HOSPICE OF ORLEANS INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- HOSPICE OF ORLEANS INC (EIN 16-1336090)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-04-25
- IRS object ID
- 201711159349300446
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-04-25T15:29:27-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 161131146 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BONADIO & CO LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 CORPORATE PKWY STE 200 | AddressLine1Txt |
| City | AMHERST | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14226 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 161336090 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE OF ORLEANS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HOSP | BusinessNameControlTxt |
| Phone | 5855890809 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14080 ROUTE 31 WEST PO BOX 489 | AddressLine1Txt |
| City | ALBION | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14411 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KELLIE SPYCHALSKI | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 5855890809 | PhoneNum |
| Signature | 2017-04-20 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JUSTIN N REID | PreparerPersonNm |
| PTIN | P01321869 | PTIN |
| Phone | 7162506600 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 4.14.157.194 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-04-20 | IPDt |
| IP Tm | 11:17:52 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 486F5516F8873DC9D2A55878F273D726BDE8D277 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 2176ED389F645C0B53641E68115263F064974EE3 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KELLIE SPYCHALSKI | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14080 ROUTE 31 WEST PO BOX 489 | AddressLine1Txt |
| City | ALBION | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14411 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,758,111 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HOSPICEOFORLEANS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1989 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE HOSPICE CARE TO QUALIFIED INDIVIDUALS AND TO INFORM THE GENERAL PUBLIC REGARDING THE DEFINITION AND ROLE OF HOSPICE CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 58 | TotalEmployeeCnt |
| Total Volunteers | 169 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $164,823 | PYContributionsGrantsAmt |
| CY Contributions Grants | $236,779 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,433,918 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,377,884 | CYProgramServiceRevenueAmt |
| PY Investment Income | $19,569 | PYInvestmentIncomeAmt |
| CY Investment Income | $20,251 | CYInvestmentIncomeAmt |
| PY Other Revenue | $59,338 | PYOtherRevenueAmt |
| CY Other Revenue | $95,151 | CYOtherRevenueAmt |
| PY Total Revenue | $1,677,648 | PYTotalRevenueAmt |
| CY Total Revenue | $1,730,065 | 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 | $1,055,310 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,153,493 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $82,478 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $524,462 | PYOtherExpensesAmt |
| CY Other Expenses | $510,252 | CYOtherExpensesAmt |
| PY Total Expenses | $1,579,772 | PYTotalExpensesAmt |
| CY Total Expenses | $1,663,745 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $97,876 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $66,320 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,498,093 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,420,417 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $444,106 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $254,760 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,053,987 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,165,657 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDE HOSPICE CARE TO QUALIFIED INDIVIDUALS AND TO INFORM THE GENERAL PUBLIC REGARDING THE DEFINITION AND ROLE OF HOSPICE CARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,387,258 | ExpenseAmt |
| Revenue | $1,377,884 | RevenueAmt |
| Desc | PROVIDE HOSPICE CARE TO QUALIFIED INDIVIDUALS AND TO INFORM THE GENERAL PUBLIC REGARDING THE DEFINITION AND ROLE OF HOSPICE CARE. 119 INDIVIDUALS WERE SERVED TOTAL THROUGH HOME CARE SERVICES AND RESIDENCE SERVICES. | Desc |
| Total Program Service Expenses | $1,387,258 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | 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 | 1 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 58 | 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 | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOEL ALLEN DIRECTOR OF FINANCE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5855890809 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14080 ROUTE 31 WEST PO BOX 489 | AddressLine1Txt |
| City | ALBION | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14411 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| SHEILA MYER | ||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| PATRICIA EICK | ||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MAURA PIERCE | ||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JON COSTELLO | ||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| NANCY ALBANESE | ||||||
| DIRECTOR EMERITUS | 1.00 | Yes (X) | $0 | $0 | $0 | |
| SANFORD CHURCH | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| PAM REAMER | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| ADA GRABOWSKI | ||||||
| VICE SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| KIM HINKLEY | ||||||
| VACATED BOARD DURING 2016 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| CRAIG LAPE | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| ROLAND HOWELL | ||||||
| DIRECTOR EMERITUS | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MARY JANET SAHUKAR | ||||||
| DIRECTOR EMERITUS | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DOUG MILLER | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DENNIS PIEDIMONTE | ||||||
| VACATED BOARD DURING 2016 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| LYNNE SHORT | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| KAREN SAWICZ | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| BEVERLY SASKOWSKI | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| ANNETTE PEARL | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JON KENNEY | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MARY ANNE FISCHER | ||||||
| EXECUTIVE DIRECTOR | 40.00 | Yes (X) | $65,746 | $0 | $1,969 | |
| JOEL ALLEN | ||||||
| DIRECTOR OF FINANCE | 20.00 | Yes (X) | $23,933 | $0 | $4,549 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $89,679 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $6,518 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $10,825 | FederatedCampaignsAmt |
| Membership Dues | $7,622 | MembershipDuesAmt |
| Fundraising | $4,022 | FundraisingAmt |
| All Other Contributions | $214,310 | AllOtherContributionsAmt |
| Total Contributions | $236,779 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | FEES FOR SERVICES | Desc |
| Business | 621610 | BusinessCd |
| Total Revenue Column | $1,377,884 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,377,884 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,377,884 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,251 | TotalRevenueColumnAmt |
| Exclusion | $20,251 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $123,197 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $4,022 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $28,046 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $95,151 | TotalRevenueColumnAmt |
| Exclusion | $95,151 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,730,065 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,377,884 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $115,402 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,679 | TotalAmt |
| Program Services | $26,537 | ProgramServicesAmt |
| Management And General | $63,142 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $862,276 | TotalAmt |
| Program Services | $748,262 | ProgramServicesAmt |
| Management And General | $54,755 | ManagementAndGeneralAmt |
| Fundraising | $59,259 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,615 | TotalAmt |
| Program Services | $8,640 | ProgramServicesAmt |
| Management And General | $1,315 | ManagementAndGeneralAmt |
| Fundraising | $660 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,702 | TotalAmt |
| Program Services | $57,545 | ProgramServicesAmt |
| Management And General | $8,756 | ManagementAndGeneralAmt |
| Fundraising | $4,401 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120,221 | TotalAmt |
| Program Services | $97,848 | ProgramServicesAmt |
| Management And General | $14,889 | ManagementAndGeneralAmt |
| Fundraising | $7,484 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,681 | TotalAmt |
| Program Services | $2,699 | ProgramServicesAmt |
| Management And General | $12,555 | ManagementAndGeneralAmt |
| Fundraising | $1,427 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,516 | TotalAmt |
| Management And General | $7,516 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,277 | TotalAmt |
| Program Services | $5,277 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,993 | TotalAmt |
| Program Services | $1,993 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,448 | TotalAmt |
| Program Services | $13,162 | ProgramServicesAmt |
| Management And General | $986 | ManagementAndGeneralAmt |
| Fundraising | $300 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,921 | TotalAmt |
| Program Services | $13,772 | ProgramServicesAmt |
| Management And General | $2,096 | ManagementAndGeneralAmt |
| Fundraising | $1,053 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,883 | TotalAmt |
| Program Services | $12,140 | ProgramServicesAmt |
| Management And General | $743 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,505 | TotalAmt |
| Program Services | $6,057 | ProgramServicesAmt |
| Management And General | $448 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,576 | TotalAmt |
| Program Services | $7,576 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $112,008 | TotalAmt |
| Program Services | $91,164 | ProgramServicesAmt |
| Management And General | $13,872 | ManagementAndGeneralAmt |
| Fundraising | $6,972 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,374 | TotalAmt |
| Program Services | $10,885 | ProgramServicesAmt |
| Management And General | $1,656 | ManagementAndGeneralAmt |
| Fundraising | $833 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| PATIENT EXPENSES | $154,392 | $154,392 | ||
| SUPPLIES - PROGRAM | $61,089 | $61,057 | $22 | $10 |
| REPAIRS AND MAINTENANCE | $26,407 | $21,907 | $4,500 | |
| BAD DEBT | $21,123 | $21,123 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,059 | TotalAmt |
| Program Services | $25,222 | ProgramServicesAmt |
| Management And General | $6,758 | ManagementAndGeneralAmt |
| Fundraising | $79 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,663,745 | TotalAmt |
| Program Services | $1,387,258 | ProgramServicesAmt |
| Management And General | $194,009 | ManagementAndGeneralAmt |
| Fundraising | $82,478 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $136,150 | BOYAmt |
| EOY | $145,272 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $474,557 | BOYAmt |
| EOY | $487,739 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,054 | BOYAmt |
| EOY | $13,617 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $204,950 | BOYAmt |
| EOY | $158,103 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,049 | BOYAmt |
| EOY | $18,641 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,178,780 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $620,871 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,664,019 | BOYAmt |
| EOY | $2,557,909 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $967,314 | BOYAmt |
| EOY | $1,039,136 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,498,093 | BOYAmt |
| EOY | $4,420,417 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,895 | BOYAmt |
| EOY | $82,493 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $326,211 | BOYAmt |
| EOY | $172,267 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $444,106 | BOYAmt |
| EOY | $254,760 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,985,001 | BOYAmt |
| EOY | $4,108,428 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,986 | BOYAmt |
| EOY | $57,229 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,053,987 | BOYAmt |
| EOY | $4,165,657 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,498,093 | BOYAmt |
| EOY | $4,420,417 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $66,320 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $45,350 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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 | $353,381 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $207,400 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $147,655 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $164,823 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $236,779 | CurrentTaxYearAmt |
| Total | $1,110,038 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $353,381 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $207,400 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $147,655 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $164,823 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $236,779 | CurrentTaxYearAmt |
| Total | $1,110,038 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $1,110,038 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $26,196 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $33,457 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $19,633 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $19,569 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $20,251 | CurrentTaxYearAmt |
| Total | $119,106 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $1,229,144 | TotalSupportAmt |
| Public Support CY170 | 0.90310 | PublicSupportCY170Pct |
| Public Support PY170 | 0.93120 | 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 | $11,450 | OtherCostOrOtherBasisAmt |
| Book Value | $11,450 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,978,855 | OtherCostOrOtherBasisAmt |
| Depreciation | $456,791 | DepreciationAmt |
| Book Value | $2,522,064 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $188,475 | OtherCostOrOtherBasisAmt |
| Depreciation | $164,080 | DepreciationAmt |
| Book Value | $24,395 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,557,909 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $1,737,860 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$20,251 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $28,046 | OtherRevenueAmt |
| Revenue Not Reported | $7,795 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,730,065 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $1,730,065 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,691,791 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $28,046 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $28,046 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,663,745 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $1,663,745 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | FOR TAX-EXEMPT ENTITIES, THEIR TAX-EXEMPT STATUS ITSELF IS DEEMED TO BE AN UNCERTAINTY, SINCE EVENTS COULD POTENTIALLY OCCUR TO JEOPARDIZE THEIR TAX-EXEMPT STATUS. AS OF DECEMBER 31, 2016 AND 2015, THE HOSPICE DOES NOT HAVE A LIABILITY FOR UNRECOGNIZED TAX BENEFITS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | SPECIAL EVENTS EXPENSE 28,046. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | SPECIAL EVENTS EXPENSE 28,046. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF TOURNAMENT | Event1Nm |
| Gross Receipts Event1 | $31,504 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $31,504 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $1,722 | NonCashPrizesEvent1Amt |
| Food And Beverage Event1 | $9,777 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $373 | OtherDirectExpensesEvent1Amt |
| Event2 | ANNUAL APPEAL | Event2Nm |
| Gross Receipts Event2 | $38,828 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $38,828 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $884 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 5 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $56,887 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $4,022 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $52,865 | GrossRevenueOtherEventsAmt |
| Non Cash Prizes Other Events | $1,553 | NonCashPrizesOtherEventsAmt |
| Food And Beverage Other Events | $914 | FoodAndBeverageOtherEventsAmt |
| Oth Direct Expnss Other Events | $12,823 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $127,219 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $4,022 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $123,197 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $3,275 | NonCashPrizesTotalEventsAmt |
| Food And Beverage Total Events | $10,691 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $14,080 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $28,046 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $95,151 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE FORM 990 IS PROVIDED TO THE GOVERNING BODY FOR REVIEW BEFORE IT IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE HOSPICE HAS A BOARD OF DIRECTORS ETHICS POLICY WHICH STATES IT IS THE BOARD MEMBERS' RESPONSIBILITY TO DISCLOSE ALL CONFLICTS OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | ALL COMPENSATION IS PAID ACCORDING TO A PAY SCALE BY POSITION AND RAISES ARE GRANTED BASED ON YEARS OF SERVICE. COMPENSATION OF THE EXECUTIVE DIRECTOR IS DETERMINED ANNUALLY BASED ON A PERFORMANCE REVIEW BY THE PERSONNEL COMMITTEE AND A DISCUSSION WITH THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S FORM 990, ORGANIZING DOCUMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE BY REQUEST AT THE ORGANIZATION'S OFFICE, AS LISTED ON PAGE 1 OF FORM 990. |
| FORM 990, PART XII, LINE 2C | PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
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