2017-10-11T10:36:17-05:00 2016-12-31 271728945 PKF O'CONNOR DAVIES LLP 32 FOSTERTOWN RD NEWBURGH NY 12550 990 2016-01-01 141703185 HOSPICE OF ORANGE AND SULLIVAN COUNTIES INC HOSP 8455616111 800 STONY BROOK COURT NEWBURGH NY 12550 DAN GRADY PRESIDENT & CEO 8455616111 2017-10-11 1 GARRETT M HIGGINS P00543209 8455655400 2017-10-04 65.51.112.58 2017-10-11 11:34:07 ED P 39A6500A14EBDEC7A476CCE4E0A7F613C193113C DBE3753688BC1776818C679406F8E276569BC57D 2016 2021-01-29 14:40:06Z DAN GRADY 800 STONY BROOK COURT NEWBURGH NY 12550 13389976 0 X HOSPICEOFORANGE.COM X 1988 NY THE PRINCIPAL PURPOSE OF THE ORGANIZATION IS TO PROVIDE HOSPICE SERVICES. 21 21 188 150 1751 0 882579 819291 10358023 10935149 174224 183593 -38990 -10709 11375836 11927324 0 0 0 0 6383272 6911322 0 0 186050 5077038 4930739 11460310 11842061 -84474 85263 11576709 11823948 2600420 2299803 8976289 9524145 X HOSPICE OF ORANGE AND SULLIVAN COUNTIES, INC. PROVIDES PHYSICAL, EMOTIONAL AND SPIRITUAL CARE FOR PATIENTS WITH LIFE LIMITING DISEASES AND THEIR FAMILIES. HOSPICE SERVICES ARE COORDINATED THROUGH A TEAM OF PROFESSIONALS, WHICH INCLUDE NURSES, SOCIAL WORKERS, PHYSICIANS, HOSPICE AIDES AND VOLUNTEERS. 0 0 9741803 10935149 HOSPICE OF ORANGE & SULLIVAN COUNTIES, INC. PROVIDED 45,939 DAYS OF CARE TO 1,106 PATIENTS AND THEIR FAMILIES IN 2016. HOSPICE ALSO SERVED 155 PATIENTS FOR A TOTAL OF 3,200 DAYS AT THE KAPLAN FAMILY HOSPICE RESIDENCE. 9741803 1 1 0 1 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 78 0 188 1 1 1 0 0 0 0 1 1 0 0 0 0 X 21 21 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X X JEANNE MALTES 8455616111 800 STONY BROOK COURT NEWBURGH NY 12550 HON JEFFERY G BERRY CHAIRMAN 2.00 X X 0 0 0 FRANK PHILLIPS VICE CHAIRMAN 1.50 X X 0 0 0 GLEN L HELLER ESQ TREASURER 5.00 X X 0 0 0 SUSAN NAJORK SECRETARY 1.00 X X 0 0 0 RONALD BARTON DIRECTOR 3.00 X 0 0 0 VINCENT MAZZIE DIRECTOR 2.00 X 0 0 0 BARBARA NARU DIRECTOR 2.00 X 0 0 0 THOMAS P SULLIVAN DIRECTOR 2.00 X 0 0 0 DR JOSEPH LAUTERSTEIN DIRECTOR 1.00 X 0 0 0 IAN RIEGER DIRECTOR 2.00 X 0 0 0 JOAN P KAPLAN DIRECTOR 3.00 X 0 0 0 LEWIS KLUGMAN DIRECTOR 1.00 X 0 0 0 JOSEPH V SMITH DIRECTOR 1.00 X 0 0 0 SR ANN SAKAC DIRECTOR 1.00 X 0 0 0 DANIEL BERKOWICZ DIRECTOR 1.00 X 0 0 0 ERIC MALDONADO DIRECTOR 1.00 X 0 0 0 ROBIN MARKS DIRECTOR 1.00 X 0 0 0 JOHN F RATH III DIRECTOR 1.00 X 0 0 0 PAUL HOFFNER DIRECTOR 1.00 X 0 0 0 CHARLES MILICH DIRECTOR 2.00 X 0 0 0 BARRY LEWIS DIRECTOR 1.00 X 0 0 0 MARY BONURA DIRECTOR THRU APRIL 2016 1.00 X 0 0 0 MYRIAM LOOR DIRECTOR THRU APRIL 2016 1.00 X 0 0 0 DANIEL GRADY PRESIDENT & CEO 37.50 X 168677 0 35997 GAIL BURTON VP & COO 37.50 X 135144 0 13656 303821 0 49653 2 0 1 0 ALITON'S MANAGED CARE PHARMACY INC 34-35 BALL STREET PORT JERVIS NY 12771 PHARMACEUTICAL SERVICES 821464 ORANGE REGIONAL MEDICAL CENTER 75 CRYSTAL RUN ROAD STE G2 MIDDLETOWN NY 10941 HOSPITAL SERVICES 491714 CRYSTAL RUN HEALTHCARE LLP 155 CRYSTAL RUN ROAD MIDDLETOWN NY 10947 PHYSICIAN SERVICES 233333 UNIDINE CORPORATION PO BOC 360639 PITTSBURGH PA 152516639 FOOD SERVICES 168498 4 3860 289065 79120 447246 34167 819291 HOSPICE SERVICES 623000 10935149 10935149 10935149 179069 1743 177326 1366070 1361546 4524 4524 8 4516 35920 289065 84165 -48245 -48245 47406 16941 30465 30465 OTHER INCOME 900099 7071 7071 7071 11927324 10935149 1751 171133 X 353474 130785 205015 17674 39790 39790 5247892 4322163 876097 49632 80164 66275 12589 1300 592970 488590 94640 9740 597032 473501 112361 11170 19281 19281 20224 20224 2592 2592 37540 37540 1588435 1581940 6495 97734 97734 412590 280163 105606 26821 4953 4953 140143 93235 46908 332175 311232 20157 786 30958 1755 5619 23584 32803 32803 249872 149923 99949 55422 41566 13856 PHARMACY 806300 806300 MEDICAL EQUIPMENT AND S 569297 569297 NURSING HOME ROOM & BOA 246378 246378 REPAIRS AND MAINTENANCE 219659 120885 98774 64383 57815 1015 5553 11842061 9741803 1914208 186050 135 404 933605 938289 20000 1000 1235273 1239458 60298 60864 6551942 2208590 4561261 4343352 4762591 5098157 138878 3546 3546 11576709 11823948 1723401 1541248 50000 50000 744754 708555 82265 2600420 2299803 X 5167927 5337494 565990 944279 3242372 3242372 8976289 9524145 11576709 11823948 85263 462593 0 X X 0 1 X 1 0 X 1115846 1280775 1138526 882579 819851 5237577 11252574 10608380 10096880 10358023 10935149 53251006 12368420 11889155 11235406 11240602 11755000 58488583 111760 57220 36135 68360 7880 281355 0 111760 57220 36135 68360 7880 281355 58207228 199767 199409 203180 193308 179069 974733 199767 199409 203180 193308 179069 974733 628 628 18601 163034 15897 2806 7071 207409 12586788 12251598 11454483 11437344 11941140 59671353 0.97550 0.95860 0.01630 0.01660 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2012 AMOUNT: $ 18,601. 2013 AMOUNT: $ 2,821. 2014 AMOUNT: $ 15,897. 2015 AMOUNT: $ 2,806. 2016 AMOUNT: $ 7,071. SETTLEMENT INCOME - 2013 AMOUNT: $ 151,244. REFUNDS - 2013 AMOUNT: $ 8,969. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 750 0 1 2592 3342 0 PART II-B, LINE 1: OTHER LOBBYING ACTIVITIES INCLUDE DUES PAID TO THE NATIONAL AND STATE HOSPICE AND PALLIATIVE CARE ASSOCIATIONS. IN ADDITION, THE CEO DANIEL GRADY AND ONE STAFF MEMBER PARTICIPATED IN AN EDUCATE CONGRESS EVENT SPONSORED BY THE HOSPICE ACTION NETWORK IN 2016. 4894856 9073 596052 197629 5302352 5552192 -421149 236187 4894856 5948801 101456 498065 5552192 5152700 996101 200000 5948801 4783418 40000 439297 110015 5152700 0.21640 0.61150 0.17210 0 0 388933 388933 5325477 1650638 3674839 837532 557952 279580 4343352 X 12453483 462593 101106 563699 11889784 37540 37540 11927324 11905627 101106 101106 11804521 37540 37540 11842061 PART V, LINE 4: HOSPICE MAINTAINS VARIOUS DONOR-RESTRICTED ENDOWMENT FUNDS AND BOARD DESIGNATED QUASI-ENDOWMENT FUNDS WHOSE PURPOSE IS TO PROVIDE LONG TERM SUPPORT FOR HOSPICE PROGRAMS. PART X, LINE 2: HOSPICE RECOGNIZES THE EFFECTS OF INCOME TAX POSITIONS ONLY IF THEY ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT HOSPICE HAS NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION AND/OR DISCLOSURE. HOSPICE IS NO LONGER SUBJECT TO EXAMINATIONS BY APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO DECEMBER 31, 2013. PART XI, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES REPORTED ON PART VIII, LINES 8B & 9B 101,106. PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES REPORTED ON PART VIII, LINES 8B & 9B 101,106. GALA 160651 140781 19870 39790 3000 8721 GOLF OUTING 67375 51325 16050 12800 2096 4 96959 96959 17758 324985 289065 35920 12800 39790 3000 28575 84165 -48245 47406 15250 1691 1 1.00000 47406 15250 1691 16941 30465 NY 1 0 0 0 1.00000 GLORIA ALISANDRELLA 800 STONY BROOK COURT NEWBURGH NY 12550 0 JEANNE MALTES JEANNE MALTES IS THE VICE PRESIDENT OF FINANCE. HER SELF AND A STAFF ACCOUNTANT REVIEW THE GAMING INFORMATION. X 0 X X X X 0 0 0 0 0 0 0 0 0 DANIEL GRADY PRESIDENT & CEO 168677 0 0 0 0 0 3609 0 32388 0 204674 0 0 0 X AUCTION ITEMS 35 34167 FAIR MARKET VALUE 0 0 1 0 PART I, COLUMN (B): THE NUMBER OF CONTRIBUTORS ARE BEING REPORTED IN COLUMN (B). FORM 990, PART VI, SECTION B, LINE 11B HOSPICE OF ORANGE AND SULLIVAN COUNTIES, INC. HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. WHEN THE FORM 990 HAS BEEN PREPARED, REVIEWED BY THE OUTSIDE ACCOUNTANTS AND IS READY TO BE FILED WITH THE INTERNAL REVENUE SERVICE, IT IS ELECTRONICALLY SENT TO THE VP OF FINANCE OF THE ORGANIZATION. ANY QUESTIONS OR CHANGES ARE PROVIDED TO THE OUTSIDE ACCOUNTANTS. A REVISED COPY OF THE FORM 990 IS THEN ELECTRONICALLY SENT TO THE TREASURER AND CHAIRMAN OF THE BOARD FOR REVIEW. AFTER THEIR REVIEW IS COMPLETE, A COPY IS PROVIDED ELECTRONICALLY OR BY MAIL TO THE BOARD MEMBERS, AND THE RETURN IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS APPLICABLE TO ALL HOSPICE PERSONNEL, AS WELL AS MEMBERS OF THE GOVERNING BODY. EACH MEMBER OF THE GOVERNING BODY IS REQUIRED TO SIGN AN ANNUAL DISCLOSURE STATEMENT WHICH STATES IF THEY BELIEVE THAT THEY HAVE AN ACTUAL OR POTENTIAL CONFLICT. IF A CONFLICT WERE TO ARISE DURING THE YEAR, THE STAFF MEMBER MUST MAKE THE PRESIDENT/CEO OF THE ORGANIZATION AWARE OF THE CONFLICT IN WRITING. THE PRESIDENT/CEO MAKES A DECISION ON HOW TO PROCEED WITH THE MATTER. IF A CONFLICT ARISES WITH A MEMBER OF THE GOVERNING BODY, HE/SHE IS OBLIGATED TO REPORT THE POTENTIAL CONFLICT TO THE GOVERNING BODY. THE GOVERNING BODY WILL RENDER A DECISION OF THAT MEMBER'S ELIGIBILITY TO BE PART OF THE VOTING, IF APPLICABLE. DISCLOSURES OF AN ACTUAL OR POTENTIAL CONFLICT AND THE GOVERNING BODY'S DECISION REGARDING VOTING WILL BE NOTED IN THE MINUTES OF THE MEETING. FORM 990, PART VI, SECTION B, LINE 15A THE COMPENSATION FOR THE ORGANIZATION'S CEO IS APPROVED BY THE BOARD AFTER AN INTERNAL REVIEW IS COMPLETED. THE ORGANIZATION USES THE FOLLOWING ITEMS TO HELP AID IN DETERMINING THE APPROPRIATE COMPENSATION: FORM 990S OF OTHER ORGANIZATION THAT ARE SIMILAR IN SIZE AND OPERATIONS, AND A COMPENSATION SURVEY OR STUDY. AFTER THE BOARD REVIEWS THIS INFORMATION, AN APPROPRIATE SALARY IS DETERMINED BY THE BOARD FOR THAT POSITION AND APPROVED. THE BOARD'S APPROVAL IS DOCUMENTED IN THE MINUTES TO THE MEETING. THIS PROCESS WAS LAST UNDERTAKEN IN JULY 2015. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FORM 990 AND FORM 1023 AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. THE RETURN IS POSTED ON GUIDESTAR.ORG AND OTHER SIMILAR TYPES OF WEBSITES. IN ADDITION, THE FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, ARTICLES OF INCORPORATION AND BY-LAWS ARE ALSO AVAILABLE UPON WRITTEN REQUEST OR BY CALLING THE ORGANIZATION DIRECTLY. FORM 990, PART IX, LINE 11G CONSULTING: PROGRAM SERVICE EXPENSES 34,880. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 34,880. INPATIENT SERVICES: PROGRAM SERVICE EXPENSES 954,274. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 954,274. HOME HEALTH AIDES: PROGRAM SERVICE EXPENSES 5,890. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,890. TEMPORARY HELP: PROGRAM SERVICE EXPENSES 33. MANAGEMENT AND GENERAL EXPENSES 162. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 195. MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 586,863. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 586,863. PENSION ADMINISTRATION EXPENSE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 6,333. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,333. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS DID NOT CHANGE FROM THE PRIOR YEAR.