2012-11-15T12:24:30-06:00 2011-12-31 351178661 BLUE & CO LLC 8800 LYRA DRIVE SUITE 450 COLUMBUS OH 43240 990 2011-01-01 610654635 MADONNA MANOR INC MADO 8594266400 2344 AMSTERDAM RD VILLA HILLS KY 41017 GREG NIJAK 8594266400 2012-11-12 1 STEPHEN A SHERIDAN P00028551 6148852583 2011 2016-02-24 21:20:13Z MARK MULLAHY 2344 AMSTERDAM RD VILLA HILLS KY 41017 5099940 0 0928 X WWW.MADONNAMANOR.ORG X 1964 KY MADONNA MANOR IS A LTC COMMUNITY PROVIDING SERVICES TO MEET OUR SENIOR RESIDENTS APPROPRIATE LEVEL OF CARE, INCLUDING A 60 BED SKILLED NURSING UNIT, A 24 BED MEMORY CARE UNIT, AND A 40 ROOM ASSISTED LIVING PROGRAM. 8 5 204 25 0 0 169680 65795 3361976 4839509 443612 -945721 23113 42190 3998381 4001773 0 0 0 0 2183848 3111204 0 0 0 1350566 3386824 3534414 6498028 463967 -2496255 42942940 38071331 34109535 30031849 8833405 8039482 X MADONNA MANOR IS A CATHOLIC HEALTHCARE FACILITY FOR SENIOR ADULTS DEVOTED TO PROVIDING A HOME WITHIN A SPIRITUAL ATMOSPHERE. FAITHFUL TO THE SPIRIT OF ST.FRANCIS OF ASSISI AND THE SISTERS OF ST.FRANCIS OF SYLVANIA, OHIO, THE VALUES OF REVERENCE, SERVICE, AND STEWARDSHIP. 1 1 2286182 3543867 SKILLED NURSING - 16,102 DAYS. WENT FROM A 25 BED FACIITY TO A 60 BED FACILITY OPENING JULY 1, 2011. 1017679 360968 MEMORY CARE UNIT - A 24 BED UNIT DESIGNED SPECIFICALLY FOR RESIDENTS WITH DEMENTIA OR OTHER MIND AFFECTING ILLNESSES. 2,285 DAYS FROM JULY-DECEMBER 1925347 774572 ASSISTED LIVING ROOMS - DESIGNED FOR RESIDENTS THAT NEED HELP WITH SOME DAY TO DAY ACTIVITIES. SEVERAL LEVELS OF CARE ARE OFFERED WITHIN THE ASSISTED LIVING AREA. 6,004 DAYS. 160102 OTHER PROGRAM RELATED SERVICES 160102 5229208 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 0 1 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 0 1 49 0 1 204 1 0 0 0 0 0 0 0 0 0 0 X 8 5 0 0 0 0 1 1 1 1 1 1 0 1 1 1 1 1 1 1 0 0 X TOM PILLE 8593413981 2344 AMSTERDAM RD VILLA HILLS KY 41017 X JOSEPH CNADER 1.00 X X 0 0 0 SISTER CAROLYN GIERA 1.00 X 0 0 0 JOHN RNIENABER 1.00 X X 0 0 0 EVA M BALLARD 1.00 X X 0 0 0 DAVID TADAMS 1.00 X 0 0 0 GREG NIJAK 40.00 X X 0 0 0 GERALD JERRY WHITE 1.00 X 0 0 0 RICK G RYAN 1.00 X 0 299149 46804 TIMOTHY DONNELLY 1.00 X 57754 0 0 57754 299149 46804 0 1 1 1 0 65795 65795 PATIENT SERVICE REVENU 623000 4653059 4653059 INDEPENDENT LIVING 623000 186450 186450 4839509 151875 151875 1097596 -1097596 -1097596 -1097596 7140 571 6569 6569 606 0 606 606 HAIR SALON 623000 11785 11785 CABLE AND INTERNET 623000 9044 9044 MEAL INCOME 623000 8743 8743 5443 5443 35015 4001773 4839509 0 -903531 57754 57754 2436361 2095190 341171 102678 88415 14263 330089 284235 45854 184322 158717 25605 52773 52773 90193 90193 36934 36934 694760 547835 146925 245054 245054 680333 561166 119167 27487 1968 25519 245159 202217 42942 14852 13623 1229 400 100 300 321905 265520 56385 68820 68820 610917 503909 107008 44852 24996 19856 BAD DEBT 160343 160343 MISCELLANEOUS 63392 52288 11104 RECRUITMENT 28650 23632 5018 6498028 5229208 1268820 0 1054794 400 1770237 2614500 576227 813539 22302 22800 36469 26408473 544462 21623592 25864011 2727929 17036622 4045015 442292 1055617 416376 891549 42942940 38071331 3644498 1454378 18480 28440000 28440000 2006557 137471 34109535 30031849 X 8015030 7221107 818375 818375 8833405 8039482 42942940 38071331 X -2496255 1702332 X 0 1 1 X 0 X 49055 360959 472949 169680 65795 1118438 3232050 3372129 3602148 3361976 4839509 18407812 3281105 3733088 4075097 3531656 4905304 19526250 0 0 0 19526250 111616 105373 124756 478312 151875 971932 111616 105373 124756 478312 151875 971932 5785 8731 5429 23113 42190 85248 3398506 3847192 4205282 4033081 5099369 20583430 0.94860 0.94430 0.04720 0.05300 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2456322 90116 2546438 2292199 164123 2456322 2035932 273614 17347 2292199 2739287 -684627 18728 2035932 0.65000 0.35000 0 0 3174862 3174862 20884244 362130 20522114 2337374 182332 2155042 11993 11993 25864011 RESTRICTED FUNDS 1011542 C TRUSTEE-HELD FUNDS 3033473 C 4045015 SECURITY DEPOSITS 33684 DUE TO AFFILIATED ENTITY 21413 THIRD PARTY SETTLEMENT 60331 RESERVE FOR INSURANCE CLAIMS 22043 137471 4001773 6498028 -2496255 30429 1671903 1702332 -793923 5667176 30429 1671907 1702336 3964840 36933 36933 4001773 6461099 4 4 6461095 36933 36933 6498028 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS IS TO SUPPORT CHARITABLE CARE WITHIN THE SKILLED NURSING, MEMORY, AND ASSISTED LIVING UNITS. AWARDS DINNER 4605 4605 318 TRIM THE TREE 2535 2535 253 7140 7140 571 571 6569 606 0 606 606 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 RICK G RYAN 0 298393 0 0 0 756 0 22000 0 24804 0 345953 0 0 TIMOTHY DONNELLY 57754 0 0 0 0 0 0 0 0 0 57754 0 0 0 KENTUCKY ECONOMIC DEVELOPMENT FINANCE AUTHORITY 610600439 49126TAD4 2010-01-05 28440000 BUILDING PROJECT, ADDITIONAL BEDS 0 0 0 28440000 547600 2012 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 NEW PROGRAM SERVICES FORM 990, PART III, LINE 2 MEMORY CARE UNIT ADDED - 24 BEDS CHANGES IN PROGRAM SERVICES FORM 990, PART III, LINE 3 THE 'PERSONAL CARE' TITLE WAS REPLACED BY 'ASSISTED LIVING' AND 'MEMORY CARE' UNITS . FORM 990, PART VI, SECTION A, LINE 6 FRANCISCAN LIVING COMMUNITIES IS THE SOLE MEMBER OF MADONNA MANOR. FORM 990, PART VI, SECTION A, LINE 7A FRANCISCAN LIVING COMMUNITIES, AS THE SOLE MEMBER OF THE ORGANIZATION, HAS RESERVED POWERS TO ELECT THE TRUSTEES OF THE ORGANIZATION, AND TO ELECT AND REMOVE THE CHAIRPERSON AND PRESIDENT/CEO OF MADONNA MANOR. FORM 990, PART VI, SECTION A, LINE 7B FRANCISCAN LIVING COMMUNITIES HAS THE RESERVED POWER TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF MADONNA MANOR. FORM 990, PART VI, SECTION B, LINE 11 THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A REVIEW BY THE ORGANIZATION'S ACCOUNTING DEPARTMENT. THE BOARD OF DIRECTORS RECEIVES A 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 THE WRITTEN CONFLICT OF INTEREST POLICY IS REGULARLY AND CONSISTENTLY MONITORED AND COMPLIANCE ENFORCED BY THE BOARD PRESIDENT, THE EXECUTIVE DIRECTOR, AND HUMAN RESOURCE DIRECTOR. THE ORGANIZATION PROVIDES AN ANNUAL QUESTIONNAIRE TO ALL BOARD MEMBERS WHICH REQUIRES DISCLOSURE OF ANY CONFLICTS OF INTEREST THE BOARD MEMBER MAY HAVE WITH THE ORGANIZATION. THIS IS REVIEWED BY THE ORGANIZATION AND REPORTED TO THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 15A THE PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S EXECUTIVE DIRECTOR IS DONE BY THE BOARD OF DIRECTORS. IN SETTING THE WAGES, THE BOARD COMPARES VARIOUS SALARIES FROM LIKE POSITIONS IN SIMILAR ORGANIZATIONS. THE BOARD REVIEWS AND APPROVES THE SALARY ON AN ANNUAL BASIS AND DOCUMENTS IN BOARD MEETING MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. OFFICER WHO CANNOT BE REACHED AT THE ORGANIZATION: PART VI SECTION A LINE 9 RICK RYAN - PRESIDENT/CEO 4942 RENAISSANCE PLACE, SUITE A TOLEDO, OH 43623 FORM 990, PT VII, AVERAGE HOURS PER WEEK RICK RYAN AND TIMOTHY DONNELLY 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. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 30,429. NET ASSETS RELEASED FROM RESTRICTION 63,471. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 1,608,432. TOTAL TO FORM 990, PART XI, LINE 5: 1,702,332. ST JOSEPH SERVICES CORPORATION 2801 FRANCISCAN DRIVE BRYAN TX 77802 742455161 GOVERNANCE TX 501 (C) (3) LINE 11A, I SFH 0 ST JOSEPH REGIONAL HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 741282696 HEALTH CARE TX 501 (C) (3) LINE 3 SJSC 0 BURLESON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742759890 HEALTH CARE TX 501 (C) (3) LINE 3 SJSC 0 MADISON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742761145 HEALTH CARE TX 501 (C) (3) LINE 3 SJSC 0 ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN TX 77802 742847594 NURSING CARE TX 501 (C) (3) LINE 9 SJSC 0 BURLESON ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN TX 77802 742913931 NURSING CARE TX 501 (C) (3) LINE 9 SJSC 0 ST JOSEPH FOUNDATION 2801 FRANCISCAN DRIVE BRYAN TX 77802 742351158 FUND RAISING TX 501 (C) (3) LINE 11A, I SJSC 0 ST JOSEPH PHYSICAN ASSOCIATES 2801 FRANCISCAN DRIVE BRYAN TX 77802 203159302 PHYSICAN PRACTICE TX 501 (C) (3) LINE 3 SJSC 0 FRANCISCAN SHELTERS DBA BETHANY HOUSE PO BOX 80596 TOLEDO OH 43608 341612437 DOMESTIC VIOLENCE SHELTER OH 501 (C) (3) LINE 7 SFH 0 SOPHIA CENTER 6832 CONVENT BLVD SYLVANIA OH 43560 341761656 MENTAL HEALTH OH 501 (C) (3) LINE 9 SFH 0 SISTERS OF ST FRANCIS 6832 CONVENT BLVD SYLVANIA OH 43560 344450609 RELIGIOUS OH 501 (C) (3) 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 SFH 0 ST LEONARD 8100 CLYO ROAD CENTERVILLE OH 45458 341940863 LONG TERM CARE FACULTY OH 501 (C) (3) LINE 9 FLC 0 ST LEONARD FOUNDATION 8100 CLYO ROAD CENTERVILLE OH 45458 320102715 FUND RAISING OH 501 (C) (3) LINE 7 ST LEONARD 0 PROVIDENCE CARE CENTER 2025 HAYES AVE SANDUSKY OH 44870 341658625 LONG TERM CARE FACULTY OH 501 (C) (3) LINE 9 FLC 0 THE COMMONS OF PROVIDENCE 5000 PROVIDENCE DRIVE SANDUSKY OH 44870 341826097 ASSISTED LIVING OH 501 (C) (3) LINE 9 PCC 0 PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION 5055 PROVIDENCE DRIVE SANDUSKY OH 44870 341896807 INDEPENDENT LIVING OH 501 (C) (3) LINE 9 PCC 0 PROVIDENCE CARE CENTERS 2025 HAYES AVE SANDUSKY OH 44870 341826099 FINANCIAL SUPPORT OH 501 (C) (3) LINE 7 FLC 0 FRANCISCAN CARE CENTER SYLVANIA 4111 HOLLAND SYLVANIA ROAD SYLVANIA OH 43623 341931806 LONG TERM CARE FACULTY OH 501 (C) (3) LINE 9 FLC 0 ST CLARE COMMONS 5942 RENAISSANCE PLACE SUITE A TOLEDO OH 43623 270163752 LONG TERM CARE FACULTY OH 501 (C) (3) LINE 9 FLC 0 ROSARY CARE CENTER 6832 CONVENT BLVD SYLVANIA OH 43560 341931795 LONG TERM CARE FACULTY OH 509 (A) (3) LINE 9 SFH 0 FRANCISCAN PROPERTIES INC 6600 CONVENT BLVD SYLVANIA OH 43560 341412966 SENIOR HOUSING OH 501 (C) (3) LINE 9 FLC 0 TRINITY HOSPITAL TWIN CITY 819 NORTH FIRST STREET DENNISON OH 44621 275401105 HEALTH CARE OH 501 (C) (3) LINE 3 SFH 0 STLEONARD CENTER LIMITED PARTNERSHIP 88 E BROAD ST COLUMBUS OH 43215 311481761 LOW INCOME RENTAL OH N/A EXCLUDED 0 0 0.01000 ALLIANCE HEALTH PROVIDERS OF BRAZOS VALLEY 2801 FRANCISCAN DR BRYAN TX 77802 742466914 PHYSICIAN HOSPITAL ORGANIZATION TX ST JOSEPH SERVICE CORPORATION C TAU ENTERPRISES 2801 FRANCISCAN DR BRYAN TX 77802 742544009 OFFICE BUILDING RENTAL TX ST JOSEPH SERVICE CORPORATION C STJOSEPH PHYSICIAN ALLIANCE 2801 FRANCISCAN DR BRYAN TX 77802 742764039 COORD EMPL INSURANCE TX ST JOSEPH SERVICE CORPORATION C STLEONARD CENTER 1 INC 8100 CLYO RD CENTERVILLE OH 45458 311481764 LOW INCOME RENTAL OH ST LEONARD C 1.00000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0