2013-11-15T09:02:14-06:00 2012-12-31 381357951 PLANTE & MORAN PLLC 1111 SUPERIOR AVENUE SUITE 1250 CLEVELAND OH 44114 990 2012-01-01 341896807 PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION PROV 4196272273 5055 PROVIDENCE DRIVE SANDUSKY OH 44870 WENDY DOLYK 4196272273 2013-11-11 1 JEREMY S HERMAN P00745789 2165231010 2012 2016-03-07 17:11:31Z WENDY DOLYK 5055 PROVIDENCE DRIVE SANDUSKY OH 44870 1003499 0 0928 X WWW.PROVIDENCECENTERS.ORG X 1999 OH PROVIDENCE RESIDENTIAL PROVIDES INDEPENDENT LIVING FACILITIES AND LIMITED NURSING SERVICES TO RESIDENTS OVER AGE 55 YEARS. 8 7 0 1 0 0 0 0 973764 1000902 138 54 8965 2543 982867 1003499 0 0 0 0 15945 66336 0 0 0 899676 893573 915621 959909 67246 43590 7301772 6990256 9159244 8804138 -1857472 -1813882 PROVIDENCE CARE CENTERS, A CATHOLIC ORGANIZATION, SPONSORED BY THE SISTERS OF ST. FRANCIS, OF SYLVANIA, OHIO, PROVIDES SERVICES TO SENIORS OF ALL FAITHS, GUIDED BY THE HEALING PRESENCE OF JESUS CHRIST. 0 0 266693 1003445 PROVIDENCE REDIDENTIAL PROVIDES INDEPENDENT LIVING FACILITIES AND LIMITED NURSING SERVICES TO RESIDENTS OVER AGE 55 YEARS. DURING 2012, 76 REDIDENTS WERE SERVED WITH 24,093 PATIENT DAYS. 266693 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 3 0 1 0 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 OH X AMY GILL 4196272273 2025 HAYES AVENUE SANDUSKY OH 44870 X RICK RYAN 1.00 40.00 X 0 347637 43887 H JOHN HILDEBRANDT 1.00 X X 0 0 0 CARL MCGOOKEY 1.00 X 0 0 0 CHARLENE MOCKENSTURM 1.00 X X 0 0 0 SISTER JULIE MEYERS 1.00 X 0 0 0 BRIAN MURPHY MD 1.00 X 0 0 0 JAMES PETERS 1.00 X 0 0 0 DONALD MAZZA 1.00 X 0 0 0 EDMOND HOTY PARTIAL YEAR 1.00 X 0 0 0 WENDY DOLYK 1.00 40.00 X 0 150795 11950 GLORIA KATTOUAH 1.00 40.00 X 0 86433 14472 0 584865 70309 1 0 1 0 BLUE SKY THERAPY MGMYT 510 W MAIN ST CANFIELD OH 44406 THERAPY 1303975 1 RENTAL INCOME 623990 957867 957867 ENTRANCE FEE REVENUE 623990 38586 38586 HOUSEKEEPING REVENUE 623000 4449 4449 1000902 54 54 OTHER REVENUE 900099 1525 1525 NURSING SERVICES REVEN 900099 1018 1018 2543 1003499 1003445 0 54 59660 16202 43458 2727 736 1991 3949 1066 2883 19723 19723 2261 2261 5665 5665 23504 23504 354 354 8365 3773 4592 76597 66639 9958 140 140 247906 247906 369352 369352 4796 4796 LICENSES AND TAXES 132130 132130 FINANCE CHARGES 2780 2780 959909 266693 693216 0 332863 281722 13295 4246 14374 5270 11608382 4942544 6919059 6665838 22181 33180 7301772 6990256 138922 166463 1445 1493 7350000 7315000 1668877 1321182 9159244 8804138 X -1857472 -1813882 -1857472 -1813882 7301772 6990256 43590 0 X X 0 1 X 1 0 X 239 239 1119162 790333 990872 973764 1003445 4877576 1119401 790333 990872 973764 1003445 4877815 0 218106 380764 266101 250682 265891 1381544 218106 380764 266101 250682 265891 1381544 3496271 921 239 608 138 54 1960 921 239 608 138 54 1960 5723 9747 8368 8965 32803 1126045 800319 999848 982867 1003499 4912578 0.71170 0.72700 0.00040 0.00270 X 678271 678271 7788748 2669168 5119580 273694 221865 51829 2867669 2051511 816158 6665838 NONREFUNDABLE RESIDENT FEES 219243 REFUNDABLE RESIDENT FEES 1037077 DUE TO AFFILIATES 34539 INSURANCE CLAIMS RESERVE 30323 1321182 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THERE ARE NO MATERIAL UNRECORDED TAX LIABILITIES AT DECEMBER 31, 2012 OR 2011. X X X 0 1 0 0 0 1 1 0 0 RICK RYAN 0 313233 0 0 0 34404 0 22490 0 21397 0 391524 0 0 WENDY DOLYK 0 137295 0 7500 0 6000 0 9350 0 2600 0 162745 0 0 PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATE IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN UNDER SECTION 457(F). CURRENT YEAR PAYMENTS, REPORTED IN PART II, COLUMN (B)(III), ARE SUMMARIZED BELOW: RICK RYAN $33,737 PART I, LINE 6 THE EXECUTIVE DIRECTOR RECEIVED A BONUS BASED ON ACHIEVING THE NET OPERATING REVENUE BUDGET FOR THE YEAR. A COUNTY OF ERIE OHIO 346400428 2009-10-15 7420000 CURRENT REFUNDING OF ISSUE DATED 12/23/1999 0 0 0 A 7420000 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 1 MORGAN STANLEY 0.025500000000 0 0 0 0 0 SCHEDULE K, PART IV, ARBITRAGE: (2C) DATE THE REBATE COMPUTATION WAS PERFORMED: 10/15/2009 FORM 990, PART VI, SECTION A, LINE 6 FRANCISCAN LIVING COMMUNITIES (FLC), IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A FRANCISCAN LIVING COMMUNITIES (FLC), AS THE SOLE MEMBER OF THE ORGANIZATION, HAS THE RESERVED POWERS TO ELECT THE TRUSTEES OF THE ORGANIZATION, AND TO ELECT AND REMOVE THE CHAIRPERSON AND PRESIDENT/CEO OF PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B FLC ALSO HAS THE RESERVED POWER TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION. FORM 990, PART VI, SECTION B, LINE 11 THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE ORGANIZATION'S ACCOUNTING DEPARTMENT. THE GOVERNING BODY RECEIVES AN ELECTRONIC COPY OF THE FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, FOR REVIEW AND APPROVE PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEMBER IS PROVIDED A COPY OF THE CORPORATE COMPLIANCE POLICY AT THE JANUARY BOARD MEETING. EACH MEMBER IS ASKED TO READ THE POLICY AND SIGN A DISCLOSURE. EACH BOARD MEMBER ALSO COMPLETES AND SIGNS AN ANNUAL QUESTIONNAIRE WHICH ASKS SPECIFIC QUESTIONS REGARDING CONFLICT OF INTEREST AND INDEPENDENCE ISSUES. ANY DISPUTE AS TO WHETHER A DESIGNATED PERSON HAS A CONFLICT OF INTEREST SHALL BE DETERMINED BY VOTE OF THE BOARD OF THE CORPORATION. THE DESIGNATED PERSON IN QUESTION AND ANY RELATED PERSON SHALL BE EXCUSED FROM THE MEETING BEFORE ANY DELIBERATION OR VOTE ON THE ISSUE OF WHETHER A CONFLICT OF INTEREST EXISTS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART VII, AVERAGE HOURS PER WEEK RICK RYAN AND WENDY DOLYK ARE OFFICERS OF THE PARENT ORGANIZATION. ONE OF THE RESPONSIBILITIES OF THEIR POSITION IS TO SERVE AS OFFICERS FOR MANY OF THE SUBSIDIARY ORGANIZATIONS. THE AVERAGE WORK WEEK FOR THESE INDIVIDUALS IS 40+ HOURS. THIS TIME IS ALLOCATED TO THEIR POSITIONS WITH THE VARIOUS SUBSIDIARIES AS WELL AS THEIR RESPONSIBILITIES OF THE PARENT ORGANIZATION. IT IS ESTIMATED THAT THESE INDIVIDUALS DEDICATE AT LEAST ONE HOUR PER WEEK TO THEIR RESPONSIBILITIES AS OFFICERS OF THE SUBORDINATE ORGANIZATIONS. FORM 990, PART XII, LINE 2C THE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT HAS NOT CHANGED ITS OVERSIGHT PROCESS OR SELECTION PROCESS FROM THE PRIOR YEAR. JOSEPH BERNADINE RESIDENCE LLC 8400 ST FRANCIS DRIVE CENTERVILLE OH 45458 461614594 LOW INCOME RENTAL RESIDENTIAL OH ST LEONARD ST JOSEPH SERVICES CORPORATION 2801 FRANCISCAN DRIVE BRYAN TX 77802 742455161 GOVERNANCE TX 501(C)(3) LINE 11A, I SYLVANIA FRANCISCAN HEALTH 0 ST JOSEPH REGIONAL HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 741282696 HEALTH CARE TX 501(C)(3) LINE 3 ST JOSEPH SERVICES CORPORATION 0 BURLESON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742759890 HEALTH CARE TX 501(C)(3) LINE 3 ST JOSEPH SERVICES CORPORATION 0 MADISON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742761145 HEALTH CARE TX 501(C)(3) LINE 3 ST JOSEPH SERVICES CORPORATION 0 ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN TX 77802 742847594 NURSING CARE TX 501(C)(3) LINE 9 ST JOSEPH SERVICES CORPORATION 0 BURLESON ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN TX 77802 742913931 NURSING CARE TX 501(C)(3) LINE 9 ST JOSEPH SERVICES CORPORATION 0 ST JOSEPH FOUNDATION 2801 FRANCISCAN DRIVE BRYAN TX 77802 742351158 FUNDRAISING TX 501(C)(3) LINE 11A, I ST JOSEPH SERVICES CORPORATION 0 ST JOSEPH PHYSICIAN ASSOCIATES 2801 FRANCISCAN DRIVE BRYAN TX 77802 203159302 PHYSICIAN PRACTICE TX 501(C)(3) LINE 3 ST JOSEPH SERVICES CORPORATION 0 SOPHIA CENTER 6832 CONVENT BLVD SYLVANIA OH 43560 341761656 MENTAL HEALTH OH 501(C)(3) LINE 9 SYLVANIA FRANCISCAN HEALTH 0 SISTERS OF ST FRANCIS 6832 CONVENT BLVD SYLVANIA OH 43560 344450609 RELIGIOUS OH 501(C)(3) LINE 1 N/A 0 SYLVANIA FRANCISCAN HEALTH 3231 CENTRAL PARK WEST SUITE 106 TOLEDO OH 43617 341412964 CHURCH ORG OH 501(C)(3) LINE 1 N/A 0 FRANCISCAN LIVING COMMUNITIES 5942 RENAISSANCE PLACE SUITE A TOLEDO OH 43623 341892096 MANAGEMENT SUPPORT OH 501(C)(3) LINE 11A, I SYLVANIA FRANCISCAN HEALTH 0 ST LEONARD 8100 CLYO ROAD CENTERVILLE OH 45458 341940863 LONG TERM CARE FACILITY OH 501(C)(3) LINE 9 FRANCISCAN LIVING COMMUNITIES 0 ST LEONARD FOUNDATION 8100 CLYO ROAD CENTERVILLE OH 45458 320102715 FUNDRAISING OH 501(C)(3) LINE 7 ST LEONARD 0 PROVIDENCE CARE CENTER 2025 HAYES ROAD SANDUSKY OH 44870 341658625 LONG TERM CARE FACILITY OH 501(C)(3) LINE 9 FRANCISCAN LIVING COMMUNITIES 0 THE COMMONS OF PROVIDENCE 5000 PROVIDENCE DRIVE SANDUSKY OH 44870 341826097 ASSISTED LIVING FACILITY OH 501(C)(3) LINE 9 PROVIDENCE CARE CENTER 0 PROVIDENCE CARE CENTERS 2025 HAYES ROAD SANDUSKY OH 44870 341826099 FINANCIAL SUPPORT OH 501(C)(3) LINE 7 PROVIDENCE CARE CENTER 0 FRANCISCAN CARE CENTER 4111 HOLLAND SYLVANIA ROAD TOLEDO OH 43623 341931806 LONG TERM CARE FACILITY OH 501(C)(3) LINE 9 FRANCISCAN LIVING COMMUNITIES 0 ST CLARE COMMONS 5942 RENAISSANCE PLACE SUITE A TOLEDO OH 43623 270163752 LONG TERM CARE FACILITY OH 501(C)(3) LINE 9 FRANCISCAN LIVING COMMUNITIES 0 ROSARY CARE CENTER 6832 CONVENT BLVD SYLVANIA OH 43560 341931795 LONG TERM CARE FACILITY OH 501(C)(3) LINE 9 SYLVANIA FRANCISCAN HEALTH 0 FRANCISCAN PROPERTIES INC 6600 CONVENT ROAD SYLVANIA OH 43560 341412966 SENIOR HOUSING OH 501(C)(3) LINE 9 FRANCISCAN LIVING COMMUNITIES 0 TRINITY HOSPITAL TWIN CITY 819 NORTH FIRST STREET DENNISON OH 44621 275401105 HEALTH CARE OH 501(C)(3) LINE 3 SYLVANIA FRANCISCAN HEALTH 0 FRANCISCAN SERVICES SELF INSURANCE TRUST FUND (DSLVD IN 2012) 6832 CONVENT BLVD SYLVANIA OH 43560 346895492 SELF INSURANCE TRUST OH 501(C)(3) LINE 11A, I SYLVANIA FRANCISCAN HEALTH 0 SYLVANIA FRANCISCAN HEALTH FOUNDATION 3231 CENTRAL PARK WEST SUITE 106 TOLEDO OH 43617 455357161 FUNDRAISING OH 501(C)(3) LINE 7 SYLVANIA FRANCISCAN HEALTH 0 MADONNA MANOR 2344 AMSTERDAM ROAD VILLA HILLS KY 41017 610654635 LONG TERM CARE FACILITY KY 501(C)(3) LINE 9 FRANCISCAN LIVING COMMUNITIES 0 FRANCISCAN SHELTERS 6832 CONVENT BLVD SYLVANIA OH 43560 341612437 DOMESTIC VIOLENCE SHELTER OH 501(C)(3) LINE 7 SYLVANIA FRANCISCAN HEALTH 0 ST JOSEPH REGIONAL HEALTH PARTNERS 2801 FRANCISCAN DRIVE BRYAN TX 77802 454088170 PHYSICIAN SUPPORT TX 501(C)(3) LINE 3 ST JOSEPH SERVICES CORPORATION 0 ST LEONARD LIMITED PARTNERSHIP 88 EAST BROAD STREET SUITE 1800 CENTERVILLE OH 45458 311481761 LOW INCOME RENTAL RESIDENTIAL OH N/A INVESTMENT 0 1 TAU ENTERPRISES 2801 FRANCISCAN DRIVE BRYAN TX 77802 742544009 OFFICE BUILDING RENTAL TX ST JOSEPH SERVICE CORPORATION C 0 ST LEONARD CENTER 1 INC 8100 CLYO ROAD CENTERVILLE OH 45458 311481764 LOW INCOME RENTAL RESIDENTIAL OH ST LEONARD C 0 SFH ASSURANCE LTD STE 6 GRAND PAVILION COMMERICAL CT 10073 GRAND CAYMAN KY1- CJ 981056892 INSURANCE CJ SYLVANIA FRANCISCAN HEALTH C 0 ALLIANCE HEALTH PROVIDERS OF BRAZOS VALLEY 2801 FRANCISCAN DRIVE BRYAN TX 77802 742466914 PHYSICIAN HOSPITAL ORGANIZATION TX ST JOSEPH SERVICE CORPORATION C 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 1 1