2023-11-10T16:07:20-06:00 2022-12-31 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2022-01-01 311480580 OHIO EASTERN STAR HEALTH CARE CENTER INC OHIO 7403971706 1451 GAMBIER ROAD MOUNT VERNON OH 43050 DARCY BUSSARD CONTROLLER 7403971706 2023-11-10 1 DARCY BUSSARD 999009999 0 AMY CIMINELLO P00796388 6148493000 2023-10-31 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MICHELE ENGELBACH 1451 GAMBIER ROAD MOUNT VERNON OH 43050 6115708 0 X WWW.OESHOME.ORG X 2001 OH TO PROVIDE SKILLED AND LONG-TERM CARE AND TREATMENT TO RESIDENTS IN A COMFORTABLE, HOME-LIKE ENVIRONMENT. VISION: TO BE A RECOGNIZED HEALTH CARE LEADER AND A PREFERRED HEALTH CARE PROVIDER IN THE COMMUNITY AT LARGE. 4 4 0 4 0 0 391390 0 7677316 6091682 308 22 15173 24004 8084187 6115708 0 0 0 0 5453163 5131973 0 0 0 3655874 3219215 9109037 8351188 -1024850 -2235480 3107315 688874 611868 428907 2495447 259967 X THE CAMPUS OF THE OHIO EASTERN STAR HOME IS DEDICATED TO LEADING THE WAY INTO THE FUTURE WHILE PROVIDING THE HIGHEST QUALITY OF SERVICES AND ENRICHING THE LIVES OF ALL WE SERVE. OUR INNOVATION AND ADAPTABILITY SUPPORT OUR ENVIRONMENT FOR GROWTH AND PROMOTES OUR COMMITMENT TO BEING AN INDUSTRY LEADER. 0 0 6588483 6115686 OPERATES AN 86-BED SKILLED NURSING FACILITY PROVIDING CARE TO THE ELDERLY RESIDENTS. 6588483 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 4 4 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X DARCY BUSSARD 7403971706 1451 GAMBIER ROAD MOUNT VERNON OH 43050 RON HARDESTY CHAIRPERSON 2.00 4.00 X X 0 0 0 DAVID MERCKLE SECRETARY 2.00 2.00 X X 0 0 0 BECKY THATCHER VICE CHAIRPERSON 2.00 2.00 X X 0 0 0 BARBARA STUART QA/HR COMMITTEE CHAIR 2.00 2.00 X 0 0 0 ARLENE SHAHEEN CONTROLLER (PART YEAR) 15.00 25.00 X X 0 91167 0 MICHELE ENGELBACH CEO 18.00 22.00 X 0 145249 8231 KATHRINE WILSON CONTROLLER 15.00 25.00 X 0 1840 0 0 238256 8231 1 0 1 0 WSB REHABILITATION SERVICES INC 510 W MAIN STREET CANFIELD OH 44406 THERAPY SERVICES 716120 EQUITY CONSTRUCTION SOLUTIONS LLC 4653 TRUEMAN BLVD HILLIARD OH 43026 CONSTRUCTION IN PROGRESS 700155 2 MEDICARE/MEDICAID PMT 623000 3452958 3452958 RESIDENT SERVICES 623000 2638724 2638724 6091682 22 22 21879 2125 0 0 21879 2125 24004 24004 6115708 6115686 0 22 X 283642 283642 4125086 3675764 449322 362340 284339 78001 360905 304676 56229 74920 74920 14166 14166 58123 58123 780346 775780 4566 36107 36107 915333 812958 102375 70908 70908 332123 332123 19970 14663 5307 1511 36 1475 439694 338381 101313 FRANCHISE PERMIT FEE 426251 426251 COVID-19 EXPENSES 25910 25910 BAD DEBT WRITE-OFF 23853 23853 8351188 6588483 1762705 0 485599 56949 953482 599348 35692 32577 1632542 0 3107315 688874 611868 338730 0 90177 611868 428907 X 2495447 259967 2495447 259967 3107315 688874 -2235480 0 X X 0 1 X 1 0 X X 1 OHIO EASTERN STAR HOME 314405826 10 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 INTERCOMPANY PAYABLE 90177 90177 0 0 0 0 0 0 0 0 0 MICHELE ENGELBACH CEO 0 145249 0 0 0 0 0 0 0 8231 0 153480 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PROVIDED TO ALL MEMBERS OF THE BOARD AND OHIO EASTERN STAR HOME'S FINANCE COMMITTEE, A RELATED ORGANIZATION, REVIEWS FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO FILL OUT A BOARD MEMBER QUESTIONNAIRE EACH YEAR TO IDENTIFY ANY TRANSACTIONS THAT NEED TO BE REPORTED ON SCHEDULE L. THE CORPORATE COMPLIANCE OFFICER REVIEWS THE QUESTIONNAIRES FOR ANY POTENTIAL CONFLICTS. ANY POTENTIAL CONFLICTS ARE REVIEWED BY THE CORPORATE COMPLIANCE COMMITTEE AND CEO. THE INDIVIDUAL IS THEN PROHIBITED FROM PARTICIPATING IN THE BOARD'S DELIBERATIONS AND DECISIONS. CONTINUOUS MONITORING IS DISCUSSED AS NEEDED AT QUARTERLY CORPORATE COMPLIANCE MEETINGS. ANY POTENTIAL CONFLICTS ARE REVIEWED BY MEMBERS OF THE COMMITTEE AND APPROPRIATE ACTIONS ARE TAKEN TO ENSURE COMPLIANCE. FORM 990, PART VI, SECTION B, LINE 15 THE RELATED ORGANIZATION, OHIO EASTERN STAR HOME, CONDUCTS THE COMPENSATION REVIEWS. SALARY AMOUNTS FOR THE CEO AND OTHER OFFICERS ARE REVIEWED AND APPROVED BY THE BOARD AT HIRE DATE. THEY REFERENCE THE AASHA AND NHCA COMPENSATION SALARY SURVEY. THE DOCUMENTATION FOR THE REVIEW OF THE CEO AND OFFICER COMPENSATION IS RECORDED IN THE BOARD MINUTES. THIS PROCESS WAS LAST COMPLETED IN AUGUST 2022. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PHYSICAL THERAPIST CONTRACT: PROGRAM SERVICE EXPENSES 271,895. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 271,895. OCCUPATIONAL THERAPIST CONTRACT: PROGRAM SERVICE EXPENSES 258,823. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 258,823. SPEECH THERAPIST CONTRACT: PROGRAM SERVICE EXPENSES 151,236. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 151,236. EMPLOYEE SCREENING SERVICES: PROGRAM SERVICE EXPENSES 45,264. MANAGEMENT AND GENERAL EXPENSES 4,566. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 49,830. OTHER FEES: PROGRAM SERVICE EXPENSES 48,562. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 48,562. FORM 990, PART XII, LINE 2C: THE FINANCE COMMITTEE OF OHIO EASTERN STAR HOME IS RESPONSIBLE FOR OVERSEEING THE AUDIT OF THE FINANCIAL STATEMENTS AND IS INVOLVED IN SELECTION OF THE INDEPENDENT ACCOUNTANT WHICH COMPLETES THE AUDIT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. OHIO EASTERN STAR HOME 1451 GAMBIER ROAD MOUNT VERNON OH 43050 314405826 OPERATING A RESIDENTIAL CARE FACILITY OH 501(C)(3) LINE 10 N/A 0 OHIO EASTERN STAR COMMUNITY SERVICES 1451 GAMBIER ROAD MOUNT VERNON OH 43050 020803707 OPERATING A COMMUNITY-BASED HOME HEALTH AGENCY OH 501(C)(3) LINE 10 OHIO EASTERN STAR HOME 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 0