2016-11-14T09:59:28-06:00 2015-12-31 HW&CO 23240 Chagrin Blvd Suite 700 Cleveland OH 441225450 990 2015-01-01 341256377 Hospice of The Western Reserve Inc % JOHN E HARVAN JR HOSP 2163832222 17876 St Clair Avenue Cleveland OH 44110 JOHN HARVAN JR CFO 2163832222 2016-11-14 true Joseph C Sbrocco CPA P00069069 2168311200 2016-11-11 2015 2017-02-10 21:41:12Z WILLIAM E FINN 17876 ST CLAIR CLEVELAND OH 44110 89946684 false X WWW.HOSPICEWR.ORG X 1978 OH WE PROVIDE PALLIATIVE END OF LIFE CARE, CAREGIVER SUPPORT, AND BEREAVEMENT SERVICES THROUGHOUT NORTHERN OHIO. WE STRIVE TO RELIEVE SUFFERING & ENHANCE COMFORT IN END OF LIFE CARE. 18 18 1102 3000 0 12268611 3316401 81765193 84378374 1355853 1156777 839898 1032699 96229555 89884251 0 0 0 0 56115953 58274783 0 0 1233974 30981855 32212840 87097808 90487623 9131747 -603372 99074447 96261364 31485688 31160277 67588759 65101087 HOSPICE OF THE WESTERN RESERVE PROVIDES PALLIATIVE END-OF-LIFE CARE, CAREGIVER SUPPORT, AND BEREAVEMENT SERVICES THROUGHOUT NORTHERN OHIO. IN CELEBRATION OF THE INDIVIDUAL WORTH OF EACH LIFE, WE STRIVE TO RELIEVE SUFFERING, ENHANCE COMFORT, PROMOTE QUALITY LIFE, FOSTER CHOICE IN END-OF-LIFE CARE AND SUPPORT EFFECTIVE GRIEVING. false false 75999563 85327876 HOSPICE CARE SERVICES ARE ABOUT PROVIDING PEOPLE (ADULTS AND CHILDREN) WITH A LIFE-LIMITING ILLNESS, AND THEIR FAMILIES WITH CHOICES AND DIGNITY. CARE IS PROVIDED WHEREVER THE PATIENTS LIVE; IN THEIR HOME, IN A HOSPITAL, ASSISTED LIVING/LONG-TERM CARE FACILITY OR at two HOSPICE HOUSE residential facilities. IN 2015, HOSPICE OF WESTERN RESERVE PROVIDED 430,887 PATIENT DAYS. CARE IS PROVIDED BY A TEAM OF PAID AND VOLUNTEERS WHO ARE AVAILABLE 24-HOURS A-DAY, SEVEN DAYS A WEEK. ADDITIONALLY, BEREAVEMENT SERVICES ARE PROVIDED FOR FAMILIES FOR MORE THAN A YEAR FOLLOWING THE LOSS OF A LOVED ONE. 75999563 true true false false false false false false false true true false false false true false false true false false false false false false true false false false false true true false false false false false false false true false true false false false false true true true true false false true 158 0 true 1102 true false false false false false false false false false false X 18 18 false false false false false false false true true false false true true true true true true true false false OH X JOHN E HARVAN JR 2163832222 17876 ST CLAIR CLEVELAND OH 44110 CYNDEE BURKE DIRECTOR 1.0 0.0 X 0 0 0 JANICE EVA DIRECTOR 1.0 0.0 X 0 0 0 VIRGINIA A MOONEY DIRECTOR 1.0 0.0 X 0 0 0 LAURA NAVIN Secretary 3.0 0.0 X X 0 0 0 MARY L OGRINC DIRECTOR 1.0 0.0 X 0 0 0 WILLIAM SPRINGER DIRECTOR 1.0 0.0 X 0 0 0 RICHARD A BARONE DIRECTOR 1.0 0.0 X 0 0 0 JAMES W ROGERSON DIRECTOR 1.0 0.0 X 0 0 0 Rev Neroy Carter Director 1.0 0.0 X 0 0 0 Alfred F Connors Jr MD Chair 1.0 0.0 X X 0 0 0 ALEX JOHNSON DIRECTOR 1.0 0.0 X 0 0 0 VICKY VARLEY VICE CHAIR 1.0 0.0 X X 0 0 0 DAN DeMONICA TREASURER 1.0 0.0 X X 0 0 0 ANDY DUNHAM DIRECTOR 1.0 2.0 X 0 0 0 CLARK HARVEY DIRECTOR 1.0 0.0 X 0 0 0 MICHAEL JACOBSON DIRECTOR 1.0 0.0 X 0 0 0 KAY K POTETZ DIRECTOR 1.0 0.0 X 0 0 0 MARK RIBBINS DIRECTOR 1.0 0.0 X 0 0 0 William Finn ceo 40.0 5.0 X 411783 0 18996 John E Harvan Jr Chief Financial Officer 40.0 5.0 X 207039 0 18180 Julia A Bartel Chief Clinical Officer 40.0 5.0 X 194590 0 20046 Dann Ganzhorn Medical Director 40.0 0.0 X 243555 0 18362 Clement HearEy VP of Human Resources 40.0 5.0 X 141396 0 17109 FLORIN SUSOIU MEDICAL DIRECTOR 40.0 0.0 X 180996 0 19822 CHARLES V WELLMAN CHIEF MEDICAL OFFICER 40.0 0.0 X 265575 0 20684 KATHLEEN SENGER MEDICAL DIRECTOR 40.0 0.0 X 193000 0 7493 MARINA LAZBIN MEDICAL DIRECTOR 40.0 0.0 X 179250 0 16790 MICHELE SEYRANIAN CHIEF MARKETING & BD OFFICER 40.0 5.0 X 166396 0 19550 ALISON D MASTERS CHIEF DEVELOPMENT OFFICER 40.0 5.0 X 140917 0 7449 ROBERT P PHILLIPS-PLONA DIR-RESIDENTIAL SVCS 40.0 5.0 X 134774 0 8732 SHAREEFAH SABUR CHIEF QUALITY & EDU. OFFICER 40.0 5.0 X 130850 0 9112 JANICE SCHEUFLER PHARMACIST 40.0 0.0 X 126933 0 4143 2717054 0 206468 24 false true false FRANTZ WARD LLP 200 PUBLIC SQUARE SUITE 3000 CLEVELAND OH 44114 LEGAL FEES 214243 LITTLE WELL PO BOX 181277 CLEVELAND HEIGHTS OH 44118 LANDSCAPING 193307 DATA RECOVERY SERVICES LLC 1343 BELMONT AVE YOUNGSTOWN OH 44504 IT CONSULTING 106814 3 310875 13990 2991536 22841 3316401 HOSPICE CARE SERVICES 623000 84289974 84289974 GRIEF COUNSELING 624100 88400 88400 84378374 1075740 1075740 0 0 0 0 0 81037 81037 145630 13990 62433 83197 83197 0 0 RESALE SHOP 900099 320748 320748 MISCELLANEOUS REVENUE 900099 362739 362739 REBATES AND REFUNDS 900099 266015 266015 949502 89884251 85327876 1239974 0 0 0 0 2208456 1544381 664075 0 43164425 36109348 6402105 652972 605667 499966 95301 10400 8589332 7366864 1141051 81417 3706903 3119884 533036 53983 0 255332 255332 0 0 0 0 2923173 853505 2012983 56685 462404 48 448558 13798 2480974 1455382 885657 139935 0 0 1359169 1107400 152028 99741 49083 15284 32594 1205 0 175703 17270 141447 16986 454190 408697 45493 0 1982929 1690190 271400 21339 330277 283962 41823 4492 NURSING FACILITIES 11777813 11777813 MEDICAL SUPPLIES 5115365 5115184 181 PATIENT SERVICES 1913076 1912273 803 PATIENT SUPPLIES 1396356 1274881 48479 72996 1536996 1447231 81740 8025 90487623 75999563 13254086 1233974 5902378 8565758 3385000 0 1538932 1477533 10294237 9786468 0 0 0 0 0 0 0 0 627775 785486 43377251 9390620 34869307 33986631 41277833 40890490 811967 438145 0 0 344087 330853 22931 0 99074447 96261364 9457021 9798288 0 0 0 0 20385000 19833750 0 0 0 0 0 0 0 0 1643667 1528239 31485688 31160277 X 63725178 61279639 3398679 3306546 464902 514902 67588759 65101087 99074447 96261364 X -603372 -1952501 68201 X false true X true false X 3336021 3910402 3482337 12146765 3316401 26191926 86180366 90576989 82003011 81765193 84378374 424903933 0 0 0 89516387 94487391 85485348 93911958 87694775 451095859 0 0 0 451095859 578773 851175 761137 1333617 1075740 4600442 0 578773 851175 761137 1333617 1075740 4600442 0 392944 1255884 1515746 778166 949502 4892242 90488104 96594450 87762231 96023741 89720017 460588543 0.97939 0.98196 0.00999 0.00882 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1201736 50000 31501 60125 1223112 1152291 67780 18335 1201736 961148 191143 1152291 829943 131205 961148 852162 -22219 829943 0.42100 0.57900 false false 8045374 8045374 26817460 6171079 20646381 25833 17426 8407 3497037 1543146 1953891 4991547 1658970 3332578 33986631 0 ANNUITY OBLIGATIONS 183985 DEFERRED COMPENSATION OBLIGATI 553648 INTEREST RATE SWAP 790606 1528239 INTENDED USES OF ENDOWMENT FUNDS DONOR-IMPOSED STIPULATIONS INDICATING THAT THE FUNDS BE MAINTAINED PERMANENTLY BY THE ORGANIZATION AND THAT ALLOW THE INCOME EARNED ON ANY RELATED INVESTMENT TO BE USED FOR GENERAL PURPOSES. Walk to Remembe 159620 13990 145630 12882 14600 2828 1750 30373 0 159620 13990 145630 12882 14600 2828 1750 30373 62433 83197 X X X X false true false false false false false false false William Finn ceo 344438 0 66067 0 1278 0 2650 0 16346 0 430779 0 0 0 John E Harvan Jr Chief Financial Officer 207039 0 0 0 0 0 2063 0 16117 0 225219 0 0 0 Dann Ganzhorn Medical Director 243555 0 0 0 0 0 2235 0 16127 0 261917 0 0 0 Julia A Bartel Chief Clinical Officer 193990 0 600 0 0 0 3712 0 16334 0 214636 0 0 0 Clement HearEy VP of Human Resources 141396 0 0 0 0 0 831 0 16278 0 158505 0 0 0 FLORIN SUSOIU MEDICAL DIRECTOR 180396 0 600 0 0 0 3465 0 16357 0 200818 0 0 0 CHARLES V WELLMAN CHIEF MEDICAL OFFICER 264975 0 600 0 0 0 4379 0 16305 0 286259 0 0 0 KATHLEEN SENGER MEDICAL DIRECTOR 193000 0 0 0 0 0 1900 0 5593 0 200493 0 0 0 MARINA LAZBIN MEDICAL DIRECTOR 179250 0 0 0 0 0 1795 0 14995 0 196040 0 0 0 MICHELE SEYRANIAN CHIEF MARKETING & BD OFFICER 166396 0 0 0 0 0 3272 0 16278 0 185946 0 0 0 SCHEDULE J, PART I, #4B PARTICIPATE IN, RECEIVE PAYMENT FROM, SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN WILLIAM FINN, JOHN HARVAN, JR, CHARLES WELLMAN, CLEMENT HEAREY, AND SHAREEFAH SABUR PARTICIPATE IN A NONQUALIFIED RETIREMENT PLAN WITH NO EMPLOYER CONTRIBUTIONS. A CLEVELAND-CUYAHOGA COUNTY PORT AUTHORITY 341029691 2010-12-30 21565000 RETIRE 1999 BONDS AND CONSTRUCT FA false false false A 1731250 0 21565000 0 120302 0 397023 0 0 17480849 3566826 0 2012 true false true true A false false false false 0 false false false true A false true true false 0 0 A WILLIAM F FINN CEO 42662 ANNUAL ORGANIZATION DUES false BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS William Finn serves on the Board of Directors of the National Partnership for Hospice Innovation. This role is voluntary and he receives no compensation. National Partnership for Hospice Innovation is a not for profit, 501 (C)(3) organization. The organizations mission is to influence the future of hospice and advanced illness care through innovation and collaboration. Hospice of the Western Reserve is a member of NPHI and paid dues of $42,662 in 2015. PAGE 6, PART VI, SECTION C, #19 DOCUMENTS AVAILABLE TO PUBLIC HOSPICE OF THE WESTERN RESERVE DOES MAKE ITS FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC BY PROVIDING COPIES UPON REQUEST, INSPECTION AT THE HEADQUARTERS OFFICE AND BY PROVIDING FINANCIAL DATA IN ANNUAL REPORTS WHICH ARE AVAILABLE ON HOSPICE OF THE WESTERN RESERVE'S WEBSITE. HOSPICE OF THE WESTERN RESERVE DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE GENERAL PUBLIC AT THIS TIME. PAGE 6, PART VI, SECTION B, #15A PROCESS FOR DETERMINING COMPENSATION THE COMPENSATION OF THE CEO IS BASED ON ANNUAL LABOR MARKET DATA FROM BOTH LOCAL AND NATIONAL SOURCES. WITH THE HELP OF THE HUMAN RESOURCES TEAM, THE ORGANIZATION PARTICIPATES IN ANNUAL AND SPECIAL COMPENSATION SURVEYS AND THE RESULTING DATA IS SHARED WITH THE BOARD OF DIRECTORS. COMPENSATION INFORMATION IS ALSO OBTAINED FROM FORM 990'S FROM OTHER COMPARABLE NOT-FOR-PROFIT HOSPICES. IN ADDITION, EACH BOARD DIRECTOR IS ASKED TO RESPOND TO A QUESTIONNAIRE EVALUATING THE CEO'S PERFORMANCE COMPARED TO GOALS ESTABLISHED DURING THE PREVIOUS YEAR'S EVALUATION. THE RESULTS OF THE QUESTIONNAIRES ARE TABULATED AND SHARED WITH THE BOARD'S EXECUTIVE COMMITTEE. BASED ON THE THE LABOR MARKET DATA AND ANNUAL PERFORMANCE EVALUATION PROCESS, THE EXECUTIVE COMMITTEE THEN ESTABLISHES THE CEO'S COMPENSATION LEVEL AS WELL AS ANY PERFORMANCE BONUS THAT MAY BE PROVIDED. FOR OTHER KEY OFFICERS, THE PROCESS IS SIMILAR TO THE PROCESS NOTED ABOVE. THE ORGANIZATION OBTAINS ANNUAL LABOR MARKET DATA FROM BOTH LOCAL AND NATIONAL SOURCES. THE ORGANIZATION PARTICIPATES IN ANNUAL AND SPECIAL COMPENSATION SURVEYS AND THE RESULTING DATA IS SHARED WITH THE CEO. IN ADDITION, THE INTERNAL ALIGNMENT OF OUR POSITIONS IS PERIODICALLY REVIEWED. RATES OF PAY ARE REVIEWED AND ESTABLISHED FOR INTERNAL POSITIONS BASED ON EQUITABLE RELATIONSHIPS AND THE DIFFICULTY AND RESPONSIBILITY OF WORK PERFORMED. RECOMMENDATIONS FOR REQUISITE CHANGES ARE DISCUSSED WITH THE CEO. THE OFFICER'S PERFORMANCE IS REVIEWED ON AN ANNUAL BASIS BY THE CEO. BASED ON THE INDIVIDUAL'S ANNUAL PERFORMANCE AND GOALS ACHIEVED, AND THE INTERNAL AND EXTERNAL DATA, THE CEO WILL ESTABLISH THE COMPENSATION LEVEL FOR HIS OFFICERS. THIS PROCESS HELPS US MAINTAIN THE ORGANIZATION'S INTERNAL ALIGNMENT AND EXTERNAL COMPETITIVENESS. THE ABOVE PROCESSES ARE DOCUMENTED AT THE TIME THE DECISIONS ARE MADE. PAGE 6, PART VI, SECTION A, #11B FORM 990 REVIEW PROCESS Initially the Form 990 is prepared by the outside accounting firm who then sends it to management for their review and approval. Management then forwards the Form 990 to the Finance Committee of the Board for their review and approval before it is finalized. Then, it is made available to the full Board for their review, prior to filing the form with the IRS. PAGE 6, PART VI, SECTION B, #12C MONITOR AND ENFORCE CONFLICT OF INTEREST POLICY All Board members and employees are required to submit a disclosure statement at the beginning of employment and annually thereafter. If a matter arises which a Board member or employee has a conflict of interest, it shall be promptly disclosed to the Board or Chief Executive Officer as appropriate. Staff may initiate disclosure through their supervisor. However, the Board member or employee shall not participate in the discussion or vote to determine whether a conflict exists unless requested to do so. The Human Resources Committee shall be available to the Chief Executive Officer for review of conflict situations. PAGE 12, PART XI, #9 RECONCILIATION OF NET ASSETS CHANGE IN FAIR VALE OF INTEREST RATE SWAP - 92,408 CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS - (24,207) ---------- 68,201 WESTERN RESERVE AT HOME SUPPORT LLC 17876 SAINT CLAIR AVE CLEVELAND OH 44110 464329577 ILLNESS MGT OH 607835 220770 HWR HOSPICE OF MEDINA COUNTY 5075 WINDFALL RD MEDINA OH 44256 341363926 Hospice OH 501(C)(3) 9 HWR true BRIDGESHOME HEALTH CARE 5075 WINDFALL RD MEDINA OH 44256 311511169 Home Health OH 501(C)(3) 9 HWR true WESTERN RESERVE CARE SOLUTIONS LLC 17876 ST CLAIR AVENUE CLEVELAND OH 44110 463262633 INACTIVE OH HWR C-CORP 0 0 1.00000 true false false false true false false false false false false false false false false false false false false HOSPICE OF MEDINA COUNTY D 121867 FMV