GLASS-JOHNSON HOSPICE HOUSE INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
GLASS-JOHNSON HOSPICE HOUSE INC (EIN 31-1732818)
Tax period
2013-05-01 to 2014-04-30
Filed
2014-12-15
IRS object ID
201403499349301435
Schema version
2013v3.1
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)
Return2014-12-15T16:19:27-06:00ReturnTs
Tax Period End2014-04-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN752795237PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BEAL & WILKES PCBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line124 SMITH RD STE 225AddressLine1
CityMIDLANDCity
StateTXState
ZIP Code79705ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-05-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN311732818EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GLASS JOHNSON HOSPICE HOUSE INCBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlGLASBusinessNameControlTxt
Phone4326822855PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1201AddressLine1
CityMIDLANDCity
StateTXState
ZIP Code79702ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonWILLSON BEEBEPersonNm
Person TitleTREASURERPersonTitleTxt
Phone4326822855PhoneNum
Signature2014-12-12SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSIDNEY R BEALPreparerPersonNm
PTINP00306776PTIN
Phone4326883946PhoneNum
Preparation2014-12-15PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDONNETTE SCHWISOWPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1201AddressLine1
CityMIDLANDCity
StateTXState
ZIP Code79702ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$85,774GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2000FormationYr
Legal Domicile StateTXLegalDomicileStateCd
Activity Or MissionGLASS-JOHNSON HOSPICE HOUSE, INC. IS CREATED FOR THE BENEFIT OF HOSPICE OF MIDLAND, INC. (EIN 75-1736007) FOR THE SOLE PURPOSE OF HOLDING AND MAINTAINING HOSPICE'S FACILITIES. HOSPICE OF MIDLAND, INC. IS A TAX-EXEMPT ORGANIZATION UNDER IRC 501(C)(3) WHICH WAS ESTABLISHED TO CARE FOR TERMINALLY ILL PATIENTS.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers7TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
CY Contributions Grants$2,000CYContributionsGrantsAmt
PY Program Service Revenue$36PYProgramServiceRevenueAmt
CY Program Service Revenue$72,000CYProgramServiceRevenueAmt
PY Investment Income$15,547PYInvestmentIncomeAmt
CY Investment Income$11,774CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$15,583PYTotalRevenueAmt
CY Total Revenue$85,774CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$198,408PYOtherExpensesAmt
CY Other Expenses$319,143CYOtherExpensesAmt
PY Total Expenses$198,408PYTotalExpensesAmt
CY Total Expenses$319,143CYTotalExpensesAmt
PY Revenues Less Expenses-$182,825PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$233,369CYRevenuesLessExpensesAmt
Total Assets BOY$3,970,578TotalAssetsBOYAmt
Total Assets EOY$3,781,153TotalAssetsEOYAmt
Total Liabilities BOY$6,404TotalLiabilitiesBOYAmt
Total Liabilities EOY$5,715TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,964,174NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$3,775,438NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionGLASS-JOHNSON HOSPICE HOUSE, INC. IS CREATED FOR THE BENEFIT OF HOSPICE OF MIDLAND, INC. (EIN 75-1736007) FOR THE SOLE PURPOSE OF HOLDING AND MAINTAINING HOSPICE'S FACILITIES. HOSPICE OF MIDLAND, INC. IS A TAX-EXEMPT ORGANIZATION UNDER IRC 501(C)(3) WHICH WAS ESTABLISHED TO CARE FOR TERMINALLY ILL PATIENTS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$314,341ExpenseAmt
DescTHE SOLE PURPOSE IS TO HOLD AND MAINTAIN THE FACILITIES OF HOSPICE OF MIDLAND, INC.Desc
Total Program Service Expenses$314,341TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
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 ActivitiesfalseFundraisingActivitiesInd
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 EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document5IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee0EmployeeCnt
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 Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
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 PrsnfalseAnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonTAMMIE THOMSONPersonNm
Phone4326860841PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13327 CALDERA BLVDAddressLine1
CityMIDLANDCity
StateTXState
ZIP Code79707ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
DONNETTE SCHWISOW
PRESIDENT0.20Yes (X)Yes (X)$0$0$0
HOLT JOHNSON
VICE PRESIDE0.20Yes (X)Yes (X)$0$0$0
ALAN HALE
SECRETARY0.20Yes (X)Yes (X)$0$0$0
WILLSON BEEBE
TREASURER0.20Yes (X)Yes (X)$0$0$0
LUCIA GRAY
DIRECTOR0.20Yes (X)$0$0$0
LAURA MCCABE
DIRECTOR0.20Yes (X)$0$0$0
NANCY PANNELL
DIRECTOR0.20Yes (X)$0$0$0
FieldValueIRS element (for citing)
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$2,000AllOtherContributionsAmt
Noncash Contributions$2,000NoncashContributionsAmt
Total Contributions$2,000TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescHOSPICE BUILDINGSDesc
Total Revenue Column$72,000TotalRevenueColumnAmt
Related Or Exempt Func Income$72,000RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$72,000TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,006TotalRevenueColumnAmt
Related Or Exempt Func Income$7,006RelatedOrExemptFuncIncomeAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$4,768SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$4,768SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,768TotalRevenueColumnAmt
Related Or Exempt Func Income$4,768RelatedOrExemptFuncIncomeAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$85,774TotalRevenueColumnAmt
Related Or Exempt Func Income$83,774RelatedOrExemptFuncIncomeAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$3,230TotalAmt
Management And General$3,230ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$1,572TotalAmt
Management And General$1,572ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$105,245TotalAmt
Program Services$105,245ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$17,895TotalAmt
Program Services$17,895ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
GRANTS TO HOM$127,237$127,237
CLEANING / MAINTENANCE$28,379$28,379
LABOR$25,744$25,744
REPAIRS$9,792$9,792

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$49TotalAmt
Program Services$49ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$319,143TotalAmt
Program Services$314,341ProgramServicesAmt
Management And General$4,802ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$37,897BOYAmt
EOY$17,185EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$10,503BOYAmt
EOY$5,505EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3BOYAmt
EOY$6,000EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$4,498,879LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,208,924LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,384,500BOYAmt
EOY$3,289,955EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$537,675BOYAmt
EOY$462,508EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,970,578BOYAmt
EOY$3,781,153EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$6,404BOYAmt
EOY$5,715EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,404BOYAmt
EOY$5,715EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,964,174BOYAmt
EOY$3,775,438EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,964,174BOYAmt
EOY$3,775,438EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,970,578BOYAmt
EOY$3,781,153EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$233,369ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$44,633NetUnrlzdGainsLossesInvstAmt
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)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
CertificationYes (X)CertificationInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1HOSPICE OF MIDLAND INCBusinessNameLine1
FieldValueIRS element (for citing)
EIN751736007EIN
Organization Type7OrganizationTypeDesc
Governing Document ListedYes (true)GoverningDocumentListedInd
Supported Org NotifiedYes (true)SupportedOrgNotifiedInd
US OrganizedYes (true)USOrganizedInd
Support$209,047SupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$209,047SupportSumAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$721,504OtherCostOrOtherBasisAmt
Book Value$721,504BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,732,597OtherCostOrOtherBasisAmt
Depreciation$1,178,526DepreciationAmt
Book Value$2,554,071BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$44,778OtherCostOrOtherBasisAmt
Depreciation$30,398DepreciationAmt
Book Value$14,380BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$3,289,955TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$130,407TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$44,633NetUnrealizedGainsInvstAmt
Revenue Not Reported$44,633RevenueNotReportedAmt
Revenue Subtotal$85,774RevenueSubtotalAmt
Total Revenue Per Form990$85,774TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$319,143TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$319,143ExpensesSubtotalAmt
Total Expenses Per Form990$319,143TotalExpensesPerForm990Amt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990 - ORGANIZATION'S MISSIONGLASS-JOHNSON HOSPICE HOUSE, INC. IS CREATED FOR THE BENEFIT OF HOSPICE OF MIDLAND, INC. (EIN 75-1736007) FOR THE SOLE PURPOSE OF HOLDING AND MAINTAINING HOSPICE'S FACILITIES. HOSPICE OF MIDLAND, INC. IS A TAX-EXEMPT ORGANIZATION UNDER IRC 501(C)(3) WHICH WAS ESTABLISHED TO CARE FOR TERMINALLY ILL PATIENTS.
FORM 990, PAGE 6, PART VI, LINE 11BFORM 990 WAS E-MAILED TO THE TREASURER AND ANY OTHER BOARD MEMBERS WHO WISHED TO REVIEW IT BEFORE IT WAS FILED.
FORM 990, PAGE 6, PART VI, LINE 12CEACH BOARD MEMBER IS ASKED TO SIGN A CONFLICT OF INTEREST FORM WHEN THEY JOIN THE BOARD, INDICATING THAT IF THEY HAVE OR SUSPECT THEY HAVE ANY CONFLICT OF INTEREST THEY ARE TO MAKE FULL DISCLOSURE TO THE ORGANIZATION OF SUCH INTEREST BEFORE ANY DISCUSSION OR NEGOTIATION OF SUCH TRANSACTIONS. IF A CONFLICT DOES IN FACT EXIST, AS DETERMINED BY THE FULL BOARD, THEN THE MEMBER AFFECTED WILL NOT PARTICIPATE IN ANY DISCUSSION OR VOTE IN CONNECTION WITH THE MATTER. THE BOARD PLANS TO HAVE EACH BOARD MEMBER SIGN THIS POLICY ANNUALLY BEGINNING IN 2014.
FORM 990, PAGE 6, PART VI, LINE 19ALL DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST AT 911 W TEXAS.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1HOSPICE OF MIDLAND INCBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1911 W TEXASAddressLine1
CityMIDLANDCity
StateTXState
ZIP Code79701ZIPCode
FieldValueIRS element (for citing)
EIN751736007EIN
Primary ActivitiesHOSPICEPrimaryActivitiesTxt
Legal Domicile StateTXLegalDomicileStateCd
Exempt Code Section501CExemptCodeSectionTxt
Public Charity Status7PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
HOSPICE OF MIDLAND INC
B$126,551CASH
HOSPICE OF MIDLAND INC
K$72,000CASH

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