2023-09-26T08:57:23-05:00 2022-12-31 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2022-01-01 310933339 HOSPICE OF DAYTON INC HOSP 9372569507 324 WILMINGTON AVENUE DAYTON OH 45420 ROBERT MORRIS CFO 9372569507 2023-09-26 1 ROBERT MORRIS 999009999 1 AMY CIMINELLO P00796388 6148493000 2023-09-26 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z KIM VESEY 324 WILMINGTON AVENUE DAYTON OH 45420 88866514 0 X WWW.HOSPICEOFDAYTON.ORG X 1978 OH TO PROVIDE HOSPICE AND PALLIATIVE CARE FOR THE TERMINALLY ILL AND SUPPORT FOR THEIR FAMILIES. 11 11 849 607 -156176 0 2277328 15111721 70306657 72011501 1849985 1482564 186516 223544 74620486 88829330 0 0 0 0 49428188 50608697 0 0 0 28844488 37386607 78272676 87995304 -3652190 834026 116257424 79723303 86773812 52832273 29483612 26891030 X THE HOSPICE OF DAYTON, INC. IS COMMITTED TO MAKING QUALITY HOSPICE CARE AVAILABLE AND ACCESSIBLE TO TERMINALLY ILL PERSONS AND THEIR FAMILIES, REGARDLESS OF ABILITY TO PAY, AND IN A MANNER CONSISTENT WITH THE HIGHEST HOSPICE STANDARDS. OUR COMMITMENT TO THE HOSPICE PHILOSOPHY OF CARE INCLUDES A COMPASSIONATE STAFF PLEDGED TO CONTINUOUSLY IMPROVE AND ENHANCE THE CARE WE PROVIDE, RESPECT THE PATIENTS' CHOICES OF CARE, RESPOND TO CHANGING COMMUNITY NEEDS, AND SERVE AS A RESOURCE TO OTHERS FOR IMPROVING THE AVAILABILITY OF QUALITY HOSPICE CARE. 0 0 64835351 0 72283159 COORDINATES A PROGRAM OF HOME, OUTPATIENTS, AND INPATIENT HOSPICE CARE THAT PROVIDES PALLIATIVE CARE, SUPPORTIVE MEDICAL SERVICES, AND OTHER SUPPORT SERVICES TO TERMINALLY ILL PERSONS AND THEIR FAMILIES, REGARDLESS OF ABILITY TO PAY. 64835351 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 849 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 X ROBERT MORRIS 9372569507 7575 PARAGON ROAD DAYTON OH 45459 THOMAS MANN CHAIR 3.00 5.00 X X 0 0 0 PETE HALEY VICE CHAIR 2.00 4.00 X X 0 0 0 TONI SPRINKEL TREASURER 2.00 2.00 X X 0 0 0 PEGGY MARK SECRETARY 2.00 2.00 X X 0 0 0 LUIS CHANAGA BOARD MEMBER 2.00 0.00 X 0 0 0 LINDSAY JOHNSON BOARD MEMBER 2.00 0.00 X 0 0 0 JON LARRABEE BOARD MEMBER 2.00 0.00 X 0 0 0 GARY LEROY MD BOARD MEMBER 2.00 2.00 X 0 0 0 RATNA PALAKODETI BOARD MEMBER 2.00 0.00 X 0 0 0 GREG TOMAN BOARD MEMBER 2.00 0.00 X 0 0 0 LISA HANUAER EMERITUS STATUS 2.00 0.00 X 0 0 0 KENT ANDERSON CHIEF EXECUTIVE OFFICER 2.00 58.00 X 0 522223 59655 ANTHONY EVANS PRESIDENT, PURE HEALTHCARE 40.00 0.00 X 388101 0 33170 ROBERT MORRIS CHIEF FINANCIAL OFFICER 2.00 38.00 X 0 304009 35339 KIM VESEY GENERAL MANAGER/EXECUTIVE VP 40.00 0.00 X 234531 0 16949 JOHN AHERN VP OF MEDICAL CARE/MEDICAL DIRECTOR 40.00 0.00 X 306850 0 32847 YVONNE TURNER VICE PRESIDENT OF CLINICAL CARE 40.00 0.00 X 176343 0 34329 AMY KEMPER VP OF FINANCE & ANALYTICS 40.00 0.00 X 157157 0 19832 RANAPREET PATEL TEAM PHYSICIAN 40.00 0.00 X 348761 0 13242 WENDY SCHMITZ TEAM PHYSICIAN 40.00 0.00 X 280233 0 36374 ANNA RYMER PHYSICIAN MANAGER, PALLIATIVE 40.00 0.00 X 276255 0 40327 ALI JAFFERY TEAM PHYSICIAN 40.00 0.00 X 258049 0 34612 CLEANNE CASS DIRECTOR COMMUNITY SERV. & PHYSICIAN EDU. 40.00 0.00 X 263218 0 18227 2689498 826232 374903 28 0 1 0 0 14601210 510511 15111721 PATIENT SERVICE REVENUE 624100 72011501 72011501 72011501 139368 139368 1380380 0 37184 1380380 -37184 1343196 1343196 CLINICAL EDUCATION SERVICES 900099 181864 181864 CAFETERIA REVENUE 722514 107201 107201 FELLOWSHIP PROGRAM 900099 89794 89794 -155315 -156176 861 223544 88829330 72283159 -156176 1590626 1584924 1584924 38339169 36249099 2090070 1452487 1382586 69901 6359977 5818531 541446 2872140 2614227 257913 102564 102564 49570 49570 6202 6202 2247704 1917954 329750 258438 35203 223235 858699 351761 506938 553355 110010 443345 2097187 987430 1109757 1607750 1522049 85701 360668 201756 158912 717077 717077 3487854 2940980 546874 319956 98 319858 ALLOCATED COSTS 13620667 13620667 MEDICAL SUPPLIES 5669171 5668455 716 ROOM & BOARD 1948603 1948603 PATIENT SERVICE 1209722 1207052 2670 2271420 1879557 391863 87995304 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24369051 3878398 1808135 118410 26320904 28829625 -730177 3730397 24369051 0.94367 0.05633 0.00000 0 1 1 1301208 1301208 48965483 20837723 28127760 350134 51796 298338 15048788 8596336 6452452 3207652 783903 2423749 38603507 RELATED PARTY RECEIVABLES 27547128 DEPOSITS 13887 LEASE ASSETS 2776442 30337457 RELATED PARTY PAYABLES 20265644 LEASE LIABILITY 2741558 23007202 PART V, LINE 4: THE ENDOWMENT FUNDS ARE HELD BY A RELATED PARTY, OHIO'S HOSPICE FOUNDATION, AND ARE INTENTED TO FURTHER SUPPORT HOSPICE OF DAYTON AND ITS ACTIVITIES. 0 0 0 0 0 0 0 1 0 KENT ANDERSON CHIEF EXECUTIVE OFFICER 0 455023 0 67200 0 0 0 35750 0 23905 0 581878 0 0 ANTHONY EVANS PRESIDENT, PURE HEALTHCARE 376626 0 11475 0 0 0 8112 0 25058 0 421271 0 0 0 RANAPREET PATEL TEAM PHYSICIAN 311051 0 37710 0 0 0 12950 0 292 0 362003 0 0 0 JOHN AHERN VP OF MEDICAL CARE/MEDICAL DIRECTOR 298569 0 8281 0 0 0 10255 0 22592 0 339697 0 0 0 ROBERT MORRIS CHIEF FINANCIAL OFFICER 0 292759 0 11250 0 0 0 8336 0 27003 0 339348 0 0 WENDY SCHMITZ TEAM PHYSICIAN 279933 0 300 0 0 0 14223 0 22151 0 316607 0 0 0 ANNA RYMER PHYSICIAN MANAGER, PALLIATIVE 272660 0 3595 0 0 0 14240 0 26087 0 316582 0 0 0 ALI JAFFERY TEAM PHYSICIAN 220849 0 37200 0 0 0 12651 0 21961 0 292661 0 0 0 CLEANNE CASS DIRECTOR COMMUNITY SERV. & PHYSICIAN 257524 0 5694 0 0 0 13172 0 5055 0 281445 0 0 0 KIM VESEY GENERAL MANAGER/EXECUTIVE VP 226268 0 8263 0 0 0 5610 0 11339 0 251480 0 0 0 YVONNE TURNER VICE PRESIDENT OF CLINICAL CARE 170842 0 5501 0 0 0 7501 0 26828 0 210672 0 0 0 AMY KEMPER VP OF FINANCE & ANALYTICS 152930 0 4227 0 0 0 6500 0 13332 0 176989 0 0 0 PART I, LINE 3 THE EXECUTIVE COMMITTEE OF THE OHI BOARD OF TRUSTEES UTILIZED LOCAL MARKET KNOWLEDGE, ANNUAL PERFORMANCE EVALUATIONS AND BENCHMARK DATA TO ESTABLISH COMPENSATION FOR THE CEO. THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS ESTABLISHED BY THE CEO UNDER GUIDELINES ESTABLISHED BY OHI AND AFFILIATE BOARDS OF TRUSTEES AS PART OF THE BUDGET PROCESS. PART I, LINE 7 THE BOARD OF DIRECTORS CONDUCTS AN ANNUAL PERFORMANCE REVIEW TO DETERMINE THE COMPENSATION AND BENEFITS OF THE CEO. IN ADDITION TO NORMAL COMPENSATION AND BENEFITS, THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS MAY ALSO AWARD BONUS COMPENSATION TO THE CEO BASED UPON THE ANNUAL PERFORMANCE REVIEW. THE CEO CONDUCTS AN ANNUAL PERFORMANCE REVIEW OF THE OTHER OFFICERS AND EMPLOYEES TO DETERMINE THEIR COMPENSATION AND BENEFITS. IN ADDITION TO NORMAL COMPENSATION AND BENEFITS, THE CEO, WITH THE APPROVAL OF THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS, MAY ALSO AWARD BONUS COMPENSATION TO THE OTHER OFFICERS AND EMPLOYEES BASED UPON THEIR ANNUAL PERFORMANCE REVIEW. A COUNTY OF MONTGOMERY OHIO 316000172 2020-04-23 15636807 SEE PART VI 0 0 0 A 15636807 974272 230000 476671 13955864 2022 0 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 1 0 1 A 0 1 0 0 1 0 0 0 1 A 1 PART I, LINE A, (F) THE PROCEEDS OF THE SERIES 2020 BONDS WERE USED TO FINANCE THE ACQUISITION, CONSTRUCTION, IMPROVEMENT, RENOVATION AND/OR EQUIPPING OF THE FACILITIES KNOWN AS PURE HEALTHCARE. PART II, LINE 3 THE AMOUNT OF PROCEEDS OF THE ISSUE DIFFERS FROM THE ISSUE PRICE OF THE ISSUE AS A RESULT OF $1,286.19 OF INTEREST EARNINGS ON THE INVESTMENT OF BOND PROCEEDS. PART I AND II THE SERIES 2020 BONDS WERE ISSUED FOR THE BENEFIT OF OHIO'S HOSPICE, INC., THE HOSPICE OF DAYTON, INCORPORATED, PURE HEALTHCARE, LLC, HOSPICE OF MIAMI COUNTY, INC. AND LIFECARE HOSPICE. ONLY A PORTION OF THE PROCEEDS OF THE SERIES 2020 BONDS ARE ALLOCABLE TO PURE HEALTHCARE, LLC, A DISREGARDED ENTITY OF THE HOSPICE OF DAYTON INCORPORATED AND THE AMOUNTS IN PART I AND PART II LINES 1-15 REFLECT SUCH ALLOCATION. THE PORTION OF THE SERIES 2020 BONDS ALLOCABLE TO THE OTHER ENTITIES IS BEING REPORTED ON SCHEDULE K TO EACH OTHER ENTITY'S FORM 990. FORM 990, PART VI, SECTION A, LINE 6 OHIO'S HOSPICE, INC BECAME THE SOLE MEMBER OF HOSPICE OF DAYTON, INC WITH AN AFFILIATION AGREEMENT SIGNED IN JULY 2013. FORM 990, PART VI, SECTION A, LINE 7A OHIO'S HOSPICE INC. HAS THE POWER TO APPOINT THE BOARD OF DIRECTORS. THE BOARD SHALL RECOMMEND INDIVIDUALS TO FILL ANY OPENINGS. OHIO'S HOSPICE HAS THE RIGHT TO ELECT FROM THESE INDIVIDUALS OR OTHER INDIVIDUALS AT ITS DISCRETION. FORM 990, PART VI, SECTION A, LINE 7B OHIO'S HOSPICE INC. RETAINS THE POWER TO AMEND THE ARTICLES OF INCORPORATION, CODE OF REGULATIONS, ETC. OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND REVIEWED BY THE CFO PRIOR TO BEING FILED WITH THE INTERNAL REVENUE SERVICE. THE FORM 990 IS SENT VIA EMAIL TO THE FULL BOARD AND WILL BE REVIEWED IN SESSION BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS AT THEIR NEXT MEETING. FORM 990, PART VI, SECTION B, LINE 12C IN THE EVENT ANY DIRECTOR, OFFICER OR EXECUTIVE OF THE ORGANIZATION SHALL HAVE ANY DIRECT OR INDIRECT INTEREST IN OR RELATIONSHIP WITH ANY INDIVIDUAL OR ORGANIZATION THAT PROPOSES TO ENTER INTO ANY TRANSACTION WITH THE ORGANIZATION FOR THE SALE, PURCHASE, LEASE OR RENTAL OF PROPERTY OR TO RENDER OR EMPLOY SERVICES, PERSONAL OR OTHERWISE, SUCH DIRECTOR, OFFICER OR EXECUTIVE SHALL FORTHWITH GIVE THE BOARD OF DIRECTORS, CHAIR OF THE BOARD OR PRESIDENT OF THE ORGANIZATION NOTICE OF SUCH INTEREST OR RELATIONSHIP AND SHALL THEREAFTER NOT BE COUNTED FOR THE PURPOSE OF DETERMINING A QUORUM AND SHALL REFRAIN FROM VOTING OR OTHERWISE ATTEMPTING TO AFFECT ITS DECISION TO PARTICIPATE IN SUCH TRANSACTION. IN THE EVENT THAT A CHALLENGE OR QUESTION IS RAISED WHETHER CONFLICT OR DUALITY OF INTEREST EXISTS, THE BOARD OR CHAIR OF THE BOARD OF THE ORGANIZATION SHALL DETERMINE THAT A DUALITY OF INTEREST EXISTS (BY A 2/3 VOTE OF THE BODY). MINUTES OF APPROPRIATE MEETINGS SHOULD REFLECT THAT SUCH DISCLOSURE WAS MADE, AND THAT SUCH DIRECTOR REMOVED HIMSELF/HERSELF FROM THE ROOM AND DID NOT PARTICIPATE IN THE FINAL DISCUSSION, AND WAS NOT COUNTED FOR THE PURPOSE OF DETERMINING A QUORUM.THE CONFLICT OF INTEREST STATEMENT SHALL BE REVIEWED ANNUALLY FOR THE INFORMATION AND GUIDANCE OF DIRECTORS, OFFICERS OR EXECUTIVES AND THAT ANY NEW DIRECTORS, OFFICERS OR EXECUTIVES BE ADVISED OF THE POLICY UPON UNDERTAKING THE DUTIES OF SUCH OFFICE. FORM 990, PART VI, SECTION B, LINE 15B THE EXECUTIVE COMMITTEE OF THE OHI BOARD OF TRUSTEES UTILIZED LOCAL MARKET KNOWLEDGE, ANNUAL PERFORMANCE EVALUATIONS AND BENCHMARK DATA TO ESTABLISH COMPENSATION FOR THE CEO. THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS ESTABLISHED BY THE CEO UNDER GUIDELINES ESTABLISHED BY OHI AND AFFILIATE BOARDS OF TRUSTEES AS PART OF THE BUDGET PROCESS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. FORM 990, PART XI, LINE 9: BOOK TO TAX ADJUSTMENT FOR S CORP INVESTMENT 161,621. PART XII LINE 2C OHI'S FINANCE COMMITTEE HAS RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT THIS PROCESS IS CONSISTENT WITH PRIOR YEAR. PURE HEALTHCARE LLC 7575 PARAGON ROAD DAYTON OH 45459 TO PROVIDE PALLIATIVE CARE PHYSICIANS & SUPPORT PERSONNEL OH 16433135 20465801 THE HOSPICE OF DAYTON INNOVATIVE CARE SOLUTIONS LLC 33 W FIRST STREET SUITE 600 DAYTON OH 45402 DURABLE MEDICAL EQUIPMENT AND TRANSPORTATION OH 1983005 1602840 THE HOSPICE OF DAYTON THE COLLABORATIVE LABORATORY 7575 PARAGON ROAD DAYTON OH 45459 INVEST IN HEALTHCARE INNOVATIONS OH 0 0 THE HOSPICE OF DAYTON OHI HOSPICE INC 7575 PARAGON ROAD DAYTON OH 45459 371495725 TO PROVIDE HOSPICE CARE OH 501(C)(3) LINE 7 OHIO'S HOSPICE INC 1 HOSPICE OF CENTRAL OHIO 2269 CHERRY VALLEY ROAD NEWARK OH 43055 311059756 TO PROVIDE HOSPICE CARE OH 501(C)(3) LINE 7 OHIO'S HOSPICE INC 1 OHIO'S HOSPICE FOUNDATION 7575 PARAGON ROAD DAYTON OH 45459 311769696 TO PROVIDE FINANCIAL SUPPORT TO ITS PARENT, OHIO'S HOSPICE INC OH 501(C)(3) LINE 7 OHIO'S HOSPICE INC 1 HOSPICE OF MIAMI COUNTY INC 3230 N COUNTY RD 25A TROY OH 45373 311031277 TO PROVIDE HOSPICE CARE OH 501(C)(3) LINE 7 OHIO'S HOSPICE INC 1 LIFECARE HOSPICE 1900 AKRON ROAD WOOSTER OH 44691 341352875 TO PROVIDE HOSPICE CARE OH 501(C)(3) LINE 7 OHIO'S HOSPICE INC 1 OHIO'S HOSPICE INC 7575 PARAGON ROAD DAYTON OH 45459 463215586 TO PROVIDE MANAGEMENT SERVICES AS A SUPPORTING ORGANIZATION OH 501(C)(3) LINE 12A, I N/A 0 LOVING CARE HOSPICE 779 LONDON AVENUE MARYSVILLE OH 43040 311370625 TO PROVIDE HOSPICE CARE OH 501(C)(3) LINE 10 OHIO'S HOSPICE INC 1 HOSPICE OF FAYETTE COUNTY 222 N OAKLAND AVE WASHINGTON COURTHOUSE OH 43160 311243376 TO PROVIDE HOSPICE CARE OH 501(C)(3) LINE 7 OHIO'S HOSPICE INC 1 NATIONAL HOSPICE COOPERATIVE 7575 PARAGON ROAD DAYTON OH 45459 832087147 BUSINESS SUPPORT OH N/A C 1 CENTRAL OHIO GERIATRICS 7575 PARAGON ROAD DAYTON OH 45459 264273198 PHYSICIAN OFFICE OH PURE HEALTHCARE LLC S -156176 41510 1.00000 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 CENTRAL OHIO GERIATRICS LLC R 100000 FMV