2025-11-12T15:49:21-06:00 2024-12-31 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2024-01-01 341940880 OTTERBEIN ST MARYS OTTE 4193942366 11230 STATE ROUTE 364 ST MARYS OH 45885 J CHRISTOPHER GREEN CFO 5139335400 2025-11-12 1 0 AMBER HAMILTON P01251012 3149254300 2025-11-12 2024 2025-03-06 01:10:19Z J CHRISTOPHER GREEN 3855 LOWER MARKET STREET SUITE 300 LEBANON OH 45036 22768527 0 X OTTERBEIN.ORG/FIND-A-LOCATION/ST-MARYS/ X 2001 OH CONTINUING CARE RETIREMENT COMMUNITY THAT PROVIDES HOUSING AND SERVICES FOR OLDER ADULTS. 13 10 233 213 0 0 542673 168494 15392080 16294914 126313 599371 291478 296866 16352544 17359645 18170 0 0 0 6110172 6358533 0 0 0 7871884 8441900 14000226 14800433 2352318 2559212 52312992 61817786 17886053 24039957 34426939 37777829 INSPIRED BY FAITH, WE STRIVE TO ENRICH INDIVIDUAL LIFE JOURNEYS FOR ALL. 0 0 13035759 0 16486300 OTTERBEIN ST. MARYS PROVIDES A CONTINUUM OF CARE INCLUDING INDEPENDENT LIVING, ASSISTED LIVING, NURSING CARE, AND DEMENTIA CARE. REHABILITATION, SOCIAL SERVICES AND CHAPLAINCY SERVICES ARE AVAILABLE TO ALL RESIDENTS.LOCAL GROUPS SUCH AS THE VETERANS, CHURCH CIRCLES, COMMUNITY CIVIC GROUPS AND A HOST OF OTHERS USE OTTERBEIN AS A MEETING PLACE. IN ADDITION, OTTERBEIN PROVIDES SPECIAL PROGRAMS AND EVENTS FOR THE COMMUNITY ON AN ONGOING BASIS. 0 0 0 GENEROUS DONORS HAVE ESTABLISHED A BENEVOLENT CARE FUND, WHICH OFFERS ASSISTANCE TO RESIDENTS WHO CANNOT PAY THE FULL COST OF CARE. OTTERBEIN'S RICH HERITAGE HAS EARNED US A SOLID REPUTATION AS A TRUSTED AND VALUABLE RESOURCE. BY PROVIDING INFORMATION AND SERVICES ON AGING ISSUES WE CONTINUE TO SERVE RESIDENTS, THEIR FAMILIES, AND THE SURROUNDING COMMUNITIES. OTTERBEIN RESIDENTS AND STAFF VOLUNTEER THEIR TIME AND TALENTS AT OTTERBEIN ST. MARYS RETIREMENT LIVING COMMUNITY BUT ALSO FOR A NUMBER OF ORGANIZATIONS AND CAUSES IN THE GREATER COMMUNITY. 0 0 -191386 THE ORGANIZATION PROVIDES NURSING CARE TO RESIDENTS UNDER THE MEDICAID PROGRAM FOR WHICH THE COSTS TO PROVIDE SUCH CARE EXCEEDS REIMBURSEMENT. THE ORGANIZATION FUNDS THIS DIFFERENCE THROUGH ITS OPERATIONS. THE SHORTFALL IS NETTED WITH PROGRAM SERVICE REVENUE. 13035759 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 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 1 1 0 0 0 1 X 0 0 233 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X J CHRISTOPHER GREEN 5139335400 3855 LOWER MARKET STREET SUITE 300 LEBANON OH 45036 BRUCE SLAVIK DIRECTOR 1.00 0.00 X 0 0 0 CHUCK GAMBLE CHAIR 1.00 0.00 X X 0 0 0 DAVE VOISARD DIRECTOR 1.00 0.00 X 0 0 0 DEB BORNS DIRECTOR 1.00 0.00 X 0 0 0 DEBORAH GEIS DIRECTOR (TERM ENDED) 1.00 0.00 X 0 0 0 GORDON COFFIN RESIDENT DIRECTOR 1.00 0.00 X 0 0 0 JAMES C GREEN CFO/TREASURER 2.00 38.00 X X 0 437456 24430 JASON MILLER VP SR - LSC 2.00 38.00 X X 0 484061 26770 JILL WILSON PRESIDENT/CEO 2.00 38.00 X X 0 725335 22531 JOHN MEDAUGH RESIDENT DIRECTOR 1.00 0.00 X 0 0 0 MARTIN BROWN DIRECTOR 1.00 0.00 X 0 0 0 STEVE DUES DIRECTOR 1.00 0.00 X 0 0 0 STEVE VONDERHAAR DIRECTOR 1.00 0.00 X 0 0 0 WILLIAM BROWNSON BOARD CHAIR OF OTTERBEIN 1.00 8.00 X 0 0 0 DALLAS AGNER EXECUTIVE DIRECTOR (TERM) 40.00 0.00 X 95190 0 0 TARA SILBERT EXECUTIVE DIRECTOR 40.00 0.00 X 41277 0 0 CATHERINE CHIOVARO VP - WORKFORCE MANAGEMENT 2.00 38.00 X 0 366772 25912 DANIEL ARNOLD VP NEIGHBORHOODS 2.00 38.00 X 0 253155 23475 GARY HORNING VP - MKTG - COMMUNICATIONS 2.00 38.00 X 0 293395 24644 MARY SIMPSON VP - CLINICAL QUALITY 2.00 38.00 X 0 289427 50010 PAMELA RICHMOND VP CHIEF STRATEGY/DEV 2.00 38.00 X 0 340696 43791 136467 3190297 241563 2 0 1 0 0 168494 168494 RESIDENT REVENUE 623000 16278906 16278906 DEPARTMENTAL REVENUE 623000 16008 16008 16294914 465366 465366 358 358 5542529 5408882 133647 133647 133647 DIETARY 623000 154659 154659 BEAUTY AND BARBER 623000 53909 53909 OTHER SERVICES 623000 42947 42947 45351 45351 296866 17359645 16294914 0 896237 136466 136466 5057559 4875831 181728 19566 18863 703 758204 730960 27244 386738 372842 13896 14829 14829 11825 11825 53609 53609 1376395 1368831 7564 228173 228173 1476704 1410182 66522 163174 160097 3077 1147454 1125816 21638 30758 19298 11460 176023 172704 3319 1524019 1495280 28739 271962 266834 5128 CORPORATE SERVICE FEES 918000 918000 REFUNDABLE LIFE USE FEE 769005 769005 BAD DEBT 166909 166909 DUES & SUBSCRIPTIONS 46164 17793 28371 66897 64514 2383 14800433 13035759 1764674 0 9529511 9972097 3094 1207 200000 200000 1138417 839963 42604 16566 90830 126682 47265033 25878491 16721093 21386542 24410751 29115085 120000 120000 56692 39644 52312992 61817786 1738264 2032956 995237 810722 4271757 8519700 3094 1207 510940 510940 10366761 12164432 17886053 24039957 X 32375354 35801063 2051585 1976766 34426939 37777829 52312992 61817786 X 2559212 786620 5058 X X 0 1 X 1 0 X 95660 159548 552890 542673 168494 1519265 11164303 12357828 14140254 15392080 16294914 69349379 123 234528 248464 282596 289080 1054791 11260086 12751904 14941608 16217349 16752488 71923435 63059 62279 47136 92262 40958 305694 0 63059 62279 47136 92262 40958 305694 71617741 247876 280959 119719 235997 465724 1350275 247876 280959 119719 235997 465724 1350275 213625 4067 4840 8882 7786 239200 11721587 13036930 15066167 16462228 17225998 73512910 0.97420 0.97190 0.01840 0.01680 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: BEAUTY AND BARBER - 2020 AMOUNT: $ 36,964. HOUSEKEEPING - 2020 AMOUNT: $ 11,279. LAUNDRY - 2020 AMOUNT: $ 1,323. TRANSPORTATION - 2020 AMOUNT: $ 5,107. UTILITY REVENUE - 2020 AMOUNT: $ 100. DIETARY - 2020 AMOUNT: $ 92,466. PLANT AND GROUNDS MAINTENANCE - 2020 AMOUNT: $ 17,389. MISCELLANEOUS - 2020 AMOUNT: $ 4,756. 2021 AMOUNT: $ 4,067. 2022 AMOUNT: $ 4,840. 2023 AMOUNT: $ 8,882. 2024 AMOUNT: $ 7,786. SERVICES TO LEASEHOLDERS - 2020 AMOUNT: $ 44,241. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 1201960 1201960 35056331 18446679 16609652 4682230 2990123 1692107 6205274 4441689 1763585 119238 119238 21386542 REFUNDABLE ADVANCE DEPOSITS 11775020 SPLIT INTEREST AGREEMENT 347786 OPERATING LEASE LIABILITY 41626 12164432 X PART IV, LINE 2B: RESIDENT FUNDS ARE DEPOSITS HELD UNDER A FIDUCIARY RESPONSIBILITY AND ARE REQUIRED BY STATE REGULATION. PART X, LINE 2: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITISION UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE CONSOLIDATED FINANCIAL STATEMENTS. 0 1 0 0 0 0 0 0 0 JILL WILSON PRESIDENT/CEO 0 482796 0 123797 0 118742 0 19450 0 3081 0 747866 0 0 JASON MILLER VP SR - LSC 0 358556 0 58834 0 66671 0 12369 0 14401 0 510831 0 0 JAMES C GREEN CFO/TREASURER 0 324852 0 50849 0 61755 0 13264 0 11166 0 461886 0 0 CATHERINE CHIOVARO VP - WORKFORCE MANAGEMENT 0 287034 0 79738 0 0 0 11511 0 14401 0 392684 0 0 PAMELA RICHMOND VP CHIEF STRATEGY/DEV 0 291357 0 46863 0 2476 0 29390 0 14401 0 384487 0 0 MARY SIMPSON VP - CLINICAL QUALITY 0 246114 0 41072 0 2241 0 35609 0 14401 0 339437 0 0 GARY HORNING VP - MKTG - COMMUNICATIONS 0 248199 0 41321 0 3875 0 10243 0 14401 0 318039 0 0 DANIEL ARNOLD VP NEIGHBORHOODS 0 220328 0 31677 0 1150 0 9074 0 14401 0 276630 0 0 PART I, LINE 3 THE PARENT ORGANIZATION, OTTERBEIN HOMES, INC. USES THE FOLLOWING METHODS TO ESTABLISH COMPENSATION FOR THE CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B 457(F) CONTRIBUTIONS - JILL WILSON $118,300 JASON MILLER $65,359 CHRIS GREEN 58,766 PAMELA RICHMOND $22,207.52 MARY SIMPSON $25,445.78 FORM 990, PAGE 5, PART V, LINE 1A THE PARENT COMPANY, OTTERBEIN HOMES, (FEIN 31-0549058) PROCESSES ACCOUNTS PAYABLE PAYMENTS FOR ALL RELATED ENTITIES. AS A RESULT, THE ORGANIZATION IS UNABLE TO DETERMINE THE NUMBER OF 1099S NOR INDEPENDENT CONTRACTORS PAID OVER $100K FOR SERVICES BY ENTITY. AS A RESULT, ALL 1099S AND INDEPENDENT CONTRACTORS PAID OVER $100K ARE ISSUED AND REPORTED OUT OF THE PARENT COMPANY. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE IS AUTHORIZED TO ACT FOR THE BOARD OF DIRECTORS BETWEEN REGULAR AND/OR CALLED SESSIONS OF THE BOARD. THE EXECUTIVE COMMITTEE HAS AUTHORITY TO MAKE ALL DECISIONS WITHOUT HAVING TO WAIT AND BRING THE ACTION TO THE FULL BOARD. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS OTTERBEIN LSC, LLC. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OF THE BOARD OF DIRECTORS SHALL BE ELECTED BY THE MEMBER OF THE CORPORATION UPON NOMINATION BY THE CORPORATION'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING CORPORATE POWERS AND ACTIONS MAY ONLY BE TAKEN WITH THE APPROVAL OF THE MEMBER AFTER GIVING CONSIDERATION TO THE CONCERNS OF THE BOARD OF DIRECTORS: 1. THE DETERMINATION AND ADOPTION OF THE CORPORATION'S ANNUAL OPERATING AND CAPITAL BUDGETS. 2. THE EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF $25,000 3. DETERMINING CORPORATION ADMINISTRATIVE AND OPERATING STAFF COMPENSATION AND BENEFITS. 4. DETERMINING ALL BUILDING PROGRAMS AND THE MAKING OF CERTIFICATE OF NEED APPLICATIONS 5. DETERMINING TO ADD OR TERMINATE ANY SERVICES 6. THE EXECUTION OF ANY CONTRACT OR AGREEMENT FOR FINANCIAL COMMITMENTS IN EXCESS OF THAT APPROVED IN THE ANNUAL BUDGET 7. THE APPOINTMENT OF AUDITORS AND LEGAL COUNSEL 8. EMPLOYING, EVALUATING, DISCIPLINING OR DISCHARGING THE PRESIDENT AND/OR TREASURER OF THE CORPORATION 9. THE ADOPTION OF LONG-RANGE PLANS AND MANAGEMENT OBJECTIVES, INCLUDING THE EXECUTION OF ANY AGREEMENT WITH CONSORTIUMS, ALLIANCES OR OTHER ORGANIZATIONS. 10. TAKING MEMBERSHIP IN OR JOINING ANY ORGANIZATION 11. THE SALE, LEASE, MORTGAGING, ENCUMBERING. LEASE OR OTHER DISPOSITION OF ANY REAL PROPERTY OR ANY PERSONAL PROPERTY OF A VALUE IN EXCESS OF $10,000 12. THE MANAGEMENT AND ADMINISTRATION OF ALL LEGAL MATTERS INVOLVING THE CORPORATION 13. THE MANAGEMENT AND ADMINISTRATION OF ALL INSURANCE FOR THE CORPORATION 14. THE ESTABLISHMENT OF UNIFORM EMPLOYMENT PRACTICES AND POLICIES 15. THE DEVELOPMENT AND IMPLEMENTATION OF MARKETING, PUBLIC RELATIONS AND FUNDRAISING EFFORTS ON BEHALF OF THE CORPORATION WITHOUT PRIOR NOTIFICATION TO AND APPROVAL FROM AN OFFICER OF THE MEMBER UNLESS APPROVED IN THE ANNUAL BUDGET 16. THE ASSUMPTION OR ISSUANCE OF ANY LONG-TERM OR SHORT-TERM DEBT IN EXCESS OF AN AMOUNT DETERMINED FROM TIME TO TIME BY THE MEMBER 17. THE APPROVAL OF ANY VOLUNTARY MERGER OR CONSOLIDATION OF THE CORPORATION OF THE SALE, ASSIGNMENT, MORTGAGING, ENCUMBERING, PLEDGING, LEASING OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR THE TRANSFER OF CONTROL OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM IS PROVIDED TO AND REVIEWED BY THE CHIEF FINANCIAL OFFICER BEFORE THE FORM IS FILED. A COMPLETE COPY OF THE 990 IS ALSO PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C IN ACCORDANCE WITH THE BY-LAWS, ANY POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY BOARD MEMBER, CORPORATE EXECUTIVE, EXECUTIVE DIRECTOR, OR ADMINITRATIVE STAFF MEMBER, OR COMMITTEE MEMBERS, WHO ARE NOT MEMBERS OF THE BOARD OF TRUSTEES OF OTTERBEIN HOMES SHALL BE DISCLOSED TO THE BOARD AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST BECOMES RELEVANT TO A MATTER OF BOARD ACTION. FORM 990, PART VI, SECTION B, LINE 15A THE INDEPENDENT EXECUTIVE COMMITTEE OF THE OTTERBEIN HOMES BOARD OF TRUSTEES HAS THE RESPONSIBILITY FOR DETERMINING THE ANNUAL COMPENSATION FOR THE OFFICERS BY THE USE OF INDUSTRY SPECIFIC DATA SUCH AS SALARY SURVEYS FROM LEADING AGE AND LEADING AGE OHIO. THE SALARIES OF THE KEY EMPLOYEES ARE DETERMINED BY THE OFFICERS USING INDUSTRY COMPARATIVE DATA SUCH AS SALARY SURVEYS FROM LEADING AGE AND LEADING AGE OHIO. THE DELIBERATIONS AND DECISIONS REGARDING COMPENSATION ARE DOCUMENTED. THIS PROCESS WAS LAST PERFORMED IN 2024 . FORM 990, PART VI, SECTION C, LINE 19 THE ANNUAL REPORT IS PROVIDED TO THE PUBLIC WHICH INCLUDES THE AUDITED FINANCIAL STATEMENT SUMMARY. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENT -64,303. CHANGE IN MINIMUM PENSION LIABILITY 69,361. FORM 990, PAGE 12, PART XII, LINE 2 THE SELECTION AND OVERSIGHT PROCESS HAS NOT CHANGED. FORM 990, PART X, PAGE 11, LINE 20 - TAX-EXEMPT BOND LIABILITIES THE PARENT COMPANY, OTTERBEIN HOMES, HAS ALLOCATED A PORTION OF THE TAX EXEMPT BONDS THAT WERE ISSUED TO THE PARENT COMPANY. THE DETAILS OF THE TAX EXEMPT BONDS ISSUED TO OTTERBEIN HOMES ARE CONTAINED ON THE SCHEDULE K THAT IS FILED WITH THE FORM 990 FOR THE PARENT COMPANY (FEIN 31-0549058). THERE IS NO SCHEDULE K FOR THIS TAX RETURN. THIS TREATMENT IS CONSISTENT WITH PRIOR YEARS. OTTERBEIN ST MARYS LLC 3855 LOWER MARKET STREET SUITE 300 LEBANON OH 45036 270513015 REAL ESTATE HOLDING COMPANY OH 1201960 OTTERBEIN ST MARYS OTTERBEIN HOMES 3855 LOWER MARKET STREET SUITE 300 LEBANON OH 45036 310549058 PARENT - RETIREMENT LIVING COMMUNITIES OH 501(C)(3) LINE 10 N/A 0 OTTERBEIN AT GRANVILLE 2158 COLUMBUS ROAD GRANVILLE OH 43023 311657346 RETIREMENT LIVING COMMUNITY OH 501(C)(3) LINE 10 OTTERBEIN HOMES 0 OTTERBEIN LEBANON 585 NORTH STATE ROUTE 741 LEBANON OH 45036 311743874 RETIREMENT LIVING COMMUNITY OH 501(C)(3) LINE 10 OTTERBEIN HOMES 0 OTTERBEIN PORTAGE VALLEY 20311 PEMBERVILLE ROAD PEMBERVILE OH 43450 341193296 RETIREMENT LIVING COMMUNITY OH 501(C)(3) LINE 10 OTTERBEIN HOMES 0 NORTH SHORE RETIREMENT COMMUNITY 9400 NORTHSHORE BLVD LAKESIDE OH 43440 341743836 RETIREMENT LIVING COMMUNITY OH 501(C)(3) LINE 10 OTTERBEIN HOMES 0 OTTERBEIN CRIDERSVILLE 100 RED OAK DRIVE CRIDERSVILLE OH 45806 341940884 RETIREMENT LIVING COMMUNITY OH 501(C)(3) LINE 10 OTTERBEIN HOMES 0 THE FRANKLIN UNITED METHODIST HOME 1070 WEST JEFFERSON STREET FRANKLIN IN 46131 350988712 RETIREMENT LIVING COMMUNITY IN 501(C)(3) LINE 10 OTTERBEIN HOMES 0 SUNSET RETIREMENT COMMUNITIES INC 4040 INDIAN ROAD TOLEDO OH 43606 344428230 RETIREMENT LIVING COMMUNITY OH 501(C)(3) LINE 10 OTTERBEIN HOMES 0 OTTERBEIN GREEN HILLS INC 6557 US HIGHWAY 68 S WEST LIBERTY OH 43357 341137582 RETIREMENT LIVING COMMUNITY OH 501(C)(3) LINE 10 OTTERBEIN HOMES 0 WEST LIBERTY GARDEN APARTMENTS INC 6557 US HIGHWAY 68 S WEST LIBERTY OH 43357 341325781 SUPPORTING ORGANIZATION OH 501(C)(3) LINE 12B, II OTTERBEIN HOMES 0 WEST LIBERTY HOMES INC 6557 US HIGHWAY 68 S WEST LIBERTY OH 43357 346708015 RETIREMENT LIVING COMMUNITY OH 501(C)(3) LINE 10 OTTERBEIN HOMES 0 OTTERBEIN GREEN HILLS FOUNDATION INC 6557 US HIGHWAY 68 S WEST LIBERTY OH 43357 272566073 SUPPORTING ORGANIZATION OH 501(C)(3) LINE 12B, II OTTERBEIN HOMES 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0