HOSPICE FOUNDATION OF JEFFERSON COUNTY INC: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization: HOSPICE FOUNDATION OF JEFFERSON COUNTY INC (EIN 16-1541636)
Tax period: 2023-10-01 to 2024-09-30
Filed: 2025-08-14
IRS object ID: 202532269349300118
Schema version: 2023v6.0
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	2025-08-14T07:38:23-05:00	ReturnTs
Tax Period End	2024-09-30	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	2023-10-01	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	2025-08-13	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	2025-08-13	PreparationDt

Field	Value	IRS element (for citing)
Tax	2023	TaxYr
Build TS	2025-03-06 01:10:19Z	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	$1,819,992	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	13	VotingMembersGoverningBodyCnt
Voting Members Independent	13	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	13	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$628,802	PYContributionsGrantsAmt
CY Contributions Grants	$572,741	CYContributionsGrantsAmt
PY Program Service Revenue	$0	PYProgramServiceRevenueAmt
CY Program Service Revenue	$0	CYProgramServiceRevenueAmt
PY Investment Income	$308,154	PYInvestmentIncomeAmt
CY Investment Income	$165,952	CYInvestmentIncomeAmt
PY Other Revenue	$126,181	PYOtherRevenueAmt
CY Other Revenue	$50,890	CYOtherRevenueAmt
PY Total Revenue	$1,063,137	PYTotalRevenueAmt
CY Total Revenue	$789,583	CYTotalRevenueAmt
PY Grants And Similar Paid	$627,464	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$520,000	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$188,320	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$182,301	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$182,301	CYTotalFundraisingExpenseAmt
PY Other Expenses	$475,433	PYOtherExpensesAmt
CY Other Expenses	$543,067	CYOtherExpensesAmt
PY Total Expenses	$1,291,217	PYTotalExpensesAmt
CY Total Expenses	$1,245,368	CYTotalExpensesAmt
PY Revenues Less Expenses	-$228,080	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$455,785	CYRevenuesLessExpensesAmt
Total Assets BOY	$9,484,927	TotalAssetsBOYAmt
Total Assets EOY	$8,167,501	TotalAssetsEOYAmt
Total Liabilities BOY	$1,410,793	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$80,204	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$8,074,134	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$8,087,297	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	$815,919	ExpenseAmt
Grant	$520,000	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	$815,919	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
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	13	GoverningBodyVotingMembersCnt
Independent Voting Member	13	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 (17 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
JILL AHLGRIM
SECRETARY	1.00	Yes (X)	Yes (X)	$0	$0	$0
DANA KEEFER
TREASURER	1.00	Yes (X)	Yes (X)	$0	$0	$0
BRYON PERRY
VICE PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
JOHN ASTAFAN
PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
BRIAN ASHLEY
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
BUNNY GORMAN
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
PENNY MCCREA
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
STACY SPAZIANI
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
EMILY SPRAGUE
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
CHRISTINA STONE
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
STEVEN YELLE
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
MAUREEN CEAN
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
DAVID KELLOGG THROUGH 09-2024
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
DIANA WOODHOUSE THROUGH 10-2023
CHIEF EXECUTIVE OFFICER	20.00		Yes (X)	$0	$9,301	$363	20.00
ANNA PATTERSON BEGINNING 10-2023
CHIEF EXECUTIVE OFFICER	20.00		Yes (X)	$0	$115,000	$8,250	20.00
MICHELE RICTER THROUGH 02-2024
DIRECTOR OF FINANCE	10.00		Yes (X)	$0	$16,253	$0	30.00
LAURIE HULBERT BEGINNING 02-2024
DIRECTOR OF FINANCE	10.00		Yes (X)	$0	$8,550	$0	10.00

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$0	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$149,104	TotReportableCompRltdOrgAmt
Total Other Compensation	$8,613	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	$572,741	AllOtherContributionsAmt
Total Contributions	$572,741	TotalContributionsAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$106,721	TotalRevenueColumnAmt
Exclusion	$106,721	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$1,006,201	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$946,970	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$59,231	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$59,231	TotalRevenueColumnAmt
Exclusion	$59,231	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$134,329	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$83,439	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$50,890	TotalRevenueColumnAmt
Exclusion	$50,890	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$789,583	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$216,842	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$520,000	TotalAmt
Program Services	$520,000	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$171,833	TotalAmt
Fundraising	$171,833	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$10,468	TotalAmt
Fundraising	$10,468	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$3,708	TotalAmt
Management And General	$3,708	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$25,914	TotalAmt
Management And General	$25,914	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$82,087	TotalAmt
Program Services	$82,087	ProgramServicesAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$17,161	TotalAmt
Management And General	$17,161	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,324	TotalAmt
Management And General	$1,324	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$5,258	TotalAmt
Management And General	$5,258	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$292,921	TotalAmt
Program Services	$213,832	ProgramServicesAmt
Management And General	$79,089	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$19,566	TotalAmt
Management And General	$19,566	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp

Field	Value	IRS element (for citing)
Desc	OTHER	Desc
Total	$95,128	TotalAmt
Management And General	$95,128	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,245,368	TotalAmt
Program Services	$815,919	ProgramServicesAmt
Management And General	$247,148	ManagementAndGeneralAmt
Fundraising	$182,301	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$880,480	BOYAmt
EOY	$160,628	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$163,739	BOYAmt
EOY	$112,948	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$23,152	BOYAmt
EOY	$5,504	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$7,207,596	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$2,511,657	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$4,921,258	BOYAmt
EOY	$4,695,939	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$2,180,624	BOYAmt
EOY	$2,002,665	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$1,315,674	BOYAmt
EOY	$1,189,817	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$9,484,927	BOYAmt
EOY	$8,167,501	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$125,040	BOYAmt
EOY	$40,054	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$1,231,079	BOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$54,674	BOYAmt
EOY	$40,150	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,410,793	BOYAmt
EOY	$80,204	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	$7,919,787	BOYAmt
EOY	$7,918,998	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$154,347	BOYAmt
EOY	$168,299	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$8,074,134	BOYAmt
EOY	$8,087,297	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$9,484,927	BOYAmt
EOY	$8,167,501	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$455,785	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$468,948	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	$353,010	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$521,144	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$829,304	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$628,802	CurrentTaxYearMinus1YearAmt
Current Tax Year	$572,741	CurrentTaxYearAmt
Total	$2,905,001	TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$353,010	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$521,144	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$829,304	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$628,802	CurrentTaxYearMinus1YearAmt
Current Tax Year	$572,741	CurrentTaxYearAmt
Total	$2,905,001	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total170	$2,905,001	PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$89,333	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$354,074	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$125,404	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$126,693	CurrentTaxYearMinus1YearAmt
Current Tax Year	$106,721	CurrentTaxYearAmt
Total	$802,225	TotalAmt

Field	Value	IRS element (for citing)
Total Support	$3,707,226	TotalSupportAmt
Public Support CY170	0.78360	PublicSupportCY170Pct
Public Support PY170	0.80250	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	$177,045	BeginningYearBalanceAmt
Investment Earnings Or Losses	$39,373	InvestmentEarningsOrLossesAmt
Other Expenditures	$6,910	OtherExpendituresAmt
End Year Balance	$209,508	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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 Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

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 Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

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

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.53850	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.23870	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.22280	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	$6,782,827	OtherCostOrOtherBasisAmt
Depreciation	$2,270,996	DepreciationAmt
Book Value	$4,511,831	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$385,269	OtherCostOrOtherBasisAmt
Depreciation	$240,661	DepreciationAmt
Book Value	$144,608	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$4,695,939	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	INVESTMENT IN THE COMMUNITY FOUNDATION	Desc
Book Value	$1,189,817	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$1,189,817	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	DUE TO AFFILIATE	Desc
Amt	$40,150	Amt

Field	Value	IRS element (for citing)
Total Liability	$40,150	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$1,316,056	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	$468,948	NetUnrealizedGainsInvstAmt
Other Revenue	$83,439	OtherRevenueAmt
Revenue Not Reported	$552,387	RevenueNotReportedAmt
Revenue Subtotal	$763,669	RevenueSubtotalAmt
Investment Expenses Not Incld	$25,914	InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt	$25,914	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$789,583	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$1,302,893	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$83,439	OtherExpensesIncludedAmt
Expenses Not Reported	$83,439	ExpensesNotReportedAmt
Expenses Subtotal	$1,219,454	ExpensesSubtotalAmt
Investment Expenses Not Incld2	$25,914	InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt	$25,914	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$1,245,368	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART XI, LINE 2D - OTHER ADJUSTMENTS:	SPECIAL EVENT EXPENSE 83,439.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	SPECIAL EVENTS 83,439.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	BALL	Event1Nm
Gross Receipts Event1	$54,077	GrossReceiptsEvent1Amt
Gross Revenue Event1	$54,077	GrossRevenueEvent1Amt
Other Direct Expenses Event1	$1,440	OtherDirectExpensesEvent1Amt
Event2	GOLF TOURNAMENT	Event2Nm
Gross Receipts Event2	$21,501	GrossReceiptsEvent2Amt
Gross Revenue Event2	$21,501	GrossRevenueEvent2Amt
Other Events Total	4	OtherEventsTotalCnt
Gross Receipts Other Events	$58,751	GrossReceiptsOtherEventsAmt
Gross Revenue Other Events	$58,751	GrossRevenueOtherEventsAmt
Oth Direct Expnss Other Events	$81,999	OthDirectExpnssOtherEventsAmt
Gross Receipts Total	$134,329	GrossReceiptsTotalAmt
Gross Revenue Total Events	$134,329	GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events	$83,439	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$83,439	DirectExpenseSummaryEventsAmt
Net Income Summary	$50,890	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	$520,000	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	$182,301	COST INCURRED
HOSPICE OF JEFFERSON COUNTY INC
B	$520,000	CASH RECEIVED