2012-11-06T15:16:40-06:00 2011-12-31 381357951 PLANTE & MORAN PLLC 65 E STATE STREET COLUMBUS OH 43215 990 2011-01-01 310668084 HEINZERLING FOUNDATION HEIN 6142728888 1800 HEINZERLING DR COLUMBUS OH 43223 ROBERT E HEINZERLING 6142728888 2012-11-06 1 BERNIE OSTROWSKI P00366367 6148493000 2011 2016-02-24 21:20:13Z ROBERT E HEINZERLING 1800 HEINZERLING DR COLUMBUS OH 43223 23785891 0 X WWW.HEINZERLING.ORG X 1959 OH LONG-TERM CARE FOR DEVELOPMENTALLY DISABLED CHILDREN AND ADULTS. 12 10 776 1613 0 0 157362 117625 23427961 23463121 -26649 9656 525530 117136 24084204 23707538 0 0 0 0 17669333 17411977 10140 14881 78113 6172802 6672391 23852275 24099249 231929 -391711 23494917 18357759 11485768 6913941 12009149 11443818 CARE AND HABILITATION OF DEVELOPMENTALLY DISABLED CITIZENS (208 TOTAL BEDS). 0 0 22327721 0 23468073 THE HEINZERLING FOUNDATION IS A 24-HOUR INTERMEDIATE CARE (MEDICAL, EDUCATIONAL, THERAPY, NUTRITIONAL, ETC.) FOR NON-AMBULATORY CHILDREN AND ADULTS WITH SEVERE/PROFOUND DEVELOPMENTAL DISABILITIES IN A RESIDENTIAL SETTING. 22327721 1 1 0 0 0 0 0 0 0 1 1 0 1 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 11 0 1 776 1 0 0 0 0 0 1 1 0 0 0 0 X 12 10 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 0 0 OH X DANELLA HICKS 6142728888 1800 HEINZERLING DR COLUMBUS OH 43223 DANIEL M O'BRIEN 1.00 X X 0 0 0 ROBERT E HEINZERLING 40.00 X X 132427 0 14551 KATHRYN P HEINZERLING 1.00 X X 0 0 0 DORIS EDWARDS RN 1.00 X X 0 0 0 ROB KOOGLER 1.00 X X 0 0 0 RICK A WANNER 1.00 X 0 0 0 LINDA HEINZERLING RN 1.00 X 0 0 0 R KEVIN KERNS ESQ 1.00 X 0 0 0 COLLEEN K NISSL JD 1.00 X 0 0 0 JOHN E HOLLBACK JR 1.00 X 0 0 0 JAMES W PRUDEN 1.00 X 0 0 0 LISA R HOUSE 1.00 X 0 0 0 DANELLA HICKS 40.00 X 73847 0 16930 206274 0 31481 2 0 0 0 UNITED HEALTHCARE INSURANCE 22561 NETWORK PLACE CHICAGO IL 60673 INSURANCE SERVICES 1313284 MEDICAL MUTUAL OF OHIO 2060 E 9TH ST CLEVELAND OH 44115 INSURANCE SERVICES 880361 FRANKLIN COUNTY BOARD OF MRDD 2879 JOHNSTOWN RD COLUMBUS OH 43219 DAY PROGRAMMING 842072 QUAL-MED 864 FREEWAY DRIVE NORTH COLUMBUS OH 43229 MEDICAL SUPPLIES 456685 COLUMBUS CENTER FOR HUMAN SERVICES 540 INDUSTRIAL MILE RD COLUMBUS OH 43228 DAY PROGRAMMING 432900 12 5823 111802 117625 PROGRAM SERVICES 623000 23463121 23463121 23463121 9656 9656 8121 8807 -686 -686 -686 80681 5823 69546 11135 11135 SCHOOL LUNCH REVENUE 900099 66108 66108 WORKERS COMP INCENTIVE 900099 23157 23157 INSURANCE REFUNDS 900099 12470 12470 4952 4952 106687 23707538 23468073 0 121840 242070 239649 2421 13596827 13070823 506300 19704 2181124 2067958 110818 2348 1391956 1317524 73126 1306 72882 72882 97065 97065 14881 14881 1500 1500 1507123 1490642 16481 25580 300 15430 9850 1399557 1215297 159848 24412 95802 94711 1091 435674 413890 21348 436 2445 2361 84 181934 171447 10487 226082 184553 41529 717853 670032 47792 29 78540 74589 3872 79 FRANCHISE FEES 1199130 1199130 FOOD 322009 322009 LOSS ON REFIN OF DEBT 173513 173513 BENEFICIAL INTEREST 82308 82308 53394 47219 4703 1472 24099249 22327721 1693415 78113 1131598 1900 4349418 5758107 1795717 1841821 196424 187029 19355842 13030346 6871749 6325496 3806932 3724624 5343079 518782 23494917 18357759 2071051 2165918 4631347 4219630 4675000 233335 108370 295058 11485768 6913941 X 11001334 10535331 1007815 908487 12009149 11443818 23494917 18357759 X -391711 -173620 X X 0 1 1 X 0 X 185350 146017 109305 157362 117625 715659 23840378 22472694 24404812 23858684 23468073 118044641 74857 70433 73040 67590 101735 387655 24100585 22689144 24587157 24083636 23687433 119147955 0 0 0 119147955 279313 124719 35534 31999 17777 489342 279313 124719 35534 31999 17777 489342 116136 108671 122132 89293 80681 516913 24496034 22922534 24744823 24204928 23785891 120154210 0.99160 0.98980 0.00410 0.00560 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3806931 -68964 13344 3724623 3390306 428846 12221 3806931 2626971 779583 16248 3390306 2864575 800000 -1019271 18333 2626971 1.00000 0.00000 0.00000 0 0 509608 509608 13451601 8632064 4819537 4449132 3744067 705065 945501 654215 291286 6325496 BENEFICIAL INTEREST IN THE COLUMBUS FOUNDATION 3724624 F 3724624 RESIDENT FUND LIABILITY 121438 FV OF INTEREST RATE SWAP 173620 295058 23707538 24099249 -391711 -173620 -173620 -565331 23785891 0 23785891 -78353 -78353 23707538 24177602 78353 78353 24099249 0 24099249 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: INVESTMENT UNTIL PURPOSE IS DESIGNATED BY THE BOARD. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN FMV OF INTEREST RATE SWAP AGREEMENTS -173,620. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECLASS OF SPECIAL EVENT EXPENSES -69,546. RECLASS OF RENTAL EXPENSES -8,807. PART XIII, LINE 2D - OTHER ADJUSTMENTS: RECLASS OF SPECIAL EVENT EXPENSES 69,546. RECLASS OF RENTAL EXPENSES 8,807. OFF THE WALL 60654 3483 57171 150 4633 1000 42438 GOLF OUTING 24355 2165 22190 1805 17276 1 1495 175 1320 100 2143 86504 5823 80681 1805 250 4633 1000 61857 69545 11136 X X 0 0 0 0 0 0 0 1 0 PART I, LINE 7 ROBERT HEINZERLING RECEIVED A NON-FIXED PAYMENT DURING 2011. THE BONUS WAS BASED ON A SUBJECTIVE ANALYSIS WHICH INCLUDES THE REVIEW OF ROBERT'S ANNUAL PERFORMANCE BY THE BOARD OF DIRECTORS AS WELL AS OTHER FACTORS. THESE OTHER FACTORS INCLUDE THE UNCERTAINTY OF THE STATE BUDGET RELATIVE TO MEDICAID FUNDING IN ADDITION TO THE AMOUNT OF PERFORMANCE BONUSES PAID TO THE MANAGEMENT TEAM OTHER THAN ROBERT. COLUMBUS-FRANKLIN COUNTY FINANCE AUTHORITY 571239430 2010-12-30 4675000 REFINANCE PRIOR ISSUES DATED 11/1/1995 AND 03/27/2001 0 0 0 202089 4675000 4616776 58224 2002 1 0 1 1 0 0 0 0 0.00000 0.00000 0.00000 1 0 1 0 0 0 1 FORM 990, SCHEDULE K, PART II, LINES 1-17 THE PROCEEDS WERE NOT DISTRIBUTED UNTIL MARCH OF 2011. AT THAT TIME, THE BONDS ORIGINALLY ISSUED IN 1995 AND 2001 FROM US BANK AND THE BANK OF NY WERE REDEEMED AND THE TERM LOAN FROM CHASE WAS PAID IN FULL. THE FINAL ALLOCATION OF PROCEEDS WAS MADE IN MARCH 2011, AND ADEQUATE BOOKS AND RECORDS ARE KEPT TO SUPPORT THE ALLOCATION. TOMMY O'BRIEN TOMMY IS THE SON OF CHAIRMAN 110813 RESIDENT SERVICES & USE OF FACILITIES FORM 990, PART VI, SECTION A, LINE 2 KATHRYN P. HEINZERLING, VICE PRESIDENT, IS THE MOTHER OF ROBERT E. HEINZERLING, PRESIDENT, AND LINDA S. HEINZERLING, TRUSTEE. FORM 990, PART VI, SECTION B, LINE 11 THE DIRECTOR OF FINANCE REVIEWS THE FINISHED FORM 990 BEFORE A COPY OF IT IS PROVIDED TO ALL BOARD MEMBERS FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, MEMBERS OF THE BOARD OF DIRECTORS REVIEW THE CONFLICT OF INTEREST POLICY. ALL BOARD MEMBERS, OFFICERS, AND DEPARTMENT HEADS MUST COMPLETE A DISCLOSURE FORM WHEN THEY FIRST JOIN AND THEN ANNUALLY IDENTIFYING ANY RELATIONSHIPS, POSITIONS OR CIRCUMSTANCES IN WHICH HE OR SHE IS INVOLVED THAT HE OR SHE BELIEVES COULD CONTRIBUTE TO A CONFLICT OF INTEREST. ALL BOARD MEMBERS ARE AWARE THAT CONFLICTS OF INTEREST SHOULD BE DISCLOSED UPON DISCOVERY. THE DIRECTOR OF FINANCE REVIEWS THESE DISCLOSURES AND MONITORS INVOICES TO FOLLOW UP ON ACTIVITIES WITH PARTIES THAT MAY HAVE A CONFLICT OF INTEREST. ANY BOARD MEMBER WITH A CONFLICT OF INTEREST ABSTAINS FROM VOTING ON THAT PARTICULAR ISSUE. FORM 990, PART VI, SECTION B, LINE 15A INPUT IS REQUESTED FROM ALL BOARD MEMBERS ANNUALLY REGARDING THE SALARY OF THE EXECUTIVE DIRECTOR. THE ORGANIZATION USES OTHER DIRECTORS' COMPENSATION AS A MEASUREMENT FOR THE EXECUTIVE DIRECTOR'S SALARY. THIS INFORMATION IS DISCUSSED AND APPROVED IN THE EXECUTIVE SESSION OF THE BOARD MEETING. COMPENSATION DECISIONS ARE DOCUMENTED IN THE MEETING NOTES KEPT BY THE SECRETARY AND PRESIDENT. THIS PROCESS WAS LAST UNDERTAKEN DURING 2011. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: CHANGE IN FMV OF INTEREST RATE SWAP AGREEMENTS -173,620. TOTAL TO FORM 990, PART XI, LINE 5: -173,620. FORM 990, PART XII, LINE 2C: THE FINANCE COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS. THE SELECTION OF AN INDEPENDENT AUDITOR IS DISCUSSED AT BOARD MEETINGS. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.