2020-11-12T11:24:38-06:00 2019-12-31 351178661 BLUE & CO LLC 500 NORTH MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2019-01-01 351479425 OUR HOSPICE OF SOUTH CENTRAL INDIANA INC OURH 8123148000 2626 E 17TH STREET COLUMBUS IN 47201 LAURA LEONARD PRESIDENT 8123148000 2020-11-12 1 ANGELA N CRAWFORD CPA P00573197 3176334705 2020-11-12 38.109.186.2 2020-11-12 11:24:34 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 AF923E04E140C4DE71FD41AF2127CF5344A3E036 2019 2021-01-29 14:40:06Z LAURA LEONARD 2626 E 17TH STREET COLUMBUS IN 47201 17934318 0 X WWW.OURHOSPICE.ORG X 1980 IN OUR HOSPICE OF SOUTH CENTRAL INDIANA, INC. (OHSCI) IS AN INDEPENDENT, NOT-FOR-PROFIT ORGANIZATION PROVIDING SERVICES TO THE TERMINALLY ILL IN A 16-COUNTY SERVICE AREA. SINCE ITS INCEPTION 39 YEARS AGO, HOSPICE HAS EXPANDED TO MEET THE NEEDS FOR END-OF-LIFE CARE IN SOUTHERN INDIANA. 11 11 188 124 0 0 950564 1177587 13261601 15017169 -227619 914308 364029 382143 14348575 17491207 0 0 0 0 11283310 12097486 0 0 397661 3834914 3895066 15118224 15992552 -769649 1498655 12208839 13892122 1442835 1627463 10766004 12264659 X OUR HOSPICE OF SOUTH CENTRAL INDIANA, INC. (OHSCI) IS AN INDEPENDENT, NOT-FOR-PROFIT ORGANIZATION PROVIDING SERVICES TO THE TERMINALLY ILL IN A 16-COUNTY SERVICE AREA. SINCE ITS INCEPTION 39 YEARS AGO, HOSPICE HAS EXPANDED TO MEET THE NEEDS FOR END-OF-LIFE CARE IN SOUTHERN INDIANA. 0 0 13934093 15143273 HOSPICE EXISTS TO PROVIDE CARE AND SUPPORT TO INDIVIDUALS AND THEIR FAMILIES IN THE LAST PHASES OF AN INCURABLE DISEASE SO THAT THEY MAY LIVE AS FULLY AND COMFORTABLY AS POSSIBLE. BEREAVEMENT SERVICES ARE PROVIDED TO FAMILY MEMBERS AND/OR SIGNIFICANT OTHERS FOR 13 MONTHS FOLLOWING A DEATH. AN INTERDISCIPLINARY TEAM CARES FOR THE PHYSICAL, PSYCHOSOCIAL, SPIRITUAL AND EMOTIONAL NEEDS OF THOSE WHO CHOOSE HSCI, WHETHER IT IS A MATTER OF DAYS, WEEKS, OR MONTHS. SERVICES ARE PROVIDED IN A VARIETY OF SETTINGS, INCLUDING THE PATIENT'S HOME, A LONG-TERM CARE FACILITY, AN ASSISTED LIVING FACILITY OR THE HOSPICE INPATIENT FACILITY. A TEAM OF HIGHLY SKILLED PROFESSIONALS AND VOLUNTEERS ARE AVAILABLE 24-HOURS A DAY, 7 DAYS A WEEK.OHSCI IS LICENSED BY THE STATE OF INDIANA AND CERTIFIED BY THE FEDERAL GOVERNMENT. MEDICARE, MEDICAID AND PRIVATE INSURANCE COVER MOST SERVICES. ADDITIONAL FUNDS ARE RAISED THROUGH MEMORIALS, PRIVATE DONATIONS, FUND-RAISING ACTIVITIES, GRANTS AND THE UNITED WAY. TO ENSURE THAT CARE CAN BE PROVIDED REGARDLESS OF ABILITY TO PAY, OHSCI IS A COMMUNITY RESOURCE FOR END-OF-LIFE CARE. HOSPICE PROFESSIONALS AND VOLUNTEERS ARE AVAILABLE TO PARTICIPATE IN EDUCATIONAL OFFERINGS IN A VARIETY OF SETTINGS, INCLUDING CHURCHES, SCHOOLS, CIVIC ORGANIZATIONS, AND OTHER HEALTH CARE PROVIDERS.IN 2019, 1,317 PATIENTS AND FAMILIES RECEIVED 86,078 DAYS OF CARE. ADDITIONALLY, BEREAVEMENT SERVICES WERE PROVIDED TO 1,060 HOSPICE BEREAVED FAMILIES IN 2019. APPROXIMATELY 10.2% OF OHSCI'S ANNUAL BUDGET IS RAISED EACH YEAR TO PROVIDE THE SPECIALIZED CARE NEEDED BY THE TERMINALLY ILL AND THEIR FAMILIES. YOU ARE WELCOME TO VISIT OUR WEBSITE AT WWW.OURHOSPICE.ORG<HTTP://WWW.OURHOSPICE.ORG> FOR ADDITIONAL INFORMATION AND TO VIEW PHOTOS OF THE INPATIENT FACILITY.OHSCI BEGAN OFFERING PALLIATIVE CARE IN 2019 BECAUSE OF THE BELIEF IT IS THE RIGHT THING TO DO. WE DEPEND ON DONORS TO FUND THIS IMPORTANT SPECIALTY BECAUSE IT IS MINIMALLY REIMBURSED (LESS THAN 17%) THROUGH INSURANCE, MEDICARE AND MEDICAID. BRINGING EXCELLENT, COMPASSIONATE PALLIATIVE CARE TO THE MEMBERS OF OUR COMMUNITIES ALLOWS US TO FURTHER FULFILL OUR MISSION; TO MAKE EVERY MOMENT COUNT FOR OUR PATIENTS AND THEIR FAMILIES. 13934093 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 1 17 1 1 188 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X X THE ORGANIZATION 8123148098 2626 E 17TH STREET COLUMBUS IN 47201 MIKE MCIVER BOARD PRESIDENT 1.00 X X 0 0 0 DAVID THOMPSON MD BOARD PRESIDENT-ELECT 1.00 X X 0 0 0 MARLENE WEATHERWAX BOARD IMMEDIATE PAST PRESIDENT 1.00 X X 0 0 0 TOM DOWD BOARD SECRETARY/TREASURER 1.00 X X 0 0 0 JAMES BICKEL BOARD MEMBER 1.00 X 0 0 0 RORY GLICK BOARD MEMBER 1.00 X 0 0 0 CHRIS IORIO MD BOARD MEMBER 1.00 X 0 0 0 REX MCKINNEY BOARD MEMBER 1.00 X 0 0 0 LARRY OLSON BOARD MEMBER 1.00 X 0 0 0 FRANK REINDL BOARD MEMBER 1.00 X 0 0 0 DOUG THOMAS BOARD MEMBER 1.00 X 0 0 0 LAURA LEONARD PRESIDENT 40.00 X 169314 0 16292 DIANE DANLY MEDICAL DIRECTOR 40.00 X 257466 0 42314 ROY GOODE MD HOSPICE PHYSICIAN 24.00 X 131899 0 43308 SHOBA SAHI MD HOSPICE PHYSICIAN 16.00 X 112349 0 43386 LISA MCHONE NURSE PRACTIONER 40.00 X 112949 0 31319 KATHY ROSE DIRECTOR OF CLINICAL SERVI 40.00 X 115233 0 18288 899210 0 194907 9 0 1 0 HOMECARE HOMEBASE LLC PO BOX 678637 DALLAS TX 752678637 ELECTRONIC MEDICAL RECORD PROVIDER 154848 WILLIAMS BROS HEALTH CARE PHARMACY PO BOX 271 WASHINGTON IN 475014535 HOME INFUSION MEDS & FEEDINGS SERVICES 100176 2 51142 1126445 28192 1177587 NET PATIENT SERVICE REVENUE 624100 15017169 15017169 15017169 914758 914758 258294 258744 -450 -450 -450 365146 167765 197381 197381 59790 12337 47453 47453 15470 4265 11205 11205 126104 126104 126104 17491207 15143273 0 1170347 185606 163369 22237 8925710 7856323 814939 254448 247823 209464 31521 6838 2077632 1757170 267830 52632 660715 558447 83709 18559 105963 21167 65341 19455 13636 13478 158 184845 71413 92543 20889 227214 166297 47984 12933 387553 288545 98006 1002 300164 294569 5595 23644 20392 1696 1556 356999 272640 78599 5760 82540 75112 7428 PATIENT SERVICE EXPENSE 2141278 2141278 DUES & SUBSCRIPTIONS 38980 23279 15331 370 32250 1150 27881 3219 15992552 13934093 1660798 397661 400 400 1855197 2758644 5000 1795729 1851370 5982 6562 21389 19754 9089398 4726733 4567260 4362665 3960782 4885627 2100 2100 12208839 13892122 1442835 1627463 1442835 1627463 X 10159662 11586916 606342 677743 10766004 12264659 12208839 13892122 1498655 0 X X 0 1 X 1 0 X 485086 934501 850082 950564 1177587 4397820 485086 934501 850082 950564 1177587 4397820 955047 3442773 6402 2331 3815 -227619 914758 699687 338974 378865 336488 110160 141574 1306061 6403568 66272770 0.53760 0.65180 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2015 AMOUNT: $ 338,974. 2016 AMOUNT: $ 378,865. 2017 AMOUNT: $ 336,488. 2018 AMOUNT: $ 110,160. 2019 AMOUNT: $ 141,574. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 255370 26023 281393 230332 25038 255370 230332 230332 1.00000 1 0 6979244 2964408 4014836 7333 4400 2933 1560714 1311361 249353 542107 446564 95543 4362665 X 17718972 60000 60000 17658972 -167765 -167765 17491207 16220317 60000 167765 227765 15992552 0 15992552 PART V, LINE 4: TO HELP FURTHER THE EXEMPT PURPOSE OF THE ORGANIZATION. PART X, LINE 2: HOSPICE IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY HOSPICE AND RECOGNIZE A TAX LIABILITY IF HOSPICE HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY HOSPICE, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2019 AND 2018, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. HOSPICE IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. AS SUCH, HOSPICE IS GENERALLY EXEMPT FROM INCOME TAXES. HOWEVER, HOSPICE IS REQUIRED TO FILE FEDERAL FORM 990 RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX WHICH IS AN INFORMATIONAL RETURN ONLY. PART XI, LINE 4B - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES -167,765. PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENTS EXPENSES 167,765. CONCERT 200321 200321 7002 1644 102191 11522 JENNINGS GALA 81027 81027 8586 1819 2 83798 83798 2449 1092 15925 15535 365146 365146 9451 11322 118116 28876 167765 197381 59790 11175 1162 1 1.00000 59790 11175 1162 12337 47453 IN 1 0 0 0 1.00000 JOCELYN ARVISAIS 2626 E 17TH STREET COLUMBUS IN 47201 0 LAURA LEONARD OVERALL RESPONSIBILITY FOR THE OPERATION AND CONDUCT OF THE GAMING EVENT. X 0 X 0 0 0 0 0 0 0 0 0 LAURA LEONARD PRESIDENT 169314 0 0 0 0 0 2615 0 13677 0 185606 0 0 0 DIANE DANLY MEDICAL DIRECTOR 257466 0 0 0 0 0 9976 0 32338 0 299780 0 0 0 ROY GOODE MD HOSPICE PHYSICIAN 131899 0 0 0 0 0 4746 0 38562 0 175207 0 0 0 SHOBA SAHI MD HOSPICE PHYSICIAN 112349 0 0 0 0 0 4824 0 38562 0 155735 0 0 0 X 200 28192 COST 0 0 0 PART I, COLUMN (B): THE AMOUNT IN COLUMN (B) REPRESENTS THE NUMBER OF SHARES RECEIVED AS A CONTRIBUTION. FORM 990, PART VI, SECTION B, LINE 11B THE EXECUTIVE COMMITTEE OF THE BOARD DELEGATED AUTHORITY TO THE FINANCE COMMITTEE OF THE BOARD TO APPROVE THE FORM 990. THE FINANCE COMMITTEE OF THE BOARD WILL REVIEW THE ENTIRE FORM 990. ONCE APPROVED BY THE FINANCE COMMITTEE OF THE BOARD, A FULL COPY OF THE FORM 990 WAS MADE AVAILABLE TO EVERY BOARD MEMBER FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EFFECTIVE 2006, BOARD MEMBERS, KEY EMPLOYEES, DIRECTORS AND OFFICERS SIGNED A CONFLICT OF INTEREST STATEMENT, STATING THAT THEY HAVE READ AND UNDERSTOOD THE STATEMENT. SINCE THAT TIME, ORIENTATION FOR NEW BOARD MEMBERS, KEY EMPLOYEES, OFFICERS AND DIRECTORS, INCLUDES REVIEW AND SIGNATURE OF A CONFLICT OF INTEREST STATEMENT. THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY THE COMPLIANCE OFFICER WITH FOLLOW-UP BY THE COMPLIANCE COMMITTEE IF ANY POTENTIAL CONFLICTS ARE IDENTIFIED. FORM 990, PART VI, SECTION B, LINE 15 EACH POSITION HAS A SALARY RANGE. COMPENSATION AT HIRE IS DETERMINED BY SEVERAL FACTORS, INCLUDING THE APPLICANT'S EXPERIENCE, EDUCATION, APPLICANT'S SALARY AT THEIR MOST RECENT EMPLOYMENT AND WHERE THE PROPOSED SALARY WOULD FALL WITHIN THE SALARY RANGE OF OTHER MEMBERS OF THE HOSPICE TEAM WHO ARE IN SIMILAR POSITIONS. INCREASES IN SALARY DURING THE YEAR WERE MADE DUE TO MARKET WAGE ADJUSTMENTS, OR BASED ON PERFORMANCE. IN 2011, HOSPICE DEVELOPED A PRESIDENT'S COMPENSATION POLICY. THE POLICY STIPULATED THAT INCREASES FOR THE PRESIDENT'S POSITION WOULD NEED TO BE APPROVED BY THE BOARD PRESIDENT. IN 2015 THE COMPENSATION COMMITTEE OF THE BOARD WAS ESTABLISHED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST STATEMENT, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C THE PROCESS OF SELECTING AN INDEPENDENT ACCOUNTANT AND OVERSIGHT OF THE AUDIT HAS NOT CHANGED FROM THE PRIOR YEAR. PALLIATIVE SUPPORT CENTER 2626 E 17TH STREET COLUMBUS IN 47201 472160334 PROVIDE SYMPTOM MANAGEMENT FOR ADVANCED ILLNESS IN 32145 385182 OUR HOSPICE OF SOUTH CENTRAL INDIANA INC