HOSPICE FOUNDATION OF JEFFERSON COUNTY INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization: HOSPICE FOUNDATION OF JEFFERSON COUNTY INC (EIN 16-1541636)
Tax period: 2022-10-01 to 2023-09-30
Filed: 2024-08-13
IRS object ID: 202442269349300524
Schema version: 2022v5.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule G
Schedule I
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2024-08-13T10:34:25-05:00	ReturnTs
Tax Period End	2023-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	161131146	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BONADIO & CO LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	432 NORTH FRANKLIN STREET	AddressLine1Txt
City	SYRACUSE	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	13204	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2022-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	161541636	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	HOSPICE FOUNDATION OF JEFFERSON COUNTY	BusinessNameLine1Txt
Business Name Line2	INC	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	HOSP	BusinessNameControlTxt
Phone	3157887323	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1398 GOTHAM ST	AddressLine1Txt
City	WATERTOWN	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	13601	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	ANNA PATTERSON	PersonNm
Person Title	CHIEF EXECUTIVE OFFICER	PersonTitleTxt
Phone	3157887323	PhoneNum
Signature	2024-08-12	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	Yes (1)	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	TYLER SASS	PreparerPersonNm
PTIN	P01829225	PTIN
Phone	3154227109	PhoneNum
Preparation	2024-08-09	PreparationDt

Field	Value	IRS element (for citing)
Tax	2022	TaxYr
Build TS	2024-08-08 14:25:15Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	ANNA PATTERSON	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1398 GOTHAM ST	AddressLine1Txt
City	WATERTOWN	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	13601	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$3,015,017	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.JEFFHOSPICE.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1993	FormationYr
Legal Domicile State	NY	LegalDomicileStateCd
Activity Or Mission	TO ENSURE THE HOSPICE SERVICES REMAIN STRONG AND FISCALLY VIABLE TO SERVE AS AN INTEGRAL COMPONENT OF OUR COMMUNITY'S HEALTHCARE DELIVERY SYSTEM.	ActivityOrMissionDesc
Voting Members Governing Body	16	VotingMembersGoverningBodyCnt
Voting Members Independent	16	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	16	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$829,304	PYContributionsGrantsAmt
CY Contributions Grants	$628,802	CYContributionsGrantsAmt
PY Program Service Revenue	$0	PYProgramServiceRevenueAmt
CY Program Service Revenue	$0	CYProgramServiceRevenueAmt
PY Investment Income	$255,498	PYInvestmentIncomeAmt
CY Investment Income	$308,154	CYInvestmentIncomeAmt
PY Other Revenue	$47,259	PYOtherRevenueAmt
CY Other Revenue	$126,181	CYOtherRevenueAmt
PY Total Revenue	$1,132,061	PYTotalRevenueAmt
CY Total Revenue	$1,063,137	CYTotalRevenueAmt
PY Grants And Similar Paid	$320,000	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$627,464	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$166,544	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$188,320	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$196,996	CYTotalFundraisingExpenseAmt
PY Other Expenses	$423,108	PYOtherExpensesAmt
CY Other Expenses	$475,433	CYOtherExpensesAmt
PY Total Expenses	$909,652	PYTotalExpensesAmt
CY Total Expenses	$1,291,217	CYTotalExpensesAmt
PY Revenues Less Expenses	$222,409	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$228,080	CYRevenuesLessExpensesAmt
Total Assets BOY	$8,511,357	TotalAssetsBOYAmt
Total Assets EOY	$9,484,927	TotalAssetsEOYAmt
Total Liabilities BOY	$399,712	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,410,793	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$8,111,645	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$8,074,134	NetAssetsOrFundBalancesEOYAmt
Mission	TO ENSURE THAT HOSPICE SERVICES REMAIN STRONG AND FISCALLY VIABLE TO SERVE AS AN INTEGRAL COMPONENT OF OUR COMMUNITY'S HEALTHCARE DELIVERY SYSTEM.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$886,693	ExpenseAmt
Grant	$627,464	GrantAmt
Desc	SOLICITING, RECEIVING, AND ACKNOWLEDGING ALL FORMS OF CHARITABLE GIFTS FROM INDIVIDUALS, ORGANIZATIONS AND FOUNDATIONS VIA FUNDRAISING EVENTS AND MAIL SOLICITATIONS.	Desc
Total Program Service Expenses	$886,693	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	0	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (1)	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	Yes (1)	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	0	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	0	EmployeeCnt
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	16	GoverningBodyVotingMembersCnt
Independent Voting Member	16	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	NY	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ANNA PATTERSON	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	3157887323	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1398 GOTHAM STREET	AddressLine1Txt
City	WATERTOWN	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	13601	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt
EMILY SPRAGUE
PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
FATHER DONALD ROBINSON
VICE PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
DAVID KELLOG
TREASURER	1.00	Yes (X)	Yes (X)	$0	$0	$0
CHRISTINA STONE
SECRETARY	1.00	Yes (X)	Yes (X)	$0	$0	$0
DANA KEEFER
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
JILL AHLGRIM
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
BUNNY GORMAN
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
BRYAN MEHAFFY
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
ERIC DELAGARZA
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
BRIAN ASHLEY
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
STEVE YELLE
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
HOLLY BUSH
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
JEFF COLE
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
JOHN ASTAFAN
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
REVEREND MOLLY PAYNE-HARDIN
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
PENNY MCCREA
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
DIANA WOODHOUSE
CHIEF EXECUTIVE OFFICER	20.00		Yes (X)	$0	$120,908	$13,300	20.00
DAVID SANFORD
DIRECTOR OF FINANCE	10.00		Yes (X)	$0	$53,407	$0	30.00
ANNA PATTERSON
CHIEF EXECUTIVE OFFICER	20.00		Yes (X)	$0	$0	$0	20.00
MICHELE RICTER
DIRECTOR OF FINANCE	10.00		Yes (X)	$0	$5,536	$0	30.00

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$0	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$179,851	TotReportableCompRltdOrgAmt
Total Other Compensation	$13,300	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	0	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt
All Other Contributions	$628,802	AllOtherContributionsAmt
Total Contributions	$628,802	TotalContributionsAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$126,693	TotalRevenueColumnAmt
Exclusion	$126,693	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$2,093,405	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$1,911,944	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$181,461	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$181,461	TotalRevenueColumnAmt
Exclusion	$181,461	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$166,117	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$39,936	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$126,181	TotalRevenueColumnAmt
Exclusion	$126,181	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,063,137	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$434,335	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$627,464	TotalAmt
Program Services	$627,464	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$172,699	TotalAmt
Fundraising	$172,699	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$15,621	TotalAmt
Fundraising	$15,621	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$2,062	TotalAmt
Management And General	$2,062	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$43,088	TotalAmt
Management And General	$43,088	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$98,118	TotalAmt
Program Services	$98,118	ProgramServicesAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,764	TotalAmt
Management And General	$3,764	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$17,399	TotalAmt
Management And General	$17,399	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$17,780	TotalAmt
Management And General	$17,780	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$220,700	TotalAmt
Program Services	$161,111	ProgramServicesAmt
Management And General	$59,589	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$17,523	TotalAmt
Management And General	$17,523	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDesc	TotalTotalAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
OTHER	$46,323	$46,323
FUNDRAISING	$8,676		$8,676

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,291,217	TotalAmt
Program Services	$886,693	ProgramServicesAmt
Management And General	$207,528	ManagementAndGeneralAmt
Fundraising	$196,996	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$241,494	BOYAmt
EOY	$880,480	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$161,561	BOYAmt
EOY	$163,739	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$7,398	BOYAmt
EOY	$23,152	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$7,139,994	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$2,218,736	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$3,914,900	BOYAmt
EOY	$4,921,258	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$2,665,134	BOYAmt
EOY	$2,180,624	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$1,520,870	BOYAmt
EOY	$1,315,674	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$8,511,357	BOYAmt
EOY	$9,484,927	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$399,712	BOYAmt
EOY	$125,040	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
EOY	$1,231,079	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$54,674	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$399,712	BOYAmt
EOY	$1,410,793	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$7,866,569	BOYAmt
EOY	$7,919,787	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$245,076	BOYAmt
EOY	$154,347	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$8,111,645	BOYAmt
EOY	$8,074,134	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$8,511,357	BOYAmt
EOY	$9,484,927	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$228,080	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$190,569	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Public Organization170	Yes (X)	PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$889,191	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$353,010	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$521,144	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$829,304	CurrentTaxYearMinus1YearAmt
Current Tax Year	$628,802	CurrentTaxYearAmt
Total	$3,221,451	TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$889,191	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$353,010	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$521,144	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$829,304	CurrentTaxYearMinus1YearAmt
Current Tax Year	$628,802	CurrentTaxYearAmt
Total	$3,221,451	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total170	$3,221,451	PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$97,488	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$89,333	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$354,074	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$125,404	CurrentTaxYearMinus1YearAmt
Current Tax Year	$126,693	CurrentTaxYearAmt
Total	$792,992	TotalAmt

Field	Value	IRS element (for citing)
Total Support	$4,014,443	TotalSupportAmt
Public Support CY170	0.80250	PublicSupportCY170Pct
Public Support PY170	0.80050	PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170	Yes (X)	ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$158,428	BeginningYearBalanceAmt
Contributions	$7,500	ContributionsAmt
Investment Earnings Or Losses	$17,697	InvestmentEarningsOrLossesAmt
Other Expenditures	$6,580	OtherExpendituresAmt
End Year Balance	$177,045	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$188,449	BeginningYearBalanceAmt
Investment Earnings Or Losses	-$30,021	InvestmentEarningsOrLossesAmt
End Year Balance	$158,428	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$158,327	BeginningYearBalanceAmt
Investment Earnings Or Losses	$30,122	InvestmentEarningsOrLossesAmt
End Year Balance	$188,449	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$153,216	BeginningYearBalanceAmt
Investment Earnings Or Losses	$5,111	InvestmentEarningsOrLossesAmt
End Year Balance	$158,327	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$142,946	BeginningYearBalanceAmt
Contributions	$3,500	ContributionsAmt
Investment Earnings Or Losses	$6,770	InvestmentEarningsOrLossesAmt
End Year Balance	$153,216	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.51670	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.28241	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.20089	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	Yes (1)	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$39,500	OtherCostOrOtherBasisAmt
Book Value	$39,500	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,731,796	OtherCostOrOtherBasisAmt
Depreciation	$2,001,625	DepreciationAmt
Book Value	$4,730,171	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$368,698	OtherCostOrOtherBasisAmt
Depreciation	$217,111	DepreciationAmt
Book Value	$151,587	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$4,921,258	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	INVESTMENT IN THE COMMUNITY FOUNDATION	Desc
Book Value	$1,315,674	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$1,315,674	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	DUE TO AFFILIATE	Desc
Amt	$54,674	Amt

Field	Value	IRS element (for citing)
Total Liability	$54,674	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$1,250,554	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	$190,569	NetUnrealizedGainsInvstAmt
Other Revenue	$39,936	OtherRevenueAmt
Revenue Not Reported	$230,505	RevenueNotReportedAmt
Revenue Subtotal	$1,020,049	RevenueSubtotalAmt
Investment Expenses Not Incld	$43,088	InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt	$43,088	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$1,063,137	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$1,288,065	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$39,936	OtherExpensesIncludedAmt
Expenses Not Reported	$39,936	ExpensesNotReportedAmt
Expenses Subtotal	$1,248,129	ExpensesSubtotalAmt
Investment Expenses Not Incld2	$43,088	InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt	$43,088	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$1,291,217	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART XI, LINE 2D - OTHER ADJUSTMENTS:	SPECIAL EVENT EXPENSE 39,936.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	SPECIAL EVENTS 39,936.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	GOLF TOURNAMENT	Event1Nm
Gross Receipts Event1	$50,232	GrossReceiptsEvent1Amt
Gross Revenue Event1	$50,232	GrossRevenueEvent1Amt
Non Cash Prizes Event1	$3,418	NonCashPrizesEvent1Amt
Rent Facility Costs Event1	$3,360	RentFacilityCostsEvent1Amt
Food And Beverage Event1	$255	FoodAndBeverageEvent1Amt
Other Direct Expenses Event1	$3,060	OtherDirectExpensesEvent1Amt
Event2	BALL	Event2Nm
Gross Receipts Event2	$46,716	GrossReceiptsEvent2Amt
Gross Revenue Event2	$46,716	GrossRevenueEvent2Amt
Food And Beverage Event2	$11,424	FoodAndBeverageEvent2Amt
Other Direct Expenses Event2	$16,320	OtherDirectExpensesEvent2Amt
Other Events Total	4	OtherEventsTotalCnt
Gross Receipts Other Events	$69,169	GrossReceiptsOtherEventsAmt
Gross Revenue Other Events	$69,169	GrossRevenueOtherEventsAmt
Oth Direct Expnss Other Events	$2,099	OthDirectExpnssOtherEventsAmt
Gross Receipts Total	$166,117	GrossReceiptsTotalAmt
Gross Revenue Total Events	$166,117	GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events	$3,418	NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$3,360	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$11,679	FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events	$21,479	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$39,936	DirectExpenseSummaryEventsAmt
Net Income Summary	$126,181	NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	0	GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	HOSPICE OF JEFFERSON COUNTY INC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1398 GOTHAM STREET	AddressLine1Txt
City	WATERTOWN	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	13601	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	161266041	RecipientEIN
IRC Section	501(C)(3)	IRCSectionDesc
Cash Grant	$627,464	CashGrantAmt
Non Cash Assistance	$0	NonCashAssistanceAmt
Valuation Method Used	COST	ValuationMethodUsedDesc
Purpose Of Grant	FINANCIAL SUPPORT TO HOSPICE OF JEFFERSON COUNTY, INC.	PurposeOfGrantTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 7A	SOLE CORPORATE MEMBER, HOSPICE OF JEFFERSON COUNTY, INC. ELECTS BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7B	JEFFERSON COUNTY HOSPICE HAS THE EXCLUSIVE POWER AND AUTHORITY TO AMEND, REPEAL, OR ADOPT BY-LAWS OF THE FOUNDATION. IN ADDITION THE JEFFERSON COUNTY HOSPICE HAS ALL RIGHTS AND POWERS RELATED TO ELECTION OF FOUNDATION DIRECTORS, AMENDING THE CERTIFICATE OF INCORPORATION OF THE FOUNDATION, APPROVE ANY MERGER OR CONSOLIDATION OF THE FOUNDATION, APPROVE THE DISSOLUTION OF THE FOUNDATION, AND APPROVE THE SALE OR ENCUMBRANCE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE FOUNDATION.
FORM 990, PART VI, SECTION B, LINE 11B	THE FOUNDATION PROVIDES DRAFT COPIES OF THE IRS FORM 990 TO THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO COMPLETION AND FILING WITH THE INTERNAL REVENUE SERVICE AT THEIR REGULARLY SCHEDULED MEETINGS.
FORM 990, PART VI, SECTION B, LINE 12C	CONFLICT OF INTEREST STATEMENTS ARE COMPLETED ANNUALLY. THE EXECUTIVE DIRECTOR AND BOARD PRESIDENT REVIEW AND FOLLOW UP ON DISCLOSURES OF CONFLICTS.
FORM 990, PART VI, SECTION B, LINE 15	THE BOARD OF DIRECTORS ANNUALLY REVIEWS THE EXECUTIVE DIRECTOR. ALL OTHER EMPLOYEES ARE EVALUATED ANNUALLY BY MANAGEMENT. AN ANNUAL SURVEY OF LOCAL HEALTHCARE AGENCIES AND CENTRAL NEW YORK HOSPICES IS PERFORMED FOR PAY SCALES AT ALL STAFFING LEVELS.
FORM 990, PART VI, SECTION C, LINE 19	A HIGH LEVEL FINANCIAL PICTURE IS PROVIDED IN THE ANNUAL REPORT, WHICH IS AVAILABLE TO THE PUBLIC. OTHER FINANCIAL DATA AND POLICY INFORMATION IS AVAILABLE UPON REQUEST AND ON A NEED TO KNOW BASIS.
FORM 990, PART XII, LINE 2C:	THE ORGANIZATION HAS NOT CHANGED EITHER ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	HOSPICE OF JEFFERSON COUNTY	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1398 GOTHAM ST	AddressLine1Txt
City	WATERTOWN	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	13601	ZIPCd

Field	Value	IRS element (for citing)
EIN	161266041	EIN
Primary Activities	HOSPICE CARE	PrimaryActivitiesTxt
Legal Domicile State	NY	LegalDomicileStateCd
Exempt Code Section	501(C)(3)	ExemptCodeSectionTxt
Public Charity Status	LINE 11	PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	HOSPICE OF JEFFERSON COUNTY INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Controlled Organization	0	ControlledOrganizationInd

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	0	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
HOSPICE OF JEFFERSON COUNTY INC
O	$188,320	COST INCURRED
HOSPICE OF JEFFERSON COUNTY INC
B	$627,464	CASH RECEIVED