2016-11-14T07:55:14-06:00 2015-12-31 381357951 PLANTE & MORAN PLLC 250 S High St Suite 100 Columbus OH 43215 990 2015-01-01 344455701 MENNONITE MEMORIAL HOME MENN 4193581015 410 W ELM STREET BLUFFTON OH 45817 JONATHAN MORSE DIRECTOR OF FINANCE 4193581015 2016-11-11 1 Bernie Ostrowski P00366367 6148493000 2015 2017-02-10 21:41:12Z SEE SCHEDULE O LAURA B VOTH 410 W ELM STREET BLUFFTON OH 45817 11759364 0 X WWW.MHCOLIVING.ORG X 1947 OH MENNONITE HOME COMMUNITIES OF OHIO IS A SENIOR CARE PROVIDER WITH A COMMITMENT TO COMPASSIONATE, INNOVATIVE CARE IN A FAITH-BASED SETTING. MHCO PROVIDES INDEPENDENT LIVING, ASSISTED LIVING, LICENSED LONG-TERM CARE, SKILLED NURSING AND REHABILITATION AND DEMENTIA CARE. MHCO ALSO BRINGS COMPASSIONATE CLINICAL CARE AND SUPPORT SERVICES TO AREA SENIORS WHO WISH TO REMAIN IN THEIR HOMES. 11 10 322 0 0 0 29699 1220 10827189 11715840 17580 2379 128602 39925 11003070 11759364 0 0 0 0 6502856 6737008 0 0 0 4618165 4769494 11121021 11506502 -117951 252862 21838831 22062442 13302310 13285183 8536521 8777259 X MISSION STATEMENT: WE ARE DEDICATED TO BEING CHRIST-CENTERED COMMUNITY THAT PROMOTES PERSONAL DECISION-MAKING AND PURPOSEFUL LIVING FOR EACH OLDER ADULT SERVED. VISION STATEMENT: TO BE THE COMMUNITY'S SOURCE OF INNOVATIVE CARE, EXCELLENT SERVICES AND COMPREHENSIVE RESOURCES FOR OLDER ADULTS. 0 0 7524492 0 7247273 SKILLED NURSING FACILITY 1753304 0 2216231 ASSISTED LIVING FACILITY 482546 0 1535098 INDEPENDENT LIVING FACILITY 358593 0 754113 ALL OTHER REVENUES AND EXPENSES INCURRRED RELATE TO MENNONITE MEMORIAL HOME'S EXEMPT PURPOSE BUT DO NOT SPECIFICALLY RELATE TO SKILLED NURSING, ASSISTED LIVING, OR INDEPENDENT LIVING. 358593 0 754113 10118935 1 0 0 1 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 63 0 1 322 1 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X JONATHAN MORSE DIRECTOR OF FINANCE 4193581015 410 W ELM ST BLUFFTON OH 45817 ELIZABETH KELLY PRES TO 6/30 CHAIR 7/1 TO 12/31 1.00 0.00 X X 0 0 0 IRIS NEUFELD VP TO 6/30 VICE CHAIR 7/1 TO 12/31 1.00 0.00 X X 0 0 0 DENNIS MAURER SECRETARY 1.00 1.00 X X 0 0 0 BOB THOMPSON TREASURER TO 6/30 1.00 0.00 X X 0 0 0 VICKIE CARTWRIGHT DIR TO 6/30 TREAS. 7/1 TO 12/31 1.00 0.00 X X 0 0 0 HOWARD SHELLY MEMBER AT LARGE TO 6/30 1.00 0.00 X 0 0 0 RON MICHEL MEMBER AT LARGE 1.00 1.00 X 0 0 0 BRICE BRENNEMAN DIRECTOR 1.00 0.00 X 0 0 0 DAVID EMANS DIRECTOR 1.00 1.00 X 0 0 0 GARY BISHOP DIRECTOR 1.00 1.00 X 0 0 0 FRANK GIBBS DIRECTOR TO 6/30 1.00 0.00 X 0 0 0 JIM DRAY DIRECTOR 1.00 1.00 X 0 0 0 CHRISSY LUGIBIHL DIRECTOR 1.00 0.00 X 0 0 0 BOB HOLT DIRECTOR 7/1 TO 12/31 1.00 1.00 X 0 0 0 LAURA VOTH CEO 30.00 10.00 X 97944 0 3047 97944 0 3047 0 0 0 0 NORTHWEST PHYSICAL THERAPY 1880 N PERRY ST OTTAWA OH 45875 THERAPY SERVICES 433669 ALL TEMP REFRIGERATION 18966 STATE ROUTE 66 DELPHOS OH 45833 HEATING & AIR SERVICE 205476 PLANTE MORAN PLLC 250 SOUTH HIGH STREET SUITE 100 COLUMBUS OH 43215 AUDIT, COST REPORTING, CONSULTING 113705 3 1220 1220 RESIDENT SERVICES 623000 11306604 11306604 MANAGEMENT FEE REVENUE 541610 263914 263914 AMORTIZATION OF ADVANCE FEES 623000 145322 145322 11715840 467 467 1912 0 1912 1912 1912 BARBER & BEAUTY SHOP 623000 31299 31299 Rebates and Refunds 900099 5576 5576 FINGERPRINT REVENUE 900099 1976 1976 1074 1074 39925 11759364 11752715 0 5429 178934 13996 164938 5407012 4729863 677149 88184 79151 9033 622504 529128 93376 440374 374318 66056 23587 23587 90406 90406 696933 662086 34847 121221 115160 6061 740395 703377 37018 703989 668791 35198 39152 39152 16096 16096 265153 251895 13258 1036080 984277 51803 90451 85928 4523 FOOD 456131 433324 22807 FRANCHISE TAXES 405572 405572 BARBER AND GIFT SHOP 33876 33876 BAD DEBT EXPENSE 5285 5285 45167 42908 2259 11506502 10118935 1387567 0 575769 699325 837640 846200 605302 774081 291918 479643 31814560 13029706 18831957 18784854 349902 337778 164784 140561 181559 0 21838831 22062442 1234035 1267430 2320646 2396624 7325793 7099205 2421836 2521924 13302310 13285183 X 8536521 8777259 8536521 8777259 21838831 22062442 252862 -12124 0 X X 0 1 X 1 0 X 21622 29699 1220 52541 10329790 10445809 10311045 10955518 11752715 53794877 10351412 10445809 10311045 10985217 11753935 53847418 0 261920 243445 184995 24350 714710 261920 243445 184995 24350 714710 53132708 12737 10794 11966 13765 467 49729 12737 10794 11966 13765 467 49729 497 273 3050 3820 10364149 10456603 10323508 10999255 11757452 53900967 0.98570 0.98550 0.00090 0.00130 X 0 0 0 0 0 0 0 0 1 1085 1085 0 Part II-B, Line 1: MENNONITE MEMORIAL HOME IS A DUES-PAYING MEMBER OF LEADING AGE. ONE OF THE MANY SERVICES LEADING AGE PROVIDES TO ITS MEMBERSHIP IS LOBBYING LEGISLATIVE BODIES ON MATTERS IMPORTANT TO ITS MEMBER ORGANIZATIONS. DURING 2015, 9.1% OF THE $11,918 IN LEADING AGE DUES IS RELATED TO LOBBYING. 357008 -12379 344629 336984 20024 357008 336984 7402 7402 336984 288384 48600 336984 288384 4845 4845 288384 0.94200 0.05800 0.00000 0 1 1 559190 559190 26554239 10180002 16374237 226337 183134 43203 4474794 2666570 1808224 18784854 RESIDENT DEPOSITS 2000 REFUNDABLE ADVANCE FEES 2510966 INTERCOMPANY PAYABLE 8958 2521924 Part V, Line 4: AN ENDOWMENT FUND IS MAINTAINED BY A RELATED PARTY, MENNONITE MEMORIAL FUND, TO PROVIDE FOR PROGRAMS AND ACTIVITIES FOR RESIDENTS. A VILLAGE OF BLUFFTON OHIO 346400139 NONEAVAIL 2011-10-25 7771123 SEE PART VI 0 0 0 A 7771113 139865 5197438 2433810 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 PART I, LINE A, (F) BONDS USED TO FINANCE THE FOLLOWING ITEMS: (1) TWO HOUSES WITH 10 SKILLED NURSING BEDS EACH AND BUILDING RENOVATIONS AT 410 WEST ELM AND 700 MAPLE CREST COURT,(2) REFUNDING AND RETIRING 1998 BONDS, (3) AND PAYING BOND ISSUANCE COSTS. DIANA DRAY WIFE OF JIM DRAY, BOARD TRUSTEE, IS EMPLOYED BY MENNONITE MEMORIAL HOME 21358 COMPENSATION IN THE FORM OF WAGES AND BENEFITS 0 FORM 990, PAGE 1, LINE C: DOING BUSINESS AS: MENNONITE HOME COMMUNITIES OF OHIO, MENNONITE MEMORIAL HOME HEALTH AND SENIOR SERVICES, MAPLE CREST, WILLOW RIDGE OF MENNONITE HOME COMMUNITIES OF OHIO Form 990, Part VI, Section B, line 11 THE DIRECTOR OF FINANCE AND CEO REVIEW FORM 990. THE BOARD OF TRUSTEES ARE PROVIDED WITH AN ELECTRONIC COPY OF THE FORM 990 PRIOR TO FILING. Form 990, Part VI, Section B, line 12c THE ORGANIZATION IS CONSCIENTIOUS IN ITS BUSINESS DEALINGS. DILIGENCE IS USED TO ENSURE THAT ALL BUSINESS TRANSACTIONS ARE MANAGED IN A WAY THAT ENSURES THAT ALL TRANSACTIONS ARE CONDUCTED AT AN "ARM'S LENGTH" TO AVOID ANY POTENTIAL CONFLICT OF INTEREST. ALL BOARD OF TRUSTEE MEMBERS AND KEY LEADERSHIP STAFF ARE REQUIRED TO COMPLETE, ANNUALLY, A CONFLICT OF INTEREST DISCLOSURE FORM, AS WELL AS COMPLY WITH THE ORGANIZATION'S BOARD-APPROVED CONFLICT OF INTEREST POLICY. THE CEO, DIRECTOR OF FINANCE, LEADERSHIP TEAM AND BOARD OF TRUSTEES DETERMINE AND REVIEW WHETHER A CONFLICT EXISTS. BOARD MEMBERS ARE NOT ALLOWED TO VOTE ON ANY TRANSACTION WHERE A POTENTIAL CONFLICT EXISTS. Form 990, Part VI, Section B, line 15 THE LEADING AGE WAGE SURVEY, ALONG WITH OTHER SIMILAR DATA, ARE USED TO DETERMINE COMPENSATION OF THE ABOVE-LISTED POSITIONS. THE BOARD EVALUATES AND REVIEWS RECOMMENDATIONS REGARDING COMPENSATION. THE SECRETARY OF THE EXECUTIVE COMMITTEE WILL RECORD MINUTES OF THE EXECUTIVE COMMITTEE MEETING WHERE THE CEO COMPENSATION DISCUSSION TOOK PLACE, RECORDING ANY SIGNIFICANT DELIBERATIONS OR DECISIONS THAT WERE MADE. THE MINUTES WILL INCLUDE SALARY RANGES FROM THE SURVEY DATA THAT WERE USED AS A REFERENCE POINT IN SETTING THE CEO'S SALARY. THE SALARY SURVEY REPORTS THAT WERE REFERENCED IN THE DISCUSSION WILL BE ATTACHED TO THE MINUTES. THIS PROCESS WAS LAST COMPLETED IN 2015. Form 990, Part VI, Section C, line 19 GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: MENNONITE MEMORIAL HOME UTILIZES THE EXECUTIVE AND FINANCE COMMITTEES FOR OVERSIGHT OF THE ANNUAL AUDIT OF THE FINANCIAL STATEMENTS AND FOR SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MENNONITE MEMORIAL FUND INC 410 W ELM STREET BLUFFTON OH 45817 341336292 SUPPORT MENNONITE MEMORIAL HOME OH 501(c)(3) Line 7 MENNNOTE MEMORIAL HOME 1 HILTY MEMORIAL HOME INC PO BOX 359 304 HILTY DR PANDORA OH 45877 341265978 CONTINUING CARE FOR THE ELDERLY OH 501(c)(3) Line 9 MENNNOTE MEMORIAL HOME 1 0 0 0 1 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0