2014-08-21T13:44:30-05:00 2013-12-31 310210560 BATTELLE RIPPE KINGSTON LLP 2000 WEST DOROTHY LANE DAYTON OH 45439 990 2013-01-01 310641121 WIDOWS HOME OF DAYTON OHIO WIDO 9372521661 50 SOUTH FINDLAY STREET DAYTON OH 45403 NANCY HINES PRESIDENT 9372521661 2014-08-13 1 KAREN O CRIM P00368385 9372980201 2013 2015-11-30 17:44:51Z JENNY WARNER 50 SOUTH FINDLAY STREET DAYTON OH 45403 5791398 0 X WWW.WIDOWSHOME.ORG X 1961 OH THE PURPOSE OF THE WIDOWS HOME IS TO PROVIDE LONG-TERM CARE SERVICES TO ELDERLY INDIVIDUALS. 10 10 164 25 0 0 0 0 5453503 5719309 -1099 0 3410 72089 5455814 5791398 0 0 0 0 2559740 2822788 0 0 0 2890539 2954544 5450279 5777332 5535 14066 7465982 7088901 8339303 4667581 -873321 2421320 THE PURPOSE OF THE WIDOWS HOME IS TO PROVIDE LONG-TERM CARE SERVICES TO ELDERLY INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. 0 0 4669702 5719309 THE WIDOWS HOME OF DAYTON, OHIO PROVIDES LONG-TERM NURSING AND RESIDENTIAL CARE, SHORT-TERM REHABILITATION, AND ADULT DAY PROGRAMS TO ELDERLY INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THE HOME IS AN INNER-CITY FACILITY WITH 75 LICENSED BEDS. 24,838 DAYS OF SERVICE WERE PROVIDED TO 219 PATIENTS IN 2013. 4669702 1 0 0 1 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 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 0 1 0 0 0 1 12 0 164 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 1 0 0 0 OH X JENNY WARNER 9372521661 50 SOUTH FINDLAY STREET DAYTON OH 45403 NANCY HINES PRESIDENT 0.50 X X 0 0 0 ROBERT PROPHATER VICE PRESIDENT 0.50 X X 0 0 0 MARILYN HOBACK SECRETARY 0.50 X X 0 0 0 JOAN FRANKS TREASURER 0.50 X X 0 0 0 ROBERT APPLEBAUM BOARD MEMBER 0.50 X 0 0 0 JANE CLIFTON BOARD MEMBER 0.50 X 0 0 0 LINDA ROEPKEN BOARD MEMBER 0.50 X 0 0 0 JEFF SORRELL BOARD MEMBER 0.50 X 0 0 0 KEITH VALIQUETTE BOARD MEMBER 0.50 X 0 0 0 ROSE WILDENHAUS BOARD MEMBER 0.50 X 0 0 0 TIMOTHY P BETE BOARD MEMBER 0.50 X 0 0 0 KIMBERLY ANDREWS BOARD MEMBER 0.50 X 0 0 0 ELIZABETH WARDECKE BOARD MEMBER 0.50 X 0 0 0 KRISTINA DIXON EXECUTIVE DIRECTOR UNTIL 11/13 32.00 X 85274 0 1480 JENNIFER WARNER EXECUTIVE DIRECTOR FROM 11/13 32.00 X 5600 0 0 90874 0 1480 0 0 0 0 ALPHA & OMEGA STAFFING SOLUTIONS 6276 PLATTSBURG ROAD S CHARLESTON OH 45368 THERAPY SERVICES 501101 BEEBER PHARMACIES 600 UNION BLVD ENGLEWOOD OH 45322 PHARMACY SERVICES 150510 2 MEDICARE/MEDICAID PAYM 623000 4436787 4436787 PRIVATE PAY RESIDENTS 623000 975748 975748 HOSPICE CARE RESIDENTS 623000 306774 306774 5719309 BWC REFUND 623000 72089 72089 72089 5791398 5791398 0 0 90874 90874 2179836 2069129 110707 1480 1480 36230 28923 7307 514368 476780 37588 76030 76030 11765 11765 9700 9700 40897 40897 1340 1340 197562 197562 348439 348439 HEALTH SERVICES 1124304 1124304 ADMINISTRATION 347690 347690 BED TAX 325663 325663 DIETARY 190450 190450 280704 234115 46589 5777332 4669702 1107630 0 277235 189749 895918 856426 5744 0 42354 39903 10347561 4971432 5646250 5376129 563638 563638 34843 63056 7465982 7088901 599139 356387 3943457 3792900 19085 15547 3777622 502747 8339303 4667581 X -873321 2421320 -873321 2421320 7465982 7088901 X 14066 3280575 X X 0 1 X 1 0 X 5677102 5768165 5689985 5432762 5719309 28287323 5677102 5768165 5689985 5432762 5719309 28287323 0 0 0 28287323 48939 49778 49778 20741 169236 48939 49778 49778 20741 169236 72089 72089 5726041 5817943 5739763 5453503 5791398 28528648 0.99150 0.99200 0.00590 0.00800 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: BWC REFUND - 2013 AMOUNT: $ 72,089. 0 0 0 0 0 0 0 0 1 0 PART II-B, LINE 1: A SMALL PORTION OF THE ORGANIZATION'S DUES PAID TO LEADINGAGE OHIO (FKA AOPHA) IS ALLOCABLE TO LOBBYING. 0 1 X 131650 131650 8937837 3998254 4939583 1278074 973178 304896 5376129 ACCRUED EXPENSES 262899 DEFERRED COST OF INTEREST RATE SWAP 239848 502747 X PART IV, LINE 2B: RESIDENT SAVINGS ACCOUNTS ARE HELD IN A SEPARATE BANK ACCOUNT. PART X, LINE 2: THE HOME AND THE FOUNDATION QUALIFY AS TAX-EXEMPT NON-PROFIT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR FEDERAL INCOME TAX IS REQUIRED. MANAGEMENT EVALUATED THE HOME AND THE FOUNDATION'S TAX POSITIONS AS OF DECEMBER 31, 2013 AND 2012 AND CONCLUDED THAT THEY HAVE TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE CONSOLIDATED FINANCIAL STATEMENTS. IN GENERAL, THE HOME AND FOUNDATION ARE NO LONGER SUBJECT TO FEDERAL, STATE, OR LOCAL INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR THE YEARS BEFORE 2010. A CITY OF RIVERSIDE 316000133 2006-12-29 2500000 25 BED EXPANSION 0 0 0 A 2500000 2008 0 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 CASH TRANSFERED FROM RELATED ENTITY 2013-12-31 3236408 ACTUAL COST OF THE WRITE OFF AMOUNT 311584036 WIDOWS HOME FOUNDATION 50 SOUTH FINDLAY STREET DAYTON OH 45403 501(C)(3) 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 8B COMMITTEE MEETING MINUTES WERE NOT TAKEN. HOWEVER, THE DISCUSSIONS DURING COMMITTEE MEETINGS ARE REPORTED AT BOARD MEETINGS AND ARE DOCUMENTED IN THE BOARD MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WILL BE PROVIDED TO BOARD MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS PROVIDE SELF-DISCLOSURE OF CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP OBLIGATION 44,167. TRANSFER FROM WIDOWS HOME FOUNDATION 3,236,408. FORM 990, PART XI, LINE 2C THE ORGANIZATION'S COMMITTEE THAT ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS HAS NOT CHANGED THAT PROCESS FROM THE PRIOR YEAR. THE FINANCIAL STATEMENTS ARE CONSOLIDATED WITH THE WIDOWS HOME FOUNDATION, A PUBLIC CHARITY WHOSE PURPOSE IS TO CONDUCT FUNDRAISING ACTIVITIES AND MANAGE THE ENDOWMENT FUNDS FOR THE BENEFIT OF THE WIDOWS HOME OF DAYTON. WIDOWS HOME FOUNDATION 50 SOUTH FINDLAY STREET DAYTON OH 45403 311584036 TO CONDUCT FUNDRAISING ACTIVITIES AND MANAGE ENDOWMENT FUNDS. OH 501(C)(3) LINE 7 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 WIDOWS HOME FOUNDATION S 3236408 FAIR MARKET VALUE