HOSPICE OF DARKE COUNTY INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization: HOSPICE OF DARKE COUNTY INC (EIN 31-1004692)
Tax period: 2019-07-01 to 2020-06-30
Filed: 2021-02-16
IRS object ID: 202110479349301131
Schema version: 2019v5.1
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 J
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2021-02-16T12:53:16-06:00	ReturnTs
Tax Period End	2020-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	310905417	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	VONLEHMAN & COMPANY INC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	810 WRIGHTS SUMMIT PARKWAY SUITE	AddressLine1Txt
Address Line2	300	AddressLine2Txt
City	FORT WRIGHT	CityNm
State Abbreviation	KY	StateAbbreviationCd
ZIP	41011	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2019-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	311004692	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	HOSPICE OF DARKE COUNTY INC	BusinessNameLine1Txt
Business Name Line2	DBA STATE OF THE HEART HOSPICE	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	HOSP	BusinessNameControlTxt
Phone	9375482999	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1350 NORTH BROADWAY	AddressLine1Txt
City	GREENVILLE	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45331	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DAVE WOLTERS	PersonNm
Person Title	PRESIDENT	PersonTitleTxt
Phone	9375482999	PhoneNum
Signature	2021-01-11	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	BETH VICE	PreparerPersonNm
PTIN	P00545816	PTIN
Phone	8593313300	PhoneNum
Preparation	2021-01-11	PreparationDt

Field	Value	IRS element (for citing)
Tax	2019	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	DAVE WOLTERS	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1350 N BROADWAY	AddressLine1Txt
City	GREENVILLE	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45331	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$11,566,866	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.STATEOFTHEHEARTCARE.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1981	FormationYr
Legal Domicile State	OH	LegalDomicileStateCd
Activity Or Mission	HOSPICE OF DARKE COUNTY, INC. WORKS TO MAINTAIN THE VALUE AND DIGNITY OF HUMAN LIFE BY PROVIDING A CHOICE FOR HIGH QUALITY, COMPASSIONATE CARE AND SUPPORT SERVICES TO PATIENTS AND FAMILIES WITH LIFE LIMITING ILLNESS, TO PROMOTE THE EMOTIONAL, PSYCHOLOGICAL, SPIRITUAL AND PHYSICAL WELL BEING OF SURVIVORS AFFECTED BY DEATH, DYING AND GRIEF, AND TO SUPPORT ALL MEMBERS OF THE COMMUNITY IN THE KNOWLEDGE AND CARE OF THOSE PERSONS EXPERIENCING END-OF-LIFE ISSUES.	ActivityOrMissionDesc
Voting Members Governing Body	10	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	118	TotalEmployeeCnt
Total Volunteers	91	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$286,780	PYContributionsGrantsAmt
CY Contributions Grants	$1,439,390	CYContributionsGrantsAmt
PY Program Service Revenue	$9,100,541	PYProgramServiceRevenueAmt
CY Program Service Revenue	$9,762,591	CYProgramServiceRevenueAmt
PY Investment Income	$395,193	PYInvestmentIncomeAmt
CY Investment Income	$350,247	CYInvestmentIncomeAmt
PY Other Revenue	$17,281	PYOtherRevenueAmt
CY Other Revenue	-$9,757	CYOtherRevenueAmt
PY Total Revenue	$9,799,795	PYTotalRevenueAmt
CY Total Revenue	$11,542,471	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$5,742,067	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$6,085,518	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$86,348	CYTotalFundraisingExpenseAmt
PY Other Expenses	$3,490,030	PYOtherExpensesAmt
CY Other Expenses	$3,914,323	CYOtherExpensesAmt
PY Total Expenses	$9,232,097	PYTotalExpensesAmt
CY Total Expenses	$9,999,841	CYTotalExpensesAmt
PY Revenues Less Expenses	$567,698	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$1,542,630	CYRevenuesLessExpensesAmt
Total Assets BOY	$10,961,920	TotalAssetsBOYAmt
Total Assets EOY	$12,715,216	TotalAssetsEOYAmt
Total Liabilities BOY	$1,080,296	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,536,006	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$9,881,624	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$11,179,210	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	HOSPICE OF DARKE COUNTY, INC. WORKS TO MAINTAIN THE VALUE AND DIGNITY OF HUMAN LIFE BY PROVIDING A CHOICE FOR HIGH QUALITY, COMPASSIONATE CARE AND SUPPORT SERVICES TO PATIENTS AND FAMILIES WITH LIFE LIMITING ILLNESS, TO PROMOTE THE EMOTIONAL, PSYCHOLOGICAL, SPIRITUAL AND PHYSICAL WELL BEING OF SURVIVORS AFFECTED BY DEATH, DYING AND GRIEF, TO SUPPORT ALL MEMBERS OF THE COMMUNITY IN THE KNOWLEDGE AND CARE OF THOSE PERSONS EXPERIENCING END-OF-LIFE ISSUES.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$9,337,406	ExpenseAmt
Revenue	$9,762,591	RevenueAmt
Desc	HOSPICE OF DARKE COUNTY, INC. WORKS TO MAINTAIN THE VALUE AND DIGNITY OF HUMAN LIFE BY PROVIDING A CHOICE FOR HIGH QUALITY, COMPASSIONATE CARE AND SUPPORT SERVICES TO PATIENTS AND FAMILIES WITH LIFE LIMITING ILLNESS, TO PROMOTE THE EMOTIONAL, PSYCHOLOGICAL, SPIRITUAL AND PHYSICAL WELL BEING OF SURVIVORS AFFECTED BY DEATH, DYING AND GRIEF, TO SUPPORT ALL MEMBERS OF THE COMMUNITY IN THE KNOWLEDGE AND CARE OF THOSE PERSONS EXPERIENCING END-OF-LIFE ISSUES.	Desc
Total Program Service Expenses	$9,337,406	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	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (1)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	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	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	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	0	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	3	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	118	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
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	10	GoverningBodyVotingMembersCnt
Independent Voting Member	10	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	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	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	OH	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	IN	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	KRISTI STRAWSER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	9375482999	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1350 N BROADWAY	AddressLine1Txt
City	GREENVILLE	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45331	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd
DAVE WOLTERS
PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
ERIC FEE
TRUSTEE	1.00	Yes (X)		$0	$0	$0
JIM STAMCOFF
2ND VICE PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
JORDAN FRANCIS
TRUSTEE	1.00	Yes (X)		$0	$0	$0
LAUREN HENRY
TRUSTEE	1.00	Yes (X)		$0	$0	$0
MIKE SCHLAMB
TRUSTEE	1.00	Yes (X)		$0	$0	$0
NICK ANDERSON
VICE PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
SARAH ROYER
SECRETARY	1.00	Yes (X)	Yes (X)	$0	$0	$0
TRACY HAINES
TREASURER	1.00	Yes (X)	Yes (X)	$0	$0	$0
TWYLA HAYES
TRUSTEE	1.00	Yes (X)		$0	$0	$0
KRISTI STRAWSER
EXECUTIVE DIRECTOR	45.00		Yes (X)	$88,330	$0	$14,646
EDWARD HOSBACH
MEDICAL DIRECTOR	30.00			$169,994	$0	$0	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$258,324	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$14,646	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	1	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
PROCARE PBM
1267 PROFESSIONAL PARKWAY	GAINSVILLE	GA	30507	MEDICATIONS	$388,755
KAUP PHARMACY
1201 COMMERCE STREET	FORT RECOVERY	OH	45846	MEDICAL SERVICES	$296,592
BRETHREN RETIREMENT COMMUNITY
750 CHESTNUT ST	GREENVILLE	OH	45331	PATIENT ROOM AND BOARD	$273,594
CELINA MANOR
1001 MYERS RD	CELINA	OH	45822	PATIENT ROOM AND BOARD	$226,291
RESTHAVEN
1096 N OHIO STREET	GREENVILLE	OH	45331	PATIENT ROOM AND BOARD	$212,682

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	11	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$37,278	FederatedCampaignsAmt
Fundraising	$8,800	FundraisingAmt
Government Grants	$1,176,588	GovernmentGrantsAmt
All Other Contributions	$216,724	AllOtherContributionsAmt
Total Contributions	$1,439,390	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	PATIENT CARE REVENUE	Desc
Business	900099	BusinessCd
Total Revenue Column	$9,762,591	TotalRevenueColumnAmt
Related Or Exempt Func Income	$9,762,591	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$9,762,591	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$350,122	TotalRevenueColumnAmt
Exclusion	$350,122	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$125	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$0	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	$125	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$125	TotalRevenueColumnAmt
Exclusion	$125	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$13,705	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$8,800	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$24,395	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$10,690	TotalRevenueColumnAmt
Exclusion	-$10,690	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	MISCELLANEOUS INCOME	Desc
Business	900099	BusinessCd
Total Revenue Column	$933	TotalRevenueColumnAmt
Exclusion	$933	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$933	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$11,542,471	TotalRevenueColumnAmt
Related Or Exempt Func Income	$9,762,591	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$340,490	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$267,884	TotalAmt
Management And General	$267,884	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$5,817,634	TotalAmt
Program Services	$5,695,714	ProgramServicesAmt
Management And General	$56,328	ManagementAndGeneralAmt
Fundraising	$65,592	FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$95,915	TotalAmt
Program Services	$53,493	ProgramServicesAmt
Management And General	$40,249	ManagementAndGeneralAmt
Fundraising	$2,173	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$79,712	TotalAmt
Program Services	$31,495	ProgramServicesAmt
Management And General	$46,594	ManagementAndGeneralAmt
Fundraising	$1,623	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$105,162	TotalAmt
Program Services	$64,712	ProgramServicesAmt
Management And General	$37,787	ManagementAndGeneralAmt
Fundraising	$2,663	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$91,032	TotalAmt
Program Services	$80,521	ProgramServicesAmt
Management And General	$10,157	ManagementAndGeneralAmt
Fundraising	$354	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$158,428	TotalAmt
Program Services	$128,922	ProgramServicesAmt
Management And General	$24,543	ManagementAndGeneralAmt
Fundraising	$4,963	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$128,631	TotalAmt
Program Services	$119,265	ProgramServicesAmt
Management And General	$8,683	ManagementAndGeneralAmt
Fundraising	$683	FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$92,864	TotalAmt
Program Services	$75,569	ProgramServicesAmt
Management And General	$14,386	ManagementAndGeneralAmt
Fundraising	$2,909	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$41,305	TotalAmt
Program Services	$16,320	ProgramServicesAmt
Management And General	$24,144	ManagementAndGeneralAmt
Fundraising	$841	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt
ROOM AND BOARD EXPENSE	$1,850,492	$1,850,492
DRUG EXPENSE	$384,529	$384,529
DURABLE MEDICAL SUPPLIE	$304,095	$304,095
MEDICAL SUPPLIES	$194,873	$194,873

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$387,285	TotalAmt
Program Services	$337,406	ProgramServicesAmt
Management And General	$45,332	ManagementAndGeneralAmt
Fundraising	$4,547	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$9,999,841	TotalAmt
Program Services	$9,337,406	ProgramServicesAmt
Management And General	$576,087	ManagementAndGeneralAmt
Fundraising	$86,348	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$100	BOYAmt
EOY	$100	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$1,161,442	BOYAmt
EOY	$2,860,057	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,000,485	BOYAmt
EOY	$934,329	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$120,456	BOYAmt
EOY	$127,938	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$3,069,574	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$1,536,786	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$1,510,573	BOYAmt
EOY	$1,532,788	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$7,168,864	BOYAmt
EOY	$7,260,004	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$10,961,920	BOYAmt
EOY	$12,715,216	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$1,080,296	BOYAmt
EOY	$1,097,175	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$438,831	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,080,296	BOYAmt
EOY	$1,536,006	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	$9,654,625	BOYAmt
EOY	$10,951,466	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$226,999	BOYAmt
EOY	$227,744	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$9,881,624	BOYAmt
EOY	$11,179,210	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$10,961,920	BOYAmt
EOY	$12,715,216	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$1,542,630	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$245,044	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)
Separate Basis Fincl Stmt	Yes (X)	SeparateBasisFinclStmtInd

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	$279,881	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$327,077	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$280,010	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$286,780	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,448,849	CurrentTaxYearAmt
Total	$2,622,597	TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$279,881	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$327,077	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$280,010	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$286,780	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,448,849	CurrentTaxYearAmt
Total	$2,622,597	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total170	$2,622,597	PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$271,412	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$210,953	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$200,792	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$395,193	CurrentTaxYearMinus1YearAmt
Current Tax Year	$350,122	CurrentTaxYearAmt
Total	$1,428,472	TotalAmt

Other Income170 OtherIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$2,391	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$6,454	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$295	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$601	CurrentTaxYearMinus1YearAmt
Current Tax Year	$933	CurrentTaxYearAmt
Total	$10,674	TotalAmt

Field	Value	IRS element (for citing)
Total Support	$4,061,743	TotalSupportAmt
Gross Receipts Rltd Activities	$44,340,348	GrossReceiptsRltdActivitiesAmt
Public Support CY170	0.64570	PublicSupportCY170Pct
Public Support PY170	0.51150	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	$160,000	BeginningYearBalanceAmt
Other Expenditures	$10,000	OtherExpendituresAmt
End Year Balance	$150,000	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$170,000	BeginningYearBalanceAmt
Other Expenditures	$10,000	OtherExpendituresAmt
End Year Balance	$160,000	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$180,000	BeginningYearBalanceAmt
Other Expenditures	$10,000	OtherExpendituresAmt
End Year Balance	$170,000	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$190,000	BeginningYearBalanceAmt
Other Expenditures	$10,000	OtherExpendituresAmt
End Year Balance	$180,000	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$200,000	BeginningYearBalanceAmt
Other Expenditures	$10,000	OtherExpendituresAmt
End Year Balance	$190,000	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Term Endowment Balance EOY	1.00000	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$227,615	OtherCostOrOtherBasisAmt
Book Value	$227,615	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,142,584	OtherCostOrOtherBasisAmt
Depreciation	$1,080,579	DepreciationAmt
Book Value	$1,062,005	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$33,366	OtherCostOrOtherBasisAmt
Depreciation	$29,136	DepreciationAmt
Book Value	$4,230	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$557,924	OtherCostOrOtherBasisAmt
Depreciation	$427,071	DepreciationAmt
Book Value	$130,853	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$108,085	OtherCostOrOtherBasisAmt
Book Value	$108,085	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$1,532,788	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	PROVIDER RELIEF FUND - REFUNDABLE ADVANCE	Desc
Amt	$438,831	Amt

Field	Value	IRS element (for citing)
Total Liability	$438,831	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$11,344,839	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	-$245,044	NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts	$23,017	DonatedServicesAndUseFcltsAmt
Other Revenue	$24,395	OtherRevenueAmt
Revenue Not Reported	-$197,632	RevenueNotReportedAmt
Revenue Subtotal	$11,542,471	RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt	$0	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$11,542,471	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$10,047,253	TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts	$23,017	DonatedServicesUseFcltsAmt
Other Expenses Included	$24,395	OtherExpensesIncludedAmt
Expenses Not Reported	$47,412	ExpensesNotReportedAmt
Expenses Subtotal	$9,999,841	ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt	$0	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$9,999,841	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART X, LINE 2:	THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE U.S. INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. IN ADDITION, THE ORGANIZATION IS NOT A PRIVATE FOUNDATION AS DEFINED IN SECTION 509(A)(1) OF THE U.S. INTERNAL REVENUE CODE. THE ORGANIZATION HAS ADOPTED THE PROVISIONS OF THE ACCOUNTING PRONOUNCEMENT RELATED TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE ORGANIZATION RECOGNIZED NO INTEREST OR PENALTIES IN THE STATEMENTS OF ACTIVITIES FOR EITHER OF THE YEARS ENDED JUNE 30, 2020 OR 2019. IF THE SITUATION AROSE IN WHICH THE ORGANIZATION WOULD HAVE INTEREST TO RECOGNIZE, IT WOULD RECOGNIZE THIS AS INTEREST EXPENSE AND PENALTIES WOULD BE RECOGNIZED IN OTHER EXPENSES. CURRENTLY, THE PRIOR THREE YEARS ARE OPEN UNDER FEDERAL AND STATE STATUTES OF LIMITATIONS AND REMAIN SUBJECT TO REVIEW AND CHANGE. THE ORGANIZATION IS NOT CURRENTLY UNDER AUDIT NOR HAS THE ORGANIZATION BEEN CONTACTED BY THESE JURISDICTIONS. BASED ON THE EVALUATION OF THE ORGANIZATION'S TAX POSITIONS, MANAGEMENT BELIEVES ALL POSITIONS TAKEN WOULD BE UPHELD UNDER AN EXAMINATION. THEREFORE, NO PROVISION FOR THE EFFECTS OF UNCERTAIN TAX POSITIONS HAS BEEN RECORDED FOR EITHER OF THE YEARS ENDED JUNE 30, 2020 OR 2019.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	FUNDRAISING EXPENSES 24,395.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	FUNDRAISING EXPENSES 24,395.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	GOLF OUTING	Event1Nm
Gross Receipts Event1	$8,800	GrossReceiptsEvent1Amt
Charitable Contri Event1	$8,800	CharitableContriEvent1Amt
Other Direct Expenses Event1	$390	OtherDirectExpensesEvent1Amt
Event2	HEART & SOLE 5K	Event2Nm
Gross Receipts Event2	$9,459	GrossReceiptsEvent2Amt
Gross Revenue Event2	$9,459	GrossRevenueEvent2Amt
Other Direct Expenses Event2	$2,429	OtherDirectExpensesEvent2Amt
Other Events Total	1	OtherEventsTotalCnt
Gross Receipts Total	$18,259	GrossReceiptsTotalAmt
Charitable Contributions Tot	$8,800	CharitableContributionsTotAmt
Gross Revenue Total Events	$9,459	GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events	$2,819	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$2,819	DirectExpenseSummaryEventsAmt
Net Income Summary	$6,640	NetIncomeSummaryAmt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

Field	Value	IRS element (for citing)
Person	EDWARD HOSBACH	PersonNm
Title	MEDICAL DIRECTOR	TitleTxt
Base Compensation Filing Org	$169,994	BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs	$0	CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization	$0	BonusFilingOrganizationAmount
Bonus Related Organizations	$0	BonusRelatedOrganizationsAmt
Other Compensation Filing Org	$0	OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs	$0	OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org	$0	DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs	$0	DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org	$0	NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs	$0	NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org	$169,994	TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs	$0	TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org	$0	CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs	$0	CompReportPrior990RltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11B	A COPY OF THE FORM 990 IS PRESENTED TO THE FINANCE COMMITTEE AND THEN RECOMMENDED FOR PRESENTATION TO THE BOARD OF DIRECTORS. THE BOARD THEN REVIEWS AND APPROVES THE FORM 990 AT ITS REGULAR MEETING.
FORM 990, PART VI, SECTION B, LINE 12C	ANNUALLY THE BOARD OF TRUSTEES REVIEW A VENDOR AND FINANCIAL INSTITUTION LIST. THE BOARD OF TRUSTEES REVIEW THIS LIST IDENTIFYING ANY POTENTIAL VIOLATIONS OF THE CONFLICT OF INTEREST POLICY. EACH BOARD MEMBER IS GIVEN THE CONFLICT OF INTEREST POLICY TO READ AND CERTIFICATION SHEET TO SIGN ANNUALLY. ALL AFFILIATIONS ARE REQUIRED TO BE DISCLOSED AND DESCRIBED ON THE AGENCY'S CONFLICT OF INTEREST DISCLOSURE DOCUMENT. THE BOARD OF TRUSTEES ANNUALLY REVIEW AND DOCUMENT ANY DISCLOSED AFFILIATIONS TO DETERMINE IF A POSSIBLE CONFLICT OF INTEREST EXISTS.
FORM 990, PART VI, SECTION B, LINE 15	THE PROCESS FOR DETERMINING COMPENSATION FOR THE EXECUTIVE DIRECTOR AND KEY EMPLYEE INCLUDES THE REVIEW AND APPROVAL BY THE GOVERNING BODY. INFORMATION CONSIDERED DURING THIS PROCESS INCLUDES COMPARATIVE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN COMPARATIVE POSITIONS AT SIMILAR ORGANIZATIONS. DOCUMENTATION AND RECORD KEEPING WITH RESPECT TO THIS REVIEW PROCESS ARE MAINTAINED THROUGHOUT THE PROCESS.
FORM 990, PART VI, SECTION C, LINE 19	THE AGENCY'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND ANNUAL AUDITED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT OUR FRONT DESK IN WHICH THE INFORMATION WILL BE MAILED TO THE ADDRESS PROVIDED.
PART XII, LINE 2C	THERE HAVE BEEN NO CHANGES IN THE METHOD OF CHOOSING AN INDIVIDUAL AUDITOR OR METHOD OF OVERSIGHT.