2015-11-16T14:35:13-06:00 2014-12-31 410746749 CLIFTONLARSONALLEN LLP 1 BRONZE POINTE BELLEVILLE IL 62226 990 2014-01-01 310549058 OTTERBEIN HOMES OTTE 5139322020 580 NORTH STATE ROUTE 741 LEBANON OH 450368839 J CHRISTOPHER GREEN CFO 5139322020 2015-11-16 1 JEFF PARKER P00970069 6182331200 2014 2016-03-07 17:11:31Z J CHRISTOPHER GREEN 580 NORTH STATE ROUTE 741 LEBANON OH 450368839 115856689 0 X WWW.OTTERBEIN.ORG X 1912 OH OTTERBEIN HOMES IS AN ORGANIZATION OF CONTINUING CARE RETIREMENT COMMUNITIES THAT PROVIDE HOUSING AND SERVICES TO ELDERS. GENEROUS DONORS HAVE ESTABLISHED A BENEVOLENT CARE FUND WHICH OFFERS ASSISTANCE TO RESIDENTS WHO CANNOT PAY THE FULL COST OF CARE. OTTERBEIN'S RICH HERITAGE HAS EARNED US A SOLID REPUTATION AS A TRUSTED AND VALUABLE RESOURCE. BY PROVIDING INFORMATION AND SERVICES ON AGING ISSUES WE CONTINUE TO SERVE RESIDENTS, THEIR FAMILIES AND SURROUNDING COMMUNITIES. OTTERBEIN RESIDENTS AND STAFF VOLUNTEER THEIR TIME AND TALENTS AT THE OTTERBEIN CAMPUSES BUT ALSO FOR A NUMBER OF ORGANIZATIONS AND CAUSES IN THE GREATER COMMUNITY. 16 16 857 117 144116 -666 444836 1285695 30752080 31657124 8282110 6954776 227230 295868 39706256 40193463 0 43169 0 0 16896245 18384300 0 0 639150 15316336 15985069 32212581 34412538 7493675 5780925 130611547 145734842 70603008 88458325 60008539 57276517 OUR MISSION - IN KEEPING WITH OUR UNITED METHODIST TRADITION WE SEEKTO ENHANCE THE QUALITY OF LIFE AND HOLISTIC GROWTH OF OLDER PERSONS. 0 0 25606318 43169 31657124 OTTERBEIN HOMES PROVIDES MANAGEMENT AND SUPPORT SERVICES FOR ITS FIVE CONTINUING CARE RETIREMENT COMMUNITIES, NINE SMALL HOUSE NURSING HOME NEIGHBORHOODS THROUGHOUT OHIO, HOME HEALTH AGENCY AND A HOSPICE AGENCY. SOME OF THE MANAGEMENT SERVICES PROVIDED INCLUDE ADMINISTRATIVE, FINANCIAL, PURCHASING, HUMAN RESOURCES, MARKETING, AND DEVELOPMENT FOR THE RELATED TAX-EXEMPT ORGANIZATIONS. IN PROVIDING MANAGEMENT AND SUPPORT TO HOSPICE, HOME HEALTH AND ITS COMMUNITIES OF LEBANON, CRIDERSVILLE, ST. MARY'S, PORTAGE VALLEY, NORTH SHORE, AND THE SMALL HOUSE NEIGHBORHOODS AT PERRYSBURG, MONCLOVA, SPRINGBORO, MIDDLETOWN, AND MAINEVILLE. OTTERBEIN SERVES OVER 3,600 PERSONS. 25606318 1 1 0 0 0 0 1 0 1 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 239 0 857 1 1 1 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 OH X J CHRISTOPHER GREEN 5139335400 580 NORTH SR 741 LEBANON OH 450368839 MEL MILLER VICE CHAIR 1.00 X X 0 0 0 PAMELA NICKELL TRUSTEE 1.00 X 0 0 0 REV GEORGE CAMPBELL TRUSTEE 1.00 X 0 0 0 JOHN WASHBURN TRUSTEE 1.00 X 0 0 0 JOE WOLF TRUSTEE 1.00 X 0 0 0 REV BRIAN BROWN TRUSTEE 1.00 X 0 0 0 LYNN APP TRUSTEE 1.00 X 0 0 0 BILL BROWNSON TRUSTEE 1.00 X 0 0 0 REV LEROY CHAMBLISS SECRETARY 1.00 X X 0 0 0 DR ROGER CLARK TRUSTEE 1.00 X 0 0 0 TOM COMPTON CHAIR 1.00 X X 0 0 0 JAMES DUNHAM TRUSTEE 1.00 X 0 0 0 REV CYNDY GARN TRUSTEE 1.00 X 0 0 0 REV TOM HANOVER TRUSTEE 1.00 X 0 0 0 THOMAS HAZELBAKER TRUSTEE 1.00 X 0 0 0 LEROY MCKAY TRUSTEE 1.00 X 0 0 0 JILL HREBEN PRESIDENT/CEO 30.00 10.00 X 358410 0 10264 JAMES C GREEN CFO/VP FINANCE 30.00 10.00 X 246425 0 16546 JASON MILLER VP OF NORTHWEST MINISTRIES/CEO LEBANON 10.00 40.00 X 82588 201486 21750 687423 201486 48560 2 0 1 0 RIDGE STONE GENERAL CONTRACTORS 7015 LIGHTHOUSE WAY PERRYSBURG OH 43551 CONSTRUCTION SERVICES 9147547 ALLIANCE REHAB SRA 28100 TORCH PARKWAY STE 600 WARRENVILLE IL 60555 THERAPY SERVICES 2906500 OLD OAK GENERAL CONTRACTORS 5874 S IDDINGS RD WEST MILTON OH 45383 CONTRACTOR 1747892 CONCEPT REHAB INC 7150 GRANITE CIRCLE SUITE 200 TOLEDO OH 43617 THERAPY SERVICES 1723696 REMEDI SENIORCARE PO BOX 75744 BALTIMORE MD 21275 SENIOR CARE 1478296 12 89402 1196293 43100 1285695 MEDICARE/MEDICAID PAYMENTS 623000 15988792 15988792 SERVICE FEES 541900 14700415 14700415 DEPARTMENTAL SERVICES 623000 967917 967917 31657124 1066085 1066085 301416 89122 212294 212294 144116 68178 81437661 75531978 16992 5905683 -16992 5888691 5888691 17584 89402 25134 -7550 -7550 BEAUTY & BARBER 623000 41287 41287 MINISTER 623000 28910 28910 MINERAL LEASES 623000 20927 20927 91124 40193463 31657124 144116 7106528 21833 21833 21336 21336 725229 725229 14049152 12989138 680307 379707 589625 518378 71247 1935873 1635839 224832 75202 1084421 929364 127733 27324 188352 188352 60865 60865 335119 335119 2846090 1921108 924982 365959 319141 46818 3493099 3053670 374496 64933 334207 334207 1668026 1294503 373523 374420 305876 42040 26504 157914 152825 5089 1628629 1263928 364701 1570209 1218590 351619 360703 279930 80773 CORPORATE SERVICE FEES 1368165 1368165 OTHER ADMINISTRATION 887792 879609 8183 BAD DEBT 218781 218781 DUES, SUBSCRIPTIONS AND 126193 120803 5390 546 546 34412538 25606318 8167070 639150 265796 654209 37821 1093821 3100160 5264324 2383280 1776091 233312 301516 56513921 13888570 43081826 42625351 68646654 69395964 2417500 2417500 930967 911388 9514231 21294678 130611547 145734842 10464771 16117216 34761309 43186973 26034 25939 900358 808536 24450536 28319661 70603008 88458325 X 53411751 50408912 379630 530753 6217158 6336852 60008539 57276517 130611547 145734842 X 5780925 -4630825 -3882122 X X 0 1 X 1 0 X 1388157 163156 232406 444836 1285695 3514250 23126500 27068889 29594091 30752080 31657124 142198684 24514657 27232045 29826497 31196916 32942819 145712934 12389 43720 27768 32717 27196 143790 711986 711986 12389 43720 27768 32717 739182 855776 144857158 1067119 1099387 1291116 1145242 1367501 5970365 1067119 1099387 1291116 1145242 1367501 5970365 27588 33349 17861 -9852 91124 160070 25609364 28364781 31135474 32332306 34401444 151843369 0.95400 0.95620 0.03930 0.04210 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2010 AMOUNT: $ 27,588. 2011 AMOUNT: $ 33,349. 2012 AMOUNT: $ 17,861. 2013 AMOUNT: $ -9,852. MINERAL LEASES - 2014 AMOUNT: $ 20,927. BEAUTY AND BARBER - 2014 AMOUNT: $ 41,287. MINISTER - 2014 AMOUNT: $ 28,910. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 1 17.80 1 0 0 1 X 17249416 723380 226156 16209 18182743 16248544 239143 780120 -18391 17249416 15133764 760932 432771 78923 16248544 14678280 601051 -107752 37815 15133764 14026059 284760 384474 17013 14678280 0.02060 0.95830 0.02110 0 0 2917724 6602539 9520263 34582572 6454281 28128291 4306231 1689541 2616690 8104855 5744748 2360107 42625351 CIP 19961100 TRUSTEED FUNDS 1307639 RESIDENT TRUST 25939 21294678 CAPITAL LEASE 1750257 SPLIT-INTEREST AGREEMENT 163957 DEFERRED COST OF INTEREST RATE SWAP 287346 INTERCOMPANY PAYABLES 26118101 28319661 X PART II, LINE 9: THE CONSERVATION EASEMENT IS LOCATED AT THE SE CORNER OF THE INTERSECTION OF SR 741 AND SR 63 IN WARREN COUNTY, OHIO. IT IS IN PLACE TO PROTECT THE PHYSICAL, BIOLOGICAL AND CHEMICAL INTEGRITY OF THE LITTLE MIAMI RIVER WATERSHED AND IS UNDER THE ENFORCEMENT OF THE OHIO EPA. OTTERBEIN HOMES ENGAGED THE FIRM OF JF NEW IN 2008 FOR MITIGATION AND MONITORING. PART IV, LINE 2B: RESIDENT FUNDS ARE DEPOSITS HELD UNDER A FIDUCIARY RESPONSIBILITY AND ARE REQUIRED BY STATE REGULATION. PART V, LINE 4: THE ORGANIZATION HAS ADOPTED INVESTMENT AND SPENDING POLICIES FOR ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO PROGRAMS SUPPORTED BY ITS ENDOWMENT. ENDOWMENT ASSETS INCLUDE THOSE ASSETS OF DONOR-RESTRICTED FUNDS THAT THE ORGANIZATION MUST HOLD IN PERPETUITY OR FOR A DONOR-SPECIFIED PERIOD. UNDER THIS POLICY, AS APPROVED BY THE BOARD OF TRUSTEES, THE ENDOWMENT ASSETS ARE INVESTED IN A MANNER THAT IS INTENDED TO PRESERVE AND GROW CAPITAL, STRIVE FOR CONSISTENT ABSOLUTE RETURNS, PRESERVE PURCHASING POWER BY STRIVING FOR LONG-TERM RETURNS WHICH EITHER MATCH OR EXCEED THE SET PAYOUT, FEES AND INFLATION WITHOUT PUTTING A PRINCIPAL VALUE AT IMPRUDENT RISK, AND DIVERSIFY INVESTMENTS CONSISTENT WITH COMMONLY ACCEPTED INDUSTRY STANDARD TO MINIMIZE THE RISK OF LARGE LOSSES. PART X, LINE 2: THE ORGANIZATION QUALIFIES AS A TAX-EXEMPT CORPORATION DESCRIBED IN SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THE ORGANIZATION IS NOT SUBJECT TO FEDERAL INCOME TAXES UNDER SECTION 501 (C)(3) OF THE CODE. THE ORGANIZATION IS CLASSIFIED AS A PUBLICLY SUPPORTED CHARITABLE ORGANIZATION UNDER THE CODE AND CONTRIBUTIONS TO THE ORGANIZATION QUALIFIES AS A CHARITABLE TAX DEDUCTIONS FOR THE CONTRIBUTOR. THE ENTITY FILES AS A TAX-EXEMPT ORGANIZATION. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, ALL YEARS SINCE INCEPTION COULD BE SUBJECT TO REVIEW BY THE IRS. THE ORGANIZATIONS 2013, 2012, AND 2011 TAX YEARS ARE OPEN FOR EXAMINATION BY THE IRS. DILGARD TOURNAMENT (GOLF) 106986 89402 17584 25134 106986 89402 17584 25134 25134 -7550 1 LEADINGAGE INC 2519 CONNECTICUT AVENUE NW WASHINGTON DC 20008 136213525 501(C)(3) 10000 GENERAL SUPPORT MARY SCOTT NURSING CENTER INC 3109 CAMPUS DRIVE DAYTON OH 45406 316010222 501(C)(3) 5000 GENERAL SUPPORT 2 TUITION ASSISTANCE 65 21336 X X X X X 0 0 0 0 0 0 0 0 0 JILL HREBEN PRESIDENT/CEO 358410 0 0 0 0 0 5682 0 4582 0 368674 0 0 0 JAMES C GREEN CFO/VP FINANCE 246425 0 0 0 0 0 5550 0 10996 0 262971 0 0 0 JASON MILLER VP OF NORTHWEST MINISTRIES/CEO LEBAN 82588 201486 0 0 0 0 0 4340 10996 6414 93584 212240 0 0 A COUNTY OF WARREN OHIO 316000058 93515PAY3 2013-07-11 65524971 REFUNDING 0 0 0 B COUNTY OF WARREN OHIO 316000058 2013-07-15 36815000 REFUNDING AND CONSTRUCTION 0 0 0 C COUNTY OF WARREN OHIO 316000058 93515PBV8 2014-10-29 33115756 REFUNDING AND CONSTRUCTION 0 0 0 A 4190000 65524971 754971 64770000 2013 1 0 1 1 B 6500000 36815000 261945 17881598 18671457 2014 1 0 0 1 C 33115757 819610 478825 19141490 6500000 6175832 2016 1 0 0 1 A 0 0 0 0 0.00000 0.00000 0 0 1 B 0 1 0 0 0.00130 0.00130 0 0 1 C 0 1 0 0 0.00130 0.00130 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 1 0 0 0 1 C 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 X 5 600 FMV X 5181 FMV X 1 5072 FMV X 4 601 FMV X GIFT CERTIFICATES 21 31647 FMV 0 1 0 FORM 990, PART VI, SECTION B, LINE 11 THE IRS FORM 990 IS PROVIDED TO AND REVIEWED BY THE OFFICERS AND BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C IN ACCORDANCE WITH THE BY-LAWS, ANY POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY BOARD MEMBER, CORPORATE EXECUTIVE, EXECUTIVE DIRECTOR, OR ADMINISTRATIVE STAFF MEMBER, OR COMMITTEE MEMBERS, WHO ARE NOT MEMBERS OF THE BOARD OF TRUSTEES OF OTTERBEIN HOMES SHALL BE DISCLOSED TO THE BOARD AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST BECOMES RELEVANT TO A MATTER OF BOARD ACTION. FORM 990, PART VI, SECTION B, LINE 15 THE INDEPENDENT EXECUTIVE COMMITTEE OF THE OTTERBEIN HOMES BOARD OF TRUSTEES HAS THE RESPONSIBILITY FOR DETERMINING THE ANNUAL COMPENSATION FOR THE OFFICERS BY THE USE OF INDUSTRY SPECIFIC DATA SUCH AS SALARY SURVEYS FROM LEADING AGE AND LEADING AGE OHIO. THE SALARIES OF THE KEY EMPLOYEES ARE DETERMINED BY THE OFFICERS USING INDUSTRY COMPARATIVE DATA SUCH AS SALARY SURVEYS FROM LEADING AGE AND LEADING AGE OHIO. THE DELIBERATIONS AND DECISIONS REGARDING COMPENSATION ARE DOCUMENTED. THIS PROCESS WAS LAST PERFORMED IN 2014. FORM 990, PART VI, SECTION C, LINE 19 THE ANNUAL REPORT IS PROVIDED TO THE PUBLIC WHICH INCLUDES THE AUDITED FINANCIAL STATEMENT SUMMARY AND IS CERTIFIED BY THE CHIEF EXECUTIVE OFFICER AND THE CHIEF FINANCIAL OFFICER. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF GIFT ANNUITY -13,464. CHANGE IN MINIMUM PENSION LIABILITY -3,833,658. RESTRICTED FUND ADJUSTMENTS -35,000. FORM 990, PART XII, LINE 2C THE SELECTION AND OVERSIGHT PROCESS HAS NOT CHANGED. OTTERBEIN PERRYSBURG LLC 580 N STATE ROUTE 741 LEBANON OH 45036 205493322 DEVELOP & OPERATE SMALL HOUSE NEIGHBORHOODS - PROVIDING SKILLED NURSING CARE OH 4091728 7088298 OTTERBEIN HOMES OTTERBEIN MONCLOVA LLC 580 N STATE ROUTE 741 LEBANON OH 45036 205493287 DEVELOP & OPERATE SMALL HOUSE NEIGHBORHOODS - PROVIDING SKILLED NURSING CARE OH 4185786 7893875 OTTERBEIN HOMES OTTERBEIN CLEAR CREEK LLC 580 N STATE ROUTE 741 LEBANON OH 45036 260731207 DEVELOP & OPERATE SMALL HOUSE NEIGHBORHOODS - PROVIDING SKILLED NURSING CARE OH 4362871 7469443 OTTERBEIN HOMES OTTERBEIN MIDDLETOWN LLC 580 N STATE ROUTE 741 LEBANON OH 45036 260731330 DEVELOP & OPERATE SMALL HOUSE NEIGHBORHOODS - PROVIDING SKILLED NURSING CARE OH 5018803 7903570 OTTERBEIN HOMES OTTERBEIN HOLDINGS LLC 580 N STATE ROUTE 741 LEBANON OH 45036 205493357 REAL ESTATE HOLDING COMPANY OH OTTERBEIN HOMES OTTERBEIN INDEPENDENT LIVING SERVICES LLC 580 N STATE ROUTE 741 LEBANON OH 45036 263554627 CLINIC OH 904399 93813 OTTERBEIN HOMES OTTERBEIN PROPERTIES LLC 580 N STATE ROUTE 741 LEBANON OH 45036 270543473 REAL ESTATE DEVELOPMENT OH OTTERBEIN HOMES OTTERBEIN HOME HEALTH 580 N STATE ROUTE 741 LEBANON OH 45036 271049483 HOME HEALTH SERVICES OH 1191827 609355 OTTERBEIN HOMES OTTERBEIN MAINEVILLE LLC 580 N STATE ROUTE 741 LEBANON OH 45036 205952379 DEVELOP & OPERATE SMALL HOUSE NEIGHBORHOODS - PROVIDING SKILLED NURSING CARE OH 5061922 8768817 OTTERBEIN HOMES OTTERBEIN HOSPICE 580 N STATE ROUTE 741 LEBANON OH 45036 461453798 HOSPICE SERVICES OH 990968 556945 OTTERBEIN HOMES OTTERBEIN BATAVIA 580 N STATE ROUTE 741 LEBANON OH 45036 462718728 DEVELOP & OPERATE SMALL HOUSE NEIGHBORHOODS - PROVIDING SKILLED NURSING CARE OH 0 2361024 OTTERBEIN HOMES OTTERBEIN GAHANNA 580 N STATE ROUTE 741 LEBANON OH 45036 462748595 DEVELOP & OPERATE SMALL HOUSE NEIGHBORHOODS - PROVIDING SKILLED NURSING CARE OH 0 6221838 OTTERBEIN HOMES OTTERBEIN NEW ALBANY 580 N STATE ROUTE 741 LEBANON OH 45036 462726708 DEVELOP & OPERATE SMALL HOUSE NEIGHBORHOODS - PROVIDING SKILLED NURSING CARE OH 60822 9426736 OTTERBEIN HOMES OTTERBEIN LOVELAND 580 N STATE ROUTE 741 LEBANON OH 45036 462733350 DEVELOP & OPERATE SMALL HOUSE NEIGHBORHOODS - PROVIDING SKILLED NURSING CARE OH 0 2329037 OTTERBEIN HOMES OTTENBEIN ST MARYS 11230 STATE ROUTE 364 ST MARYS OH 45885 341940880 CONTINUING CARE RETIREMENT COMMUNITY OH 501(C)(3) LINE 9 OTTERBEIN HOMES 1 OTTERBEIN LEBANON 585 NORTH STATE ROUTE 741 LEBANON OH 45036 311743874 CONTINUING CARE RETIREMENT COMMUNITY OH 501(C)(3) LINE 9 OTTERBEIN HOMES 1 OTTERBEIN NORTH SHORE 9400 NORTH SHORE BLVD LAKESIDE OH 43440 341743836 CONTINUING CARE RETIREMENT COMMUNITY OH 501(C)(3) LINE 9 OTTERBEIN HOMES 1 OTTERBEIN PORTAGE VALLEY 20311 PEMBERVILLE ROAD PEMBERVILLE OH 43450 341193296 CONTINUING CARE RETIREMENT COMMUNITY OH 501(C)(3) LINE 9 OTTERBEIN HOMES 1 OTTERBEIN CRIDERSVILLE 100 RED OAK DRIVE CRIDERSVILLE OH 45806 341940884 CONTINUING CARE RETIREMENT COMMUNITY OH 501(C)(3) LINE 9 OTTERBEIN HOMES 1 OTTERBEIN SERVICES CORPORATION (INACTICE) 580 N STATE ROUTE 741 LEBANON OH 45036 311293054 INACTIVE OH OTTERBEIN HOMES C 1.00000 1 0 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 1 1 OTTERBEIN CRIDERSVILLE L 492144 PERCENTAGE OF REVENUE OTTERBEIN LEBANON L 2256036 PERCENTAGE OF REVENUE OTTERBEIN ST MARYS L 666960 PERCENTAGE OF REVENUE OTTERBEIN NORTH SHORE L 282936 PERCENTAGE OF REVENUE OTTERBEIN PORTAGE VALLEY L 570852 PERCENTAGE OF REVENUE