LIFECARE HOSPICE: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- LIFECARE HOSPICE (EIN 34-1352875)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-13
- IRS object ID
- 202033189349310723
- Schema version
- 2019v5.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-11-13T15:32:32-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 S HIGH ST SUITE 100 | AddressLine1Txt |
| City | COLUMBUS | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43215 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 341352875 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LIFECARE HOSPICE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LIFE | BusinessNameControlTxt |
| Phone | 3302644899 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 AKRON ROAD | AddressLine1Txt |
| City | WOOSTER | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44691 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CALVIN W ROBINSON CFO | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3302644899 | PhoneNum |
| Signature | 2020-11-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMY CIMINELLO | PreparerPersonNm |
| PTIN | P00796388 | PTIN |
| Phone | 6148493000 | PhoneNum |
| Preparation | 2020-11-09 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 76.196.244.133 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-11-12 | IPDt |
| IP Tm | 09:58:33 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | A37BA3EEF2DF157CE517102B87C1825C045A57BE | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KURT HOLMES | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 AKRON ROAD | AddressLine1Txt |
| City | WOOSTER | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44691 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $11,988,244 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.LIFECAREHOSPICE.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1980 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF HOSPICE IS TO PROVIDE MEDICAL CARE, NURSING CARE, PAIN RELIEF, AND EMOTIONAL AND SPIRITUAL SUPPORT SERVICES TO TERMINALLY ILL PATIENTS AND THEIR FAMILIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 165 | TotalEmployeeCnt |
| Total Volunteers | 198 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $657,582 | PYContributionsGrantsAmt |
| CY Contributions Grants | $686,895 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $9,814,460 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,278,579 | CYProgramServiceRevenueAmt |
| PY Investment Income | $62 | PYInvestmentIncomeAmt |
| CY Investment Income | -$830 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$3,825 | PYOtherRevenueAmt |
| CY Other Revenue | -$1,120 | CYOtherRevenueAmt |
| PY Total Revenue | $10,468,279 | PYTotalRevenueAmt |
| CY Total Revenue | $11,963,524 | 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 | $7,389,037 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,328,808 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $114,999 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,601,179 | PYOtherExpensesAmt |
| CY Other Expenses | $4,789,423 | CYOtherExpensesAmt |
| PY Total Expenses | $11,990,216 | PYTotalExpensesAmt |
| CY Total Expenses | $13,118,231 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,521,937 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,154,707 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $13,970,059 | TotalAssetsBOYAmt |
| Total Assets EOY | $13,817,750 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,504,819 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,369,222 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,465,240 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,448,528 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF HOSPICE IS TO PROVIDE MEDICAL CARE, NURSING CARE, PAIN RELIEF, AND EMOTIONAL AND SPIRITUAL SUPPORT SERVICES TO TERMINALLY ILL PATIENTS AND THEIR FAMILIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $10,214,041 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $11,292,946 | RevenueAmt |
| Desc | LIFECARE HOSPICE IS COMMITTED TO BEING THE PREMIER PROVIDER DEDICATED TO PRESERVING THE QUALITY OF LIFE BY PROVIDING EXPERT PHYSICAL, EMOTIONAL, AND SPIRITUAL CARE TO PATIENTS AND FAMILIES WITH LIFE-LIMITING ILLNESSES. | Desc |
| Total Program Service Expenses | $10,214,041 | 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 | 0 | 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 | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | Yes (1) | 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 | 59 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 165 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 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 | Yes (1) | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | 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 | CALVIN W ROBINSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3302644899 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7575 PARAGON ROAD | AddressLine1Txt |
| City | DAYTON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45459 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| KENT ANDERSON | |||||||||
| PRESIDENT & CEO - OHI | 2.00 | 38.00 | Yes (X) | $0 | $472,400 | $63,733 | |||
| CALVIN W ROBINSON | |||||||||
| CHIEF FINANCIAL OFFICER - OHI | 2.00 | 38.00 | Yes (X) | $0 | $247,587 | $63,863 | |||
| DAVID LANCE | |||||||||
| MEDICAL DIRECTOR LIFECARE HOSPICE | 40.00 | 0.00 | $209,993 | $0 | $31,413 | Yes (X) | |||
| KURT HOLMES | |||||||||
| EXECUTIVE DIRECTOR OF LIFECARE HOSPICE | 40.00 | 0.00 | Yes (X) | $160,170 | $0 | $15,463 | Yes (X) | ||
| JODI HANNAN | |||||||||
| TEAM PHYSICIAN | 40.00 | 0.00 | $105,426 | $0 | $31,984 | Yes (X) | |||
| SHARON POOLER | |||||||||
| PAST CHAIR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| ROSE SOLTZ | |||||||||
| CHAIR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| DAVID REYNOLDS | |||||||||
| VICE CHAIR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JIM GEISER | |||||||||
| TREASURER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JOHN MILLER | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| KHANKEO KHOUNBORIN | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| MONICA MIYASHITA | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| RICHARD GUTTMAN | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| TOM CIHA | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $475,589 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $719,987 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $206,456 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SCENIC POINTE NURSING & REHAB | |||||
| 8067 TOWNSHIP ROAD 334 | MILLERSBURG | OH | 44654 | NURSING AND REHABILITATION SERVICES | $355,987 |
| WEST VIEW MANOR INC | |||||
| 1715 MECHANICSBURG ROAD | WOOSTER | OH | 44691 | HEALTH CARE SERVICES | $264,278 |
| SMITHVILLE WESTERN INC | |||||
| 3905 OBERLIN AVENUE | LORAIN | OH | 44053 | HEALTH CARE SERVICES | $235,393 |
| PROGRESSIVE WOOSTER | |||||
| 1700 E SMITHVILLE WESTERN RD | WOOSTER | OH | 44691 | NURSING AND REHABILITATION SERVICES | $222,990 |
| CASTLE NURSING HOMES INC | |||||
| 6180 STATE ROUTE 83 | MILLERSBURG | OH | 44654 | NURSING AND REHABILITATION SERVICES | $221,490 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 12 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $68,394 | FundraisingAmt |
| All Other Contributions | $618,501 | AllOtherContributionsAmt |
| Noncash Contributions | $32,666 | NoncashContributionsAmt |
| Total Contributions | $686,895 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $11,278,579 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,278,579 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $11,278,579 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $345 | TotalRevenueColumnAmt |
| Exclusion | $345 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,175 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$1,175 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,175 | TotalRevenueColumnAmt |
| Exclusion | -$1,175 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $7,500 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $68,394 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $23,545 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$16,045 | TotalRevenueColumnAmt |
| Exclusion | -$16,045 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| CAFETERIA REVENUE | 900099 | $14,367 | $14,367 | |
| MISCELLANEOUS REVENUE | 900099 | $558 | $558 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $14,925 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,963,524 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,292,946 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$16,317 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $417,039 | TotalAmt |
| Management And General | $417,039 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,271,465 | TotalAmt |
| Program Services | $5,826,436 | ProgramServicesAmt |
| Management And General | $374,690 | ManagementAndGeneralAmt |
| Fundraising | $70,339 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $250,631 | TotalAmt |
| Program Services | $215,539 | ProgramServicesAmt |
| Management And General | $35,092 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $908,314 | TotalAmt |
| Program Services | $792,942 | ProgramServicesAmt |
| Management And General | $107,152 | ManagementAndGeneralAmt |
| Fundraising | $8,220 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $481,359 | TotalAmt |
| Program Services | $421,079 | ProgramServicesAmt |
| Management And General | $60,148 | ManagementAndGeneralAmt |
| Fundraising | $132 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,323 | TotalAmt |
| Management And General | $3,323 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,800 | TotalAmt |
| Management And General | $4,800 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,415 | TotalAmt |
| Program Services | $4,631 | ProgramServicesAmt |
| Management And General | $11,784 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,235 | TotalAmt |
| Program Services | $1,780 | ProgramServicesAmt |
| Management And General | $50,333 | ManagementAndGeneralAmt |
| Fundraising | $122 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $501,420 | TotalAmt |
| Program Services | $331,700 | ProgramServicesAmt |
| Management And General | $166,776 | ManagementAndGeneralAmt |
| Fundraising | $2,944 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $231,359 | TotalAmt |
| Management And General | $231,359 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $285,182 | TotalAmt |
| Program Services | $225,656 | ProgramServicesAmt |
| Management And General | $59,526 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $291,684 | TotalAmt |
| Program Services | $260,557 | ProgramServicesAmt |
| Management And General | $30,760 | ManagementAndGeneralAmt |
| Fundraising | $367 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,551 | TotalAmt |
| Program Services | $8,437 | ProgramServicesAmt |
| Management And General | $35,114 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $239,532 | TotalAmt |
| Management And General | $239,532 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $360,511 | TotalAmt |
| Program Services | $328,220 | ProgramServicesAmt |
| Management And General | $32,291 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,594 | TotalAmt |
| Program Services | $36,038 | ProgramServicesAmt |
| Management And General | $8,847 | ManagementAndGeneralAmt |
| Fundraising | $709 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PATIENT SERVICE | $1,450,752 | $1,450,752 | |
| ALLOCATION COSTS | $852,368 | $852,368 | |
| ROOM & BOARD | $251,247 | $251,247 | |
| DUES & SUBSCRIPTIONS | $33,163 | $11,895 | $21,268 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,287 | TotalAmt |
| Program Services | $47,132 | ProgramServicesAmt |
| Management And General | $46,989 | ManagementAndGeneralAmt |
| Fundraising | $32,166 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,118,231 | TotalAmt |
| Program Services | $10,214,041 | ProgramServicesAmt |
| Management And General | $2,789,191 | ManagementAndGeneralAmt |
| Fundraising | $114,999 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $480,798 | BOYAmt |
| EOY | $845,507 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,711,752 | BOYAmt |
| EOY | $2,032,813 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,428 | BOYAmt |
| EOY | $35,432 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $11,418,677 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $875,519 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,506,081 | BOYAmt |
| EOY | $10,543,158 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $250,000 | BOYAmt |
| EOY | $250,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $110,840 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,970,059 | BOYAmt |
| EOY | $13,817,750 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,412,255 | BOYAmt |
| EOY | $1,761,626 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,781,760 | BOYAmt |
| EOY | $5,512,627 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,310,804 | BOYAmt |
| EOY | $3,094,969 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,504,819 | BOYAmt |
| EOY | $10,369,222 | 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 | $4,455,240 | BOYAmt |
| EOY | $3,334,487 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,000 | BOYAmt |
| EOY | $114,041 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,465,240 | BOYAmt |
| EOY | $3,448,528 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,970,059 | BOYAmt |
| EOY | $13,817,750 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,154,707 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $955 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $137,041 | 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 | $380,121 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $541,492 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $85,286 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $657,582 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $686,895 | CurrentTaxYearAmt |
| Total | $2,351,376 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $380,121 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $541,492 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $85,286 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $657,582 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $686,895 | CurrentTaxYearAmt |
| Total | $2,351,376 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $233,249 | SubstantialContributorsTotAmt |
| Public Support Total170 | $2,118,127 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $22,251 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $41,738 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $30 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $62 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $345 | CurrentTaxYearAmt |
| Total | $64,426 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $69,342 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $51,569 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $65,579 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | -$1,714 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,058 | CurrentTaxYearAmt |
| Total | $192,834 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $2,608,636 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $49,952,575 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.81200 | PublicSupportCY170Pct |
| Public Support PY170 | 0.86040 | 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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,155,107 | OtherCostOrOtherBasisAmt |
| Book Value | $1,155,107 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,780,754 | OtherCostOrOtherBasisAmt |
| Depreciation | $456,774 | DepreciationAmt |
| Book Value | $8,323,980 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $412,247 | OtherCostOrOtherBasisAmt |
| Depreciation | $40,005 | DepreciationAmt |
| Book Value | $372,242 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,050,604 | OtherCostOrOtherBasisAmt |
| Depreciation | $375,722 | DepreciationAmt |
| Book Value | $674,882 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,965 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,018 | DepreciationAmt |
| Book Value | $16,947 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $10,543,158 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PAYABLE TO RELATED PARTY | Desc |
| Amt | $3,094,969 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,094,969 | TotalLiabilityAmt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | SPRING GALA | Event1Nm |
| Gross Receipts Event1 | $75,894 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $68,394 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $7,500 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $0 | CashPrizesEvent1Amt |
| Non Cash Prizes Event1 | $0 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $1,000 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $10,181 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $40 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $12,324 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $75,894 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $68,394 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $7,500 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $1,000 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $10,181 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $40 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $12,324 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $23,545 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$16,045 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KENT ANDERSON | ||||||||||||||
| PRESIDENT & CEO - OHI | $0 | $405,900 | $0 | $66,500 | $0 | $0 | $0 | $38,348 | $0 | $25,385 | $0 | $536,133 | $0 | $0 |
| CALVIN W ROBINSON | ||||||||||||||
| CHIEF FINANCIAL OFFICER - OHI | $0 | $222,387 | $0 | $25,200 | $0 | $0 | $0 | $38,574 | $0 | $25,289 | $0 | $311,450 | $0 | $0 |
| DAVID LANCE | ||||||||||||||
| MEDICAL DIRECTOR LIFECARE HOSPICE | $194,318 | $0 | $15,675 | $0 | $0 | $0 | $10,300 | $0 | $21,113 | $0 | $241,406 | $0 | $0 | $0 |
| KURT HOLMES | ||||||||||||||
| EXECUTIVE DIRECTOR OF LIFECARE HOSPI | $146,670 | $0 | $13,500 | $0 | $0 | $0 | $15,463 | $0 | $0 | $0 | $175,633 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE EXECUTIVE COMMITTEE OF THE OHI BOARD OF TRUSTEES UTILIZED LOCAL MARKET KNOWLEDGE, ANNUAL PERFORMANCE EVALUATIONS AND BENCHMARK DATA TO ESTABLISH COMPENSATION FOR THE CEO. THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS ESTABLISHED BY THE CEO UNDER GUIDELINES ESTABLISHED BY OHI AND AFFILIATE BOARDS OF TRUSTEES AS PART OF THE BUDGET PROCESS. |
| PART I, LINE 7 | THE BOARD OF DIRECTORS CONDUCTS AN ANNUAL PERFORMANCE REVIEW TO DETERMINE THE COMPENSATION AND BENEFITS OF THE CEO. IN ADDITION TO NORMAL COMPENSATION AND BENEFITS, THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS MAY ALSO AWARD BONUS COMPENSATION TO THE CEO BASED UPON THE ANNUAL PERFORMANCE REVIEW. THE CEO CONDUCTS AN ANNUAL PERFORMANCE REVIEW OF THE OTHER OFFICERS AND EMPLOYEES TO DETERMINE THEIR COMPENSATION AND BENEFITS. IN ADDITION TO NORMAL COMPENSATION AND BENEFITS, THE CEO, WITH THE APPROVAL OF THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS, MAY ALSO AWARD BONUS COMPENSATION TO THE OTHER OFFICERS AND EMPLOYEES BASED UPON THEIR ANNUAL PERFORMANCE REVIEW. |
Schedule M IRS990ScheduleM
Works Of Art WorksOfArtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $4,220 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp (6 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | HEARING AIDS | 26 | $13,800 | FAIR MARKET VALUE |
| Yes (X) | FURNITURE | 1 | $7,000 | FAIR MARKET VALUE |
| Yes (X) | MASSAGE EQUIPMENT | 1 | $3,471 | FAIR MARKET VALUE |
| Yes (X) | LEGAL WORK | 1 | $1,750 | FAIR MARKET VALUE |
| Yes (X) | EVENT VENUE DISCOUNT | 1 | $1,000 | FAIR MARKET VALUE |
| Yes (X) | PUMP | 1 | $925 | FAIR MARKET VALUE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | OHIO'S HOSPICE, INC BECAME THE SOLE MEMBER OF LIFECARE HOSPICE WITH AN AFFILIATION AGREEMENT SIGNED IN JUNE 2017. |
| FORM 990, PART VI, SECTION A, LINE 7A | OHIO'S HOSPICE INC. HAS THE POWER TO APPOINT THE BOARD OF DIRECTORS. THE BOARD SHALL RECOMMEND INDIVIDUALS TO FILL ANY OPENINGS. OHIO'S HOSPICE HAS THE RIGHT TO ELECT FROM THESE INDIVIDUALS OR OTHER INDIVIDUALS AT ITS DISCRETION. |
| FORM 990, PART VI, SECTION A, LINE 7B | OHIO'S HOSPICE INC. RETAINS THE POWER TO AMEND THE ARTICLES OF INCORPORATION, CODE OF REGULATIONS, ETC. OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WAS PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND REVIEWED BY THE CFO PRIOR TO BEING FILED WITH THE INTERNAL REVENUE SERVICE. THE FORM 990 IS SENT VIA EMAIL TO THE FULL BOARD AND WILL BE REVIEWED IN SESSION BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS AT THEIR NEXT MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | IN THE EVENT ANY DIRECTOR, OFFICER OR EXECUTIVE OF THE ORGANIZATION SHALL HAVE ANY DIRECT OR INDIRECT INTEREST IN OR RELATIONSHIP WITH ANY INDIVIDUAL OR ORGANIZATION THAT PROPOSES TO ENTER INTO ANY TRANSACTION WITH THE ORGANIZATION FOR THE SALE, PURCHASE, LEASE OR RENTAL OF PROPERTY OR TO RENDER OR EMPLOY SERVICES, PERSONAL OR OTHERWISE, SUCH DIRECTOR, OFFICER OR EXECUTIVE SHALL FORTHWITH GIVE THE BOARD OF DIRECTORS, CHAIR OF THE BOARD OR PRESIDENT OF THE ORGANIZATION NOTICE OF SUCH INTEREST OR RELATIONSHIP AND SHALL THEREAFTER NOT BE COUNTED FOR THE PURPOSE OF DETERMINING A QUORUM AND SHALL REFRAIN FROM VOTING OR OTHERWISE ATTEMPTING TO AFFECT ITS DECISION TO PARTICIPATE IN SUCH TRANSACTION. IN THE EVENT THAT A CHALLENGE OR QUESTION IS RAISED WHETHER CONFLICT OR DUALITY OF INTEREST EXISTS, THE BOARD OR CHAIR OF THE BOARD OF THE ORGANIZATION SHALL DETERMINE THAT A DUALITY OF INTEREST EXISTS (BY A 2/3 VOTE OF THE BODY). MINUTES OF APPROPRIATE MEETINGS SHOULD REFLECT THAT SUCH DISCLOSURE WAS MADE, AND THAT SUCH DIRECTOR REMOVED HIMSELF/HERSELF FROM THE ROOM AND DID NOT PARTICIPATE IN THE FINAL DISCUSSION, AND WAS NOT COUNTED FOR THE PURPOSE OF DETERMINING A QUORUM. THE CONFLICT OF INTEREST STATEMENT SHALL BE REVIEWED ANNUALLY FOR THE INFORMATION AND GUIDANCE OF DIRECTORS, OFFICERS OR EXECUTIVES AND THAT ANY NEW DIRECTORS, OFFICERS OR EXECUTIVES BE ADVISED OF THE POLICY UPON UNDERTAKING THE DUTIES OF SUCH OFFICE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE COMMITTEE OF THE OHI BOARD OF TRUSTEES UTILIZED LOCAL MARKET KNOWLEDGE, ANNUAL PERFORMANCE EVALUATIONS AND BENCHMARK DATA TO ESTABLISH COMPENSATION FOR THE CEO. THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS ESTABLISHED BY THE CEO UNDER GUIDELINES ESTABLISHED BY OHI AND AFFILIATE BOARDS OF TRUSTEES AS PART OF THE BUDGET PROCESS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. |
| FORM 990, PART XI, LINE 9: | RESTRICTED CONTRIBUTIONS 135,795. NET CHANGE IN FAIR VALUE OF PERPETUAL TRUST 1,246. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| COMMUNITY CARE HOSPICE INC | |||||||||||
| PO BOX 123 | WILMINGTON | OH | 45177 | 371495725 | TO PROVIDE HOSPICE CARE | OH | 501(C)(3) | LINE 7 | OHIO'S HOSPICE INC | Yes (1) | |
| FOUNDATION FOR HOSPICE OF CENTRAL OHIO | |||||||||||
| 2269 CHERRY VALLEY ROAD | NEWARK | OH | 43055 | 550855205 | TO PROVIDE FINANCIAL SUPPORT TO ITS PARENT, HOSPICE OF CENTRAL OHIO | OH | 501(C)(3) | LINE 12A, I | HOSPICE OF CENTRAL OHIO | Yes (1) | |
| HOSPICE OF CENTRAL OHIO | |||||||||||
| 2269 CHERRY VALLEY ROAD | NEWARK | OH | 43055 | 311059756 | TO PROVIDE HOSPICE CARE | OH | 501(C)(3) | LINE 7 | OHIO'S HOSPICE INC | Yes (1) | |
| HOSPICE OF DAYTON FOUNDATION | |||||||||||
| 7575 PARAGON ROAD | DAYTON | OH | 45459 | 311769696 | TO PROVIDE FINANCIAL SUPPORT TO ITS PARENT, HOSPICE OF DAYTON | OH | 501(C)(3) | LINE 12A, I | HOSPICE OF DAYTON INC | Yes (1) | |
| HOSPICE OF DAYTON INC | |||||||||||
| 7575 PARAGON ROAD | DAYTON | OH | 45459 | 310933339 | TO PROVIDE HOSPICE CARE | OH | 501(C)(3) | LINE 7 | OHIO'S HOSPICE INC | Yes (1) | |
| HOSPICE OF MIAMI COUNTY INC | |||||||||||
| 550 SUMMIT AVENUE | TROY | OH | 45373 | 311031277 | TO PROVIDE HOSPICE CARE | OH | 501(C)(3) | LINE 7 | OHIO'S HOSPICE INC | Yes (1) | |
| OHIO'S HOSPICE INC | |||||||||||
| 7575 PARAGON ROAD | DAYTON | OH | 45459 | 463215586 | TO PROVIDE MANAGEMENT SERVICES AS A SUPPORTING ORGANIZATION | OH | 501(C)(3) | LINE 12A, I | 0 | N/A | |
| LOVING CARE HOSPICE | |||||||||||
| PO BOX 445 | LONDON | OH | 43140 | 311370625 | TO PROVIDE HOSPICE CARE | OH | 501(C)(3) | LINE 10 | OHIO'S HOSPICE INC | Yes (1) | |
| HOSPICE OF FAYETTE COUNTY | |||||||||||
| 222 N OAKLAND AVE | WASHINGTON COURTHOUSE | OH | 43160 | 311243376 | TO PROVIDE HOSPICE CARE | OH | 501(C)(3) | LINE 7 | OHIO'S HOSPICE INC | Yes (1) | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NATIONAL HOSPICE COOPERATIVE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 324 WILMINGTON AVE | AddressLine1Txt |
| City | DAYTON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45420 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 832087147 | EIN |
| Primary Activities | BUSINESS SUPPORT | PrimaryActivitiesTxt |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | 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 | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | 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 |
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