TY 2015 Form 990 Schedule O

efile Public Visual Render ObjectId: 201613199349304666 - Submission: 2016-11-14 TIN: 34-1940884

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

OTTERBEIN CRIDERSVILLE

Employer identification number

34-1940884

Return Reference	Explanation
FORM 990, PART VI, SECTION B, LINE 11	THE FORM 990 IS PROVIDED TO AND REVIEWED BY THE CHIEF FINANCIAL OFFICER BEFORE IT IS FILED. IT IS ALSO PROVIDED TO THE ENTIRE BOARD BEFORE 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 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 2015.
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 MINIMUM PENSION LIABILITY 259,886. CHANGE IN VALUE OF SPLIT INTEREST AGREEMENT -10,023.
FORM 990. PART XII, LINE 2C	THERE HAS BEEN NO CHANGE IN THE OVERSIGHT OR THE SELECTION OF AN INDEPENDENT ACCOUNTANT FROM THE PRIOR YEAR.
FORM 990, PART X, PAGE 11, LINE 20-LIABILITIES/TAX EXEMPT BONDS	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.

Return Reference

Explanation

FORM 990, PART VI, SECTION B, LINE 11

THE FORM 990 IS PROVIDED TO AND REVIEWED BY THE CHIEF FINANCIAL OFFICER BEFORE IT IS FILED. IT IS ALSO PROVIDED TO THE ENTIRE BOARD BEFORE 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 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 2015.

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 MINIMUM PENSION LIABILITY 259,886. CHANGE IN VALUE OF SPLIT INTEREST AGREEMENT -10,023.

FORM 990. PART XII, LINE 2C

THERE HAS BEEN NO CHANGE IN THE OVERSIGHT OR THE SELECTION OF AN INDEPENDENT ACCOUNTANT FROM THE PRIOR YEAR.

FORM 990, PART X, PAGE 11, LINE 20-LIABILITIES/TAX EXEMPT BONDS

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.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Software ID:
Software Version: