IOWA CITY HOSPICE INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- IOWA CITY HOSPICE INC (EIN 42-1154098)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-06-08
- IRS object ID
- 202111599349301221
- Schema version
- 2020v4.1
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-06-08T14:00:01-05:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 411431613 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BERGANKDV LTD | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2100 | AddressLine1Txt |
| City | WATERLOO | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 507042100 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421154098 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IOWA CITY HOSPICE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | IOWA | BusinessNameControlTxt |
| Phone | 3193515665 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1025 WADE STREET | AddressLine1Txt |
| City | IOWA CITY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52240 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KARLA KAMAL | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 3196884212 | PhoneNum |
| Signature | 2021-06-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | KARLA | PersonFirstNm |
| Person Last | KAMAL | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BRIAN ARONSON CPA | PreparerPersonNm |
| PTIN | P01425251 | PTIN |
| Phone | 3192346885 | PhoneNum |
| Preparation | 2021-05-24 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KARLA KAMAL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1025 WADE STREET | AddressLine1Txt |
| City | IOWA CITY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52240 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,615,114 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.IOWACITYHOSPICE.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1980 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE INNOVATIVE CARE FOR PEOPLE WITH SERIOUS ADVANCED ILLNESSES AND END OF LIFE CONDITIONS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 78 | TotalEmployeeCnt |
| Total Volunteers | 109 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $787,463 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,200,117 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,269,895 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,234,262 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,078 | PYInvestmentIncomeAmt |
| CY Investment Income | $31,064 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$3,074 | PYOtherRevenueAmt |
| CY Other Revenue | -$4,895 | CYOtherRevenueAmt |
| PY Total Revenue | $7,055,362 | PYTotalRevenueAmt |
| CY Total Revenue | $7,460,548 | 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 | $4,093,082 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,262,347 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $119,351 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,690,564 | PYOtherExpensesAmt |
| CY Other Expenses | $2,531,261 | CYOtherExpensesAmt |
| PY Total Expenses | $6,783,646 | PYTotalExpensesAmt |
| CY Total Expenses | $6,793,608 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $271,716 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $666,940 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,130,514 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,184,182 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,085,321 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,228,888 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,045,193 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,955,294 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE COMPASSIONATE CARE FOR ANYONE IN OUR COMMUNITY AFFECTED BY SERIOUS ADVANCED ILLNESS AND END OF LIFE CONDITIONS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $4,799,199 | ExpenseAmt |
| Revenue | $6,234,262 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDES SERVICES TO THOSE FACING A LIFE LIMITING ILLNESS. IN 2020, 650 NEW PATIENTS AND FAMILIES WERE SERVED IN OUR SEVEN COUNTY SERVICE AREA (CEDAR, IOWA, JOHNSON, LINN, LOUISA, MUSCATINE AND WASHINGTON COUNTIES) FOR A TOTAL OF 35,076 DAYS OF CARE. IN ADDITION TO OUR PROFESSIONAL STAFF, IOWA CITY HOSPICE VOLUNTEERS PROVIDE SERVICES THAT ARE AS VARIED AS THE PATIENTS, FAMILIES AND COMMUNITIES WE SERVE. PATIENT CARE VOLUNTEERS PROVIDE COMPANIONSHIP AND SUPPORT TO TERMINALLY ILL PATIENTS AND THEIR LOVED ONES. VOLUNTEERS PROVIDE MANY FORMS OF ASSISTANCE, AT ALL LEVELS OF SKILL. OUR 109 PATIENT CARE VOLUNTEERS PROVIDED 741 HOURS OF SUPPORTIVE SERVICES TO THOSE WE SERVED IN 2020. FOLLOWING A PATIENT'S DEATH, IOWA CITY HOSPICE BEREAVEMENT STAFF IS AVAILABLE TO SUPPORT FAMILY MEMBERS AND FRIENDS THROUGHOUT THE GRIEVING PROCESS. OUR SERVICES ARE ALSO AVAILABLE TO ANYONE WHO IS GRIEVING THE LOSS OF A LOVED ONE, REGARDLESS OF WHETHER THE PERSON WAS IN HOSPICE CARE. IOWA CITY HOSPICE OFFERS A VARIETY OF GRIEF SUPPORT SERVICES INCLUDING SUPPORT GROUPS, GRIEF EDUCATION, AND SPECIAL EVENTS. IOWA CITY HOSPICE STAFF MADE 47 HOME VISITS TO SURVIVORS AND 56 PEOPLE ATTENDED SUPPORT GROUPS, BEREAVEMENT LUNCHEONS AND OTHER EVENTS.INCLUDED IN OUR BEREAVEMENT SERVICES ARE SPECIALIZED CARE TO CHILDREN AND YOUTH. MANY CHILDREN AND YOUTH FIND COMFORT AND SECURITY THROUGH GRIEF SUPPORT GROUPS WHERE EVERYONE PARTICIPATING SHARES ONE COMMON ELEMENT: SOMEONE THEY LOVED HAS DIED. IOWA CITY HOSPICE OFFERS THREE UNIQUE GROUPS FOR CHILDREN, YOUTH AND THEIR PARENTS/CAREGIVERS WHO HAVE EXPERIENCED THE LOSS OF A LOVED ONE. IN 2020, 12 CHILDREN, YOUTH AND ADULTS ATTENDED THESE GROUP EVENTS. | Desc |
| Total Program Service Expenses | $4,799,199 | 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 | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | 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 | 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 | 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 | 2 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 78 | 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KAREN DEGROOT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3196884212 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1025 WADE STREET | AddressLine1Txt |
| City | IOWA CITY | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52240 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| CATHERINE PUGH | |||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| LATASHA DELOACH | |||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| CYNTHIA SCHROCK | |||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| DIANA LUNDELL | |||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| DR STEPHEN SCHECKEL | |||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| BEN RUSSELL | |||||||
| PAST CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| BEN EVANS | |||||||
| CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| SUSAN STUTZEL | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| RANDY MCDONOUGH | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| CHARLES COULTER | |||||||
| FORMER DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| KARLA KAMAL | |||||||
| EXECUTIVE DIRECTOR | 40.00 | $124,491 | $0 | $14,034 | Yes (X) | ||
| KAREN DEGROOT | |||||||
| DIRECTOR OF FINANCE | 40.00 | $99,322 | $0 | $13,650 | Yes (X) | ||
| JOSHUA CURPHY | |||||||
| ARNP | 40.00 | $114,065 | $0 | $5,432 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $337,878 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $33,116 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | 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 |
| Fundraising | $41,180 | FundraisingAmt |
| Government Grants | $809,182 | GovernmentGrantsAmt |
| All Other Contributions | $349,755 | AllOtherContributionsAmt |
| Total Contributions | $1,200,117 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT CARE FEES | Desc |
| Business | 623990 | BusinessCd |
| Total Revenue Column | $6,234,262 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,234,262 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,234,262 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,430 | TotalRevenueColumnAmt |
| Exclusion | $9,430 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $171,305 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $149,671 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $21,634 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,634 | TotalRevenueColumnAmt |
| Exclusion | $21,634 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $41,180 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $4,895 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$4,895 | TotalRevenueColumnAmt |
| Exclusion | -$4,895 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,460,548 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,234,262 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $26,169 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $251,497 | TotalAmt |
| Management And General | $251,497 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,284,859 | TotalAmt |
| Program Services | $2,223,316 | ProgramServicesAmt |
| Management And General | $976,342 | ManagementAndGeneralAmt |
| Fundraising | $85,201 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,517 | TotalAmt |
| Program Services | $56,090 | ProgramServicesAmt |
| Management And General | $30,278 | ManagementAndGeneralAmt |
| Fundraising | $2,149 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $407,233 | TotalAmt |
| Program Services | $250,889 | ProgramServicesAmt |
| Management And General | $145,957 | ManagementAndGeneralAmt |
| Fundraising | $10,387 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $230,241 | TotalAmt |
| Program Services | $145,895 | ProgramServicesAmt |
| Management And General | $78,755 | ManagementAndGeneralAmt |
| Fundraising | $5,591 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,411 | TotalAmt |
| Management And General | $100,411 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,700 | TotalAmt |
| Management And General | $15,700 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,922 | TotalAmt |
| Management And General | $24,922 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $275,788 | TotalAmt |
| Program Services | $235,391 | ProgramServicesAmt |
| Management And General | $40,397 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,180 | TotalAmt |
| Management And General | $21,180 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $112,471 | TotalAmt |
| Program Services | $54,946 | ProgramServicesAmt |
| Management And General | $55,762 | ManagementAndGeneralAmt |
| Fundraising | $1,763 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,996 | TotalAmt |
| Program Services | $74,996 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,421 | TotalAmt |
| Management And General | $29,421 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,684 | TotalAmt |
| Program Services | $35,604 | ProgramServicesAmt |
| Management And General | $80 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,979 | TotalAmt |
| Program Services | $131 | ProgramServicesAmt |
| Management And General | $26,848 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,124 | TotalAmt |
| Program Services | $73,124 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $196,484 | TotalAmt |
| Program Services | $137,538 | ProgramServicesAmt |
| Management And General | $53,051 | ManagementAndGeneralAmt |
| Fundraising | $5,895 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $822 | TotalAmt |
| Management And General | $822 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES & DRUG | $908,306 | $908,306 | ||
| PATIENT EXPENSES | $534,790 | $534,790 | ||
| BAD DEBT | $67,150 | $67,150 | ||
| DUES AND SUBSCRIPTIONS | $20,003 | $12,003 | $8,000 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,030 | TotalAmt |
| Program Services | $1,033 | ProgramServicesAmt |
| Management And General | $11,632 | ManagementAndGeneralAmt |
| Fundraising | $365 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,793,608 | TotalAmt |
| Program Services | $4,799,199 | ProgramServicesAmt |
| Management And General | $1,875,058 | ManagementAndGeneralAmt |
| Fundraising | $119,351 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $314,193 | BOYAmt |
| EOY | $1,128,997 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $984,673 | BOYAmt |
| EOY | $983,521 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,995 | BOYAmt |
| EOY | $35,216 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,084,734 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $962,919 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,115,390 | BOYAmt |
| EOY | $1,121,815 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,691,263 | BOYAmt |
| EOY | $1,914,633 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,130,514 | BOYAmt |
| EOY | $5,184,182 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $665,397 | BOYAmt |
| EOY | $524,450 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $244,046 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $419,924 | BOYAmt |
| EOY | $460,392 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,085,321 | BOYAmt |
| EOY | $1,228,888 | 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 | $1,518,071 | BOYAmt |
| EOY | $2,465,341 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,527,122 | BOYAmt |
| EOY | $1,489,953 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,045,193 | BOYAmt |
| EOY | $3,955,294 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,130,514 | BOYAmt |
| EOY | $5,184,182 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $666,940 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $243,161 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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 | $526,181 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $493,152 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $505,009 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $551,703 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,200,117 | CurrentTaxYearAmt |
| Total | $3,276,162 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $526,181 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $493,152 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $505,009 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $551,703 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,200,117 | CurrentTaxYearAmt |
| Total | $3,276,162 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $31,489 | SubstantialContributorsTotAmt |
| Public Support Total170 | $3,244,673 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $37,779 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $13,967 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $57,458 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,821 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,634 | CurrentTaxYearAmt |
| Total | $137,659 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $3,920 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,060 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,745 | CurrentTaxYearMinus1YearAmt |
| Total | $11,725 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $3,425,546 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $29,191,605 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.94720 | PublicSupportCY170Pct |
| Public Support PY170 | 0.93380 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FUNDRAISING INCOME - 2017 AMOUNT: $ 3,920. 2018 AMOUNT: $ 4,060. 2019 AMOUNT: $ 3,745. 2020 AMOUNT: $ 0. |
| SCHEDULE A, PART VI, LIST OF UNUSUAL GRANTS: | DESCRIPTION: BEQUEST DATE: 06/06/19 AMOUNT: 235760. |
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 | $1,890,030 | BeginningYearBalanceAmt |
| Contributions | $5,313 | ContributionsAmt |
| Investment Earnings Or Losses | $249,974 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $2,145,317 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,578,173 | BeginningYearBalanceAmt |
| Contributions | $6,870 | ContributionsAmt |
| Investment Earnings Or Losses | $304,987 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,890,030 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,102,063 | BeginningYearBalanceAmt |
| Contributions | $7,895 | ContributionsAmt |
| Investment Earnings Or Losses | -$81,785 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $450,000 | GrantsOrScholarshipsAmt |
| End Year Balance | $1,578,173 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,190,680 | BeginningYearBalanceAmt |
| Contributions | $9,160 | ContributionsAmt |
| Investment Earnings Or Losses | $310,348 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $408,125 | GrantsOrScholarshipsAmt |
| End Year Balance | $2,102,063 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,070,680 | BeginningYearBalanceAmt |
| Contributions | $7,795 | ContributionsAmt |
| Investment Earnings Or Losses | $112,205 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $2,190,680 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.11000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.89000 | 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 | $143,130 | OtherCostOrOtherBasisAmt |
| Book Value | $143,130 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,009,288 | OtherCostOrOtherBasisAmt |
| Depreciation | $459,064 | DepreciationAmt |
| Book Value | $550,224 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $910,101 | OtherCostOrOtherBasisAmt |
| Depreciation | $481,640 | DepreciationAmt |
| Book Value | $428,461 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,215 | OtherCostOrOtherBasisAmt |
| Depreciation | $22,215 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,121,815 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | BENEFICIAL INTEREST IN ASSETS HELD | Desc |
| Book Value | $1,914,633 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,914,633 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAPITAL LEASE OBLIGATION | Desc |
| Amt | $460,392 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $460,392 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $7,678,422 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $242,796 | OtherRevenueAmt |
| Revenue Not Reported | $242,796 | RevenueNotReportedAmt |
| Revenue Subtotal | $7,435,626 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $24,922 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $24,922 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $7,460,548 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,768,321 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | -$365 | OtherExpensesIncludedAmt |
| Expenses Not Reported | -$365 | ExpensesNotReportedAmt |
| Expenses Subtotal | $6,768,686 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $24,922 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $24,922 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $6,793,608 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE ENDOWMENT FUND REPRESENTS AMOUNTS HELD BY A COMMUNITY FOUNDATION FOR THE ORGANIZATION. THE FUNDS CAN BE USED FOR OPERATING PURPOSES. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | CHANGE IN VALUE OF BENEFICIAL INTEREST 243,161. FUNDRAISING EXPENSES -365. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES -365. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | WALK EVENT | Event1Nm |
| Gross Receipts Event1 | $41,180 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $41,180 | CharitableContriEvent1Amt |
| Other Direct Expenses Event1 | $4,895 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $41,180 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $41,180 | CharitableContributionsTotAmt |
| Oth Direct Expnss Total Events | $4,895 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $4,895 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$4,895 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE EXECUTIVE DIRECTOR EMAILS THE FINAL COPY OF THE FORM 990 TO THE EXECUTIVE COMMITTEE TO REVIEW AND APPROVE BEFORE IT IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL BOARD MEMBERS AND EMPLOYEES ARE REQUIRED TO DECLARE ALL CONFLICTS OF INTEREST AT LEAST ANNUALLY. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION'S HUMAN RESOURCE SPECIALIST EVALUATES THE PAY RANGE OF THE EXECUTIVE DIRECTOR ANNUALLY BY USING COMPARATIVE DATA. PAY RANGES FOR THE ORGANIZATION ARE APPROVED BY IOWA CITY HOSPICE'S PERSONNEL COMMITTEE. THIS INFORMATION IS TAKEN INTO ACCOUNT WHEN THE EXECUTIVE DIRECTOR IS EVALUATED ANNUALLY BY THE ENTIRE BOARD OF DIRECTORS. ANY CHANGES TO THE COMPENSATION ARE APPROVED THROUGH THE BUDGETING PROCESS; REVIEWED AND APPROVED BY FIRST THE FINANCE COMMITTEE AND THEN THE BOARD OF DIRECTORS. COMMITTEE WORK HAPPENS THE SECOND HALF OF THE YEAR FOR IMPLEMENTATION IN THE SUBSEQUENT JANUARY. THE APPROVED PAY RATE IS THEN DOCUMENTED AND PLACED IN THE EXECUTIVE DIRECTOR'S PERSONNEL FILE. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS AND FORM 990 ARE MADE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. |
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