2017-11-15T11:58:02-06:00 2016-12-31 381357951 PLANTE & MORAN PLLC 250 S High St Suite 100 Columbus OH 43215 990 2016-01-01 310536997 THE OHIO MASONIC HOME OHIO 9373251531 2655 WEST NATIONAL ROAD SPRINGFIELD OH 45504 THOMAS MALONEY CHIEF OPERATING & FINANCIAL OFFICER 9373251531 2017-11-13 1 Bernie Ostrowski P00366367 6148493000 2017-11-08 67.59.56.32 2017-11-13 09:34:25 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 F51046F0BD5714FDBFEEE435C204D6AFFC186FF5 2016 2017-02-10 21:41:12Z X THOMAS J MALONEY 2655 WEST NATIONAL ROAD SPRINGFIELD OH 45504 9535287 0 3773 X WWW.OHIOMASONICHOME.ORG X 1890 OH WE ARE THE LIVING EXPRESSION OF OUR MASONIC OBLIGATION - WE SERVE AS THE TRUSTED PARTNER TO HELP PEOPLE AGE RESPECTFULLY: HOW THEY WANT; WHERE THEY WANT. 10 10 43 55 0 0 285890 30231 5735782 6788218 1565208 2600301 78915 116537 7665795 9535287 21500 19500 0 0 3783638 3899934 0 0 0 5401260 7830341 9206398 11749775 -1540603 -2214488 137824504 133092978 38521950 35745789 99302554 97347189 THE MISSION OF THE OHIO MASONIC HOME IS TO BE THE TRUSTED PARTNER TO HELP PEOPLE AGE RESPECTFULLY, HOW THEY WANT, WHERE THEY WANT 0 0 3159693 19500 6837859 THE OHIO MASONIC HOME PROVIDED MANAGEMENT SERVICES, STRATEGIC PLANNING, ADMINISTRATIVE SERVICES AND FINANCIAL SUPPORT TO AFFILIATES. THE LONG TERM GOAL IS TO BE A TRUSTED PARTNER TO HELP PEOPLE AGE RESPECTFULLY. 3159693 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 152 0 1 43 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 X THOMAS J MALONEY 9375253012 2655 WEST NATIONAL ROAD SPRINGFIELD OH 455043698 TERRY POSEY CHAIRMAN 1.00 0.00 X X 0 0 0 ROSS R BLACK II MD VICE CHAIRMAN 1.00 1.00 X X 0 0 0 DONALD LOSASSO 1ST VICE CHAIRMAN 1.00 0.00 X X 0 0 0 RONALD CONNELLY TREASURER 1.00 0.00 X X 0 0 0 KERMIT ZIMMERMAN SECRETARY 1.00 0.00 X X 0 0 0 DAVID L COLLINS TRUSTEE 1.00 1.00 X 0 0 0 STEVEN A DUNCAN TRUSTEE 1.00 1.00 X 0 0 0 DAVID FREEMAN TRUSTEE 1.00 1.00 X 0 0 0 CLARENCE HARTZELL III TRUSTEE 1.00 1.00 X 0 0 0 GARY NICHOLSON MD TRUSTEE 1.00 1.00 X 0 0 0 GERALD PUGH TRUSTEE 1.00 0.00 X 0 0 0 WILLIAM D STRATTON TRUSTEE 1.00 0.00 X 0 0 0 THOMAS THINNES TRUSTEE 1.00 1.00 X 0 0 0 KEVIN TODD TRUSTEE 1.00 0.00 X 0 0 0 GARY B WILLIAMS MD TRUSTEE 1.00 2.00 X 0 0 0 SCOTT A BUCHANAN CEO 40.00 2.00 X 207401 0 38305 THOMAS STOFAC CEO (PART YEAR) 40.00 1.00 X 212063 0 16267 THOMAS J MALONEY CHIEF OPERATING & FINANCIAL OFFICER (PART YEAR) 40.00 1.00 X 71250 0 1299 CARA L SCHUSTER CHIEF CLINICAL OFFICER 40.00 0.00 X 160753 0 30285 JOSEPH LICATA COO (PART YEAR) 40.00 0.00 X 122032 0 21487 LARA E BENTLEY DIRECTOR OF HUMAN RESOURCES 40.00 0.00 X 131391 0 16427 JOHN B WHITE DIRECTOR OF TREASURY 40.00 0.00 X 140650 0 35420 ADRIENNE HERRING DIRECTOR OF FINANCE 40.00 0.00 X 101951 0 9113 ROB LANE DIRECTOR OF PROCUREMENT 40.00 0.00 X 120372 0 24241 JASON ZIELINSKI DIRECTOR OF MARKETING 40.00 0.00 X 101942 0 18590 1369805 0 211434 10 0 1 0 RIDGE STONE GENERAL CONTRACTORS 7015 LIGHTHOUSE WAY SUITE 500 PERRYSBURG OH 43551 CONSTRUCTION 2744622 HEALTH PRO REHABILITATION 16600 SPRAGUE ROAD SUITE 365 MIDDLEBURG HEIGHTS OH 44256 MEDICAL SERVICES 2040918 DATASERV INTEGRATIONS LLC 29260 CLEMENS RD WESTLAKE OH 44145 TECHNOLOGY SERVICES 662088 YATES BUILDERS 8177 ST ROUTE 134 NORTH WILMINGTON OH 45177 CONSTRUCTION 292838 BRIGHTREE 5001 HOSPITALITY CT MORRISVILLE OH 27560 MEDICAL SERVICES 141223 9 30231 30231 SERVICE TO AFFILIATES 900099 6788218 6788218 6788218 1313818 1313818 61200 0 61200 61200 61200 1052663 233820 0 0 1052663 233820 1286483 1286483 CANCELLATION FEES 900099 50000 50000 PROCESSING FEES 900099 4246 4246 REBATES 900099 1091 1091 55337 9535287 6788218 0 2716838 X 19500 19500 881140 881140 2118174 1525085 593089 36287 26127 10160 663070 477410 185660 201263 144909 56354 60188 60188 92256 92256 321926 321926 1836140 734456 1101684 43431 43431 300021 120008 180013 711039 711039 188206 188206 119835 47934 71901 154357 154357 522781 522781 182140 182140 DISCONTINUED OPERATIONS 3883232 3883232 INTERCOMPANY ALLOCATION 1581661 1581661 SOCIAL SERVICES 113819 113819 CORPORATE ALLOCATIONS -3394548 -3394548 1113857 445543 668314 11749775 3159693 8590082 0 150 150 1574203 -17131 417250 231450 32693834 27104063 245985 312516 92897937 49199932 42883636 43698005 53413125 54864968 6596321 6898957 137824504 133092978 4985256 3040837 31178631 29275888 2358063 3429064 38521950 35745789 X 80760780 78414285 12065817 12265323 6475957 6667581 99302554 97347189 137824504 133092978 X -2214488 2418389 -1862230 -297036 X X 0 1 X 1 0 X 667626 15676418 115345 285890 30231 16775510 667626 15676418 115345 285890 30231 16775510 16775510 2134067 1767292 1396117 802276 1375018 7474770 4535 11540 26565 55337 97977 24348257 18386514 0.68900 0.76100 X 106771006 639711 28057 -5003 107443777 106701991 69015 106771006 106704446 7061 -9516 106701991 106526036 34213 106704446 105299293 116773 27424 106670233 0.00000 1.00000 0.00000 0 1 1 123096 622812 745908 76257199 36551573 39705626 10134954 8849441 1285513 5759876 3798918 1960958 43698005 BENEFICIAL INTERESTS IN TRUSTS 6864575 DEPOSITS 34382 6898957 LINE OF CREDIT 3000000 ACCRUED PENSION LIABILITY 386672 SPLIT INTEREST AGREEMENTS 42392 3429064 PART V, LINE 4: THE PURPOSE OF THE FOUNDATION ENDOWMENT FUNDS IS/ARE TO PROVIDE PERPETUAL SUPPORT TO FUND THE CHARITABLE MISSION OF THE OHIO MASONIC HOME. 1 SCHOLARSHIPS 17 19500 Part I, Line 2: THE OHIO MASONIC HOME SCHOLARSHIP COMMITTEE SET FORTH THE GUIDELINES FOR ELIGIBILITY FOR THE OHIO MASONIC HOME SCHOLARSHIP. THE CRITERIA USED TO DETERMINE WHICH APPLICANTS WILL ULTIMATELY RECEIVE THE SCHOLARSHIP IS BASED ON THE FOLLOWING CRITERIA: CONSISTENCY WITH THE ORIGINAL INTENT OF THE SCHOLARSHIP FUND, FINANCIAL NEED, ACADEMIC PERFORMANCE, AND AN INDIVIDUAL APPLICATION/ESSAY REVIEW. FROM THE ELIGIBLE POOL, A COMMITTEE COMPOSED OF THREE EMPLOYEES EVALUATES THE APPLICATION AND ASSIGNS A POINT VALUE. THIS POINT VALUE IS THEN USED TO DETERMINE WHICH INDIVIDUALS WILL ULTIMATELY RECEIVE THE SCHOLARSHIP. IN ORDER TO ENSURE THAT THE SCHOLARSHIPS ARE APPLIED TO THEIR INTENDED USE, THE OHIO MASONIC HOME PROVIDED THE FUNDS DIRECTLY TO THE COLLEGE/UNIVERSITY AND REQUESTS THAT ANY UNUSED PORTION BE RETURNED TO OHIO MASONIC HOME. X X X 1 0 0 0 0 0 0 0 0 SCOTT A BUCHANAN CEO 207401 0 0 0 0 0 8296 0 30009 0 245706 0 0 0 THOMAS STOFAC CEO (PART YEAR) 191821 0 0 0 20242 0 8483 0 7784 0 228330 0 0 0 CARA L SCHUSTER CHIEF CLINICAL OFFICER 160753 0 0 0 0 0 6430 0 23855 0 191038 0 0 0 JOHN B WHITE DIRECTOR OF TREASURY 140650 0 0 0 0 0 5626 0 29794 0 176070 0 0 0 Part I, Line 4a THOMAS STOFAC LISTED ON FORM 990, PART VII RECEIVED A SEVERANCE PAYMENT DURING THE 2016 CALENDAR YEAR. THE SEVERANCE PAYMENT, IN THE AMOUNT OF $20,242, IS REPORTED ON SCHEDULE J, PART II, COLUMN B(III). A COUNTY OF CLARK OHIO 316000132 2014-10-01 43975000 SEE PART VI 0 0 0 A 5490000 43975000 43975000 2009 1 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 1 0 1 0 0 0 1 A 1 PART III, LINE 9; PART IV, LINE 7 AND PART V THE ORGANIZATION IMPLEMENTED POST-ISSUANCE COMPLIANCE PROCEDURES ON JANUARY 1, 2014. PART I, LINE A(F) SECOND REISSUANCE OF BONDS ISSUED ON 02/18/2009 AND 02/01/2012 TO CURRENTLY REFUND (A) 1999 BONDS ISSUED TO CURRENTLY REFUND 1997 AND 1998 BONDS AND FINANCE A 1999 MULTIFAMILY HOUSING PROJECT; (B) 2001 BONDS TO FINANCE A 2001 MULTIFAMILY HOUSING PROJECT; AND (C) 2002 BONDS TO FINANCE A 2002 MULTIFAMILY HOUSING PROJECT; AND (III) FINANCE THE ACQUISITION, CONSTRUCTION, RENOVATIONS AND EQUIPPING OF THE ORGANIZATION'S FACILITIES. Form 990, Part VI, Section B, line 11b THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM WHO THEN SUBMITS THE FORM 990 TO THE PRESIDENT OF THE FOUNDATION, CEO, AND CFO FOR REVIEW. A COPY OF THE FORM 990 WAS PROVIDED TO THE BOARD OF TRUSTEES PRIOR TO THE FILING. Form 990, Part VI, Section B, line 12c THE OHIO MASONIC HOME AND ITS RELATED ORGANIZATIONS HAVE A WRITTEN CONFLICT OF INTEREST POLICY THAT STATES THAT CORPORATION SHALL NOT ENGAGE OR CONTRACT WITH ANY BUSINESS ENTITY WITHIN WHICH A TRUSTEE OR OFFICER HAS A MATERIAL FINANCIAL OR PERSONAL INTEREST UNLESS CERTAIN CRITERIA IS MET. PART OF THIS CRITERIA INCLUDES A MAJORITY VOTE OF THE BOARD OF TRUSTEES. MONITORING OF THE STATE OF CONFLICT IS DONE ANNUALLY BY SENDING OUT A QUESTIONNAIRE TO ALL OF THOSE WHO ARE REQUIRED TO DISCLOSE IF A CONFLICT EXISTS. WITHIN ONE (1) BUSINESS DAY AFTER BEING NOTIFIED OF A POSSIBLE CONFLICT OF INTEREST, THE CORPORATE COMPLIANCE OFFICER SHALL CONTACT THE BOARD MEMBER, AND ACKNOWLEDGE THE POSSIBLE CONFLICT. WITHIN FOUR (4) BUSINESS DAYS OF ACKNOWLEDGEMENT OF A POSSIBLE CONFLICT OR RECEIPT OF OTHER INFORMATION WHICH INDICATES THE OCCURRENCE OF A CONFLICT, THE CORPORATE COMPLIANCE SHALL INITIATE A REVIEW TO DETERMINE WHETHER FURTHER INQUIRY SHOULD BE UNDERTAKEN ON BEHALF OF THE CORPORATION. THE CORPORATE COMPLIANCE OFFICER SHALL ACT DILIGENTLY TO DETERMINE WHETHER A CONFLICT OF INTEREST IS PRESENT. THE CORPORATE COMPLIANCE OFFICER MAY COORDINATE AN INTERNAL REVIEW AND/OR ENGAGE OUTSIDE AUDITORS AND/OR CONSULTANTS TO REVIEW THE POTENTIAL CONFLICT. THE REVIEWS MAY INVOLVE AN EXAMINATION OF ANY DEPARTMENT OF THE CORPORATION. IN THE EVENT THE REVIEW POINTS TO AN ACTUAL CONFLICT, THE CORPORATE COMPLIANCE OFFICER SHALL ADVISE THE CHIEF EXECUTIVE OFFICER, AND IF NECESSARY, THE CHIEF OPERATING OFFICER, THE CHAIRMAN OF THE BOARD OF TRUSTEES, AND THE CORPORATION'S LEGAL COUNSEL, OF THE CONFLICT OF INTEREST AND DETERMINE A COURSE OF ACTION. Form 990, Part VI, Section B, line 15 THE BOARD OF TRUSTEES DETERMINES THE COMPENSATION OF THE ORGANIZATION'S CEO. COMPENSATION IS APPROVED IN ADVANCE FOR ALL EMPLOYEES THROUGH THE ANNUAL BUDGET APPROVAL, AND THE DETERMINATIONS ARE RECORDED IN THE MEETING MINUTES AT THE TIME THE DECISIONS ARE MADE. THE REASONABLENESS OF THE COMPENSATION PAID IS REVIEWED PERIODICALLY WITH A REVIEW OF COMPENSATION DATA WHICH MAY BE AVAILABLE THROUGH PUBLISHED SOURCES OR THOUGH COMPARABLE ORGANIZATIONS AND/OR INDUSTRY GROUPS. THE ORGANIZATION HAS COMPENSATION GUIDELINES FOR MOST OTHER POSITIONS. THE COMPENSATION REVIEW FOR THE CEO IS CONDUCTED AND APPROVED BY THE BOARD ANNUALLY. THE COMPENSATION REVIEW FOR ALL OTHER OFFICERS AND KEY EMPLOYEES WAS LAST CONDUCTED IN 2012 AND IS PLANNED TO BE COMPLETED ONCE AGAIN IN 2018. Form 990, Part VI, Section C, line 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part IX, line 11g CONTRACTED SERVICES: Program service expenses 734,456. Management and general expenses 1,101,684. Fundraising expenses 0. Total expenses 1,836,140. Form 990, Part XI, line 9: CHANGE IN VALUE OF BENEFICIAL TRUST AND CONTRIBUTIONS RECEIVABLE 191,624. NET ASSETS RELEASED FROM RESTRICTION -30,231. TRANSFER FROM (TO) PARENT 1,526,955. CHANGE IN TEMP. RESTRICTED NET ASSETS -24,684. RESULTS FROM DISCONTINUED OPERATIONS -1,960,700. FORM 990, PART XII, LINE 2C THE AUDIT COMMITTEE OVERSEES THE PROCESS FOR SELECTING AN INDEPENDENT AUDITOR. THIS PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. OHIO MASONIC HOME BENEVOLENT ENDOWMENT FOUNDATION FIVE MASONIC DRIVE SPRINGFIELD OH 45504 311451818 ENDOWMENT FUND OH 501(c)(3) Line 12a, I THE OHIO MASONIC HOME 1 THE OHIO MASONIC HOME AFFILIATES 2655 WEST NATIONAL ROAD SPRINGFIELD OH 45504 900054759 AGING SERVICES OH 501(c)(3) Line 10 THE OHIO MASONIC HOME 1 MASONIC AGING SERVICES 2655 WEST NATIONAL ROAD SPRINGFIELD OH 45504 901016483 ADMINISTRATIVE SERVICES OH MASONIC SENIOR SEVICES OF OHIO CORP C 213 1.00000 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 1 OHIO MASONIC HOME AFFILIATES J 2257001 CORPORATE LEASE OHIO MASONIC HOME K 188205 CORPORATE LEASE THE OHIO MASONIC HOME BENEVOLENT ENDOWMENT FOUNDATION S 1526955 TRANSFER FROM AFFILIATES FORM 990, SCHEDULE R, PART II RELATED TAX-EXEMPT ORGANIZATIONS ARE UNDER GROUP EXEMPTION #3773.