2025-11-12T12:41:58-06:00 2024-12-31 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2024-01-01 341743836 NORTH SHORE RETIREMENT COMMUNITY NORT 4197988203 9400 NORTH SHORE BLVD LAKESIDE OH 43440 J CHRISTOPHER GREEN CFO 4197988203 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 9216652 0 X OTTERBEIN.ORG/FIND-A-LOCATION/MARBLEHEAD/ X 1993 OH CONTINUING CARE RETIREMENT COMMUNITY THAT PROVIDES HOUSING AND SERVICES FOR OLDER ADULTS. 11 8 134 189 0 0 678088 334075 7321316 7859097 44306 126169 432992 193392 8476702 8512733 0 0 0 0 3358427 3252776 0 0 0 4094999 4460873 7453426 7713649 1023276 799084 14321080 15236657 8031236 7988382 6289844 7248275 INSPIRED BY FAITH, WE STRIVE TO ENRICH INDIVIDUAL LIFE JOURNEYS FOR ALL. 0 0 6585392 0 8441652 OTTERBEIN NORTH SHORE 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 DONATIONS 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 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 TO OTTERBEIN NORTH SHORE RETIREMENT LIVING COMMUNITY BUT ALSO FOR A NUMBER OF ORGANIZATIONS AND CAUSES IN THE GREATER COMMUNITY. 0 0 -582555 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. 6585392 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 0 1 0 0 0 1 X 0 0 134 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 8 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 BECKY JOHNSON DIRECTOR 1.00 0.00 X 0 0 0 HELEN ROFKAR DIRECTOR (TERM ENDED) 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 BUTCHKO CHAIR 1.00 0.00 X X 0 0 0 MARILYN FARIS RESIDENT DIRECTOR 1.00 0.00 X 0 0 0 PHILIP FELTMAN DIRECTOR 1.00 0.00 X 0 0 0 ROBIN PALMER DIRECTOR 1.00 0.00 X 0 0 0 SHIRLEY ENGLE RESIDENT DIRECTOR (TERM END 4/24) 1.00 0.00 X 0 0 0 WILLIAM BROWNSON BOARD CHAIR OF OTTERBEIN 1.00 8.00 X 0 0 0 KERRILL BELL RESIDENT DIRECTOR 1.00 0.00 X 0 0 0 JENNIFER LENTHE EXECUTIVE DIRECTOR 40.00 0.00 X 151117 0 17315 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 151117 3190297 258878 4 0 1 0 0 334075 940 334075 RESIDENTIAL SERVICE FE 623000 7827589 7827589 DEPARTMENTAL REVENUE 623000 31508 31508 7859097 108400 108400 376 376 721312 703919 17393 17393 17393 INSURANCE REIMBURSEMEN 623000 138048 138048 DIETARY 623000 22466 22466 BEAUTY AND BARBER 623000 12176 12176 20702 20702 193392 8512733 7859097 0 319561 X 168432 168432 2425837 2330518 95319 15116 13579 1537 449711 403990 45721 193680 173989 19691 9708 9708 11668 11668 11604 11604 1047410 1026529 20881 196543 196543 848873 819893 28980 103693 100797 2896 493911 480116 13795 12400 7357 5043 109959 106888 3071 733402 712919 20483 91993 89424 2569 CORPORATE SERVICE FEES 444744 444744 RLUF FINANCING 192797 192797 BAD DEBT 80863 80863 DUES & SUBSRIPTIONS 28538 4705 23833 42767 41028 1739 7713649 6585392 1128257 0 1784 2243 366192 293868 558412 676653 10546 10607 39614 49328 21013281 11296989 9212823 9716292 3990308 4354981 100000 100000 41401 32685 14321080 15236657 672575 718726 5000 2547963 2421563 1784 2243 302078 260390 4501836 4585460 8031236 7988382 X 6196514 6931762 93330 316513 6289844 7248275 14321080 15236657 X 799084 145315 14032 X X 0 1 X 1 0 X 29922 136973 319836 678088 334075 1498894 5903915 6570132 6870535 7321316 7859097 34524995 32320 53949 46625 45011 177905 5933837 6739425 7244320 8046029 8238183 36201794 78457 78107 90584 186801 144994 578943 629675 336869 966544 708132 414976 90584 186801 144994 1545487 34656307 99798 93576 52559 67174 108776 421883 99798 93576 52559 67174 108776 421883 63158 30358 25096 386367 148381 653360 6096793 6863359 7321975 8499570 8495340 37277037 0.92970 0.92110 0.01130 0.01240 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: BEAUTY AND BARBER - 2020 AMOUNT: $ 11,055. HOUSEKEEPING - 2020 AMOUNT: $ 2,090. MISCELLANEOUS - 2020 AMOUNT: $ 32,392. 2021 AMOUNT: $ 30,358. 2022 AMOUNT: $ 25,096. 2023 AMOUNT: $ 35,300. 2024 AMOUNT: $ 10,333. DIETARY - 2020 AMOUNT: $ 17,246. PLANT MAINT - 2020 AMOUNT: $ 375. INSURANCE CLAIM RECEIPTS - 2023 AMOUNT: $ 351,067. 2024 AMOUNT: $ 138,048. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 574075 574075 17313750 9056928 8256822 367400 223679 143721 2572800 2016382 556418 185256 185256 9716292 REFUNDABLE ADVANCE DEPOSITS 3843548 SPLIT-INTEREST AGREEMENT 53670 INTERCOMPANY PAYABLE 654082 OPERATING LEASE LIABILITY 34160 4585460 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 POSITIONS 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 JENNIFER LENTHE EXECUTIVE DIRECTOR 139569 0 11548 0 0 0 2914 0 14401 0 168432 0 0 0 PART I, LINE 3 A RELATED ORGANIZATION 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 IT 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 ADMINISTRATIVE 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 THE 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 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 901,156. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 901,156. SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 109,364. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 109,364. OTHER SERVICES: PROGRAM SERVICE EXPENSES 16,009. MANAGEMENT AND GENERAL EXPENSES 20,881. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 36,890. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF SPLIT INTEREST AGREEMENT -8,798. CHANGE IN MINIMUM PENSION LIABILITY 22,830. FORM 990, PAGE 12, PART XII, LINE 2C THERE HAVE BEEN NO CHANGES IN THE OVERSIGHT OR THE SELECTION OF AN INDEPENDENT ACCOUNTANT FROM THE PRIOR YEAR. 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 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 THE FRANKLIN UNITED METHODIST HOME INC 1070 WEST JEFFERSON STREET FRANKLIN IN 46131 350988712 RETIREMENT LIVING COMMUNITY IN 501(C)(3) LINE 10 OTTERBEIN HOMES 0 OTTERBEIN ST MARYS 11230 STATE ROUTE 364 ST MARYS OH 45885 341940880 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 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 68 SOUTH WEST LIBERTY OH 43357 341137582 RETIREMENT LIVING COMMUNITY OH 501(C)(3) LINE 10 OTTERBEIN HOMES 0 WEST LIBERTY GARDEN APARTMENTS INC 6557 US 68 SOUTH WEST LIBERTY OH 43357 341325781 SUPPORTING ORGANIZATION OH 501(C)(3) LINE 12B, II OTTERBEIN HOMES 0 OTTERBEIN GREEN HILLS FOUNDATION INC 6557 US 68 SOUTH WEST LIBERTY OH 43357 272566073 SUPPORTING ORGANIZATION OH 501(C)(3) LINE 12B, II OTTERBEIN HOMES 0 WEST LIBERTY HOMES INC 6557 US 68 SOUTH WEST LIBERTY OH 43357 346708015 RETIREMENT LIVING COMMUNITY OH 501(C)(3) LINE 10 OTTERBEIN HOMES 0 0 0 0 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 0