2014-11-17T15:25:26-06:00 2013-12-31 410746749 CLIFTONLARSONALLEN LLP 1 BRONZE POINTE BELLEVILLE IL 62226 990 2013-01-01 310549058 OTTERBEIN HOMES OTTE 5139322020 580 NORTH STATE ROUTE 741 LEBANON OH 450368839 J CHRISTOPHER GREEN CFO 5139335400 2014-11-17 1 JEFF PARKER P00970069 6182331200 2013 2015-11-30 17:44:51Z J CHRISTOPHER GREEN 580 NORTH SR 741 LEBANON OH 450368839 87008850 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. 23 23 758 109 172002 -46368 232406 444836 29594091 30752080 3237518 8282110 269109 227230 33333124 39706256 0 0 0 0 16558427 16896245 0 0 682043 14538053 15316336 31096480 32212581 2236644 7493675 117548976 130611547 68949071 70603008 48599905 60008539 OUR MISSION - IN KEEPING WITH OUR UNITED METHODIST TRADITION WE SEEKTO ENHANCE THE QUALITY OF LIFE AND HOLISTIC GROWTH OF OLDER PERSONS. 0 0 19904684 30752080 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 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 4,000 PERSONS. 19904684 1 1 0 0 0 0 1 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 121 0 758 1 1 1 0 0 0 0 0 0 0 X 23 23 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 REV BRIAN BROWN TRUSTEE 1.00 X 0 0 0 REV MARLA BROWN TRUSTEE 1.00 X 0 0 0 BILL BROWNSON TRUSTEE 1.00 X 0 0 0 REV GEORGE CAMPBELL TRUSTEE 1.00 X X 0 0 0 REV LEROY CHAMBLISS SECRETARY 1.00 X 0 0 0 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 MICHAEL MCCARTY TRUSTEE 1.00 X 0 0 0 LEROY MCKAY TRUSTEE 1.00 X 0 0 0 MEL MILLER VICE CHAIR 1.00 X X 0 0 0 PAMELA NICKELL TRUSTEE 1.00 X 0 0 0 GEORGE SEHI TRUSTEE 1.00 X 0 0 0 TINA BASINGER 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 DAVID WOODYARD TRUSTEE 1.00 X 0 0 0 LYNN APP TRUSTEE 1.00 X 0 0 0 JOE FREDERICK TRUSTEE 1.00 X 0 0 0 PATTY CISCO TRUSTEE 1.00 X 0 0 0 RUTH FLOYD TRUSTEE 1.00 X 0 0 0 JILL HREBEN PRESIDENT/CEO 38.00 2.00 X 335426 0 15186 JAMES C GREEN CFO/VP FINANCE 38.00 2.00 X 220646 0 13812 556072 0 28998 14 0 1 0 GORDON FOOD SERVICE INC PO BOX 88029 CHICAGO IL 606801029 FOOD SERVICES 2683034 RIDGE STONE GENERAL CONTRACTORS 7015 LIGHTHOUSE WAY PERRYSBURG OH 43551 CONSTRUCTION SERVICES 1834446 CONCEPT REHAB INC 7150 GRANITE CIRCLE SUITE 200 TOLEDO OH 43617 THERAPY SERVICES 1723696 MCKESSON MEDICAL-SURGICAL PO BOX 630693 CINCINNATI OH 452630693 MEDICAL SERVICES 994346 REMEDI SENIORCARE PO BOX 75744 BALTIMORE MD 212755744 MEDICAL SERVICES 572289 26 61384 383452 21016 444836 SERVICE FEES 541900 29704511 29704511 DEPARTMENTAL SERVICES 623000 1047569 1047569 30752080 816540 816540 328732 91650 237082 237082 172002 65080 54647675 3850 47117603 68352 7530072 -64502 7465570 7465570 15137 61384 24989 -9852 -9852 39706256 30752080 172002 8337338 556072 556072 13032005 8177747 4491643 362615 564877 104190 460687 1746253 1072233 591660 82360 997038 607545 361725 27768 78642 78442 200 65706 65706 2277174 2277174 319825 277263 42562 2700898 2391800 231858 77240 271121 184414 69382 17325 1582984 1554863 28121 321750 46135 250172 25443 88872 15076 71284 2512 1566698 1311439 255259 1625600 1393562 232038 245801 221709 24092 OTHER ADMINISTRATION 1848994 85266 1732655 31073 CORPORATE SERVICE FEES 1540775 1540775 MAINENANCE EQUIPMENT 490637 454044 30884 5709 BAD DEBT 173031 173031 117828 7487 103105 7236 32212581 19904684 11625854 682043 53455 265796 2672709 3100160 2149765 2383280 183731 233312 53165251 12609181 39444855 40556070 57265168 61489630 325000 325000 15454293 22258299 117548976 130611547 11276470 10464771 31198918 35661666 26473683 24476571 68949071 70603008 X 54127483 53411751 -11259594 379630 5732016 6217158 48599905 60008539 117548976 130611547 X 7493675 3914959 X X 0 1 X 1 0 X 217962 1388157 163156 232406 444836 2446517 18325253 23126500 27068889 29594091 30752080 128866813 18543215 24514657 27232045 29826497 31196916 131313330 20406 12389 43720 27768 32717 137000 0 20406 12389 43720 27768 32717 137000 131176330 1174737 1067119 1099387 1291116 1145242 5777601 1174737 1067119 1099387 1291116 1145242 5777601 28575 27588 33349 17861 -9852 97521 19746527 25609364 28364781 31135474 32332306 137188452 0.95620 0.94590 0.04210 0.05220 X SCHEDULE A, PART III, LINE 12, EXPLANATION FOR OTHER INCOME: OTHER INCOME 2009 AMOUNT: $ 28,575. 2010 AMOUNT: $ 27,588. 2011 AMOUNT: $ 33,349. 2012 AMOUNT: $ 17,861. 2013 AMOUNT: $ -9,852. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 1 17.80 1 0 16248544 239143 780120 -18391 17249416 15133764 760932 432771 78923 16248544 14678280 601051 -107752 37815 15133764 14026059 284760 384474 17013 14678280 13222168 500699 303192 14026059 0.01590 0.98410 0.00000 0 0 6614539 6614539 34358652 5598615 28760037 7979250 5537406 2441844 4212810 1473160 2739650 40556070 UNAMORTIZED FINANCE COST 605967 CIP 8231990 UNEXPECTED BOND PROCEED & SINKING FUND 1256206 INVESTMENTS 7157024 OTHER PROPERTY 2417500 RESIDENT TRUST 26035 LAND HELD FOR RESALE 2525756 CONTRIBUTIONS RECEIVABLE 37821 22258299 CAPITAL LEASE 2215442 SPLIT-INTEREST AGREEMENT 179902 DEFERRED COST OF INTEREST RATE SWAP 284936 RESIDENT TRUST 26035 INTERCOMPANY PAYABLES 21770256 24476571 X PART II, LINE 9: THE CONSERVATION EASEMENT IS LOCATED AT 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 ENGAGEMENT THE FIRM OF JF NEW IN 2008 FOR MITIGATION AND MONITORING. 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 2012, 2011, AND 2010 TAX YEARS ARE OPEN FOR EXAMINATION BY THE IRS. DILGARD TOURNAMENT (GOLF) 76521 61384 15137 24989 76521 61384 15137 24989 24989 -9852 X X X X X 0 0 0 0 0 0 0 0 0 JILL HREBEN PRESIDENT/CEO 335426 0 0 0 0 0 0 0 15186 0 350612 0 0 0 JAMES C GREEN CFO/VP FINANCE 220646 0 0 0 0 0 0 0 13812 0 234458 0 0 0 A COUNTY OF WARREN OHIO 316000058 93515PAY3 2013-07-11 65524971 REFUNDING 0 0 0 B COUNTY OF WARREN OHIO 316000058 2013-07-11 36815000 REFUNDING AND CONSTRUCTION 0 0 0 A 65524971 754971 1 0 1 1 B 36815000 261945 8286397 1 0 0 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 1 0 0 0 1 DEUTSCHE BANK 2.580000000000 0 0 0 0 1 A 1 B 1 JILL HREBEN CEO/PRESIDENT OF OTTERBEIN HOMES & BOARD REPRESENTATIVE OF CCIC 691559 CARING COMMUNITES INSURANCE COMPANY (CCIC) - OTTERBEIN HOMES HAS A CLAIMS MADE POLICY FOR GENERAL LIABILITY INSURANCE. HS. HREBEN ALSO SERVES ON THE BOARD OF DIRECTORS OF CCIC. DURING 2012, OTTERBEIN HOMES PAID INSURANCE PREMIUMS TO CCIC TOTALING APPROXIMATELY $653,000. MS. HREBEN RECEIVES NO PERSONAL BENEFIT FROM THIS RELATIONSHIP. 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 AN AD HOC 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. 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 FAIR VALUE OF INTEREST RATE SWAP 78,632. CHANGE IN FAIR VALUE OF SPLIT INTEREST AGREEMENT -21,620. CHANGE IN MINIMUM PENSION LIABILITY 2,440,704. TRANSFERS OF UNRESTRICTED NET ASSETS -39,855. RESTRICTED FUND ADJUSTMENTS 1,457,098. 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 AND OPERATE SMALL HOUSE NEIGHHOODS - PROVIDING SKILLED NURSING CARE OH 4438243 6933678 OTTERBEIN HOMES OTTERBEIN MONCLOVA LLC 580 N STATE ROUTE 741 LEBANON OH 45036 205493287 DEVELOP AND OPERATE SMALL HOUSE NEIGHHOODS - PROVIDING SKILLED NURSING CARE OH 4346348 7793390 OTTERBEIN HOMES OTTERBEIN CLEARCREEK LLC 580 N STATE ROUTE 741 LEBANON OH 45036 260731207 DEVELOP AND OPERATE SMALL HOUSE NEIGHHOODS - PROVIDING SKILLED NURSING CARE OH 4384600 7249341 OTTERBEIN HOMES OTTERBEIN MIDDLETOWN LLC 580 N STATE ROUTE 741 LEBANON OH 45036 260731330 DEVELOP AND OPERATE SMALL HOUSE NEIGHHOODS - PROVIDING SKILLED NURSING CARE OH 5014771 7609627 OTTERBEIN HOMES OTTERBEIN HOLDING 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 899331 114745 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 1240406 547556 OTTERBEIN HOMES OTTERBEIN MAINEVILLE LLC 580 N STATE ROUTE 741 LEBANON OH 45036 205952379 DEVELOP AND OPERATE SMALL HOUSE NEIGHHOODS - PROVIDING SKILLED NURSING CARE OH 4645311 8545045 OTTERBEIN HOMES OTTERBEIN HOSPICE 580 N STATE ROUTE 741 LEBANON OH 45036 461453798 HOSPICE SERVICES OH 39977 84304 OTTERBEIN HOMES OTTERBEIN BATAVIA 580 N STATE ROUTE 741 LEBANON OH 45036 462718728 DEVELOP AND OPERATE SMALL HOUSE NEIGHHOODS - PROVIDING SKILLED NURSING CARE OH 0 1311405 OTTERBEIN HOMES OTTERBEIN GAHANNA 580 N STATE ROUTE 741 LEBANON OH 45036 462748595 DEVELOP AND OPERATE SMALL HOUSE NEIGHHOODS - PROVIDING SKILLED NURSING CARE OH 0 2507525 OTTERBEIN HOMES OTTERBEIN NEW ALBANY 580 N STATE ROUTE 741 LEBANON OH 45036 462726708 DEVELOP AND OPERATE SMALL HOUSE NEIGHHOODS - PROVIDING SKILLED NURSING CARE OH 0 3604000 OTTERBEIN HOMES OTTERBEIN LOVELAND 580 N STATE ROUTE 741 LEBANON OH 45036 462733350 DEVELOP AND OPERATE SMALL HOUSE NEIGHHOODS - PROVIDING SKILLED NURSING CARE OH 0 1686239 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 0 0 1 0 0 0 0 0 1 1 OTTERBEIN PERRYSBURG L 263220 PERCENTAGE OF REVENUE OTTERBEIN MONCLOVA L 272616 PERCENTAGE OF REVENUE OTTERBEIN CLEARCREEK L 259272 PERCENTAGE OF REVENUE OTTERBEIN MIDDLETOWN L 309972 PERCENTAGE OF REVENUE OTTERBEIN MAINEVILLE L 279852 PERCENTAGE OF REVENUE OTTERBEIN HOME HEALTH SERVICES L 74438 PERCENTAGE OF REVENUE OTTERBEIN INDEPENDENT LIVING SUPPORT SERVICES L 78956 PERCENTAGE OF REVENUE OTTERBEIN CRIDERSVILLE L 501504 PERCENTAGE OF REVENUE OTTERBEIN LEBANON L 2207100 PERCENTAGE OF REVENUE OTTERBEIN ST MARYS L 615432 PERCENTAGE OF REVENUE OTTERBEIN NORTH SHORE L 258852 PERCENTAGE OF REVENUE OTTERBEIN PORTAGE VALLEY L 549816 PERCENTAGE OF REVENUE