2011-05-16T12:36:50-05:00 2010-06-30 PLANTE & MORAN PLLC 65 EAST STATE STREET SUITE 600 COLUMBUS OH 43215 990 2009-07-01 311534051 HOLZER SENIOR CARE CENTER HOLZ 7404465060 380 COLONIAL DRIVE BIDWELL OH 45614 KENNETH PAYNE 7404465060 2011-05-16 1 Bernie Ostrowski 6148493000 2009 2016-02-24 21:20:13Z SEE SCHEDULE O TERESA REMY-DETTY 100 JACKSON PIKE GALLIPOLIS OH 45631 9172070 0 X WWW.HOLZER.ORG X 1996 OH HOLZER SENIOR CARE CENTER IS A SKILLED NURSING FACILITY FOR THE CARE AND TREATMENT OF THE SICK, DISABLED, AND INJURED, PROVIDING CARING AND QUALITY SERVICES TOWARD THE ENHANCEMENT OF PHYSICAL AND MENTAL WELL-BEING WITHOUT REGARD TO THE PERSON'S FINANCIAL RESOURCES. 9 4 308 0 0 0 40600 8258841 8985906 6179 52466 562370 93098 8827390 9172070 0 0 5232417 5301250 0 0 3227679 3494911 8460096 8796161 367294 375909 15318794 15439992 9784167 9570056 5534627 5869936 NONE 0 0 6521576 0 8985906 HOLZER SENIOR CARE CENTER IS A SEVENTY (70) BED FACILITY, GUIDED BY THE VISION OF QUALITY CARE AND OPTIMUM OUTCOME. IT IS COMMITTED TO IDENTIFY, UNDERSTAND AND RESPOND TO THE NEEDS OF THE RESIDENTS. HOLZER SENIOR CARE CENTER OFFERS:* A MEDICAL DIRECTOR* SKILLED NURSING CARE 24 HOURS PER DAY* REHABILITATION THERAPIES INCLUDING: PHYSICAL THERAPIES, OCCUPATIONAL THERAPIES, SPEECH THERAPY* SHORT AND LONG TERM PLACEMENT OF RESIDENTS* SOCIAL AND THERAPEUTIC ACTIVITIES* PROGRAM FOR HOSPICE PATIENTS* CHAPLAINCY SERVICES* DIETARY SERVICES WITH A QUALIFIED DIETITIAN* PERSONAL CARE (BEAUTICIAN & BARBER SERVICES)* ALL INCLUSIVE ROOM RATE* CABLE TVMEDICAL SUPPORT: HOLZER SENIOR CARE CENTER IS UNDER THE DIRECT SUPERVISION OF A MEDICAL DIRECTOR, WHO HELPS PROVIDE THE LATEST IN HIGH ACUITY CARE. RESIDENTS OF HOLZER SENIOR CARE CENTER MAY USE THE SERVICES OF THE CENTER'S MEDICAL DIRECTOR, OR CONTINUE UNDER THE DIRECT CARE OF THEIR OWN PHYSICIAN. A TRAINED STAFF, COMMITTED TO THE HIGHEST STANDARD IN CARING FOR THE RESIDENTS OF HOLZER SENIOR CARE CENTER IS ON DUTY TWENTY FOUR HOURS A DAY, EVERY DAY.REHABILITATION SERVICES: A COMPLETE RANGE OF REHABILITATION SERVICES IS OFFERED AT HOLZER SENIOR CARE CENTER, CONDUCTED BY REGISTERED THERAPISTS. PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES ARE AVAILABLE TO PROVIDE THE MOST THOROUGH REHABILITATION CARE TO RESIDENTS. A RESTORATIVE NURSING CARE PROGRAM IS AN ONGOING SERVICE TO THE CENTER RESIDENTS. THE WIDE RANGE OF SPECIALIZED THERAPY PROGRAMS ENABLES MANY RESIDENTS TO RESUME THEIR FORMER LIFESTYLES AS THEY BECOME MORE INDEPENDENT.NUTRITIONAL SERVICES: RESIDENTS AT HOLZER SENIOR CARE CENTER ENJOY NUTRITIONAL AND APPETIZING MEALS IN A COMFORTABLE AND ATTRACTIVE DINING SETTING. A REGISTERED DIETITIAN WHO SPECIALIZES IN MEETING EACH RESIDENT'S NEEDS PLANS THE MENUS. BED SIDE SERVICE IS AVAILABLE FOR THOSE RESIDENTS WHO ARE UNABLE TO GO TO THE DINING ROOM FOR THEIR MEALS. FAMILY AND FRIENDS WHO WISH TO DINE WITH THEIR LOVED ONES MAY ALSO PURCHASE A MEAL FOR A NOMINAL FEE.SOCIAL AND RECREATIONAL ACTIVITIES: THE OVERALL ACTIVITY PROGRAM AT HOLZER SENIOR CARE CENTER IS THERAPEUTICALLY DESIGNED BY A QUALIFIED AND EXPERIENCED ACTIVITIES COORDINATOR, WHO GIVES SPECIAL ATTENTION TO THE PHYSICAL, MENTAL, SPIRITUAL, AND SOCIAL NEEDS OF EACH RESIDENT. THERE IS SOMETHING FOR EVERYONE. AMONG THE MOST POPULAR EVENTS ARE THE GAMES, CRAFTS, SING-ALONGS, RELIGIOUS SERVICES, PICNICS, AND COMMUNITY OUTINGS. EACH RESIDENT IS ENCOURAGED TO PARTICIPATE IN WHATEVER ACTIVITIES PROVIDE THE MOST FULFILLMENT AND BEST SERVES HIS OR HER PERSONAL NEEDS.ACCOMMODATIONS: A COMFORTABLE HOME-LIKE SETTING CAN PLAY A MAJOR ROLE IN RESTORING HEALTH AND WELL-BEING. THE ROOMS AT HOLZER SENIOR CARE CENTER ARE SPACIOUS AND SUNNY WITH WINDOWS THAT BRING IN AN ABUNDANCE OF NATURAL LIGHT. RESIDENTS ARE ENCOURAGED TO DECORATE THEIR ROOMS WITH FAVORITE PERSONAL BELONGINGS, SUCH AS QUILTS, PILLOWS, AND PICTURES. THE ROOM RATE AT HOLZER SENIOR CARE CENTER IS AN ALL-INCLUSIVE RATE. NO ADDITIONAL CHARGES ARE MADE FOR PERSONAL GROOMING ITEMS OR LAUNDRY SERVICES. THE ATTRACTIVE SOLARIUM AREAS ARE ALWAYS AVAILABLE FOR THE ENJOYMENT OF THE RESIDENTS, THEIR FAMILIES AND FRIENDS. QUALITY OF LIFE: EVERY MEMBER OF THE STAFF AT HOLZER SENIOR CARE CENTER IS COMMITTED TO ADDRESSING AND MEETING THE NEEDS OF EACH RESIDENT ON A PERSONAL BASIS. THEY RESPECT EVERY RESIDENT'S RIGHT TO PRIVACY, DIGNITY AND TREATMENT AS AN INDIVIDUAL.DURING THE YEAR, HOLZER SENIOR CARE SERVED 24,272 PATIENTS AND ASSISTED LIVING SERVED 15,330 PATIENTS. 6521576 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 9 0 1 308 1 0 0 0 0 0 0 0 0 0 9 4 0 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 OH X WILLIAM CRABTREE 7402880192 190 WATER ST SUITE 4 JACKSON OH 45640 STEVE CHAPMAN CPA 1.00 X X 0 14000 0 ALAN STOCKMEISTER 1.00 X X 0 12000 0 PHIL A BOWMAN 1.00 X X 0 14000 0 RYAN SMITH 1.00 X X 0 3500 0 JAMES MAGNUSSEN MD 1.00 X 0 7000 0 BRENT SAUNDERS 1.00 X X 0 132776 276 VERLIN L SWAIN 1.00 X 0 14000 0 TERESA REMY DETTY 40.00 X X 0 141764 24620 WILLIAM CRABTREE 40.00 X X 0 82816 10541 THOMAS TOPE 1.00 X X 0 654883 6370 PETE DETTY 40.00 X 56647 0 4333 CLINT POTTER 40.00 X 52541 0 4019 PEGGY WILLIAMS 40.00 X 75578 0 18288 KEVIN YEAGER 40.00 X 0 197063 0 184766 1273802 68447 0 1 1 0 STOCKMEISTER ENTERPRISE 980 E MAIN ST JACKSON OH 45640 CONSTRUCTION 348424 REHABCARE GROUP PO BOX 503534 ST LOUIS MO 63150 THERAPY 234217 2 40600 40600 PROGRAM SERVICES 623000 8431763 8431763 RESIDENT MEALS 623000 510610 510610 ADMISSION FEES 623000 43533 43533 8985906 52466 52466 MEALS & VENDING 623000 33522 33522 PHONE INCOME 623000 26459 26459 CABLE TV INCOME 623000 21604 21604 11513 11513 93098 9172070 8985906 0 145564 209866 209866 4070161 3134024 936137 92 71 21 719892 554317 165575 301239 231954 69285 5737 5737 73701 73701 387620 298467 89153 55372 55372 964029 742305 221724 384575 296123 88452 10243 10243 402028 309562 92466 620997 478168 142829 134888 103864 31024 OHIO BED TAX 307174 307174 EXP REIMB RELATED ORG 83000 83000 RESIDENT SERVICES 61047 61047 BAD DEBT EXPENSE 4500 4500 8796161 6521576 2274585 0 1583 1500 640688 918969 658226 623590 10000 10000 59249 107471 12562743 4379088 8164774 8183655 513058 517571 4633538 4432080 637678 645156 15318794 15439992 972229 1048509 7732550 7428416 1079388 1093131 9784167 9570056 X 5534627 5869936 5534627 5869936 15318794 15439992 X 0 1 1 X 0 X 40600 40600 6823915 7481839 8033379 8836134 8985906 40161173 6823915 7481839 8033379 8836134 9026506 40201773 0 0 0 40201773 7299 44079 63135 40554 52466 207533 7299 44079 63135 40554 52466 207533 84390 218079 126466 -14923 93098 507110 6915604 7743997 8222980 8861765 9172070 40916416 0.98250 0.94030 0.00510 0.00430 X Schedule A, Part II, Line 12, Explanation of Other Income: GUEST MEALS BARBER & BEAUTY SERVICES VENDING MACHINES PHONE INCOME CABLE TV INCOME MISCELLANEOUS RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 542107 542107 9011135 3346981 5664154 547523 85737 461786 1648243 895492 752751 813735 50878 762857 8183655 COST REPORT SETTLEMENTS 5141 RELATED PARTY PAYABLE 1087990 1093131 9172070 8796161 375909 -40600 -40600 335309 Part XI, Line 8 - Other Adjustments: CONTRIBUTION FROM HOLZER FOUNDATION NOT RECORDED ON FINANCIALS: -40600. 1 1 0 0 0 0 0 0 0 TERESA REMY DETTY 0 141764 0 0 0 0 0 20508 0 4112 0 166384 0 0 THOMAS TOPE 0 0 0 0 0 654883 0 0 0 6370 0 661253 0 0 KEVIN YEAGER 0 0 0 0 0 197063 0 0 0 0 0 197063 0 0 Part I, Line 4a PART I, LINE 4A: DURING THE FISCAL YEAR, THOMAS TOPE RECEIVED SEVERANCE PAY IN THE AMOUNT OF $500,335 AND KEVIN YEAGER RECEIVED SEVERANCE PAY IN THE AMOUNT OF $102,064. PART I, LINE 4B: DURING THE FISCAL YEAR, THOMAS TOPE WITHDREW FUNDS FROM A NON-QUALIFIED RETIREMENT PLAN (457F) IN THE AMOUNT OF $136,343. Supplemental Information Part III PART I, LINE 3: COMPENSATION PAID TO THE ORGANIZATION'S CEO IS ESTABLISHED BY A RELATED ORGANIZATION AND INCLUDES USE OF AN INDEPENDENT COMPENSATION CONSULTANT, A WRITTEN EMPLOYMENT CONTRACT, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. STOCKMEISTER ENTERPRISE BOARD VICE CHAIR ALAN STOCKMEISTER IS AN OWNER OF STOCKMEISTER ENTERPRISE. 328424 STOCKMEISTER ENTERPRISE COMPLETED CONSTRUCTION PROJECTS FOR THE ORGANIZATION DURING THE FISCAL YEAR. THE PROJECTS WERE PART OF A COMPETITIVE BIDDING PROCESS AND MR. STOCKMEISTER WAS NOT INVOLVED IN THE DECISION. 0 Form 990, Part VI, Section A, line 6 HOLZER CONSOLIDATED HEALTH SYSTEMS IS THE SOLE MEMBER OF THE ORGANIZATION. Form 990, Part VI, Section A, line 7b HOLZER SENIOR CARE CENTER'S DECISIONS THAT ARE MADE BY THEIR BOARD OF DIRECTORS CAN BE OVERRULED BY HOLZER CONSOLIDATED HEALTH SYSTEM'S BOARD OF DIRECTORS. Form 990, Part VI, Section B, line 11 THE CONTROLLER AND THE CFO OF HOLZER CONSOLIDATED HEALTH SYSTEMS REVIEW FORM 990. A COPY WILL BE PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING. Form 990, Part VI, Section B, line 12c CONFLICT OF INTEREST STATEMENTS ARE COMPLETED ANNUALLY AND ARE REVIEWED BY THE CONFLICT OF INTEREST REVIEW COMMITTEE. MEMBERS OF THE BOARD ARE AWARE THAT THEY SHOULD DISCLOSE CONFLICTS WHEN THEY ARISE, AND MEMBERS ABSTAIN FROM PARTICIPATING IN DISCUSSIONS OR VOTING ON MATTERS WHERE A CONFLICT IS PRESENT. Form 990, Part VI, Section B, line 15 COMPENSATION OF OFFICERS IS BASED ON EXPERIENCE AND MARKET VALUE AS EVIDENCED BY COMPARABILITY DATA AND IS APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD. THE PROCESS WAS LAST UNDERTAKEN DURING 2010. Form 990, Part VI, Section C, line 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 2C: THE AUDIT OVERSIGHT PROCESS AND THE PROCESS OF SELECTION OF AN INDEPENDENT ACCOUNTANT HAVE NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PAGE 1, LINE C: DOING BUSINESS AS: HOLZER ASSISTED LIVING - GALLIPOLIS HOLZER ASSISTED LIVING - JACKSON FORM 990, PAGE 7, PART VII: THE FOLLOWING TRUSTEES DEVOTED TIME TO HOLZER CONSOLIDATED HEALTH SYSTEMS: VERLIN L. SWAIN 1 HRS JAMES MAGNUSSEN, M.D. 1 HRS THE FOLLOWING OFFICERS DEVOTED TIME TO HOLZER CONSOLIDATED HEALTH SYSTEMS: ALAN STOCKMEISTER 1 HRS BRENT SAUNDERS 40 HRS PHIL A. BOWMAN 1 HRS STEVE CHAPMAN, CPA 1 HRS RYAN SMITH 1 HRS THE FOLLOWING OFFICERS DEVOTED TIME TO HOLZER HOSPITAL FOUNDATION: BRENT SAUNDERS .8 HRS THE FOLLOWING TRUSTEES DEVOTED TIME TO HOLZER HOSPITAL FOUNDATION: THOMAS TOPE .8 HRS GALLIA HEALTH PARTNERS LLC 300 BRIARWOOD DR GALLIPOLIS OH 45631 311534051 ASSISTED LIVING OH 2160526 6065666 N/A JACKSON HEALTH PARTNERS LLC 101 MARKHAM DRIVE JACKSON OH 45640 311534051 ASSISTED LIVING OH 1634577 5205783 N/A HOLZER CONSOLIDATED HEALTH SYSTEMS 100 JACKSON PIKE GALLIPOLIS OH 45631 311156690 MANAGEMENT SERVICES OH 501(C)(3) Line 11a, I N/A HOLZER HOSPITAL FOUNDATION 100 JACKSON PIKE GALLIPOLIS OH 45631 314379491 HEALTH CARE OH 501(C)(3) Line 3 HOLZER CONSOLIDATED HEALTH SYSTEMS HOLZER MEDICAL CENTER - JACKSON 100 JACKSON PIKE GALLIPOLIS OH 45631 311724085 HEALTH CARE OH 501(C)(3) Line 3 HOLZER CONSOLIDATED HEALTH SYSTEMS HOLZER FOUNDATION 100 JACKSON PIKE GALLIPOLIS OH 45631 310927482 CONTINUING ADVANCEMENT OF HEALTH AND MEDICAL CARE OH 501(C)(3) Line 7 HOLZER CONSOLIDATED HEALTH SYSTEMS HOLZER CARDIOVASCULAR LLC 90 JACKSON PIKE GALLIPOLIS OH 45631 311780671 MEDICAL OH N/A HOLZER VANGUARD INC 100 JACKSON PIKE GALLIPOLIS OH 45631 311192567 STOCK HOLDING COMPANY OH N/A C 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 HOLZER CONSOLIDATED HEALTH SYSTEM O 83000