2020-11-13T15:32:32-06:00 2019-12-31 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2019-01-01 311769696 HOSPICE OF DAYTON FOUNDATION HOSP 9372564490 324 WILMINGTON AVENUE DAYTON OH 45420 CALVIN W ROBINSON CFO 9372564490 2020-11-12 1 AMY CIMINELLO P00796388 6148493000 2020-11-12 76.196.244.133 2020-11-12 10:15:55 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 A37BA3EEF2DF157CE517102B87C1825C045A57BE 2019 2021-01-29 14:40:06Z LORI IGEL 324 WILMINGTON AVE DAYTON OH 45420 4911361 0 X WWW.HOSPICEOFDAYTON.ORG X 2001 OH TO PROVIDE FINANCIAL SUPPORT TO ITS PARENT ORGANIZATION, THE HOSPICE OF DAYTON, INC. (31-0933339) 14 12 24 12 0 0 4044447 3090026 0 0 2168327 1524340 114916 160250 6327690 4774616 2635729 2124745 0 0 828497 745303 0 0 1056934 595459 666657 4059685 3536705 2268005 1237911 36393582 42688733 263417 285272 36130165 42403461 X HOSPICE OF DAYTON FOUNDATION IS A SUPPORTIVE FOUNDATION OF THE HOSPICE OF DAYTON, INC. IT PROVIDES COUNSEL AND ASSISTANCE TO THE HOSPICE OF DAYTON INC., BY HELPING TO IDENTIFY AND ACCESS INDIVIDUAL AND CORPORATE FINANCIAL SUPPORT WITHIN THE HOSPICE OF DAYTON'S SERVICE AREA, PROVIDING A COMMUNITY PERSPECTIVE ON KEY ISSUES RELEVANT TO PALLIATIVE AND HOSPICE CARE, AIDING IN THE DEVELOPMENT OF A COMPREHENSIVE COMMUNITY OUTREACH EDUCATIONAL PROGRAM, HELPING TO SHAPE KEY MESSAGES ON HOSPICE AND PALLIATIVE CARE, HELPING FORMULATE STRATEGIES TO INCREASE NON-EARNED REVENUE, AND MAKING FUNDING/GRANTING DECISIONS RELATIVE TO THE HOSPICE OF DAYTON, INC. 0 0 2130547 2124745 175493 SUPPORT OF THE HOSPICE OF DAYTON, INC. (EIN 31-0933339) GRANTS PAID SUPPORT INDIGENT CARE, PATHWAYS OF HOPE, COMPLIMENTARY CARE, PALLIATIVE CARE, AS WELL AS THE OVERALL COMMUNITY BASED MODEL OF CARE. 2130547 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 24 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 14 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X CALVIN W ROBINSON 9372564490 324 WILMINGTON AVENUE DAYTON OH 45420 KENT ANDERSON PRESIDENT & CEO - OHI 2.00 38.00 X 0 472400 63733 MARY MURPHY PRESIDENT OF HOSPICE OF DAYTON 2.00 38.00 X X 0 252193 60235 CALVIN W ROBINSON CHIEF FINANCIAL OFFICER - OHI 2.00 38.00 X 0 247587 63863 LORI IGEL EXEC DIR. FOUNDATION/SR. VP PHILANTHROPY & EN 40.00 0.00 X X 128607 0 42431 JANICE CULVER CHAIR 3.00 0.00 X X 0 0 0 TONY LOMBARDO VICE CHAIR 2.00 0.00 X X 0 0 0 CHIP MUES BOARD MEMBER 2.00 0.00 X 0 0 0 DON FODOR BOARD MEMBER 2.00 0.00 X 0 0 0 GREG TOMAN BOARD MEMBER 2.00 5.00 X 0 0 0 JANE WINCH BOARD MEMBER 2.00 0.00 X 0 0 0 JERRY TATAR BOARD MEMBER 2.00 0.00 X 0 0 0 JOHN SWEENEY BOARD MEMBER 2.00 0.00 X 0 0 0 LYNDA HOFFMAN BOARD MEMBER 2.00 0.00 X 0 0 0 MICHAEL BOLAND BOARD MEMBER 2.00 0.00 X 0 0 0 RICHARD WICK BOARD MEMBER 2.00 0.00 X 0 0 0 THOMAS MANN BOARD MEMBER 2.00 5.00 X 0 0 0 128607 972180 230262 1 0 1 0 0 238987 2851039 48782 3090026 838457 838457 685883 0 685883 685883 685883 113281 238987 128524 -15243 -15243 183714 8221 175493 175493 4774616 175493 0 1509097 2124745 2124745 171039 171039 445254 445254 27823 27823 50670 50670 50517 50517 768 768 842 842 164120 164120 4187 4187 26845 26845 254182 3523 250659 97744 97744 9281 9281 26745 26745 7600 7600 7341 5802 1424 115 VOLUNTEER EXPENSE 48761 48761 DUES & SUBSCRIPTIONS 17421 17421 EMPLOYEE EXPENSE 676 676 DONATED IN-KIND EXPENSE 144 144 3536705 2130547 349224 1056934 1982 2000 183615 467325 1273058 1550392 13151 47060 38000 23433 22167 14567 24369051 26320904 10530558 14286485 36393582 42688733 74737 115294 188680 169978 263417 285272 X 33647107 37670555 2483058 4732906 36130165 42403461 36393582 42688733 X 1237911 2658695 2376690 X X 0 1 X 1 0 X X 1 THE HOSPICE OF DAYTON INC 310933339 7 1 2124745 0 1 2124745 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 24369051 3878398 1808135 118410 26320904 28829625 -730177 3730397 24369051 24949847 709925 3378753 208900 28829625 28773188 30000 1146659 5000000 24949847 28776265 25000 -4436 23641 28773188 0.95780 0.04220 0.00000 0 0 38000 23433 14567 14567 DUE FROM RELATED ENTITIES 14286485 14286485 PAYABLE TO RELATED PARTY 169978 169978 PART V, LINE 4 ENDOWMENT FUNDS ARE MAINTAINED TO PROVIDE FINANCIAL SUPPORT TO THE FOUNDATION'S PARENT ORGANIZATION, THE HOPSICE OF DAYTON, INC. (31-0933339) IT IS THE FOUNDATION'S OBJECTIVE TO UTILIZE CURRENT FUNDRAISING TO SUPPORT THE HOSPICE OF DAYTON, INC'S PROGRAMS, TO GROW AND PROVIDE RESERVES FOR UNFORESEEN CIRCUMSTANCES OR TO FUND SIGNIFICANT NEW INITIATIVES. STEINS AND STEMS 119634 92594 27040 0 27320 5761 3431 25798 GOLF OUTING 121016 92016 29000 0 0 6807 18620 0 3302 4 111618 54377 57241 0 1100 7384 4500 300 24201 352268 238987 113281 28420 19952 26551 300 53301 128524 -15243 1 THE HOSPICE OF DAYTON INC 324 WILMINGTON AVENUE DAYTON OH 45420 310933339 501(C)(3) 2124745 TO FACILITATE THE HOSPICE OF DAYTON, INC PURPOSE TO PROVIDE HOSPICE CARE TO THE TERMINALLY ILL 1 0 PART I, LINE 2: THE GRANTS ARE PROVIDED TO A RELATED ORGANIZATION. MANAGEMENT OVERLAP BETWEEN THE RELATED ORGANIZATIONS ALLOWS FOR THE ORGANIZATION TO SUBSTANTIATE THE AMOUNT OF THE GRANT. MANAGEMENT OF THE ORGANIZATIONS DETERMINE THE AMOUNT OF FUNDS THAT WILL BE PROVIDED AS THE CRITERIA FOR THE GRANT. 0 0 0 0 0 0 0 1 0 KENT ANDERSON PRESIDENT & CEO - OHI 0 405900 0 66500 0 0 0 38348 0 25385 0 536133 0 0 MARY MURPHY PRESIDENT OF HOSPICE OF DAYTON 0 225193 0 27000 0 0 0 33907 0 26328 0 312428 0 0 CALVIN W ROBINSON CHIEF FINANCIAL OFFICER - OHI 0 222387 0 25200 0 0 0 38574 0 25289 0 311450 0 0 LORI IGEL EXEC DIR. FOUNDATION/SR. VP PHILANTH 117107 0 11500 0 0 0 16640 0 25792 0 171039 0 0 0 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. X INTERIOR DESIGN SERVICES 3 21807 FAIR MARKET VALUE X PRINTING SERVICES 5 6600 FAIR MARKET VALUE X GOLE APPAREL & EQUIPMENT 471 6130 FAIR MARKET VALUE X ADVERTISING SERVICES 1 5000 FAIR MARKET VALUE X FOOD & FOOD DISCOUNTS 23 4925 FAIR MARKET VALUE X CATORING SERVICES 2 1550 FAIR MARKET VALUE X MISCELLANEOUS ITEMS 4 1360 X PERFORMING ARTS TICKETS 5 496 FAIR MARKET VALUE X SPORTS & RECREATION PASSES 7 466 FAIR MARKET VALUE X DJ SERVICES 1 250 FAIR MARKET VALUE X KATE SPADE TICKETS 2 198 FAIR MARKET VALUE 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 HOSPICE OF DAYTON BECAME THE SOLE MEMBER OF HOSPICE OF DAYTON FOUNDATION WITH AN AFFILIATION AGREEMENT SIGNED IN JULY 2013. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE MEMBER, HOD HAS THE EXCLUSIVE AUTHORITY BY ACT OF HOD'S BOARD OF DIRECTORS TO APPROVE -REMOVAL OF ONE OR MORE TRUSTEES OF THE FOUDATION'S BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B AS THE SOLE MEMBER, HOD HAS THE EXCLUSIVE AUTHORITY BY ACT OF HOD'S BOARD OF DIRECTORS TO APPROVE -AMENDMENT OR REPEAL OF THE ARTICLES OF INCORPORATION, CODE OF REGULATIONS OR BYLAWS OF THE FOUNDATION, -CHANGE IN THE CORPORATE PURPOSE AND MISSION OF THE FOUNDATION, -DISSOLUTION, LIQUIDATION OR CESSATION OF OPERATIONS OF THE FOUNDATION, AND, -MERGER OR CONSOLIDATION OF THE FOUNDATION, OR SALE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE FOUNDATION'S PROPERTY SUBJECT TO THE AUTHORITY OF HOD AS MEMBER, THE FOUNDATION IS CONTROLLED AND MANAGED UNDER THE DIRECTION OF THE BOARD OF TRUSTEES. 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 3,295,331. NET ASSETS RELEASED FROM RESTRICTION -918,641. FORM 990, PART XII, LINE 2C: OHI'S FINANCE COMMITTEE HAS RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT THIS PROCESS IS CONSISTENT WITH PRIOR YEAR. 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 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 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 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 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 1 LIFECARE HOSPICE 1900 AKRON ROAD WOOSTER OH 44691 341352875 TO PROVIDE HOSPICE CARE OH 501(C)(3) LINE 7 OHIO'S HOSPICE INC 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 N/A 0 LOVING CARE HOSPICE PO BOX 445 LONDON OH 43140 311370625 TO PROVIDE HOSPICE CARE OH 501(C)(3) LINE 10 OHIO'S HOSPICE INC 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 1 NATIONAL HOSPICE COOPERATIVE 324 WILMINGTON AVE DAYTON OH 45420 832087147 OH N/A C 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0