IOWA CITY HOSPICE INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
IOWA CITY HOSPICE INC (EIN 42-1154098)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-07
IRS object ID
201733119349301453
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)
Return2017-11-07T09:35:06-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN270402452PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WINKEL PARKER & FOSTER CPA PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1519 KIRKWOOD AVEAddressLine1Txt
CityIOWA CITYCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52240ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN421154098EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1IOWA CITY HOSPICE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlIOWABusinessNameControlTxt
Phone3193515665PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11025 WADE STREETAddressLine1Txt
CityIOWA CITYCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52240ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKARLA KAMALPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone3193515665PhoneNum
Signature2017-10-30SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSTEVEN J KUHL CPAPreparerPersonNm
PTINP00099793PTIN
Phone3193510231PhoneNum
Preparation2017-10-30PreparationDt

Filing Security Information FilingSecurityInformation

FieldValueIRS element (for citing)
At Submission Creation Device IdE999802B31CBE05EA8FF5E0381DA2C07B76CA20EAtSubmissionCreationDeviceId
At Submission Filing Device IdCAC1E6D563E1C5D2391738252FE966F84F9D1673AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKARLA KAMALPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11025 WADE STREETAddressLine1Txt
CityIOWA CITYCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52240ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$5,578,811GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.IOWACITYHOSPICE.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1980FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionTO BE THE LEADERS IN PROVIDING EXCEPTIONAL PATIENT-CENTERED, END-OF-LIFE CARE AND GRIEF SUPPORT TO ANYONE AFFECTED BY A TERMINAL ILLNESS.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent14VotingMembersIndependentCnt
Total Employee78TotalEmployeeCnt
Total Volunteers106TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$540,157PYContributionsGrantsAmt
CY Contributions Grants$526,181CYContributionsGrantsAmt
PY Program Service Revenue$6,272,495PYProgramServiceRevenueAmt
CY Program Service Revenue$5,012,761CYProgramServiceRevenueAmt
PY Investment Income$25,663PYInvestmentIncomeAmt
CY Investment Income$37,779CYInvestmentIncomeAmt
PY Other Revenue$2,000PYOtherRevenueAmt
CY Other Revenue$2,090CYOtherRevenueAmt
PY Total Revenue$6,840,315PYTotalRevenueAmt
CY Total Revenue$5,578,811CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$3,708,009PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$3,554,396CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$72,708CYTotalFundraisingExpenseAmt
PY Other Expenses$3,455,188PYOtherExpensesAmt
CY Other Expenses$3,423,372CYOtherExpensesAmt
PY Total Expenses$7,163,197PYTotalExpensesAmt
CY Total Expenses$6,977,768CYTotalExpensesAmt
PY Revenues Less Expenses-$322,882PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,398,957CYRevenuesLessExpensesAmt
Total Assets BOY$5,046,834TotalAssetsBOYAmt
Total Assets EOY$4,273,670TotalAssetsEOYAmt
Total Liabilities BOY$998,376TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,521,870TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,048,458NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,751,800NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO BE THE LEADERS IN PROVIDING EXCEPTIONAL PATIENT-CENTERED, END-OF-LIFE CARE AND GRIEF SUPPORT TO ANYONE AFFECTED BY A TERMINAL ILLNESS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$5,637,848ExpenseAmt
Revenue$5,012,761RevenueAmt
DescTHE ORGANIZATION PROVIDES SERVICES TO THOSE FACING A LIFE LIMITING ILLNESS. IN 2016, 1,628 PATIENTS AND FAMILIES WERE SERVED IN OUR SEVEN COUNTY SERVICE AREA (CEDAR, IOWA, JOHNSON, LINN, LOUISA, MUSCATINE AND WASHINGTON COUNTIES) FOR A TOTAL OF 31,417 DAYS OF CARE. IN ADDITION TO OUR PROFESSIONAL STAFF, IOWA CITY HOSPICE VOLUNTEERS PROVIDE SERVICES THAT ARE AS VARIED AS THE PATIENTS, FAMILIES AND COMMUNITIES WE SERVE. PATIENT CARE VOLUNTEERS PROVIDE COMPANIONSHIP AND SUPPORT TO TERMINALLY ILL PATIENTS AND THEIR LOVED ONES. VOLUNTEERS PROVIDE MANY FORMS OF ASSISTANCE, AT ALL LEVELS OF SKILL. OUR 106 PATIENT CARE VOLUNTEERS PROVIDED 3,181 HOURS OF SUPPORTIVE SERVICES TO THOSE WE SERVED IN 2016. FOLLOWING A PATIENT'S DEATH, IOWA CITY HOSPICE BEREAVEMENT STAFF IS AVAILABLE TO SUPPORT FAMILY MEMBERS AND FRIENDS THROUGHOUT THE GRIEVING PROCESS. OUR SERVICES ARE ALSO AVAILABLE TO ANYONE WHO IS GRIEVING THE LOSS OF A LOVED ONE, REGARDLESS OF WHETHER THE PERSON WAS IN HOSPICE CARE. IOWA CITY HOSPICE OFFERS A VARIETY OF GRIEF SUPPORT SERVICES INCLUDING SUPPORT GROUPS, GRIEF EDUCATION, AND SPECIAL EVENTS. IOWA CITY HOSPICE STAFF MADE 162 HOME VISITS TO SURVIVORS AND HAD 241 ATTENDEES AT OUR SUPPORT GROUPS, BEREAVEMENT LUNCHEONS AND MEMORIAL SERVICES. INCLUDED IN OUR BEREAVEMENT SERVICES ARE SPECIALIZED CARE TO CHILDREN AND YOUTH. MANY CHILDREN AND YOUTH FIND COMFORT AND SECURITY THROUGH GRIEF- SUPPORT GROUPS WHERE EVERYONE PARTICIPATING SHARES ONE COMMON ELEMENT: SOMEONE THEY LOVE HAS DIED. IOWA CITY HOSPICE OFFERS THREE UNIQUE GROUPS FOR CHILDREN, YOUTH AND THEIR PARENTS/CAREGIVERS WHO HAVE EXPERIENCED THE LOSS OF A LOVED ONE. IN 2016, 6 CHILDREN, YOUTH AND ADULTS ATTENDED THESE GROUP MEETINGS.Desc
Total Program Service Expenses$5,637,848TotalProgramServiceExpensesAmt
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 ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
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 EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document4IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee78EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
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
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member14IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
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 CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonKARLA KAMALPersonNm
Phone3196884212PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11025 WADE STREETAddressLine1Txt
CityIOWA CITYCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52240ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
JOSHUA BREWSTER
CHAIR1.00Yes (X)Yes (X)$0$0$0
DEAN CARRINGTON
TREASURER1.00Yes (X)Yes (X)$0$0$0
TODD MEANS
SECRETARY1.00Yes (X)Yes (X)$0$0$0
MIKE MESSIER
PAST CHAIR1.00Yes (X)Yes (X)$0$0$0
TERESA WEINER
DIRECTOR1.00Yes (X)$0$0$0
ELIZABETH COULTER
DIRECTOR1.00Yes (X)$0$0$0
BOYD CROSBY
DIRECTOR1.00Yes (X)$0$0$0
ELI WYNES
DIRECTOR1.00Yes (X)$0$0$0
JIM PRATT
DIRECTOR1.00Yes (X)$0$0$0
MIKE LEBSACK
DIRECTOR1.00Yes (X)$0$0$0
JULIE JOHNSTON
DIRECTOR1.00Yes (X)$0$0$0
ARLEEN CLARK-CAIN
DIRECTOR1.00Yes (X)$0$0$0
MAHMOODA AHMAD
DIRECTOR1.00Yes (X)$0$0$0
DR STEPHEN SCHECKEL
DIRECTOR1.00Yes (X)$0$0$0
KARLA KAMAL
EXECUTIVE DI40.00Yes (X)$108,257$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$108,257TotalReportableCompFromOrgAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

FieldValueIRS element (for citing)
PersonANN MARIE MACHALBPersonNm

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line12680 GLEN HOLLOW COURTAddressLine1Txt
CityCORALVILLECityNm
State AbbreviationIAStateAbbreviationCd
ZIP52241ZIPCd
FieldValueIRS element (for citing)
ServicesMEDICALServicesDesc
Compensation$115,425CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Fundraising$271,579FundraisingAmt
All Other Contributions$254,602AllOtherContributionsAmt
Total Contributions$526,181TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICARE/MEDICAID PAYMENTS$4,710,159$4,710,159
PRIVATE INSURANCE$302,602$302,602
FieldValueIRS element (for citing)
Total Program Service Revenue$5,012,761TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$37,779TotalRevenueColumnAmt
Exclusion$37,779ExclusionAmt
FieldValueIRS element (for citing)
Contri Rpt Fundraising Event$271,579ContriRptFundraisingEventAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER INCOMEDesc
Total Revenue Column$2,090TotalRevenueColumnAmt
Related Or Exempt Func Income$2,090RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,090OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,578,811TotalRevenueColumnAmt
Related Or Exempt Func Income$5,014,851RelatedOrExemptFuncIncomeAmt
Exclusion$37,779ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,997,268TotalAmt
Program Services$2,130,574ProgramServicesAmt
Management And General$815,720ManagementAndGeneralAmt
Fundraising$50,974FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$328,940TotalAmt
Program Services$235,100ProgramServicesAmt
Management And General$88,324ManagementAndGeneralAmt
Fundraising$5,516FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$228,188TotalAmt
Program Services$162,196ProgramServicesAmt
Management And General$62,113ManagementAndGeneralAmt
Fundraising$3,879FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$51,554TotalAmt
Management And General$51,554ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$32,856TotalAmt
Program Services$1,872ProgramServicesAmt
Management And General$30,984ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$90,570TotalAmt
Program Services$47,680ProgramServicesAmt
Management And General$42,890ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$10,211TotalAmt
Management And General$10,211ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$31,785TotalAmt
Program Services$31,696ProgramServicesAmt
Management And General$89ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$40,389TotalAmt
Program Services$40,389ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$217,253TotalAmt
Program Services$176,915ProgramServicesAmt
Management And General$40,338ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
MEDICAL SUPPLIES$786,392$786,392
HOSPITAL INPATIENT$510,280$510,280
NURSING HOME FEES$438,148$438,148
MEDICATIONS$387,825$387,825

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$826,109TotalAmt
Program Services$688,781ProgramServicesAmt
Management And General$124,989ManagementAndGeneralAmt
Fundraising$12,339FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$6,977,768TotalAmt
Program Services$5,637,848ProgramServicesAmt
Management And General$1,267,212ManagementAndGeneralAmt
Fundraising$72,708FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,089,598BOYAmt
EOY$4,600EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$656,361BOYAmt
EOY$867,803EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$13,790BOYAmt
EOY$25,068EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,873,630LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$688,111LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,216,405BOYAmt
EOY$1,185,519EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,070,680BOYAmt
EOY$2,190,680EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$5,046,834BOYAmt
EOY$4,273,670EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$376,151BOYAmt
EOY$508,388EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
EOY$344,665EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$622,225BOYAmt
EOY$668,817EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$998,376BOYAmt
EOY$1,521,870EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,033,715BOYAmt
EOY$2,735,202EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$14,743BOYAmt
EOY$16,598EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,048,458BOYAmt
EOY$2,751,800EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,046,834BOYAmt
EOY$4,273,670EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$1,398,957ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$102,299OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$661,362CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$557,494CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$685,222CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$540,157CurrentTaxYearMinus1YearAmt
Current Tax Year$526,181CurrentTaxYearAmt
Total$2,970,416TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$661,362CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$557,494CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$685,222CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$540,157CurrentTaxYearMinus1YearAmt
Current Tax Year$526,181CurrentTaxYearAmt
Total$2,970,416TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$2,970,416PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$39,721CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$36,663CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$32,133CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$37,074CurrentTaxYearMinus1YearAmt
Current Tax Year$37,779CurrentTaxYearAmt
Total$183,370TotalAmt
FieldValueIRS element (for citing)
Total Support$3,153,786TotalSupportAmt
Gross Receipts Rltd Activities$5,014,851GrossReceiptsRltdActivitiesAmt
Public Support CY1700.94190PublicSupportCY170Pct
Public Support PY1700.94470PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

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

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,070,680BeginningYearBalanceAmt
Contributions$7,795ContributionsAmt
Investment Earnings Or Losses$155,883InvestmentEarningsOrLossesAmt
Administrative Expenses$25,976AdministrativeExpensesAmt
End Year Balance$2,190,680EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,828,150BeginningYearBalanceAmt
Contributions$262,720ContributionsAmt
Investment Earnings Or Losses$275,853InvestmentEarningsOrLossesAmt
Administrative Expenses$23,737AdministrativeExpensesAmt
End Year Balance$2,070,680EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,716,804BeginningYearBalanceAmt
Contributions$9,865ContributionsAmt
Investment Earnings Or Losses$138,500InvestmentEarningsOrLossesAmt
Administrative Expenses$21,450AdministrativeExpensesAmt
End Year Balance$1,828,150EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,456,262BeginningYearBalanceAmt
Contributions$14,120ContributionsAmt
Investment Earnings Or Losses$268,864InvestmentEarningsOrLossesAmt
Administrative Expenses$22,442AdministrativeExpensesAmt
End Year Balance$1,716,804EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,089,029BeginningYearBalanceAmt
Contributions$244,364ContributionsAmt
Investment Earnings Or Losses$140,828InvestmentEarningsOrLossesAmt
Administrative Expenses$17,959AdministrativeExpensesAmt
End Year Balance$1,456,262EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY1.00000BoardDesignatedBalanceEOYPct
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$140,000OtherCostOrOtherBasisAmt
Book Value$140,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,001,564OtherCostOrOtherBasisAmt
Depreciation$333,109DepreciationAmt
Book Value$668,455BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$732,066OtherCostOrOtherBasisAmt
Depreciation$355,002DepreciationAmt
Book Value$377,064BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,185,519TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescBENEFICIAL INTEREST IN ENDOWMENTDesc
Book Value$2,190,680BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$2,190,680TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
LEASE PAYABLE$445,699
ACCRUED PTO$199,622
ACCRUED WAGES$23,496
FieldValueIRS element (for citing)
Total Liability$668,817TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$5,681,110TotalRevEtcAuditedFinclStmtAmt
Other Revenue$102,299OtherRevenueAmt
Revenue Not Reported$102,299RevenueNotReportedAmt
Revenue Subtotal$5,578,811RevenueSubtotalAmt
Total Revenue Per Form990$5,578,811TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$6,977,768TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$6,977,768ExpensesSubtotalAmt
Total Expenses Per Form990$6,977,768TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PAGE 3, PART XGENERALLY ACCEPTED ACCOUNTING PRINCIPLES PRESCRIBE RULES FOR THE RECOGNITION, MEASUREMENT, CLASSIFICATION, AND DISCLOSURE IN THE FINANCIAL STATEMENTS OF UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THE ORGANIZATION'S INCOME TAX RETURNS. MANAGEMENT IS NOT AWARE OF ANY TAX POSITIONS THAT WOULD HAVE A MATERIAL EFFECT ON THE FINANCIAL STATEMENTS THAT ARE MORE LIKELY THAN NOT TO CHANGE IN THE NEXT TWELVE MONTHS, OR THAT WOULD NOT SUSTAIN AN EXAMINATION BY APPLICABLE TAXING AUTHORITIES WITH FULL KNOWLEDGE OF THE POSITION AND ALL RELEVANT FACTS. SINCE TAX MATTERS ARE SUBJECT TO SOME DEGREE OF UNCERTAINTY, THERE CAN BE NO ASSURANCE THAT THE ORGANIZATION'S INCOME TAX RETURNS WILL NOT BE CHALLENGED BY THE TAXING AUTHORITIES AND THAT THE ORGANIZATION WILL NOT BE SUBJECT TO ADDITIONAL TAX, PENALTIES, AND INTEREST AS A RESULT OF SUCH CHALLENGE. THE ORGANIZATION RECOGNIZES PENALTIES AND INTEREST ARISING FROM UNCERTAIN TAX POSITIONS AS INCURRED IN MANAGEMENT AND GENERAL EXPENSES. NO SUCH PENALTIES OR INTEREST WERE RECOGNIZED DURING THE YEARS ENDED DECEMBER 31, 2016 AND 2015. THE ORGANIZATION IS EXEMPT FROM INCOME TAXES UNDER PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS SUCH, THE ORGANIZATION IS TAXED ONLY ON ITS UNRELATED BUSINESS INCOME. MANAGEMENT HAS DETERMINED THE ORGANIZATION DID NOT RECEIVE ANY UNRELATED BUSINESS INCOME FOR THE YEARS ENDED DECEMBER 31, 2016 AND 2015. THE ORGANIZATION IS NOT A PRIVATE FOUNDATION UNDER PROVISIONS OF SECTION 509(A)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION IS NO LONGER SUBJECT TO FEDERAL OR STATE INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2013.
SCHEDULE D, PAGE 4, PART XI, LINE 2DCHANGE IN BENEFICIAL INTEREST IN ASSETS HELD BY COMM FOUND 102,299

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1990PTVIII1CEvent1Nm
Gross Receipts Event1$271,579GrossReceiptsEvent1Amt
Charitable Contri Event1$271,579CharitableContriEvent1Amt
Gross Receipts Total$271,579GrossReceiptsTotalAmt
Charitable Contributions Tot$271,579CharitableContributionsTotAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 2, PART III, LINE 4AAVAILABLE TO SUPPORT FAMILY MEMBERS AND FRIENDS THROUGHOUT THE GRIEVING PROCESS. OUR SERVICES ARE ALSO AVAILABLE TO ANYONE WHO IS GRIEVING THE LOSS OF A LOVED ONE, REGARDLESS OF WHETHER THE PERSON WAS IN HOSPICE CARE. IOWA CITY HOSPICE OFFERS A VARIETY OF GRIEF SUPPORT SERVICES INCLUDING SUPPORT GROUPS, GRIEF EDUCATION, AND SPECIAL EVENTS. IOWA CITY HOSPICE STAFF MADE 162 HOME VISITS TO SURVIVORS AND HAD 241 ATTENDEES AT OUR SUPPORT GROUPS, BEREAVEMENT LUNCHEONS AND MEMORIAL SERVICES. INCLUDED IN OUR BEREAVEMENT SERVICES ARE SPECIALIZED CARE TO CHILDREN AND YOUTH. MANY CHILDREN AND YOUTH FIND COMFORT AND SECURITY THROUGH GRIEF- SUPPORT GROUPS WHERE EVERYONE PARTICIPATING SHARES ONE COMMON ELEMENT: SOMEONE THEY LOVE HAS DIED. IOWA CITY HOSPICE OFFERS THREE UNIQUE GROUPS FOR CHILDREN, YOUTH AND THEIR PARENTS/CAREGIVERS WHO HAVE EXPERIENCED THE LOSS OF A LOVED ONE. IN 2016, 6 CHILDREN, YOUTH AND ADULTS ATTENDED THESE GROUP MEETINGS.
FORM 990, PAGE 6, PART VI, LINE 11BTHE EXECUTIVE DIRECTOR EMAILS THE FINAL COPY OF THE FORM 990 TO THE EXECUTIVE COMMITTEE TO REVIEW BEFORE IT IS FILED.
FORM 990, PAGE 6, PART VI, LINE 12CALL BOARD MEMBERS AND EMPLOYEES ARE REQUIRED TO DECLARE ALL CONFLICTS AT LEAST ANNUALLY.
FORM 990, PAGE 6, PART VI, LINE 15ATHE ORGANIZATION'S HUMAN RESOURCE SPECIALIST EVALUATES THE PAY RANGE OF THE EXECUTIVE DIRECTOR ANNUALLY USING COMPARATIVE DATA. PAY RANGES FOR THE ORGANIZATION ARE APPROVED BY IOWA CITY HOSPICE'S PERSONNEL COMMITTEE. THIS INFORMATION IS TAKEN INTO ACCOUNT WHEN THE EXECUTIVE DIRECTOR IS EVALUATED ANNUALLY BY THE ENTIRE BOARD OF DIRECTORS. ANY CHANGES TO THE COMPENSATION ARE APPROVED THROUGH THE BUDGETING PROCESS; REVIEWED AND APPROVED BY FIRST THE FINANCE COMMITTEE AND THEN THE IOWA CITY HOSPICE BOARD OF DIRECTORS. COMMITTEE WORK HAPPENS THE SECOND HALF OF THE YEAR FOR IMPLEMENTATION IN THE SUBSEQUENT JANUARY.
FORM 990, PAGE 6, PART VI, LINE 15BTHERE ARE NO OTHER OFFICERS OR BOARD MEMBERS THAT ARE COMPENSATED.
FORM 990, PAGE 6, PART VI, LINE 19IOWA CITY HOSPICE MAKES THEIR GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND FORM 990 AVAILABLE TO THE PUBLIC THROUGH REQUEST DURING NORMAL OPERATING HOURS.
FORM 990, PART IX, LINE 24EBAD DEBT 325,753 0 0 CONTRACTUAL SERVICES 164,200 5,752 0 EQUIPMENT RENTAL AND MAIN 69,527 13,337 0 INSURANCE 41,150 27,010 984 MISCELLANEOUS 0 49,094 0 DONATIONS AND GIFTS 41,134 0 1,976 PRINTING AND PRODUCTION 5,058 14,079 9,379 ENDOWMENT FEES 25,976 0 0 EDUCATION 15,983 4,349 0 DUES AND SUBSCRIPTIONS 0 11,368 0 TOTAL 688,781 124,989 12,339
FORM 990, PART XI, LINE 9CHANGE IN BENEFICIAL INTEREST IN ASSETS HELD BY COMM FOUND 102,299

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