2015-06-22T09:01:08-05:00 2014-09-30 161131146 BONADIO & CO LLP 115 SOLAR STREET SYRACUSE NY 13204 990 2013-10-01 161541636 HOSPICE FOUNDATION OF JEFFERSON COUNTY INC HOSP 3157887323 425 WASHINGTON STREET WATERTOWN NY 13601 DIANA WOODHOUSE CEO 3157887323 2015-06-16 1 BETTINA LIPPHARDT P00956232 3152147575 2013 2016-03-07 17:11:31Z DIANA WOODHOUSE 425 WASHINGTON STREET WATERTOWN NY 13601 3524830 0 X WWW.JEFFHOSPICE.ORG X 1993 NY TO ENSURE THE HOSPICE SERVICES REMAIN STRONG AND FISCALLY VIABLE TO SERVE AS AN INTEGRAL COMPONENT OF OUR COMMUNITY'S HEALTHCARE DELIVERY SYSTEM. 15 15 0 49 0 0 1226214 728023 0 0 310433 262756 42017 15906 1578664 1006685 150000 487169 0 0 67072 205530 0 0 56240 347142 409805 564214 1102504 1014450 -95819 7978778 8004870 7217 66405 7971561 7938465 TO ENSURE THAT HOSPICE SERVICES REMAIN STRONG AND FISCALLY VIABLE TO SERVE AS AN INTEGRAL COMPONENT OF OUR COMMUNITY'S HEALTHCARE DELIVERY SYSTEM. 0 0 487169 487169 FINANCIAL SUPPORT HOSPICE OF JEFFERSON COUNTY, INC. IN ITS OPERATIONS TO PROVIDE MEDICAL CARE AND TREATMENT TO THE TERMINALLY ILL. 36250 SOLICITING, RECEIVING, AND ACKNOWLEDGING ALL FORMS OF CHARITABLE GIFTS FROM INDIVIDUALS, ORGANIZATIONS AND FOUNDATIONS VIA FUNDRAISING EVENTS AND MAIL SOLICITATIONS. 523419 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 15 15 1 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X JORDAN JONES 3157887323 425 WASHINGTON STREET WATERTOWN NY 13601 BARBARA MADDOCKS BOARD MEMBER 1.00 X 0 0 0 DR JAN TURCOTTE BOARD MEMBER 1.00 X 0 0 0 JEFF COLE BOARD MEMBER 1.00 X 0 0 0 TOBY SCHILLING HOSPICE PRESIDENT 1.00 X X 0 0 0 STEVE HAYES BOARD MEMBER 1.00 X 0 0 0 TODD DEMAR BOARD MEMBER 1.00 X 0 0 0 TREVOR GARLOCK BOARD MEMBER 1.00 X 0 0 0 LORI GERVERA BOARD MEMBER 1.00 X 0 0 0 CAROLYN OSBORNE BOARD MEMBER 1.00 X 0 0 0 JULIA STORMS BOARD MEMBER 1.00 X 0 0 0 JILL WILEY BOARD MEMBER 1.00 X 0 0 0 ERIC DELAGARZA PRESIDENT 1.00 X X 0 0 0 JOANNE LAVARNWAY SECRETARY 1.00 X X 0 0 0 HOLLY BUSH TREASURER 1.00 X X 0 0 0 AMY DEMAR VICE PRESIDENT 1.00 X X 0 0 0 DIANA WOODHOUSE CHIEF EXECUTIVE OFFICER 20.00 20.00 X 0 108717 0 SUSAN WARNERTHRU 714 FINANCE DIRECTOR 30.00 10.00 X 0 80916 0 JORDAN JONES FINANCE DIRECTOR 30.00 10.00 X 0 0 0 0 189633 0 0 0 0 0 0 728023 728023 61008 61008 2691121 2489373 201748 201748 201748 44358 28772 15586 15586 MISCELLANEOUS 900099 320 320 320 1006685 0 0 278662 487169 487169 117999 117999 87531 87531 2166 2166 7549 7549 31056 31056 3341 3341 16524 16524 23617 23617 27733 27733 474 474 2991 2991 194508 194508 5946 5946 FUNDRAISING 56240 56240 BAD DEBTS 36250 36250 MISCELLANEOUS 1410 1410 1102504 523419 522845 56240 422111 399355 151896 39646 20500 0 292 0 4468850 491755 4164617 3977095 3162160 2500307 57202 1088467 7978778 8004870 7217 66405 7217 66405 X 7846894 7820784 124667 117681 7971561 7938465 7978778 8004870 -95819 62723 0 X X 0 1 X 1 0 X 523007 3547555 498485 1226214 728023 6523284 523007 3547555 498485 1226214 728023 6523284 6523284 68552 62464 28875 46665 61008 267564 592 600 150 320 1662 6792510 0.96040 0.95760 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 39500 39500 4256710 425596 3831114 172640 66159 106481 3977095 INVESTMENT IN THE COMMUNITY FOUNDATION 1088467 C 1088467 X 1098180 62723 28772 91495 1006685 0 1006685 1131276 28772 28772 1102504 0 1102504 PART X, LINE 2: THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION, EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE). THE ORGANIZATION ALSO HAS BEEN CLASSIFIED BY THE INTERNAL REVENUE SERVICE AS AN ENTITY THAT ARE NOT PRIVATE FOUNDATIONS UNDER SECTION 509(A) OF THE CODE. FOR TAX-EXEMPT ENTITIES, THEIR TAX-EXEMPT STATUS ITSELF IS DEEMED TO BE AN UNCERTAINTY, SINCE EVENTS COULD POTENTIALLY OCCUR TO JEOPARDIZE THEIR TAX-EXEMPT STATUS. AS OF SEPTEMBER 30, 2014, THE ORGANIZATION DOES NOT HAVE A LIABILITY FOR UNRECOGNIZED TAX BENEFITS. THE ORGANIZATION FILES AN INCOME TAX RETURNS IN THE U.S. FEDERAL JURISDICTION AND NEW YORK STATE. THE ORGANIZATIONS ARE GENERALLY NO LONGER SUBJECT TO U.S. FEDERAL AND STATE INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2011. PART XI, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENTS EXPENSE 28,772. PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENTS 28,772. REGATTA 19006 19006 148 190 2001 CONCERT 14439 14439 5095 14586 1 10913 10913 1394 3844 1480 35 44358 44358 1542 3844 6765 16622 28773 15585 0 HOSPICE OF JEFFERSON COUNTY INC 1398 GOTHAM STREET WATERTOWN NY 13601 161266041 501(C)(3) 487169 FINANCIAL SUPPORT HOSPICE OF JEFFERSON COUNTY, INC. IN ITS OPERATIONS TO PROVIDE MEDICAL CARE AND TREATMENT TO THE TERMINALLY ILL. FORM 990, PART VI, SECTION A, LINE 2 VICE PRESIDENT AMY DEMAR AND BOARD MEMBER TODD DEMAR ARE RELATED. AMY IS TODD'S SISTER-IN-LAW. FORM 990, PART VI, SECTION A, LINE 7A SOLE CORPORATE MEMBER, HOSPICE OF JEFFERSON COUNTY, INC. ELECTS BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B JEFFERSON COUNTY HOSPICE HAS THE EXCLUSIVE POWER AND AUTHORITY TO AMEND, REPEAL, OR ADOPT BY-LAWS OF THE FOUNDATION. IN ADDITION THE JEFFERSON COUNTY HOSPICE HAS ALL RIGHTS AND POWERS RELATED TO ELECTION OF FOUNDATION DIRECTORS, AMENDING THE CERTIFICATE OF INCORPORATION OF THE FOUNDATION, APPROVE ANY MERGER OR CONSOLIDATION OF THE FOUNDATION, APPROVE THE DISSOLUTION OF THE FOUNDATION, AND APPROVE THE SALE OR ENCUMBRANCE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE FOUNDATION. FORM 990, PART VI, SECTION B, LINE 11 THE FOUNDATION PROVIDES DRAFT COPIES OF THE IRS FORM 990 TO THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO COMPLETION AND FILING WITH THE INTERNAL REVENUE SERVICE AT THEIR REGULARLY SCHEDULED MEETINGS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE COMPLETED ANNUALLY. THE EXECUTIVE DIRECTOR AND BOARD PRESIDENT REVIEW AND FOLLOW UP ON DISCLOSURES OF CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS ANNUALLY REVIEWS THE EXECUTIVE DIRECTOR. ALL OTHER EMPLOYEES ARE EVALUATED ANNUALLY BY MANAGEMENT. AN ANNUAL SURVEY OF LOCAL HEALTHCARE AGENCIES AND CENTRAL NEW YORK HOSPICES IS PERFORMED FOR PAY SCALES AT ALL STAFFING LEVELS. FORM 990, PART VI, SECTION C, LINE 19 A HIGH LEVEL FINANCIAL PICTURE IS PROVIDED IN THE ANNUAL REPORT, WHICH IS AVAILABLE TO THE PUBLIC. OTHER FINANCIAL DATA AND POLICY INFORMATION IS AVAILABLE UPON REQUEST AND ON A NEED TO KNOW BASIS. FORM 990, PART XII, LINE 2C THE BOARD OF DIRECTORS SELECTS AND MEETS WITH THE INDEPENDENT AUDITORS TO DISCUSS THE RESULTS OF THE AUDIT. HOSPICE OF JEFFERSON COUNTY 425 WASHINGTON STREET WATERTOWN NY 13601 161266041 HOSPICE CARE NY 501(C)(3) 9 HOSPICE OF JEFFERSON COUNTY INC 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 0 HOSPICE OF JEFFERSON COUNTY INC O 205530 COST INCURRED HOSPICE OF JEFFERSON COUNTY INC B 487169 COST INCURRED