2017-04-25T15:29:27-05:00 2016-12-31 161131146 BONADIO & CO LLP 100 CORPORATE PKWY STE 200 AMHERST NY 14226 990 2016-01-01 161336090 HOSPICE OF ORLEANS INC HOSP 5855890809 14080 ROUTE 31 WEST PO BOX 489 ALBION NY 14411 KELLIE SPYCHALSKI CEO 5855890809 2017-04-20 1 JUSTIN N REID P01321869 7162506600 4.14.157.194 2017-04-20 11:17:52 ED P 486F5516F8873DC9D2A55878F273D726BDE8D277 2176ED389F645C0B53641E68115263F064974EE3 2016 2021-01-29 14:40:06Z KELLIE SPYCHALSKI 14080 ROUTE 31 WEST PO BOX 489 ALBION NY 14411 1758111 0 X WWW.HOSPICEOFORLEANS.ORG X 1989 NY PROVIDE HOSPICE CARE TO QUALIFIED INDIVIDUALS AND TO INFORM THE GENERAL PUBLIC REGARDING THE DEFINITION AND ROLE OF HOSPICE CARE. 15 15 58 169 0 0 164823 236779 1433918 1377884 19569 20251 59338 95151 1677648 1730065 0 0 0 0 1055310 1153493 0 0 82478 524462 510252 1579772 1663745 97876 66320 4498093 4420417 444106 254760 4053987 4165657 PROVIDE HOSPICE CARE TO QUALIFIED INDIVIDUALS AND TO INFORM THE GENERAL PUBLIC REGARDING THE DEFINITION AND ROLE OF HOSPICE CARE. 0 0 1387258 1377884 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. 1387258 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 58 1 0 0 0 0 0 1 1 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X X JOEL ALLEN DIRECTOR OF FINANCE 5855890809 14080 ROUTE 31 WEST PO BOX 489 ALBION NY 14411 SHEILA MYER PRESIDENT 1.00 X X 0 0 0 PATRICIA EICK VICE PRESIDENT 1.00 X X 0 0 0 MAURA PIERCE SECRETARY 1.00 X X 0 0 0 JON COSTELLO TREASURER 1.00 X X 0 0 0 NANCY ALBANESE DIRECTOR EMERITUS 1.00 X 0 0 0 SANFORD CHURCH DIRECTOR 1.00 X 0 0 0 PAM REAMER DIRECTOR 1.00 X 0 0 0 ADA GRABOWSKI VICE SECRETARY 1.00 X X 0 0 0 KIM HINKLEY VACATED BOARD DURING 2016 1.00 X 0 0 0 CRAIG LAPE DIRECTOR 1.00 X 0 0 0 ROLAND HOWELL DIRECTOR EMERITUS 1.00 X 0 0 0 MARY JANET SAHUKAR DIRECTOR EMERITUS 1.00 X 0 0 0 DOUG MILLER DIRECTOR 1.00 X 0 0 0 DENNIS PIEDIMONTE VACATED BOARD DURING 2016 1.00 X 0 0 0 LYNNE SHORT DIRECTOR 1.00 X 0 0 0 KAREN SAWICZ DIRECTOR 1.00 X 0 0 0 BEVERLY SASKOWSKI DIRECTOR 1.00 X 0 0 0 ANNETTE PEARL DIRECTOR 1.00 X 0 0 0 JON KENNEY DIRECTOR 1.00 X 0 0 0 MARY ANNE FISCHER EXECUTIVE DIRECTOR 40.00 X 65746 0 1969 JOEL ALLEN DIRECTOR OF FINANCE 20.00 X 23933 0 4549 89679 0 6518 0 0 0 0 0 10825 7622 4022 214310 236779 FEES FOR SERVICES 621610 1377884 1377884 1377884 20251 20251 123197 4022 28046 95151 95151 1730065 1377884 0 115402 89679 26537 63142 862276 748262 54755 59259 10615 8640 1315 660 70702 57545 8756 4401 120221 97848 14889 7484 16681 2699 12555 1427 7516 7516 5277 5277 1993 1993 14448 13162 986 300 16921 13772 2096 1053 12883 12140 743 6505 6057 448 7576 7576 112008 91164 13872 6972 13374 10885 1656 833 PATIENT EXPENSES 154392 154392 SUPPLIES - PROGRAM 61089 61057 22 10 REPAIRS AND MAINTENANCE 26407 21907 4500 BAD DEBT 21123 21123 32059 25222 6758 79 1663745 1387258 194009 82478 136150 145272 474557 487739 24054 13617 204950 158103 27049 18641 3178780 620871 2664019 2557909 967314 1039136 4498093 4420417 117895 82493 326211 172267 444106 254760 X 3985001 4108428 68986 57229 4053987 4165657 4498093 4420417 66320 45350 0 X X 0 1 X 1 0 X 353381 207400 147655 164823 236779 1110038 353381 207400 147655 164823 236779 1110038 1110038 26196 33457 19633 19569 20251 119106 1229144 0.90310 0.93120 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 11450 11450 2978855 456791 2522064 188475 164080 24395 2557909 X 1737860 -20251 28046 7795 1730065 0 1730065 1691791 28046 28046 1663745 0 1663745 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. GOLF TOURNAMENT 31504 31504 1722 9777 373 ANNUAL APPEAL 38828 38828 884 5 56887 4022 52865 1553 914 12823 127219 4022 123197 3275 10691 14080 28046 95151 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.