0 1 X 0 0 X 1000197 1000000 2000100 58929 4059226 7915733 7653138 8396225 8228806 7946503 40140405 7915733 8653335 9396225 10228906 8005432 44199631 0 0 0 44199631 50 5 14 25 30 124 50 5 14 25 30 124 345118 345118 7915783 8653340 9396239 10228931 8350580 44544873 0.99220 1.00000 0.00000 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISC INCOME - 2018 AMOUNT: $ 345,118. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 43508 21055 22453 164842 112343 52499 74952 8350580 0 8350580 0 8350580 8990259 0 8990259 0 8990259 FORM 990, PART VI, SECTION A, LINE 3 DELEGATION OF MANAGEMENT DUTIES: THE ORGANIZATION HAS DELEGATED CERTAIN OPERATIONAL AND MANAGEMENT DUTIES AND DECISIONS TO GENERATIONS, A COMPANY THAT IS UNRELATED TO THE OFFICERS AND DIRECTORS OF THE ORGANIZATION. THE FEES PAID FOR THESE MANAGEMENT SERVICES ARE AT OR BELOW FAIR MARKET VALUE. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OF THE ORGANIZATION: THE MEMBER OF THE CORPORATION IS THE RELIGIOUS ORDER OF THE SISTERS OF ST. JOSEPH OF ST. MARK. FORM 990, PART VI, SECTION A, LINE 7A POWERS OF APPOINTMENT: THE MOTHER SUPERIOR OF THE SISTERS OF ST. JOSEPH OF ST. MARK SELECTS THE VOTING MEMBERS OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B REVIEW OF FORM 990: FORM 990 IS REVIEWED BY THE OFFICERS AND OUTSIDE COUNSEL BEFORE THE RETURN IS FILED. FORM 990, PART VI, SECTION B, LINE 12C MONITORING AND ENFORCEMENT OF CONFLICT POLICY: THE OFFICERS AND DIRECTORS ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. WHEN A CONFLICT ARISES, THE PERSON IS NOT PERMITTED TO PARTICIPATE IN THE DISCUSSION OF THE PROPOSED TRANSACTION. THOSE THAT ARE INDEPENDENT OF THE PERSON WITH THE CONFLICT MAKE THE DECISION ABOUT THE TRANSACTION IN THE BEST INTERESTS OF THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF DOCUMENTS: THE ORGANIZATION DOES NOT MAKE ITS FINANCIAL STATEMENTS OR GOVERNING DOCUMENTS AVAILABLE TO THE GENERAL PUBLIC. SINCE THE ORGANIZATION HAS NOT YET ADOPTED A CONFLICT OF INTEREST POLICY, IT ALSO IS NOT AVAILABLE TO THE PUBLIC. SRS OF ST JOSEPH OF ST MARK-GENERALATE 21800 CHARDON ROAD EUCLID OH 44117 237160781 CONVENT OH 501 (C) (3) LINE 1 N/A 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1