2011-11-14T11:07:45-06:00 2010-12-31 PLANTE & MORAN PLLC 65 EAST STATE ST STE 600 COLUMBUS OH 43215 990 2010-01-01 311190446 FRIENDS OF GOOD SHEPHERD MANOR INC FRIE 7402892861 374 GOOD MANOR ROAD PO BOX 1029 LUCASVILLE OH 45648 JACKIE BOWLING 7402892861 2011-11-14 1 BERNIE OSTROWSKI 6148493000 2010 2016-03-07 17:11:31Z JACKIE BOWLING 374 GOOD MANOR ROAD PO BOX 1029 LUCASVILLE OH 45648 5088733 0 X WWW.FGSMO.COM X 1985 OH PROVIDING RESIDENTIAL SUPPORT & SERVICES TO ADULT MEN WHO ARE DISABLED MENTALLY. 14 14 165 14 0 0 77256 63402 4977800 4951258 6967 -21050 1979 68346 5064002 5061956 0 0 0 0 3254353 3161576 0 0 0 1628350 1612886 4882703 4774462 181299 287494 2706601 2657142 802623 544670 1903978 2112472 TO PROVIDE A SAFE AND NURTURING HOME FOR ADULT MEN WHO HAVE MRDD WHERE EACH INDIVIDUAL CAN LEAD A LIFE OF DIGNITY, DEVELOPMENT AND PURPOSE. 0 0 3984379 4956985 THE ORGANIZATION PROVIDES RESIDENTIAL CARE, ACTIVITIES AND HABILITATION PROGRAMS TO ITS RESIDENTS WHO HAVE MENTAL RETARDATION AND DEVELOPMENTAL DISABILITIES. THE ORGANIZATION ALSO PROVIDES VOCATIONAL TRAINING. 3984379 1 1 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 1 1 1 0 0 1 4 0 165 1 0 0 0 0 0 0 0 0 0 0 X 14 14 1 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 1 1 1 0 OH X JACKIE BOWLING 7402892861 374 GOOD MANOR RD LUCASVILLE OH 45648 X MICHAEL LUKOWSKI 1.00 X X 0 0 0 ROBERT KAMMER 1.00 X X 0 0 0 LINDA KAMMER 1.00 X X 0 0 0 ROBERT GRUNDEY 1.00 X X 0 0 0 JUDY LAWRENCE 1.00 X 0 0 0 JOSEPH LUKOWSKI 1.00 X 0 0 0 ED MONDE 1.00 X 0 0 0 SUZANNE PAHLS 1.00 X 0 0 0 JERRY KURSBAN 1.00 X 0 0 0 DALE TARASCO 1.00 X 0 0 0 SCOTT SHER 1.00 X 0 0 0 STEVE JUDGE 1.00 X 0 0 0 ROBERT GRUBER 1.00 X 0 0 0 JANE PETTIGREW 1.00 X 0 0 0 JACKIE BOWLING 30.00 X 85016 0 8806 DAVID PHIPPS 32.00 X 66653 0 12464 151669 0 21270 0 0 0 0 0 63402 63402 RESIDENTS ROOM & BOARD 623000 4951258 4951258 4951258 5727 5727 1200 1200 1200 1200 26777 -26777 -26777 -26777 W/O OUTSTANDING CHECKS 900099 29363 29363 MAINTENANCE, VENDING 623000 16845 16845 REAL ESTATE TAX REFUND 531390 14263 14263 6675 6675 67146 5061956 4956985 0 41569 172939 172939 2578167 2320361 257806 67173 57097 10076 135835 133539 2296 207462 176343 31119 18889 18889 67050 67050 110328 88262 22066 2653 2653 487864 390291 97573 50575 50575 171326 137062 34264 5951 5951 15443 13127 2316 135511 115184 20327 FOOD 280811 238689 42122 FRANCHISE TAX 261213 261213 5272 2636 2636 4774462 3984379 790083 0 184218 597770 589138 101123 589867 571007 18770 23296 3050555 1733646 1283171 1316909 14372 39670 12353 7367 14712 0 2706601 2657142 512502 296187 258560 224044 31561 24439 802623 544670 X 1903978 2112472 1903978 2112472 2706601 2657142 X 287494 -79000 X X 0 1 1 X 0 X 559123 177583 127981 77256 63402 1005345 559123 177583 127981 77256 63402 1005345 203733 801612 25511 55149 3084 6967 6927 97638 67146 67146 1170129 25938155 0.68510 0.67010 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE REAL ESTATE TAX REFUND W/O OUTSTANDING CHECKS MAINTENANCE, VENDING RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 48535 48535 1657192 901042 756150 888628 586261 302367 456200 246343 209857 1316909 SOFTWARE LEASE 24439 24439 TOM KAMMER TOM KAMMER'S BROTHER, ROBERT KAMMER, IS A BOARD MEMBER OF THE ORG. 83403 RESIDENT OF GOOD SHEPHERD MANOR RECEIVING SSD AND MEDICAID AT FACILITY THOMAS LUKOWSKI THOMAS LUKOWSKI'S BROTHER AND FATHER ARE BOARD MEMBERS OF THE ORG. 83403 RESIDENT OF GOOD SHEPHERD MANOR RECEIVING SSD AND MEDICAID AT FACILITY ERICH GRUNDEY ERICH GRUNDEY'S BROTHER, ROBERT GRUNDEY, IS A BOARD MEMBER OF THE ORG. 83403 RESIDENT OF GOOD SHEPHERD MANOR RECEIVING SSD AND MEDICAID AT FACILITY WILLIAM SCHLEE JR WILLIAM SCHLEE'S SISTER, SUZANNE PAHLS, IS A BOARD MEMBER OF THE ORG. 83403 RESIDENT OF GOOD SHEPHERD MANOR RECEIVING SSD AND MEDICAID AT FACILITY RANDY SHER RANDY SHER'S BROTHER, SCOTT SHER, IS A BOARD MEMBER OF THE ORG. 83403 RESIDENT OF GOOD SHEPHERD MANOR RECEIVING SSD AND MEDICAID AT FACILITY DEAN TARASCO DEAN TARASCO'S BROTHER, DALE TARASCO, IS A BOARD MEMBER OF THE ORG. 83403 RESIDENT OF GOOD SHEPHERD MANOR RECEIVING SSD AND MEDICAID AT FACILITY ED MONDE ED MONDE IS A BOARD MEMBER OF THE ORGANIZATION. 83403 RESIDENT OF GOOD SHEPHERD MANOR RECEIVING SSD AND MEDICAID AT FACILITY KARLSBERGER ARCHITECTURE MR. GRUNDEY IS SENIOR VP & EXECUTIVE ARCHITECT AT KARLSBERGER ARCHITECTURE 35700 ARCHITECTURE SERVICES 0 FORM 990, PART VI, SECTION A, LINE 2 BOARD MEMBER JOSEPH LUKOWSKI & BOARD PRESIDENT MICHAEL LUKOWSKI ARE FATHER & SON. BOARD MEMBERS JERRY KURSBAN & JUDY LAWRENCE ARE BROTHER & SISTER. BOARD TREASURER ROBERT KAMMER & BOARD SECRETARY LINDA KAMMER ARE HUSBAND & WIFE. FORM 990, PART VI, SECTION B, LINE 11 THE EXECUTIVE DIRECTOR WILL REVIEW A COPY OF FORM 990 PRIOR TO FILING. A COPY OF FORM 990 WILL BE PROVIDED TO EACH BOARD MEMBER PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE EXECUTIVE DIRECTOR AND OTHER OFFICERS AND KEY EMPLOYEES WAS COMPARED WITH OTHERS IN COMPARABLE POSITIONS BY THE BOARD. IN ADDITION, THE BOARD CONSULTED AN EMPLOYMENT AGENCY FOR FURTHER REVIEW. THIS PROCESS IS DOCUMENTED AND COMPLETED ANNUALLY. THIS PROCESS WAS LAST PERFORMED IN 2010. FORM 990, PART VI, SECTION C, LINE 18 THESE DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC BY MAINTAINING THE FILES AT THE PRIMARY FACILITY AND MAKING THEM AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII JACKIE BOWLING, EXECUTIVE DIRECTOR, WORKS AN AVERAGE OF 10 HOURS PER WEEK WITH RELATED ORGANIZATION FRIENDS OF GOOD SHEPHERD MANOR HOUSING ORGANIZATION. DAVID PHIPPS, ASSOCIATE EXECUTIVE DIRECTOR, WORKS AN AVERAGE OF 8 HOURS PER WEEK WITH RELATED ORGANIZATION FRIENDS OF GOOD SHEPHERD MANOR HOUSING ORGANIZATION. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: PRIOR PERIOD ADJUSTMENTS: -79,000. FORM 990, PART XI, LINE 2C: THE FINANCE COMMITTEE OVERSEES THE AUDIT PROCESS AND APPROVES THE INDEPENDENT AUDIT FIRM. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS. FRIENDS OF GOOD SHEPHERD MANOR HOUSING ORGANIZATION 374 GOOD MANOR ROAD PO BOX 1029 LUCASVILLE OH 45648 311315438 INTERMEDIATE CARE FACILITY OH 501(C)(3) LINE 9 FRIENDS OF GOOD SHEPHERD MANOR INC 1 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 0 NO TRANSACTIONS OVER 50000