AGRACE HOSPICECARE HOLDINGS INCORPORATED: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
AGRACE HOSPICECARE HOLDINGS INCORPORATED (EIN 30-0001715)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-07-07
IRS object ID
201711889349300511
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)
Return2017-07-07T10:00:39-05:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN350921680PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CROWE HORWATH LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1225 West Wacker Drive Suite 2600AddressLine1Txt
CityChicagoCityNm
State AbbreviationILStateAbbreviationCd
ZIP606061224ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN300001715EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Agrace HospiceCare Holdings IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlAGRABusinessNameControlTxt
Phone6082764660PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15395 East Cheryl ParkwayAddressLine1Txt
CityFitchburgCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53711ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLynne SextenPersonNm
Person TitlePresident/CEOPersonTitleTxt
Signature2017-07-07SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonNicole BencikPreparerPersonNm
PTINP00756195PTIN
Phone3128997000PhoneNum
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1Lynne SextenBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line15395 East Cheryl ParkwayAddressLine1Txt
CityFitchburgCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53711ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$2,537,580GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.agrace.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2001FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionAgrace HospiceCare Holdings, Inc.'s (Holdings) mission is "Partnering with patients and families to improve quality of life throughout serious illness." Holdings is operated exclusively for the (Continued on Schedule O)ActivityOrMissionDesc
Voting Members Governing Body17VotingMembersGoverningBodyCnt
Voting Members Independent16VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers14TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$998,276PYContributionsGrantsAmt
CY Contributions Grants$219,843CYContributionsGrantsAmt
PY Program Service Revenue$2,087,604PYProgramServiceRevenueAmt
CY Program Service Revenue$2,310,066CYProgramServiceRevenueAmt
PY Investment Income-$18,127PYInvestmentIncomeAmt
CY Investment Income-$88CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$3,067,753PYTotalRevenueAmt
CY Total Revenue$2,529,821CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,237,396PYOtherExpensesAmt
CY Other Expenses$2,506,117CYOtherExpensesAmt
PY Total Expenses$2,237,396PYTotalExpensesAmt
CY Total Expenses$2,506,117CYTotalExpensesAmt
PY Revenues Less Expenses$830,357PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$23,704CYRevenuesLessExpensesAmt
Total Assets BOY$32,915,283TotalAssetsBOYAmt
Total Assets EOY$32,191,116TotalAssetsEOYAmt
Total Liabilities BOY$1,425,471TotalLiabilitiesBOYAmt
Total Liabilities EOY$677,600TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$31,489,812NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$31,513,516NetAssetsOrFundBalancesEOYAmt
MissionHoldings' mission is "Partnering with patients and families to improve quality of life throughout serious illness." Holdings is operated exclusively for the support and benefit of Agrace Hospicecare, a related tax-exempt organization. In carrying out its mission, Agrace Holdings invests in, receives, holds, uses and (Continued on Schedule O)MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$1,818,564ExpenseAmt
Revenue$2,310,066RevenueAmt
DescPROVISION OF CAPITAL ASSETS: AGRACE HOLDINGS SUPPORTS AGRACE HOSPICECARE BY PROVIDING THE STRATEGIC AND OPERATIONAL CAPITAL ASSETS NECESSARY FOR AGRACE HOSPICECARE TO BEST SERVE PATIENTS AND THEIR FAMILIES NOW AND INTO THE FUTURE. THE LARGEST CAPITAL ASSETS OF AGRACE HOLDINGS ARE THE BUILDINGS. THE ELLEN & PETER JOHNSON HOSPICECARE RESIDENCE, THE DON & MARILYN ANDERSON HOSPICECARE CENTER, AND AGRACE CENTER FOR HOSPICE & PALLIATIVE CARE JANESVILLE CAMPUS WERE GENEROUS GIFTS FUNDED ENTIRELY BY THE COMMUNITY. AGRACE HOLDINGS HAS A RESPONSIBILITY TO KEEP THESE BUILDINGS IN THEIR ORIGINAL STATE FOR THE USE OF PATIENTS AND FAMILIES IN PERPETUITY. MAJOR CAPITAL PROJECTS IN 2016 INCLUDED COMPUTER SOFTWARE AND EQUIPMENT, AND BUILDING IMPROVEMENTS RELATED TO IMPROVING SAFETY, IMPROVING QUALITY OF CARE, REDUCING RISK AND AIDING IN RECOVERY OF CRITICAL SYSTEMS.Desc
Total Program Service Expenses$1,818,564TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtYes (true)CollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document12IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members17GoverningBodyVotingMembersCnt
Independent Voting Member16IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Jennifer MaurerBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6082764660PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15935 EAST CHERYL PARKWAYAddressLine1Txt
CityFitchburgCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53711ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
Michael F Fitzpatrick
Chair1.01.0Yes (X)Yes (X)$0$0$0
David Cullen
Past Chair1.01.0Yes (X)Yes (X)$0$0$0
Christopher Queram
Treasurer1.01.0Yes (X)Yes (X)$0$0$0
Ann Sheehy MD
Secretary1.01.0Yes (X)Yes (X)$0$0$0
Lynne Sexten (formerly Myers)
President / CEO5.035.0Yes (X)Yes (X)$0$432,828$58,620
Julia Arata-Fratta
Director1.01.0Yes (X)$0$0$0
Lou Bernhardt MD
Director1.02.0Yes (X)$0$0$0
Dr Toby Campbell
Director1.01.0Yes (X)$0$0$0
Mike Dallman
Director1.01.0Yes (X)$0$0$0
Brian Happ
Director1.01.0Yes (X)$0$0$0
Erik Johnson
Director1.01.0Yes (X)$0$0$0
David Kruger
Director1.01.0Yes (X)$0$0$0
Everett Mitchell
Director1.01.0Yes (X)$0$0$0
Ken Thompson
Director1.01.0Yes (X)$0$0$0
Dr Pamela Wetzel
Director1.01.0Yes (X)$0$0$0
SHARON CHAMBERLAIN
DIRECTOR1.01.0Yes (X)$0$0$0
GORDON DERZON
DIRECTOR1.01.0Yes (X)$0$0$0
LAURA DOUGLASS
DIRECTOR- PARTIAL YEAR1.01.0Yes (X)$0$0$0
MARIAN WOZNIAK
DIRECTOR- PARTIAL YEAR1.01.0Yes (X)$0$0$0
Julia Houck
Chief Administrative Officer5.035.0Yes (X)$0$217,896$48,682
Jennifer Maurer
Chief Financial Officer5.035.0Yes (X)$0$219,895$20,711
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$870,619TotReportableCompRltdOrgAmt
Total Other Compensation$128,013TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1AGRACE HOSPICECARE INCBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line15395 E CHERYL PKWYAddressLine1Txt
CityFITCHBURGCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53711ZIPCd
FieldValueIRS element (for citing)
ServicesADMINISTRATIVE SERVICESServicesDesc
Compensation$175,071CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Related Organizations$197,343RelatedOrganizationsAmt
All Other Contributions$22,500AllOtherContributionsAmt
Noncash Contributions$22,500NoncashContributionsAmt
Total Contributions$219,843TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescRental income from Agrace HospiceCare, IncDesc
Business900002BusinessCd
Total Revenue Column$2,310,066TotalRevenueColumnAmt
Related Or Exempt Func Income$2,310,066RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$2,310,066TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,131TotalRevenueColumnAmt
Exclusion$3,131ExclusionAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$4,540OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$7,759OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other-$3,219OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$3,219TotalRevenueColumnAmt
Exclusion-$3,219ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,529,821TotalRevenueColumnAmt
Related Or Exempt Func Income$2,310,066RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$88ExclusionAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$23,333TotalAmt
Management And General$23,333ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$175,071TotalAmt
Program Services$0ProgramServicesAmt
Management And General$175,071ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$279TotalAmt
Management And General$279ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$22,125TotalAmt
Management And General$22,125ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$20,335TotalAmt
Program Services$16,183ProgramServicesAmt
Management And General$4,152ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,264,924TotalAmt
Program Services$1,802,381ProgramServicesAmt
Management And General$462,543ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescLicensing feeDesc
Total$50TotalAmt
Management And General$50ManagementAndGeneralAmt

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$2,506,117TotalAmt
Program Services$1,818,564ProgramServicesAmt
Management And General$687,553ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,165,893BOYAmt
EOY$3,197,303EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$718,739BOYAmt
EOY$721,747EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$77BOYAmt
EOY$2,470EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$42,969,638LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$15,441,552LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$28,480,732BOYAmt
EOY$27,528,086EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,549,842BOYAmt
EOY$741,510EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$32,915,283BOYAmt
EOY$32,191,116EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,196,155BOYAmt
EOY$233,945EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$229,316BOYAmt
EOY$443,655EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,425,471BOYAmt
EOY$677,600EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$31,489,812BOYAmt
EOY$31,513,516EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$31,489,812BOYAmt
EOY$31,513,516EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$32,915,283BOYAmt
EOY$32,191,116EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$23,704ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1AGRACE HOSPICECARE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN391319537EIN
Organization Type9OrganizationTypeCd
Governing Document ListedYes (true)GoverningDocumentListedInd
Support$0SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (true)ListedByNameGoverningDocInd
Suprt Org No IRS DeterminationfalseSuprtOrgNoIRSDeterminationInd
Supported Org Section C456falseSupportedOrgSectionC456Ind
Supported Org Not Organized USfalseSupportedOrgNotOrganizedUSInd
Organization Change Suprt OrgfalseOrganizationChangeSuprtOrgInd
Support Non Supported OrgfalseSupportNonSupportedOrgInd
Payment Substantial ContribtrfalsePaymentSubstantialContribtrInd
Loan Disqualified PersonfalseLoanDisqualifiedPersonInd
Controlled Disqualified PrsnfalseControlledDisqualifiedPrsnInd
Disqualified Prsn Controll IntfalseDisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr IntfalseDisqualifiedPrsnOwnrIntInd
Excess Business Holdings RulesfalseExcessBusinessHoldingsRulesInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (true)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt OrgfalseOperateBenefitNonSuprtOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule A, Part I, Line 11 SUPPORT TO RELATED TAX-EXEMPT ORGANIZATIONFormAndLineReferenceDesc
ExplanationHOLDINGS PROVIDES THE USE OF THEIR FACILITIES AND FIXED ASSETS TO AGRACE HOSPICECARE, INC., A RELATED TAX-EXEMPT ORGANIZATION, TO SUPPORT ITS MISSION OF ENHANCING THE QUALITY OF LIFE AT THE END OF LIFE.ExplanationTxt

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

Art Public Exhibition Amounts ArtPublicExhibitionAmountsGrp

FieldValueIRS element (for citing)
Revenues Included$15,000RevenuesIncludedAmt
Assets Included$519,423AssetsIncludedAmt
FieldValueIRS element (for citing)
Collection Used Pub ExhibitionYes (X)CollectionUsedPubExhibitionInd

Collection Used Other Purposes CollectionUsedOtherPurposesGrp

FieldValueIRS element (for citing)
Collection Used Other PurposesYes (X)CollectionUsedOtherPurposesInd
Other PurposesProviding welcoming environmentOtherPurposesDesc
FieldValueIRS element (for citing)
Solicited Assets SalefalseSolicitedAssetsSaleInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,775,145OtherCostOrOtherBasisAmt
Book Value$1,775,145BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$30,591,578OtherCostOrOtherBasisAmt
Depreciation$9,073,505DepreciationAmt
Book Value$21,518,073BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$342,606OtherCostOrOtherBasisAmt
Depreciation$114,879DepreciationAmt
Book Value$227,727BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,785,672OtherCostOrOtherBasisAmt
Depreciation$5,222,324DepreciationAmt
Book Value$2,563,348BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,474,637OtherCostOrOtherBasisAmt
Depreciation$1,030,844DepreciationAmt
Book Value$1,443,793BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$27,528,086TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Capital Leases$165,492
Due to affiliates$278,163
FieldValueIRS element (for citing)
Total Liability$443,655TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part III, Line 4 Collections of art - description of collectionsThe organization's collections consist primarily of works of art that are on display in public spaces as well as patient rooms at the facilities owned by Agrace HospiceCare Holdings and operated by Agrace HospiceCare, Inc. These works of art are used to provide a welcoming, therapeutic, home-like environment to Agrace HospiceCare patients and families in furtherance of the organization's mission of partnering with patients and families to improve quality of life throughout serious illness. The artwork represents each of the many cultures of the people living in south central Wisconsin. The familiarity of the pieces helps patients and their families feel more comfortable in our health care facility.
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteThe Organization is exempt from income taxes on income from related activities under Section 501(c)(3) of the U.S. Internal Revenue Code and corresponding state tax law. Accordingly, no provision has been made for federal or state income taxes. Additionally, the Organization has been determined not to be a private foundation under Section 509(a) of the Internal Revenue Code. U.S. GAAP requires that a tax position is recognized as a benefit only if it is "more likely than not" that the tax position would be sustained in a tax examination, with a tax examination being presumed to occur. The amount recognized is the largest amount of tax benefit that is greater than 50 percent likely of being realized on examination. For tax positions not meeting the "more likely than not" test, no tax benefit is recorded. Due to its tax-exempt status, the Organization is not subject to U.S. federal income tax or state income tax. The Organization's Form 990 has not been subject to examination by the Internal Revenue Service or the state of Wisconsin for the last three years. The Organization does not expect the total amount of unrecognized tax benefits to significantly change in the next 12 months. The Organization recognizes interest and/or penalties related to income tax matters in income tax expense. The Organization did not have any amounts accrued for interest and penalties at December 31, 2016 or 2015.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (true)CompBsdNetEarnsRltdOrgsInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Lynne Sexten (formerly Myers)
President / CEO$0$342,072$0$89,856$0$900$0$37,600$0$21,020$0$491,448$0$0
Julia Houck
Chief Administrative Officer$0$191,145$0$25,030$0$1,721$0$21,974$0$26,708$0$266,578$0$0
Jennifer Maurer
Chief Financial Officer$0$204,753$0$14,499$0$643$0$11,868$0$8,843$0$240,606$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensationThe organization relied on Agrace HospiceCare, Inc. a related tax-exempt organization, to determine the compensation of its top management official. Below is the process used by Agrace HospiceCare, Inc. for determining compensation: Each year the organization gathers market data for determining compensation of the chief executive officer. This includes benchmarks of national, regional, and local compensation that are provided from independent compensation surveys. Each year, the chief administrative officer presents this information to the executive committee of the board, Based on this information, the executive committee sets and approves the compensation package for the chief executive officer for the year and contemporaneously documents their approval in writing. This process was completed in February 2016.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planLynne Sexten (Myers)participated in a 457(f) plan. No distributions were made from the plan during 2016. A contribution in the amount of $27,000 was made to the plan during 2016.
Schedule J, Part I, Line 6b Compensation contingent on net earnings of a related organizationThe cash bonus under the Plan is determined in part by two factors: company operating margin performance and individual employee performance.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part I, Line 1 BRIEF MISSION(CONTINUED FROM FORM 990, PART 1, LINE 1) SUPPORT AND BENEFIT OF AGRACE HOSPICECARE, INC., A RELATED TAX-EXEMPT ORGANIZATION.
Form 990, Part III, Line 1 ORGANIZATION'S MISSION(CONTINUED FROM FORM 990, PART III, LINE 1) disposes of all property, real or personal, as may be necessary or desirable to support the operations of Agrace HospiceCare, Inc. and, Because the buildings were funded entirely by gifts from the community, Agrace Holdings has a responsibility to keep them in their original state for the use of patients and families in perpetuity.
Form 990, Part V, Line 2a REPORTING OF EMPLOYEES COMPENSATIONTHE ORGANIZATION SHARES EMPLOYEES WITH AGRACE HOSPICECARE, INC. (AHI), A RELATED TAX-EXEMPT ORGANIZATION. NONE OF THE EMPLOYEES SPEND THE MAJORITY OF THEIR TIME WORKING FOR THE ORGANIZATION; THEREFORE, NO EMPLOYEES ARE REPORTED ON FORM 990, PART V, LINE 2A. THE ORGANIZATION DOES REIMBURSE AHI FOR THE TIME THE SHARED EMPLOYEES SPEND WORKING AT THE ORGANIZATION. THIS COMPENSATION EXPENSE IS REPORTED ON FORM 990, PART IX, LINE 11G.
Form 990, Part VI, Line 15a PROCESS USED TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIALTHE ORGANIZATION RELIED ON AGRACE HOSPICECARE, A RELATED TAX-EXEMPT ORGANIZATION, TO DETERMINE THE COMPENSATION OF ITS OTHER OFFICERS AND KEY EMPLOYEES. BELOW IS THE PROCESS USED BY AGRACE HOSPICECARE FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL. Each year the organization gathers market data for determining compensation of the chief executive officer. This includes benchmarks of national, regional, and local compensation that are provided from independent compensation surveys. The chief administrative officer presents this information to the executive committee of the board, Based on this information, the executive committee sets and approves the compensation package for the chief executive officer for the year and contemporaneously documents their approval in writing. THIS PROCESS WAS LAST UNDERTAKEN FEBRUARY 2016.
Form 990, Part VI, Line 15b PROCESS USED TO ESTABLISH COMP OF OTHER OFFICERS AND KEY EMPLOYEESTHE ORGANIZATION RELIED ON AGRACE HOSPICECARE, A RELATED TAX-EXEMPT ORGANIZATION, TO DETERMINE THE COMPENSATION OF ITS OTHER OFFICERS. BELOW IS THE PROCESS USED BY AGRACE HOSPICECARE FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S OTHER OFFICERS. Each year the organization gathers market data for compensation of the executive leadership team. This data includes benchmarks of national, regional, and local compensation that are provided from independent compensation surveys. Executive leadership pay is adjusted based on: 1) years of experience; 2) performance; and 3) market data for the 65th percentile of total compensation for the position. The chief administrative officer presents the market data information to the executive committee of the board. Based on this information, the executive committee of the board approves the compensation package for the executive leadership team and documents their approval in writing. THIS PROCESS WAS LAST UNDERTAKEN FEBRUARY 2016.
Form 990, Part VI, Line 2 Family/business relationships amongst interested personsKen Thompson and Erik Johnson - Business relationship
Form 990, Part VI, Line 6 Classes of members or stockholdersAgrace HospiceCare, Inc., a related 501(c)(3) organization, is the sole member of Agrace Holdings and has the authority to appoint, remove, and replace any director on Agrace Holdings board. Agrace HospiceCare, Inc. also has the sole authority to amend the Holdings' bylaws and articles of incorporation. Agrace HospiceCare, Inc. has no other responsibilities or voting rights with respect to the operations of Agrace Holdings.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodySEE RESPONSE TO FORM 990, PART VI, SECTION A, LINE 6.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyThe Controller and CFO performed a detailed review of Form 990 and the related schedules prior to filing the return. This included verification of all amounts for accuracy and completeness. The form and schedules were also reviewed for content, presentation and reasonableness. The entire Form 990 is made available to the entire executive leadership team and an entity specific highlights summary is provided. The entire Form 990 is provided to the entire Board of Directors prior to filing and is accompanied by a 990 highlight summary. The audit committee reviewed the Form 990 and related schedules for reasonableness.
Form 990, Part VI, Line 12c Conflict of interest policyDirectors, officers and key employees (interested persons) are required to annually review the organization's Code of Conduct, including the conflict of interest policy/statement. Interested persons are required to disclose potential or actual conflicts with the organization in writing via the annual questionnaire distributed electronically to each interested person. When a disclosure arises, the person shall promptly make disclosure of the interest to the governing board or committee. After disclosure and discussion the interested person shall leave the governing board or committee meeting while the determination of a conflict of interest is further discussed and voted upon by the remaining disinterested governing board or committee members. Once an actual conflict of interest exists with respect to a particular contract, transaction or arrangement the disinterested members of the board exercise due diligence to determine whether said contract, transaction or arrangement is reasonable. The conflict of interest questionnaires are reviewed by the Controller and governance coordinator. The controller and governance coordinator determine whether a potential conflict exists based on the completed questionnaires submitted by each interested person.
Form 990, Part VI, Line 19 Required documents available to the publicFinancial statements, governing documents, and conflict of interest policies are not required disclosures pursuant to Internal Revenue Code (IRC) Section 6104. These documents may be made available to the public upon receipt of a written request.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
AGRACE HOSPICECARE INC
5395 E CHERYL PARKWAYFitchburgWI53711391319537HEALTHCAREWI501(c)(39NAfalse
AGRACE HOSPICECARE FOUNDATION INC
5395 E CHERYL PARKWAYFitchburgWI53711300001703FUNDRAISINGWI501(c)(311AHCIfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

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