ROCK RIVER HOSPICE & HOME: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
ROCK RIVER HOSPICE & HOME (EIN 36-3378606)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-14
IRS object ID
201713189349304641
Schema version
2016v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2017-11-14T13:21:48-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390758449PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Wipfli LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1403 East Third StreetAddressLine1Txt
CitySterlingCityNm
State AbbreviationILStateAbbreviationCd
ZIP61081ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN363378606EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Hospice of the Rock River ValleyBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHOSPBusinessNameControlTxt
Phone8156253858PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12600 N Locust St Ste BAddressLine1Txt
CitySterlingCityNm
State AbbreviationILStateAbbreviationCd
ZIP61081ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonEMILY TAYLORPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone8152883673PhoneNum
Signature2017-11-02SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJessica MacklinPreparerPersonNm
PTINP01613179PTIN
Phone8156261277PhoneNum
Preparation2017-10-26PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address199.168.71.34IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-11-02IPDt
IP Tm16:48:03IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device Id49E3870F3668247A667EA7A551B803BBC2B6D114AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerEmily TaylorPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12600 N Locust St STE BAddressLine1Txt
CitySterlingCityNm
State AbbreviationILStateAbbreviationCd
ZIP61081ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$2,109,769GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.hospicerockriver.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1982FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionHOSPICE OF THE ROCK RIVER VALLEY AFFIRMS LIFE BY PROVIDING EXCEPTIONAL CARE AND SUPPORT TO THOSE TRANSITIONING THROUGH SERIOUS ILLNESS, DEATH AND GRIEF.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee27TotalEmployeeCnt
Total Volunteers35TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$382,368PYContributionsGrantsAmt
CY Contributions Grants$554,359CYContributionsGrantsAmt
PY Program Service Revenue$1,267,984PYProgramServiceRevenueAmt
CY Program Service Revenue$1,247,806CYProgramServiceRevenueAmt
PY Investment Income$145,870PYInvestmentIncomeAmt
CY Investment Income$13,090CYInvestmentIncomeAmt
PY Other Revenue$166,077PYOtherRevenueAmt
CY Other Revenue$48,827CYOtherRevenueAmt
PY Total Revenue$1,962,299PYTotalRevenueAmt
CY Total Revenue$1,864,082CYTotalRevenueAmt
PY Grants And Similar Paid$324,631PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$324,691CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$897,685PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$879,810CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$4,745CYTotalFundraisingExpenseAmt
PY Other Expenses$320,112PYOtherExpensesAmt
CY Other Expenses$310,686CYOtherExpensesAmt
PY Total Expenses$1,542,428PYTotalExpensesAmt
CY Total Expenses$1,515,187CYTotalExpensesAmt
PY Revenues Less Expenses$419,871PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$348,895CYRevenuesLessExpensesAmt
Total Assets BOY$1,528,844TotalAssetsBOYAmt
Total Assets EOY$2,011,142TotalAssetsEOYAmt
Total Liabilities BOY$215,046TotalLiabilitiesBOYAmt
Total Liabilities EOY$344,245TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,313,798NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,666,897NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionHOSPICE IS THE CONCEPT AND PRACTICE OF COMPASSIONATE HEALTHCARE FOR PATIENTS AND FAMILIES DEALING WITH THE FINAL STAGES OF A LIFE LIMITING ILLNESS. WHEN A CURE IS NO LONGER A VIABLE OPTION, MUCH CAN STILL BE DONE. HOSPICE NEITHER PROLONGS LIFE NOR HASTENS DEATH. INSTEAD, HOSPICE FOCUSES ON QUALITY OF LIFE BY (1)KEEPING THE PATIENT COMFORTABLE IN HIS/HER OWN HOME OR PLACE OF RESIDENCE (2)HELPING THE PATIENT AND FAMILY GAIN A SENSE OF CONTROL AND COMPETENCE (3)PROMOTING THE PATIENT'S AND FAMILY'S DIGNITY, AUTONOMY AND RIGHT TO PRIVACY (4)ENHANCING THE TIME THE PATIENT AND FAMILY SHARE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$826,298ExpenseAmt
Grant$309,691GrantAmt
Revenue$1,252,229RevenueAmt
DescHOSPICE CARE - To provide fully-licensed hospice care services for terminally ill patients and their families in the Rock River Valley.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$3,763ExpenseAmt
Grant$5,000GrantAmt
DescVOLUNTEER - Volunteers provide ongoing support and reassurance as well as a broad spectrum of services, including daily household tasks and activities that contribute to the comfort of the patient and family.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$5,894ExpenseAmt
Grant$10,000GrantAmt
DescBEREAVEMENT - Provide bereavement support to families to help them work through the anxiety, fear, depression, sorrow and anger that are often present at the time of death.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$54,909ExpenseAmt
DescSOCIAL SERVICES - Provide social services to patients and familes to help ensure they are informed of other services available to help them through local agencies.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$54,909TotalOtherProgSrvcExpenseAmt
Total Program Service Expenses$890,864TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee27EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Brenda Van HornBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8156256152PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12600 N Locust st Ste BAddressLine1Txt
CitySterlingCityNm
State AbbreviationILStateAbbreviationCd
ZIP61081ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
Linda Olds-Steinert
VICE PRESIDENT2.00Yes (X)Yes (X)$0$0$0
pAT PETTENGER
Treasurer2.00Yes (X)Yes (X)$0$0$0
Donna Adams
SECRETARY2.00Yes (X)$0$0$0
KRISTIE GEIL
Director2.00Yes (X)$0$0$0
Rick Kerley
Director2.00Yes (X)$0$0$0
MARGO JAKOBS
DIRECTOR2.00Yes (X)$0$0$0
EMILY TAYLOR
EXECUTIVE DIRECTOR45.00Yes (X)Yes (X)$64,997$0$0
JIM EGGELSTON
DIRECTOR2.00Yes (X)$0$0$0
Deb Keachall
AdvisoRY BOARD MEMBER2.00Yes (X)$0$0$0
Randy Clark
president2.00Yes (X)Yes (X)$0$0$0
Linda Giesen
Director2.00Yes (X)$0$0$0
kAYLA bURN
DIRECTOR2.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$64,997TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$32,275FundraisingAmt
Government Grants$43,931GovernmentGrantsAmt
All Other Contributions$478,153AllOtherContributionsAmt
Noncash Contributions$65,419NoncashContributionsAmt
Total Contributions$554,359TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET Patient ServiceDesc
Business624100BusinessCd
Total Revenue Column$1,247,806TotalRevenueColumnAmt
Related Or Exempt Func Income$1,247,806RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$1,247,806TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,250TotalRevenueColumnAmt
Exclusion$11,250ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$232,038SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$230,198SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$1,840SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,840TotalRevenueColumnAmt
Related Or Exempt Func Income$1,840RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$65,610FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$32,275ContriRptFundraisingEventAmt
Fundraising Direct Expenses$15,489FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$50,121TotalRevenueColumnAmt
Exclusion$50,121ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER REVENUES AND SUPDesc
Business900099BusinessCd
Total Revenue Column-$1,294TotalRevenueColumnAmt
Related Or Exempt Func Income-$1,294RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total-$1,294OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,864,082TotalRevenueColumnAmt
Related Or Exempt Func Income$1,248,352RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$61,371ExclusionAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$324,691TotalAmt
Program Services$324,691ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$56,878TotalAmt
Management And General$56,878ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$688,891TotalAmt
Program Services$403,982ProgramServicesAmt
Management And General$284,909ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$7,143TotalAmt
Program Services$2,514ProgramServicesAmt
Management And General$4,629ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$74,059TotalAmt
Program Services$47,073ProgramServicesAmt
Management And General$26,986ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$52,839TotalAmt
Program Services$34,321ProgramServicesAmt
Management And General$18,518ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$9,850TotalAmt
Management And General$9,850ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$23,831TotalAmt
Program Services$569ProgramServicesAmt
Management And General$23,262ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$67,043TotalAmt
Program Services$21,101ProgramServicesAmt
Management And General$45,942ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$5,595TotalAmt
Management And General$5,595ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$10,201TotalAmt
Program Services$68ProgramServicesAmt
Management And General$10,133ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$52,451TotalAmt
Program Services$45,124ProgramServicesAmt
Management And General$7,327ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$332TotalAmt
Program Services$78ProgramServicesAmt
Management And General$254ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$3,456TotalAmt
Management And General$3,456ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$8,220TotalAmt
Management And General$8,220ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$14,225TotalAmt
Management And General$14,225ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
OTHER EXPENSES$61,220$10,815$45,660$4,745
Misc$48,454$48,454
FEES$5,808$528$5,280

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,515,187TotalAmt
Program Services$890,864ProgramServicesAmt
Management And General$619,578ManagementAndGeneralAmt
Fundraising$4,745FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$735,869BOYAmt
EOY$922,512EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$81,155BOYAmt
EOY$79,684EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$217,278BOYAmt
EOY$346,246EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$4,098BOYAmt
EOY$9,985EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$485,307LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$65,123LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$274,263BOYAmt
EOY$420,184EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$216,181BOYAmt
EOY$232,531EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,528,844BOYAmt
EOY$2,011,142EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$209,445BOYAmt
EOY$342,110EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$5,601BOYAmt
EOY$2,135EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$215,046BOYAmt
EOY$344,245EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,168,994BOYAmt
EOY$1,366,065EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$144,804BOYAmt
EOY$300,832EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,313,798BOYAmt
EOY$1,666,897EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,528,844BOYAmt
EOY$2,011,142EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$348,895ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$4,204NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$303,085CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$185,274CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$550,293CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$382,368CurrentTaxYearMinus1YearAmt
Current Tax Year$562,544CurrentTaxYearAmt
Total$1,983,564TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,387,490CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,244,743CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,326,696CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,267,984CurrentTaxYearMinus1YearAmt
Current Tax Year$1,247,806CurrentTaxYearAmt
Total$6,474,719TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,690,575CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,430,017CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,876,989CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,650,352CurrentTaxYearMinus1YearAmt
Current Tax Year$1,810,350CurrentTaxYearAmt
Total$8,458,283TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$8,458,283PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$279CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$37,941CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$17,376CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$145,870CurrentTaxYearMinus1YearAmt
Current Tax Year$13,090CurrentTaxYearAmt
Total$214,556TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$279CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$37,941CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$17,376CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$145,870CurrentTaxYearMinus1YearAmt
Current Tax Year$13,090CurrentTaxYearAmt
Total$214,556TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$42,174CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$42,668CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$40,036CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$166,077CurrentTaxYearMinus1YearAmt
Current Tax Year$40,642CurrentTaxYearAmt
Total$331,597TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,603CurrentTaxYearMinus4YearsAmt
Total$2,603TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,735,631CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,510,626CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,934,401CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,962,299CurrentTaxYearMinus1YearAmt
Current Tax Year$1,864,082CurrentTaxYearAmt
Total$9,007,039TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.93910PublicSupportCY509Pct
Public Support PY5090.93870PublicSupportPY509Pct
Investment Income CY0.02380InvestmentIncomeCYPct
Investment Income PY0.02370InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$245,000OtherCostOrOtherBasisAmt
Book Value$245,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Book Value$0BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,927OtherCostOrOtherBasisAmt
Depreciation$14,333DepreciationAmt
Book Value$1,594BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$39,448OtherCostOrOtherBasisAmt
Depreciation$34,810DepreciationAmt
Book Value$4,638BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$184,932OtherCostOrOtherBasisAmt
Depreciation$15,980DepreciationAmt
Book Value$168,952BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$420,184TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$1,883,775TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$4,204NetUnrealizedGainsInvstAmt
Revenue Not Reported$4,204RevenueNotReportedAmt
Revenue Subtotal$1,879,571RevenueSubtotalAmt
Other Revenues Not Included-$15,489OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$15,489RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$1,864,082TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,530,676TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$15,489OtherExpensesIncludedAmt
Expenses Not Reported$15,489ExpensesNotReportedAmt
Expenses Subtotal$1,515,187ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$1,515,187TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part X, Line 2:Accounting principles generally accepted in the United States of America provides detailed guidance for the financial statement recognition, measurement and disclosure of uncertain tax positions recognized in an enterprise's financial statements. Generally accepted accounting principles require an entity to recognize the financial statement impact of a tax position when it is more likely than not that the position will be sustained upon examination. THERE WERE NO UNCERTAIN TAX POSITIONS NOTED ON THE AUDITED FINANCIAL STATEMENTS.
Part XI, Line 4b - Other Adjustments:RECLASS Fundraising Direct Benefit to Donors -15,489.
Part XII, Line 2d - Other Adjustments:RECLASS Fundraising Direct Benefit to Donors 15,489.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1ANNUAL GOLF OUTINGEvent1Nm
Gross Receipts Event1$15,545GrossReceiptsEvent1Amt
Charitable Contri Event1$3,680CharitableContriEvent1Amt
Gross Revenue Event1$11,865GrossRevenueEvent1Amt
Other Direct Expenses Event1$4,388OtherDirectExpensesEvent1Amt
Event2FESTIVAL OF TREESEvent2Nm
Gross Receipts Event2$72,223GrossReceiptsEvent2Amt
Charitable Contri Event2$28,595CharitableContriEvent2Amt
Gross Revenue Event2$43,628GrossRevenueEvent2Amt
Other Direct Expenses Event2$14,526OtherDirectExpensesEvent2Amt
Other Events Total1OtherEventsTotalCnt
Gross Receipts Other Events$10,117GrossReceiptsOtherEventsAmt
Gross Revenue Other Events$10,117GrossRevenueOtherEventsAmt
Oth Direct Expnss Other Events$1,320OthDirectExpnssOtherEventsAmt
Gross Receipts Total$97,885GrossReceiptsTotalAmt
Charitable Contributions Tot$32,275CharitableContributionsTotAmt
Gross Revenue Total Events$65,610GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events$20,234OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$20,234DirectExpenseSummaryEventsAmt
Net Income Summary$45,376NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeASSISTANCE PROVIDED TO THE PATIENTS INCLUDES MEDICATIONS, ROOM AND BOARD, ANGrantTypeTxt
Cash Grant$324,691CashGrantAmt
Non Cash AssistanceTHE ASSISTANCE PROVIDED IS THE ORGANIZATION PAYS FOR THE PATIENTS' MEDICATIONS, ROOM AND BOARD, AND BRINGS IN MEDICAL EQUIPMENT TO BE USED IN THE PATIENTS' HOMES, AS DESIGNATED IN THE CARE PLAN BASED ON THE PATIENT NEEDS AND ORDERED BY A PHYSICIAN.NonCashAssistanceDesc

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationTHE PATIENT MUST MEET THE CRITERIA DESIGNATED BY MEDICARE, TERMINAL DIAGNOSIS AND A LIFE EXPECTANCY OF 6 MONTHS OR LESS. A PHYSICIAN MUST CERTIFY THE PATIENT'S MEDICAL CONDITION AND WRITE THE ORDER TO ADMIT TO HOSPICE CARE. PATIENTS ARE NEVER DENIED ADMISSION UNLESS THEY DO NOT MEET THE CRITERIA OR THE PHYSICIAN DOES NOT CERTIFY THE DIAGNOSIS. THE ORGANIZATION MONITORS THEIR REFERRALS AND ADMISSIONS TO ASSURE EVERY REFERRAL RECEIVES PROMPT ATTENTION.ExplanationTxt

Schedule M IRS990ScheduleM

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
DescGOODS RELATED TO FUNDRAISINGDesc
Contribution68ContributionCnt
Noncash Contributions Rpt F990$3,680NoncashContributionsRptF990Amt
Method Of Determining RevenuesFAIR MARKET VALUEMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section B, line 11bONCE THE 990 IS PREPARED BY AN ACCOUNTING FIRM, THE BOARD CHAIRMAN AND TREASURER REVIEW THE 990 COMPARING IT TO THE AUDITED F/S BEFORE SIGNATURE
Form 990, Part VI, Section B, line 12cMEMBERS OF THE BOARD OF DIRECTORS AND HOSPICE STAFF MUST DISCLOSE PERSONAL OR FINANCIAL INTERESTS THAT COULD POTENTIALLY INTERFERE WITH THEIR DUTIES AND RESPONSIBILITIES TO HOSPICE OF THE ROCK RIVER VALLEY. DISCLOSURE FORMS ARE SUBMITTED AT THE TIME OF HIRE OR BOARD APPOINTMENT, ANNUALLY, AND WHENEVER A POTENTIAL CONFLICT ARISES. POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED BY THE BOARD OF DIRECTORS AND/OR BY THE EXECUTIVE DIRECTOR TO DETERMINE APPROPRIATE ACTION. INFORMATION REGARDING THE HOSPICE'S POLICY ON CONFLICTS OF INTEREST IS PROVIDED DURING ORIENTATION OF NEW STAFF, VOLUNTEERS, AND BOARD MEMBERS. FAILURE TO DISCLOSE EXISTING OR POTENTIAL CONFLICTS OF INTEREST IS GROUNDS FOR TERMINATION OF EMPLOYMENT OR BOARD APPOINTMENT.
Form 990, Part VI, Section B, line 15aCOMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS. THE PERSONNEL COMMITTEE OF THE BOARD IS RESPONSIBLE FOR ASSESSING THE PERFORMANCE OF THE EXECUTIVE DIRECTOR AND COMMUNICATING THIS TO THE EXECUTIVE DIRECTOR. A SALARY RECOMMENDATION IS MADE TO THE BOARD AND THEY APPROVE IT.
Form 990, Part VI, Section C, line 19ALL OF THE ORGANIZATIONS FORMS AND GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT HOSPICE OF THE ROCK RIVER VALLEY DURING NORMAL BUSINESS HOURS.
FORM 990, PART XI, LINE 2CTHERE WAS NO CHANGE IN AUDIT COMMITTEE OVERSIGHT REVIEW FROM THE PRIOR YEAR.

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