2015-05-14T16:00:03-05:00 2014-06-30 381357951 PLANTE & MORAN PLLC 65 E STATE STREET SUITE 600 COLUMBUS OH 43215 990 2013-07-01 272564811 SENIOR INDEPENDENCE SENI 6148887800 1001 KINGSMILL PARKWAY COLUMBUS OH 43229 ROBERT B STILLMAN CFO/TREASURER 6148887800 2015-05-14 1 BERNIE OSTROWSKI P00366367 6148493000 2013 2016-02-25 16:41:14Z LAURENCE C GUMINA 1001 KINGSMILL PARKWAY COLUMBUS OH 43229 39458366 0 X WWW.SENIORINDEPENDENCE.ORG X 2010 OH SENIOR INDEPENDENCE'S MISSION IS TO SERVE OLDER ADULTS WHO CHOOSE TO REMAIN HOME BY PROVIDING SERVICES THAT WILL HELP THEM LIVE SAFELY AND SUCCESSFULLY IN THEIR OWN HOMES, WHEREVER THAT HOME MAY BE. OUR MOST SIGNIFICANT ACTIVITIES INCLUDE PROVIDING HOME CARE, HOME HEALTH CARE, HOSPICE, ADULT DAY SERVICES, TRANSPORTATION AND HOME DELIVERED MEALS. 11 10 866 121 0 0 0 0 40697914 39302168 0 0 71453 156198 40769367 39458366 0 0 0 0 27824346 28020081 0 0 0 17541202 17357854 45365548 45377935 -4596181 -5919569 11668705 11391127 9834576 2613804 1834129 8777323 X OUR MISSION IS TO EXTEND AND ENHANCE THE INDEPENDENCE AND WELL BEING OF OLDER ADULTS AND BUILD THE CAPACITY OF FAMILY MEMBERS, COMMUNITIES, AND ORGANIZATIONS TO CARE FOR THEM AT HOME. 0 0 21321606 0 19526040 HOME HEALTH CARE AND HOME CARE - SI OFFERS PARTICIPANTS HOME HEALTH CARE SERVICES INCLUDING SKILLED NURSING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, HOME HEALTH AIDE, SOCIAL WORK SERVICES, AND MEDICINE ADMINISTRATION. SI ALSO OFFERS HOME CARE SERVICES INCLUDING PERSONAL CARE ASSISTANCE, TRANSPORTATION, LIGHT HOUSEKEEPING AND MEAL PREPARATION. 13198524 0 16504599 HOSPICE - SI DELIVERS HOSPICE CARE TO PATIENTS IN THEIR HOMES, IN THE HOME OF A FAMILY MEMBER, IN A RETIREMENT OR ASSISTED LIVING APARTMENT, IN A NURSING FACILITY, OR IN A HOSPICE CENTER. SI SPECIALIZES IN GERIATRIC CARE AND PROVIDES THE PATIENTS AND THEIR FAMILIES' PAIN MANAGEMENT, SYMPTOM CONTROL, COUNSELING, EDUCATION, BEREAVEMENT SUPPORT, AND SPIRITUAL SUPPORT. 3004081 0 2092553 ADULT DAY CENTERS - PARTICIPANTS MAY ENJOY A VARIETY OF ACTIVITIES AT SI-OPERATED FACILITIES. SERVICES INCLUDE TRANSPORTATION, ASSISTANCE WITH ACTIVITIES OF DAILY LIVING INCLUDING BATHING, NUTRITIOUS MEALS AND SNACKS, ARRANGEMENTS FOR THERAPIES, NURSING OBSERVATIONS, STIMULATING ACTIVITIES, AND INDIVIDUALIZED CARE PLAN. SI CURRENTLY OPERATES TWELVE ADULT DAY CENTERS IN OHIO, AND IT IS ONE OF THE LARGEST NON-FOR-PROFIT PROVIDERS OF ADULT CARE CENTERS IN OHIO. 1580379 0 1178976 OTHER - SERVICES INCLUDING SENIOR CENTER, TRANSPORTATION AND RESIDENT SERVICE COORDINATOR. 1580379 0 1178976 39104590 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 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 1 1 0 0 1 0 0 866 1 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 OH X ROBERT B STILLMAN 6148887800 1001 KINGSMILL PARKWAY COLUMBUS OH 43229 LAURENCE C GUMINA PRESIDENT/CEO 10.00 30.00 X X 0 448961 21415 RICHARD A KRIEGER DIRECTOR/ASSISTANT TREASURER 2.00 2.00 X X 0 0 0 JOHN A PETERSON DIRECTOR/CHAIR 2.00 2.00 X X 0 0 0 BARBARA E RILEY DIRECTOR/VICE CHAIR 2.00 2.00 X X 0 0 0 AMY J ROSCOE DIRECTOR/ASSISTANT SECRETARY 2.00 2.00 X X 0 0 0 SANDRA R BYERS DIRECTOR 2.00 0.00 X 0 0 0 DEBORAH D SAMPSEL DIRECTOR 2.00 0.00 X 0 0 0 DR WILLIAM THOMAS SCOTT DIRECTOR 2.00 0.00 X 0 0 0 STEVEN JOHNSTON DIRECTOR 2.00 2.00 X 0 0 0 ED SNELZ DIRECTOR 2.00 0.00 X 0 0 0 BRETT WINGART DIRECTOR 2.00 0.00 X 0 0 0 RICHARD BOYSON PRESIDENT SENIOR INDEPENDENCE 40.00 0.00 X 131186 0 13793 ROBERT STILLMAN TREASURER/CFO 10.00 30.00 X 0 171656 14873 JOYCE MILLER-EVANS VICE PRESIDENT - INFORMATION SYSTEMS 10.00 30.00 X 0 219611 28134 DANA ULLOM-VUCELICH VICE PRESIDENT - HUMAN RESOURCES 10.00 30.00 X 0 235252 32321 KAREN AMBROSE EXECUTIVE DIRECTOR - MAHONING VALLEY 40.00 0.00 X 108066 0 22141 SHEILA FLANNERY EXECUTIVE DIRECTOR - AKRON CANTON 40.00 0.00 X 117249 0 12868 ANN HERRINGHAUS EXECUTIVE DIRECTOR - CENTRAL OHIO 40.00 0.00 X 126095 0 23047 KENNETH KEMPER FORMER OFFICER 10.00 30.00 X 0 312662 33351 482596 1388142 201943 4 1 1 0 PROGRESSIVE THERAPY PO BOX 611 HOLLAND OH 43528 THERAPY SERVICE 941776 THERAPY SUPPORT INC 2803 N OAK GROVE AVE SPRINGFIELD MO 65803 THERAPY SERVICE 817000 HOMECARE HOMEBASE LLC 6688 N CENTRAL EXPRESSWAY SUITE 1 DALLAS TX 75206 OPERATIONAL SERVICES 730348 PARK REHAB 14176 NATIONAL RD SW REYNOLDSBURG OH 43068 REHAB SERVICE 653605 CONCEPT REHAB INC 7150 GRANITE CIRCLE SUITE 200 TOLEDO OH 43617 REHAB SERVICE 636248 19 PATIENT SERVICES 623000 38742874 38742874 ADMINISTRATIVE SERVICES 561000 559294 559294 39302168 MEALS 900099 156198 156198 156198 39458366 39302168 0 156198 X 438035 438035 21282114 19836320 1445794 117012 109040 7972 4578748 4266800 311948 1604172 1498340 105832 101564 101564 22795 22795 6324785 5492339 832446 393045 358107 34938 1404991 1308396 96595 549051 549051 723742 604165 119577 1802705 1707736 94969 703655 76023 627632 341672 171414 170258 194348 194348 MEDICAL SUPPLIES AND DR 2184222 2184222 ALLOCATED CORPORATE OVE 1862990 1862990 BAD DEBT EXPENSE 471220 471220 COST OF FOOD 202331 202331 74738 74738 45377935 39104590 6273345 0 200 200 10829541 9547099 39561 37464 4157395 2378208 775122 1779187 24281 27177 11668705 11391127 2324972 2613804 457921 0 7051683 0 9834576 2613804 X 1834129 8777323 1834129 8777323 11668705 11391127 X -5919569 12862763 X 0 1 X 1 0 X 335092 257044 592136 42166949 41657747 40697914 39302168 163824778 879537 682215 71453 156198 1789403 43381578 42597006 40769367 39458366 166206317 0 0 0 166206317 43381578 42597006 40769367 39458366 166206317 X 642750 187157 455593 30563 23834 6729 2898603 1764001 1134602 585479 403216 182263 1779187 X PART X, LINE 2: ACCOUNTING STANDARDS REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CORPORATION AND RECOGNIZE A TAX LIABILITY IF THE CORPORATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT ANALYZED THE TAX POSITIONS TAKEN BY THE CORPORATION PERTAINING TO ANY INFORMATIONAL OR TAX RELATED FORMS REQUIRED TO FILE WITH THE IRS OR OTHER TAXING AUTHORITIES AND CONCLUDED THAT THERE WERE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS AS OF JUNE 30, 2014 AND 2013. THE NON-PROFIT CORPORATIONS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO EXAMINATIONS BY ANY TAXING AUTHORITIES FOR YEARS PRIOR TO 2011. X 1 1 0 0 0 0 0 0 0 0 0 LAURENCE C GUMINA PRESIDENT/CEO 0 376398 0 72293 0 270 0 4008 0 17407 0 470376 0 0 ROBERT STILLMAN TREASURER/CFO 0 171469 0 0 0 187 0 0 0 14873 0 186529 0 0 JOYCE MILLER-EVANS VICE PRESIDENT - INFORMATION SYSTEMS 0 192504 0 26350 0 757 0 9815 0 18319 0 247745 0 0 DANA ULLOM-VUCELICH VICE PRESIDENT - HUMAN RESOURCES 0 207249 0 27733 0 270 0 11401 0 20920 0 267573 0 0 KENNETH KEMPER FORMER OFFICER 0 273757 0 36619 0 2286 0 15706 0 17645 0 346013 0 0 PART I, LINE 1A PAYMENTS FOR HEALTH CLUB ARE PAID FOR EVERY CORPORATE EMPLOYEE WHO ENROLLS IN A QUALIFYING HEALTH CLUB. THERE ARE PARAMETERS SET FOR PAYING A % AND A CEILING AMOUNT. THEY ARE PAID FOR OFFICERS WHO ARE EMPLOYEES, NOT BOARD MEMBERS. THEY ARE TREATED AS TAXABLE COMPENSATION. PART I, LINE 3: SENIOR INDEPENDENCE RELIED ON A RELATED ORGANIZATION (OHIO PRESBYTERIAN RETIREMENT SERVICES) THAT USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -FORM 990 OF OTHER ORGANIZATIONS -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE FORM 990, PART VI, SECTION A, LINE 6 OHIO PRESBYTERIAN RETIREMENT SERVICES (OPRS), AN OHIO NONPROFIT CORPORATION, IS THE SOLE MEMBER OF SENIOR INDEPENDENCE AND SHALL HAVE AND EXERCISE ALL OF THE RIGHTS AND PRIVILEGES OF MEMBERS OF A NONPROFIT CORPORATION CONFERRED UNDER THE LAWS OF THE STATE OF OHIO. FORM 990, PART VI, SECTION A, LINE 7A DIRECTORS OF SENIOR INDEPENDENCE WILL BE APPOINTED BY THE SOLE MEMBER, OHIO PRESBYTERIAN RETIREMENT SERVICES (OPRS), THROUGH ITS BOARD OF DIRECTORS, AT THE ANNUAL MEETING OF THE SOLE MEMBER. NOMINEES TO THE BOARD OF DIRECTORS OF SENIOR INDEPENENCE WILL BE SELECTED AND APPOINTED BY OPRS BASED UPON THEIR ABILITY TO CONTRIBUTE IN TERMS OF EXPERTISE AND TIME AND THEIR COMMITMENT TO THE OPRS MISSION STATEMENT. FORM 990, PART VI, SECTION A, LINE 7B THE CODE OF REGULATIONS OF SENIOR INDEPENENCE MAY BE AMENDED BY A MAJORITY VOTE OF THE DIRECTORS PRESENT AT ANY MEETING AT WHICH THERE IS A QUORUM IN ATTENDANCE, PROVIDED NOTICE OF THE MEETING AND THE PROPOSED CHANGES IN THE CODE OF REGULATIONS HAVE BEEN GIVEN TO ALL DIRECTORS NO FEWER THAN TWENTY-ONE (21) DAYS IN ADVANCE OF SUCH A MEETING. THE ARTICLES OF INCORPORATION OF SENIOR INDEPENENCE MAY ALSO BE AMENDED IN THE SAME MANNER. NOTWITHSTANDING THE FOREGOING, ALL AMENDMENTS TO THIS CODE OF REGULATIONS AND THE ARTICLES OF INCORPORATION OF SENIOR INDEPENDENCE MUST BE RATIFIED BY OPRS AS SOLE MEMBER. FORM 990, PART VI, SECTION B, LINE 11 AFTER MANAGEMENT PERFORMS A DETAILED REVIEW OF THE DRAFT 990, THE ORGANIZATION DELEGATES THE REVIEW OF THE 990 TO A BOARD MEMBER WITH SUFFICIENT EXPERIENCE TO EVALUATE THE CONTENT CONTAINED THEREIN. THE MEMBER THEN REPORTS HIS REVIEW FINDINGS TO THE BOARD AND FINANCE COMMITTEE. A DRAFT OF THE FORM 990 IS POSTED TO THE ONLINE BOARD PORTAL PRIOR TO FILING AND EACH BOARD MEMBER IS GRANTED ACCESS TO REVIEW AND COMMENT. THE FINAL ISSUED FORM 990 IS ALSO POSTED TO THE BOARD PORTAL. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD INQUIRES ABOUT CONFLICTS PRIOR TO EACH MEETING. ANNUALLY A WRITTEN DISCLOSURE IS CIRCULATED. IN ORDER TO CONTINUE SERVING, A MEMBER MUST COMPLETE THE WRITTEN DISCLOSURE. THE CORPORATE SECRETARY REVIEWS DISCLOSURES FOR CONFLICTS OF INTEREST. IF A CONFLICT ARISES, MEMBERS MUST RESOLVE THE CONFLICT OR BE REMOVED FROM SERVICE. THE GOVERNING BOARD AND ALL EMPLOYEES OF OPRS ARE BOUND BY THE CONFLICT OF INTEREST POLICY. THE CORPORATE SECRETARY IS RESPONSIBLE FOR DETERMINING IF A CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST ARISES OR IS DISCOVERED, THE INDIVIDUAL WITH THE CONFLICT MUST EITHER RESOLVE THE CONFLICT OF INTEREST OR MUST NOT SERVE IN THE MATTER WHICH GIVES RISE TO THE CONFLICT. ANY MEMBERS INVOLVED IN A VOTING MATTER WHO HAVE A CONFLICT OF INTEREST WITH RESPECT TO THAT VOTING MATTER MUST EXCUSE THEMSELVES, IE, NOT VOTE ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 OHIO PRESBYTERIAN RETIREMENT SERVICES (OPRS), A RELATED ENTITY, CHIEF HUMAN RESOURCES OFFICER IN CONJUNCTION WITH THE OPRS EXECUTIVE COMPENSATION AND EVALUATION COMMITTEE (ECEC) OF THE BOARD OVERSEE THE COMPENSATION OF THE EXECUTIVE LEADERSHIP PERSONNEL. THE ECEC IS COMPRISED OF KEY BOARD MEMBERS WHO INCLUDE THE BOARD CHAIR FROM EACH SUBSIDIARY BOARD, THE BOARD CHAIR FROM THE OPRS PARENT BOARD, THE FINANCE, AUDIT, ETHICS & COMPLIANCE COMMITTEE CHAIR AND THE HUMAN RESOURCES COMMITTEE CHAIR. THE ECEC IS GOVERNED BY A CHARTER AND MEETS REGULARLY. RESOURCES USED BY THE ECEC INCLUDE MARKET SURVEYS AVAILABLE THROUGH HEALTHCARE, LONG-TERM CARE, HOSPICE AND HOME HEALTH DATA COLLECTION CLEARINGHOUSES, CONSULTANTS SUCH AS AON HEWITT AND OTHER AVAILABLE RESOURCES THAT ARE IN COMPLIANCE WITH ANTI-TRUST REGULATIONS. DECISIONS INVOLVING EXECUTIVE LEADERSHIP PAY IS DISCUSSED AND APPROVED DURING EXECUTIVE SESSIONS OF THE OPRS PARENT BOARD MEETINGS. THIS PROCESS IS UPDATED ANNUALLY AND REVIEWED THROUGHOUT THE YEAR DURING QUARTERLY MEETINGS. THE CEO, EXECUTIVE OFFICERS (EXCLUDING THE FOUNDATION PRESIDENT), AND KEY EMPLOYEES ARE PAID FROM AND RECEIVE W-2'S FROM OPRS COMMUNITIES, AND ARE SUBJECT TO THE ABOVE PROCESS, HOWEVER THE INSTRUCTIONS FROM THE IRS FOR FORM 990, PART VI, SECTION B, LINES 15A AND 15B REQUIRE QUESTIONS TO BE ANSWERED NO IF THE REPORTING ORGANIZATION DOES NOT ACTUALLY TECHNICALLY PAY THE EMPLOYEE. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVIDED UPON WRITTEN REQUEST. FORM 990, PART IX, LINE 11G PHYSICAL THERAPY: PROGRAM SERVICE EXPENSES 2,121,382. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,121,382. OCCUPATIONAL THERAPY: PROGRAM SERVICE EXPENSES 656,841. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 656,841. SPEECH THERAPY: PROGRAM SERVICE EXPENSES 141,189. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 141,189. INPATIENT CONTRACTS: PROGRAM SERVICE EXPENSES 2,181,982. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,181,982. OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 390,945. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 390,945. CORPORATE OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 832,446. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 832,446. FORM 990, PART XI, LINE 9: TRANSFERRED PROGRAM FUNDS FROM OPRS FOUNDATION 221,622. GRANTS OBTAINED BY FOUNDATION, CASH TRANSFERRED TO SENIOR INDEPENDENCE 415,075. BOOK ENTRY TO CLOSE OUT CUMULATIVE INTERCOMPANY ACCOUNTS TO NET ASSETS 12,226,066. OHIO PRESBYTERIAN RETIREMENT SERVICES 1001 KINGSMILL PARKWAY COLUMBUS OH 43229 311340918 SUPPORT/PARENT OH 501(C)(3) LINE 11B, II N/A 0 OPRS COMMUNITIES 1001 KINGSMILL PARKWAY COLUMBUS OH 43229 344429863 ADULT CARE OH 501(C)(3) LINE 9 OPRS 1 VINEYARD CONDOMINIUM ASSOCIATION 1001 KINGSMILL PARKWAY COLUMBUS OH 43229 262702410 MANAGEMENT OH 501(C)(4) OPRSC 1 OHIO PRESBYTERIAN RETIREMENT SERVICES FOUNDATION 1001 KINGSMILL PARKWAY COLUMBUS OH 43229 311166164 FUNDRAISING OH 501(C)(3) LINE 11B, II OPRS 1 OPRS DEVELOPMENT CORP 1001 KINGSMILL PARKWAY COLUMBUS OH 43229 311166160 INACTIVE OH N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 OHIO PRESBYTERIAN RETIREMENT SERVICES FOUNDATION S 636697 CASH TRANSACTION