2017-10-25T12:52:57-05:00 2016-12-31 420714325 RSM US LLP 1 S WACKER DRIVE STE 800 CHICAGO IL 60606 990 2016-01-01 363191281 JOLIET AREA COMMUNITY HOSPICE CORP JOLI 8157404104 250 WATER STONE CIRCLE JOLIET IL 604318313 MARY SHEEHAN CEO 8157404104 2017-10-19 1 WAYNE HARDER P00294296 3126343400 108.171.131.188 2017-10-19 16:04:38 CD P DF4CF14E49A62D8DBB20D8911D69718CC116CD32 AD15A3810732ABE718E69ACD65531973B45CBB59 2016 2021-01-29 14:40:06Z MARY SHEEHAN 250 WATER STONE CIRCLE JOLIET IL 604318313 18306167 0 X WWW.JOLIETHOSPICE.ORG X 1982 IL JOLIET AREA COMMUNITY HOSPICE PROVIDES COMPREHENSIVE, HOLISTIC, COMMUNITY BASED SERVICES AND CARE. 12 12 184 286 0 0 900430 1049892 10707353 14689713 539772 457084 -467 -182 12147088 16196507 0 0 0 0 7602367 7728810 0 0 0 5002083 5966485 12604450 13695295 -457362 2501212 20162588 22171405 2960863 2067766 17201725 20103639 X THE MISSION OF JOLIET AREA COMMUNITY HOSPICE IS TO PROVIDE COMPREHENSIVE, HOLISTIC, COMMUNITY BASED SUPPORT SERVICES AND CARE FOR TERMINALLY ILL PERSONS, THEIR CAREGIVERS AND LOVED ONES WITHOUT REGARD TO ECONOMIC STATUS, TO ENABLE THE DYING PERSON TO LIVE PEACEFULLY, IN COMFORT, AND WITH DIGNITY TO THE LAST MOMENT OF LIFE. 0 0 10800049 14689713 PROVIDING A COORDINATED PROGRAM OF SUPPORT, SERVICE AND CARE FOR TERMINALLY ILL PATIENTS AND THEIR CAREGIVERS BOTH THROUGHOUT THE SURROUNDING COUNTIES AND WITHIN OUR 16 BED HOSPICE HOME. JOLIET AREA COMMUNITY HOSPICE SERVED OVER 1,400 PATIENTS IN 2016. 10800049 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 42 0 1 184 1 0 0 0 0 0 1 1 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X NANCY MUELLER 8157404104 250 WATER STONE CIRCLE JOLIET IL 60431 CAROLYN DYSTRUP PRESIDENT (UNTIL 4/11/16) 1.00 X X 0 0 0 CATHY SCHLEY VICE PRESIDENT (UNTIL 4/11/16) 1.00 X X 0 0 0 TOM VANA VICE PRESIDENT 1.00 X X 0 0 0 GEOFFREY TRYON PRESIDENT 1.00 X X 0 0 0 WILLIAM BENOIT SECRETARY 1.00 X X 0 0 0 JAMES GALLIGAN TREASURER 1.00 X X 0 0 0 JEFFREY BONNAR DIRECTOR (UNTIL 4/11/16) 1.00 X 0 0 0 THOMAS DOHM DIRECTOR 1.00 X 0 0 0 BOB FUNK DIRECTOR 1.00 X 0 0 0 DUANE KRIEGER DIRECTOR 1.00 X 0 0 0 LORRAINE LUCENTA DIRECTOR 1.00 X 0 0 0 CARMEN ROXANNE QUARLES DIRECTOR 1.00 X 0 0 0 MICHAEL RITTOF DIRECTOR 1.00 X 0 0 0 MARK TURK DIRECTOR 1.00 X 0 0 0 CHRISTOPHER WARD DIRECTOR 1.00 X 0 0 0 MARY SHEEHAN CEO 40.00 X 140315 0 1660 KEVIN KRISTIN CFO (UNTIL 2/29/16) 40.00 X 28663 0 3789 NANCY MUELLER DIRECTOR OF FINANCE 40.00 X 55301 0 956 DR JAMES D WRIGHT MEDICAL DIRECTOR 40.00 X 200214 0 1677 GRETA JONES REGISTERED NURSE 40.00 X 102968 0 11342 527461 0 19424 3 0 1 0 0 52704 111800 885388 1049892 HOSPICE CARE SERVICES 621610 14689713 14689713 14689713 396794 396794 2134642 2074352 60290 60290 60290 35126 111800 35308 -182 -182 16196507 14689713 0 456902 424493 200214 224279 5880489 4784417 1096072 959966 758936 201030 463862 366723 97139 20691 20691 93246 93246 31751 31751 888093 642106 245987 81939 81939 479733 123710 356023 143179 109510 33669 220538 195247 25291 18926 1285 17641 330459 178923 151536 117339 35239 82100 NURSING HOME ROOM & BOA 1687778 1687778 MEDICAL SUPPLIES 851572 851572 PHARMACY 794591 794591 REPAIRS & MAINTENANCE 82281 69067 13214 124369 731 123638 13695295 10800049 2895246 0 1199 867 1394567 3402177 2377512 3440266 97885 175490 9273726 4705009 4815146 4568717 11476279 10583888 20162588 22171405 1666797 2038901 1294066 0 0 28865 2960863 2067766 X 17195559 20089836 6166 13803 17201725 20103639 20162588 22171405 2501212 400702 0 X 0 1 X 1 0 X 1531547 856035 879069 900430 1049892 5216973 12491013 10708629 10616888 10744261 14724839 59285630 14022560 11564664 11495957 11644691 15774731 64502603 0 0 0 64502603 287243 426389 547745 521224 396794 2179395 287243 426389 547745 521224 396794 2179395 14309803 11991053 12043702 12165915 16171525 66681998 0.96730 0.96810 0.03270 0.03190 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 187500 187500 7693289 3460986 4232303 1392937 1244023 148914 4568717 CAPITAL LEASE PAYABLE 28865 28865 X 16632517 400702 35308 436010 16196507 0 16196507 13730603 35308 35308 13695295 0 13695295 PART X, LINE 2: THE HOSPICE IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE EXCEPT FOR UNRELATED BUSINESS INCOME. IN ACCORDANCE WITH THE ACCOUNTING STANDARD ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, THE HOSPICE ADDRESSES THE DETERMINATION OF WHETHER TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE FINANCIAL STATEMENTS. UNDER THIS GUIDANCE, THE HOSPICE MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. EXAMPLES OF TAX POSITIONS INCLUDE THE TAX-EXEMPT STATUS OF THE HOSPICE AND VARIOUS POSITIONS RELATED TO THE POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME (UBTI). THE TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50 PERCENT LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. AT DECEMBER 31, 2016 AND 2015, THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED AS LIABILITIES. THE HOSPICE FILES FORMS 990 IN THE U.S. FEDERAL JURISDICTION AND THE STATE OF ILLINOIS. THE HOSPICE IS GENERALLY NO LONGER SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE FOR YEARS BEFORE 2013. PART XI, LINE 2D - OTHER ADJUSTMENTS: EXPENSES RELATED TO SPECIAL EVENTS 35,308. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES RELATED TO SPECIAL EVENTS 35,308. ANNUAL DINNER 57156 43134 14022 300 13722 GOLF OUTING 43425 30628 12797 12979 3 46345 38038 8307 4000 4307 146926 111800 35126 4300 31008 35308 -182 X X 1 0 0 0 0 0 0 0 0 DR JAMES D WRIGHT MEDICAL DIRECTOR 199985 0 0 0 229 0 0 0 1677 0 201891 0 0 0 PART I, LINE 4A KEVIN KRISTIN RECEIVED A $6,970 SEVERANCE PAYMENT DURING 2016. THIS PAYMENT WAS INCLUDED ON HIS 2016 FORM W-2 AS REPORTABLE COMPENSATION. FORM 990, PART VI, SECTION B, LINE 11B IT IS THE PROCESS OF JOLIET AREA COMMUNITY HOSPICE TO HAVE THE AUDIT COMMITTEE REVIEW THE COMPLETED FORM 990. ONCE THIS HAS BEEN DONE, THE AUDIT COMMITTEE SHARES THE COMPLETED FORM 990 WITH THE BOARD OF DIRECTORS FOR REVIEW, PRIOR TO SIGNATURE BY THE PRESIDENT. FORM 990, PART VI, SECTION B, LINE 12C OUR CONFLICT OF INTEREST POLICIES ARE SIGNED BY EVERY BOARD MEMBER AT THE START OF EACH NEW OR RENEWAL TERM. ADDITIONALLY, ALL STAFF AT DIRECTOR LEVEL AND ABOVE SIGN CONFLICT OF INTEREST POLICIES. THE POLICY IS THEN REVIEWED ANNUALLY WITH STATEMENTS SIGNED ANNUALLY. TO DATE, WE HAVE NOT HAD TO IMPOSE ANY RESTRICTIONS. THE BOARD OF DIRECTORS WOULD DETERMINE RESTRICTIONS. POSSIBILITIES INCLUDE PROHIBITING VOTES ON VENDORS USED OR PARTICIPATING IN DISCUSSIONS HELD, OR DECISIONS MADE. THE CURRENT PROCEDURE BEFORE EACH BOARD MEETING BEGINS IS FOR THE PRESIDENT OF THE BOARD OF DIRECTORS TO INQUIRE OF ALL BOARD MEMBERS PRESENT AS TO WHETHER THEY HAVE ANY CONFLICTS OF INTEREST TO DISCLOSE. FORM 990, PART VI, SECTION B, LINE 15 THERE IS NO WRITTEN POLICY. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS MEETS TO DISCUSS COMPENSATION FOR THE CEO OF THE ORGANIZATION. A COMPENSATION SURVEY WAS USED DURING THE PROCESS TO DETERMINE THE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN IRC SECTION 6104(D). THEY ARE ALSO AVAILABLE UPON REQUEST AND AT OUR OFFICE FOR INSPECTION.