HOSPICE FOUNDATION OF JEFFERSON COUNTY INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: HOSPICE FOUNDATION OF JEFFERSON COUNTY INC (EIN 16-1541636)
Tax period: 2018-10-01 to 2019-09-30
Filed: 2020-08-14
IRS object ID: 202032279349301633
Schema version: 2018v3.2
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	2020-08-14T10:09:19-05:00	ReturnTs
Tax Period End	2019-09-30	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	2018-10-01	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	DIANA WOODHOUSE	PersonNm
Person Title	CEO	PersonTitleTxt
Phone	3157887323	PhoneNum
Signature	2020-08-13	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	BETTINA LIPPHARDT	PreparerPersonNm
PTIN	P00956232	PTIN
Phone	3154227109	PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	74.79.194.7	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2020-08-13	IPDt
IP Tm	14:04:45	IPTm
IP Timezone	ED	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	DA39A3EE5E6B4B0D3255BFEF95601890AFD80709	AtSubmissionCreationDeviceId
At Submission Filing Device Id	DA1A484D3CC47FF66C0B8D4EBBE168F869E0E8F9	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2018	TaxYr
Build TS	2020-09-22 18:59:49Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	DIANA WOODHOUSE	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	$1,315,976	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	14	VotingMembersGoverningBodyCnt
Voting Members Independent	14	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	46	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$445,308	PYContributionsGrantsAmt
CY Contributions Grants	$889,191	CYContributionsGrantsAmt
PY Program Service Revenue	$0	PYProgramServiceRevenueAmt
CY Program Service Revenue	$0	CYProgramServiceRevenueAmt
PY Investment Income	$257,319	PYInvestmentIncomeAmt
CY Investment Income	$127,541	CYInvestmentIncomeAmt
PY Other Revenue	$13,558	PYOtherRevenueAmt
CY Other Revenue	$13,582	CYOtherRevenueAmt
PY Total Revenue	$716,185	PYTotalRevenueAmt
CY Total Revenue	$1,030,314	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$200,000	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$174,864	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$136,895	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$155,262	CYTotalFundraisingExpenseAmt
PY Other Expenses	$364,735	PYOtherExpensesAmt
CY Other Expenses	$356,748	CYOtherExpensesAmt
PY Total Expenses	$539,599	PYTotalExpensesAmt
CY Total Expenses	$693,643	CYTotalExpensesAmt
PY Revenues Less Expenses	$176,586	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$336,671	CYRevenuesLessExpensesAmt
Total Assets BOY	$7,868,984	TotalAssetsBOYAmt
Total Assets EOY	$8,327,340	TotalAssetsEOYAmt
Total Liabilities BOY	$47,621	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$25,904	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$7,821,363	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$8,301,436	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	$260,444	ExpenseAmt
Grant	$200,000	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	$260,444	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
Temp Or Permanent Endowments	0	TempOrPermanentEndowmentsInd
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	0	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (1)	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 With Officer Ent	0	BusinessRlnWithOfficerEntInd
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
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	0	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	14	GoverningBodyVotingMembersCnt
Independent Voting Member	14	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	FRANCES SOURWINE	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 (16 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
DR JAN TURCOTTE
PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
REV DONALD ROBINSON
VICE PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
STEPHEN SWAIN
TREASURER	1.00	Yes (X)	Yes (X)	$0	$0	$0
CAROLYN OSBORNE
SECRETARY	1.00	Yes (X)	Yes (X)	$0	$0	$0
JEFF COLE
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
HOLLY BUSH
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
RAEANN CHATTERTON
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
LORI GERVERA
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
BRYAN MEHAFFY
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
TODD R DEMAR
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
CHRISTINA STONE
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
EMILY SPRAGUE
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
ERIC DELAGARZA
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
DIANA WOODHOUSE
CHIEF EXECUTIVE OFFICER	20.00		Yes (X)	$0	$121,714	$9,542	20.00
JORDAN JONES
DIRECTOR OF FINANCE	30.00		Yes (X)	$0	$70,731	$7,580	10.00
FRANCES SOURWINE
DIRECTOR OF FINANCE	30.00		Yes (X)	$0	$0	$0	10.00

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$0	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$192,445	TotReportableCompRltdOrgAmt
Total Other Compensation	$17,122	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
Fundraising	$22,643	FundraisingAmt
All Other Contributions	$866,548	AllOtherContributionsAmt
Total Contributions	$889,191	TotalContributionsAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$97,488	TotalRevenueColumnAmt
Exclusion	$97,488	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$289,976	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$259,923	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$30,053	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$30,053	TotalRevenueColumnAmt
Exclusion	$30,053	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$39,321	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$22,643	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$25,739	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$13,582	TotalRevenueColumnAmt
Exclusion	$13,582	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,030,314	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$141,123	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$200,000	TotalAmt
Program Services	$200,000	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$127,822	TotalAmt
Fundraising	$127,822	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$9,073	TotalAmt
Fundraising	$9,073	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$7,574	TotalAmt
Management And General	$7,574	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$27,781	TotalAmt
Management And General	$27,781	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$60,444	TotalAmt
Program Services	$60,444	ProgramServicesAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,099	TotalAmt
Management And General	$1,099	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$30,407	TotalAmt
Management And General	$30,407	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$15	TotalAmt
Management And General	$15	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$189,201	TotalAmt
Management And General	$189,201	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$15,198	TotalAmt
Management And General	$15,198	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDesc	TotalTotalAmt	FundraisingFundraisingAmt	Management And GeneralManagementAndGeneralAmt
FUNDRAISING	$18,367	$18,367
DUES AND LICENSES	$2,775		$2,775

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,887	TotalAmt
Management And General	$3,887	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$693,643	TotalAmt
Program Services	$260,444	ProgramServicesAmt
Management And General	$277,937	ManagementAndGeneralAmt
Fundraising	$155,262	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$128,761	BOYAmt
EOY	$344,021	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$55,000	BOYAmt
EOY	$294,809	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$4,528,983	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$1,466,074	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$3,252,110	BOYAmt
EOY	$3,062,909	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$3,007,584	BOYAmt
EOY	$3,130,908	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$1,425,529	BOYAmt
EOY	$1,494,693	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$7,868,984	BOYAmt
EOY	$8,327,340	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$47,621	BOYAmt
EOY	$25,904	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$47,621	BOYAmt
EOY	$25,904	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$7,552,673	BOYAmt
EOY	$7,542,299	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$218,690	BOYAmt
EOY	$709,137	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$50,000	BOYAmt
EOY	$50,000	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$7,821,363	BOYAmt
EOY	$8,301,436	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$7,868,984	BOYAmt
EOY	$8,327,340	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$336,671	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$143,402	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)
Consol And Sep Basis Fincl Stmt	Yes (X)	ConsolAndSepBasisFinclStmtInd

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	$264,501	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$301,159	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$276,945	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$445,309	CurrentTaxYearMinus1YearAmt
Current Tax Year	$889,191	CurrentTaxYearAmt
Total	$2,177,105	TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$264,501	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$301,159	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$276,945	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$445,309	CurrentTaxYearMinus1YearAmt
Current Tax Year	$889,191	CurrentTaxYearAmt
Total	$2,177,105	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total170	$2,177,105	PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$69,885	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$84,678	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$83,551	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$90,690	CurrentTaxYearMinus1YearAmt
Current Tax Year	$97,488	CurrentTaxYearAmt
Total	$426,292	TotalAmt

Other Income170 OtherIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$15	CurrentTaxYearMinus4YearsAmt
Total	$15	TotalAmt

Field	Value	IRS element (for citing)
Total Support	$2,603,412	TotalSupportAmt
Public Support CY170	0.83630	PublicSupportCY170Pct
Public Support PY170	0.83780	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	$142,946	BeginningYearBalanceAmt
Contributions	$3,500	ContributionsAmt
Investment Earnings Or Losses	$6,770	InvestmentEarningsOrLossesAmt
End Year Balance	$153,216	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$130,150	BeginningYearBalanceAmt
Contributions	$3,500	ContributionsAmt
Investment Earnings Or Losses	$9,296	InvestmentEarningsOrLossesAmt
End Year Balance	$142,946	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$115,851	BeginningYearBalanceAmt
Contributions	$1,750	ContributionsAmt
Investment Earnings Or Losses	$12,549	InvestmentEarningsOrLossesAmt
End Year Balance	$130,150	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$94,360	BeginningYearBalanceAmt
Contributions	$11,500	ContributionsAmt
Investment Earnings Or Losses	$9,991	InvestmentEarningsOrLossesAmt
End Year Balance	$115,851	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$62,909	BeginningYearBalanceAmt
Contributions	$35,300	ContributionsAmt
Investment Earnings Or Losses	-$3,849	InvestmentEarningsOrLossesAmt
End Year Balance	$94,360	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.50590	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.32630	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.16780	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	$4,276,682	OtherCostOrOtherBasisAmt
Depreciation	$1,283,156	DepreciationAmt
Book Value	$2,993,526	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$199,587	OtherCostOrOtherBasisAmt
Depreciation	$182,918	DepreciationAmt
Book Value	$16,669	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$13,214	OtherCostOrOtherBasisAmt
Book Value	$13,214	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$3,062,909	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	INVESTMENT IN THE COMMUNITY FOUNDATION	Desc
Book Value	$1,494,693	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$1,494,693	TotalBookValueSecuritiesAmt
Total Rev Etc Audited Fincl Stmt	$1,171,674	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	$143,402	NetUnrealizedGainsInvstAmt
Other Revenue	$25,739	OtherRevenueAmt
Revenue Not Reported	$169,141	RevenueNotReportedAmt
Revenue Subtotal	$1,002,533	RevenueSubtotalAmt
Other Revenues Not Included	$27,781	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$27,781	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$1,030,314	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$691,601	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$25,739	OtherExpensesIncludedAmt
Expenses Not Reported	$25,739	ExpensesNotReportedAmt
Expenses Subtotal	$665,862	ExpensesSubtotalAmt
Other Expenses Not Included	$27,781	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$27,781	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$693,643	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART XI, LINE 2D - OTHER ADJUSTMENTS:	SPECIAL EVENT EXPENSE 25,739.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	INVESTMENT FEES 27,781.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	SPECIAL EVENTS 25,739.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	INVESTMENT FEES 27,781.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	REGATTA	Event1Nm
Gross Receipts Event1	$14,748	GrossReceiptsEvent1Amt
Charitable Contri Event1	$1,500	CharitableContriEvent1Amt
Gross Revenue Event1	$13,248	GrossRevenueEvent1Amt
Food And Beverage Event1	$1,725	FoodAndBeverageEvent1Amt
Other Direct Expenses Event1	$2,581	OtherDirectExpensesEvent1Amt
Event2	BALL	Event2Nm
Gross Receipts Event2	$15,015	GrossReceiptsEvent2Amt
Charitable Contri Event2	$8,000	CharitableContriEvent2Amt
Gross Revenue Event2	$7,015	GrossRevenueEvent2Amt
Rent Facility Costs Event2	$2,500	RentFacilityCostsEvent2Amt
Food And Beverage Event2	$4,025	FoodAndBeverageEvent2Amt
Other Direct Expenses Event2	$1,985	OtherDirectExpensesEvent2Amt
Other Events Total	3	OtherEventsTotalCnt
Gross Receipts Other Events	$32,201	GrossReceiptsOtherEventsAmt
Charitable Contri Other Events	$13,143	CharitableContriOtherEventsAmt
Gross Revenue Other Events	$19,058	GrossRevenueOtherEventsAmt
Rent Fclty Costs Other Events	$1,300	RentFcltyCostsOtherEventsAmt
Oth Direct Expnss Other Events	$11,623	OthDirectExpnssOtherEventsAmt
Gross Receipts Total	$61,964	GrossReceiptsTotalAmt
Charitable Contributions Tot	$22,643	CharitableContributionsTotAmt
Gross Revenue Total Events	$39,321	GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events	$3,800	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$5,750	FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events	$16,189	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$25,739	DirectExpenseSummaryEventsAmt
Net Income Summary	$13,582	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	$200,000	CashGrantAmt
Valuation Method Used	COST	ValuationMethodUsedDesc
Purpose Of Grant	FINANCIAL SUPPORT TO HOSPICE OF JEFFERSON COUNTY, INC. IN ITS OPERATIONS TO PROVIDE MEDICAL CARE AND TREATMENT TO THE TERMINALLY ILL.	PurposeOfGrantTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 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.

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	$127,496	COST INCURRED
HOSPICE OF JEFFERSON COUNTY INC
B	$200,000	CASH PAID