2013-08-12T16:28:11-05:00 2012-12-31 381357951 PLANTE & MORAN PLLC 65 E STATE STREET COLUMBUS OH 43215 990 2012-01-01 310675610 CHRISTIAN BENEVOLENT ASSOCIATION OF GREATER CINCINNATI INC CHRI 5139315000 8097 HAMILTON AVENUE CINCINNATI OH 45231 BRIAN GIBBONEY 5139315000 2013-08-07 1 BERNIE OSTROWSKI P00366367 6148493000 2012 2016-02-24 21:20:13Z BRIAN GIBBONEY 8097 HAMILTON AVENUE CINCINNATI OH 45231 1720313 0 X WWW.CHRISTIANBENEVOLENT.ORG X 1960 OH FOUNDED IN 1960, THE ORGANIZATION IS A NON-PROFIT PROVIDER OF RETIREMENT SERVICES, OFFERING A VARIETY OF LIVING STYLES FROM INDEPENDENT LIVING COTTAGES TO APARTMENTS, ASSISTED LIVING AND SKILLED NURSING. THE ORGANIZATION'S MISSION IS TO DEVELOP COMMUNITIES DESIGNED TO PROVIDE SECURE, QUALITY LIVING IN A CHRISTIAN ENVIRONMENT, DIRECTED ESPECIALLY TO PERSONS IN THEIR RETIREMENT YEARS. THE ORGANIZATION'S MINISTRY SERVES OVER 150 OLDER ADULTS. OUR SERVICES ARE DEDICATED TO THE ENHANCEMENT OF EACH RESIDENT IN AN ENVIRONMENT THAT RECONGNIZES AND PROMOTES PERSONAL DIGNITY. CBA PROVIDES ASSISTANCE TO THE RESIDENTS OF MT. HEALTHY CHRISTIAN HOME AND MCV HEALTH CARE FACILITIES IN THE FORM OF A GRANT. THIS ASSISTANCE OR GRANT ENABLES RESIDENTS TO CONTINUE TO RESIDE AT THEIR RESPECTIVE RESIDENCE WITHIN THE COMMUNITIES. 9 9 7 9 0 0 257340 332312 834810 1362641 138575 378 -20550 3963 1210175 1699294 147989 130600 0 0 403063 638868 0 0 39994 702455 1025327 1253507 1794795 -43332 -95501 6871074 12858483 8636742 14719652 -1765668 -1861169 SERVING WITH EXCELLENCE REFLECTING JESUS' COMPASSION 0 0 1708547 130600 1362641 THE ORGANIZATION PROVIDES MANAGEMENT AND SUPPORT SERVICES FOR ITS RELATED TAX-EXEMPT RETIREMENT COMMUNITIES. TOGETHER THESE FACILITIES, LOCATED IN TWO COMMUNITIES IN SOUTHWESTERN OHIO, PROVIDE RESIDENTIAL AND HEALTH CARE SERVICES TO OLDER ADULTS. MANAGEMENT SERVICES PROVIDED INCLUDE,BUT ARE NOT LIMITED TO: ADMINISTRATIVE, FINANCIAL, HUMAN RESOURCES, MARKETING AND DEVELOPMENT FOR THE RELATED TAX-EXEMPT ORGANIZATIONS. SERVICES PROVIDED BY THE RELATED ORGANIATIONS INCLUDE HEALTHCARE, DIETARY, PROGRAM, SOCIAL ACTIVITIES AND PERSONAL NEED SERVICES. LIVING STYLES INCLUDE: INDEPENDENT LIVING IN COTTAGES OR APARTMENTS, ASISSTED LIVING, SKILLED NURSING CARE AND CARE FOR DEMENTIA/ALZHEIMER'S PATIENTS IN A HOMELIKE ENVIRONMENT. 1708547 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 6 0 1 7 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 0 0 OH X ROBIN DIETZ 5138001674 8097 HAMILTON AVENUE CINCINNATI OH 45231 DAVID PHILLIPS 1.00 X X 0 0 0 LARRY COLLINS 1.00 X X 0 0 0 MICK MCLAUGHLIN 1.00 X X 0 0 0 JONATHAN BOWERS 1.00 X X 0 0 0 KITTY GARNER 1.00 X 0 0 0 MILDRED MERKEL 1.00 X 0 0 0 ROBERT STEVENS 1.00 X 0 0 0 THOMAS STURM 1.00 X 0 0 0 LAWSON WALKER 1.00 X 0 0 0 J DONALD SAMS 20.00 20.00 X 107660 0 45000 ROGER SCHWARTZ 4.50 25.50 X 94209 0 0 BRIAN GIBBONEY 4.00 36.00 X 91066 0 0 LARRY MONROE 20.00 20.00 X 45549 0 0 338484 0 45000 1 0 1 0 PLANTE MORAN PLLC 65 E STATE STREET SUITE 600 COLUMBUS OH 43215 AUDIT AND TAX 129400 1 332312 332312 ADMIN SERVICE FEES 561000 1362492 1362492 RESIDENT SERVICES 532000 149 149 1362641 378 378 24982 21019 3963 3963 1699294 1362641 0 4341 130600 130600 402633 362639 39994 103944 103944 96123 96123 36168 36168 46254 46254 28515 28515 80167 80167 28830 28830 364 364 1263 1263 25620 25620 3159 3159 689990 689990 6650 6650 17700 17700 CHARITY CARE EXPENSE 87188 87188 DEFERRED BOND COSTS 6173 6173 LICENSES & FEES 3454 3454 1794795 1708547 46254 39994 111292 53186 11708 0 9330 9330 5900 5900 87815 73980 6671 13835 6726173 12776232 6871074 12858483 108461 116288 8528281 8439128 0 6164236 8636742 14719652 X -1765668 -1861169 -1765668 -1861169 6871074 12858483 -95501 0 X X 0 1 X 1 0 X 436243 291776 236795 257340 332312 1554466 436243 291776 236795 257340 332312 1554466 68716 1485750 139898 139746 139418 138575 378 558015 385768 266625 62154 149 714696 2827177 4181746 0.52550 0.49210 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS - 2010 AMOUNT: $ 775. 2012 AMOUNT: $ 149. DEPOSIT FORFEITURES - MCV COTTAGE TURNOVER - 2008 AMOUNT: $ 385,768. 2009 AMOUNT: $ 266,625. 2010 AMOUNT: $ 61,379. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 71815 57980 13835 16000 16000 0 13835 DEFERRED LOAN COSTS 27778 DEPOSITS 71 INVESTMENTS IN AFFILIATES 12745208 CONSTRUCTION IN PROGRESS 3175 12776232 RELATED PARTY PAYABLE 6164236 6164236 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: NO PROVISION HAS BEEN MADE FOR INCOME TAXES SINCE THE ASSOCIATION AND ITS CONTROLLED NOT-FOR-PROFIT ENTITIES ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER CODE SECTION 501(C)(3) AND IS CLASSIFIED AS OTHER THAN A PRIVATE FOUNDATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE ASSOCIATION, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2012, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE ASSOCIATION IS NOT CURRENTLY UNDER EXAMINATION BY THE INTERNAL REVENUE SERVICE OR ANY STATE OR LOCAL TAX AUTHORITIES. THE ASSOCIATION'S FEDERAL TAX RETURNS FOR THE YEARS ENDED PRIOR TO DECEMBER 31, 2009 ARE NO LONGER SUBJECT TO EXAMINATION. 1 MT HEALTHY CHRISTIAN HOME 8097 HAMILTON AVENUE CINCINNATI OH 45231 310714767 501(C)(3) 48626 SUBSIDY FOR RESIDENTS OF MT. HEALTHY CHRISTIAN HOME MCV HEALTH CARE FACILITIES 8097 HAMILTON AVENUE CINCINNATI OH 45231 311257250 501(C)(3) 81974 SUBSIDY FOR RESIDENTS OF MCV HEALTH CARE FACILITIES 2 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: CHRISTIAN BENEVOLENT ASSOCIATION OF GREATER CINCINNATI, INC. PROVIDES FUNDING FOR ITS RELATED ORGANIZATIONS TO HELP FURTHER THEIR EXEMPT PURPOSES. X 1 1 X X X X 0 0 0 0 0 0 0 0 0 J DONALD SAMS 107660 0 0 0 0 0 0 0 45000 0 152660 0 0 0 PART I, LINE 1A J. DONALD SAMS RECEIVED A HOUSING ALLOWANCE IN THE AMOUNT OF $45,000 IN 2012. THIS IS TAXABLE COMPENSATION. FORM 990, PART VI, SECTION A, LINE 3 THE MANAGEMENT SERVICES ARE PROVIDED BY MIDWEST CHRISTIAN VILLAGES. MIDWEST CHRISTIAN VILLAGES PROVIDES AN EXECUTIVE DIRECTOR FOR THE CAMPUS, AS WELL AS OPERATIONS, ACCOUNTING, BILLING, AND OTHER SUPPORT. FORM 990, PART VI, SECTION A, LINE 8B WITH THE EXCEPTION OF THE DEVELOPMENT COMMITTEE, INDIVIDUAL COMMITTEES DO NOT CONTEMPORANEOUSLY DOCUMENT MEETINGS HELD OR WRITTEN ACTIONS UNDERTAKEN DURING THE YEAR. ACTIONS OF THE ANNUAL NOMINATING COMMITTEE ARE DOCUMENTED IN THE GOVERNING BODY'S MINUTES. FORM 990, PART VI, SECTION B, LINE 11 THE CONTROLLER AND COO REVIEW THE FORM 990 AND THEN WILL PROVIDE ELECTRONIC COPIES OF THE FORM 990 TO ALL BOARD MEMBERS PRIOR TO FILING. MAJOR POINTS OF THE FORM ARE ADDRESSED WITH THE BOARD EITHER VIA EMAIL OR AT THE CLOSEST BOARD MEETING DATE. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS AND DIRECTORS REVIEW AND SIGN THE CONFLICT OF INTEREST STATEMENT ON AN ANNUAL BASIS. IT IS THE RESPONSIBILTY OF OFFICERS AND DIRECTORS TO DISCLOSE THE EXISTENCE OF A CONFLICT AND SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF THE CONFLICT IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. THOSE WITH CONFLICTS ARE SUBJECT TO VOTING AND PARTICIPATION RESTRICTIONS. FORM 990, PART VI, SECTION B, LINE 15A THE COMPENSATION POLICY FOR THE CEO INCLUDES A REVIEW, OVERSEEN BY THE BOARD OF DIRECTORS OF CBA, BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DECISION. THE PROCESS WAS LAST COMPLETED IN 2012. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: CHRISTIAN BENEVOLENT ASSOCIATION HAS AN AUDIT COMMITTEE WHICH OVERSEES AUDIT OF THE FINANCIAL STATEMENTS AND IS INVOLVED IN THE SELECTION OF THE INDEPENDENT ACCOUNTANT WHICH COMPLETES THE AUDIT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MT HEALTHY CHRISTIAN HOME INC 8097 HAMILTON AVENUE CINCINNATI OH 45231 310714767 RETIREMENT SERVICES OH 501(C)(3) 509(A)(2) CHRISTIAN BENEVOLENT ASSOCIATION OF GREATER CINCINNATI INC 1 MASON CHRISTIAN VILLAGE INC 411 WESTERN ROW ROAD MASON OH 45040 311173965 RETIREMENT SERVICES OH 501(C)(3) 509(A)(2) CHRISTIAN BENEVOLENT ASSOCIATION OF GREATER CINCINNATI INC 1 MCV HEALTH CARE FACILITIES INC 411 WESTERN ROW ROAD MASON OH 45040 311257250 RETIREMENT SERVICES OH 501(C)(3) 509(A)(2) CHRISTIAN BENEVOLENT ASSOCIATION OF GREATER CINCINNATI INC 1 CHRISTIAN BENEVOLENT ASSOCIATION FOUNDATION FOR THE AGING INC 8097 HAMILTON AVENUE CINCINNATI OH 45231 311413825 FUNDRAISING & FINANCIAL SUPPORT FOR CBA OF GREATER CINCINNATI OH 501(C)(3) 509(A)(3) CHRISTIAN BENEVOLENT ASSOCIATION OF GREATER CINCINNATI INC 1 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 MT HEALTHY CHRISTIAN HOME INC L 490000 FMV MCV HEALTH CARE FACILITIES INC L 700000 FMV MASON CHRISTIAN VILLAGE INC L 172492 FMV CHRISTIAN BENEVOLENT ASSOCIATION FOUNDATION FOR THE AGING INC B 96245 FMV MCV HEALTH CARE FACILITIES INC B 81974 FMV MT HEALTHY CHRISTIAN HOME INC D 1186695 FMV MCV HEALTH CARE FACILITIES INC D 1777847 FMV MT HEALTHY CHRISTIAN HOME INC R 6515198 FMV