2013-05-13T10:09:05-05:00 2012-12-31 611129886 KELLEY GALLOWAY & CO PSC PO BOX 990 ASHLAND KY 411050990 990 2012-01-01 310970252 COMMUNITY HOSPICE INC COMM 6063291890 1480 CARTER AVENUE ASHLAND KY 41101 SUSAN HUNT 6063291890 2013-05-09 1 KELLEY GALLOWAY CO PSC P00039427 6063291811 2012 2016-02-24 21:20:13Z SUSAN HUNT 1480 CARTER AVE ASHLAND KY 41101 18080277 0 X WWW.CHOSPICE.ORG X 1979 KY PROVIDING MEDICAL CARE TO TERMINALLY ILL PATIENTS. 17 17 160 220 0 0 300136 152358 13729418 13859529 194881 74920 72781 46165 14297216 14132972 0 0 0 0 5864945 6187438 0 0 0 6472887 6451021 12337832 12638459 1959384 1494513 20348937 21879201 1653704 1478461 18695233 20400740 PROVIDING MEDICAL CARE TO TERMINALLY ILL PATIENTS. 0 0 11379532 13959868 PROVIDING MEDICAL CARE, SOCIAL SERVICES, AND SPIRITUAL SUPPORT TO TERMINALLY ILL PATIENTS AND THEIR FAMILIES. 11379532 1 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 81 0 0 160 1 0 0 0 0 0 0 0 0 0 0 X 17 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 KY X CHARLOTTE HORN 6063291890 1480 CARTER AVENUE ASHLAND KY 41101 SUSAN HUNT 40.00 X X 148912 0 0 JC BROWN 0.00 X 0 0 0 PAT STEEN 0.00 X 0 0 0 TOM BURNETTE 0.00 X 0 0 0 DR TIMOTHY DIXON 0.00 X 0 0 0 DARLENE HENNECKE 0.00 X 0 0 0 STEVE KANOUSE 0.00 X 0 0 0 BRUCE VANHORN 0.00 X 0 0 0 WILLIAM ELKINS 0.00 X 0 0 0 VERN LINCOLN 0.00 X 0 0 0 JOHN MCMEANS 0.00 X 0 0 0 RAMONA SALYER 0.00 X 0 0 0 DOROTHY RHODES 0.00 X 0 0 0 JOHN VINCENT 0.00 X 0 0 0 TYLER WALTERS 0.00 X 0 0 0 ROBERT BAYES 0.00 X 0 0 0 JIM BERTON 0.00 X 0 0 0 CHRISTI MCKINNEY 0.00 X 0 0 0 DR LISA BARKER 40.00 X 180631 0 0 SANDY ZERKLE 40.00 X 103068 0 0 432611 0 0 3 0 1 0 DIVERSICARE LEASING CORP 12800 PRINCELAND DRIVE ASHLAND KY 41102 NURSING HOME SERVICES 660237 HOSPICE PHARMACIA BOX 510818 PHILADELPHIA PA 19175 PHARMACY SERVICES 625454 RJ CONSTRUCTION 61 CONSTRUCTION LANE VANCEBURG KY 41179 CONTRACTOR 414696 WOODLAND OAKS 1820 OAKVIEW RD ASHLAND KY 41101 NURSING HOME SERVICES 365710 OAKMONT MANOR PO BOX 822 FLATWOODS KY 41139 NURSING HOME SERVICES 277028 15 152358 152358 PATIENT CARE 621610 10543907 10543907 PATIENT CARE 623000 3315622 3315622 13859529 154122 154122 3121275 722680 3105051 818106 16224 -95426 -79202 -79202 44894 24148 20746 20746 MISCELLANEOUS 900099 25419 25419 25419 14132972 13959868 0 20746 X 148912 148912 5347144 4867885 479259 298471 241342 57129 392911 346499 46412 47320 20348 26972 59720 48428 11292 34600 34600 238709 234542 4167 315626 164558 151068 CONTRACTED PROFESSIONAL 2729367 2729367 0 MEDICATION 700052 700052 0 INSURANCE 666687 550577 116110 MEDICAL EQUIPMENT RENTA 312735 312735 0 1346205 1128599 217606 12638459 11379532 1258927 0 4347536 5884074 1814455 1823483 1335556 1656671 79592 69297 28197 34276 9291666 2188085 7782693 7103581 3863802 4178032 1084846 1114782 12260 15005 20348937 21879201 1653704 1478461 1653704 1478461 X 18695233 20400740 18695233 20400740 20348937 21879201 1494513 210994 0 X X 0 1 X 1 0 X 206798 180116 153971 300136 152358 993379 206798 180116 153971 300136 152358 993379 57912 935467 217722 143675 152035 138557 154122 806111 52317 73446 136847 103013 70313 435936 2235426 66391793 0.41850 0.41220 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 917458 917458 6524204 871353 5652851 1502559 1082015 420544 347445 234717 112728 7103581 INVESTMENTS - US GOVT AGENCY SECURITIES 1038923 F INVESTMENTS - MUTUAL FUNDS 92143 F INVESTMENTS - CORPORATE BONDS 692839 F INVESTMENTS - PUBLICLY TRADED SECURITIES 2069927 F INVESTMENTS - MUNICIPAL BONDS 79430 F INVESTMENTS - FIXED ACCOUNT 204770 F 4178032 INVESTMENTS - CDS AND MONEY MARKET ACCOUNTS 1114782 F 1114782 X 14463540 210994 95426 306420 14157120 -24148 -24148 14132972 12758033 119574 119574 12638459 0 12638459 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: NONE. PART XI, LINE 2D - OTHER ADJUSTMENTS: NET LOSS ON SALE OF ASSETS PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRASING EXPENSES PART XII, LINE 2D - OTHER ADJUSTMENTS: NET LOSS ON SALE OF ASSETS FUNDRAISING EXPENSES PART XI - LINE 8 - UNREALIZED GAIN (LOSS) ON INVESTMENTS FROM AUDIT REPORT. MEMORIAL BRICKS 14599 14599 7486 WINERY DINNER 14133 14133 1850 4553 250 1816 3 16162 16162 164 3995 4034 44894 44894 164 1850 8548 250 13336 24148 20746 X X 0 0 0 0 0 0 0 0 0 DR LISA BARKER 180631 0 0 0 0 0 0 0 0 0 180631 0 0 0 ASHLAND OFFICE SUPPLIES DIRECTOR OWNS THE VENDOR 30566 VENDOR PROVIDES OFFICE SUPPLIES TO THE ORGANIZATION.ORGAINIZATION PURCHASE OFFICE SUPPLIES FROM THE VENDOR. 0 KING'S DAUGHTERS MEDICAL CENTER DIRECTOR IS THE HEALTH CARE PLANNER OF FACILITIES 104640 THE VENDOR PROVIDES MEDICAL SERVICES TO THE ORGANIZATION. 0 OUR LADY OF BELLEFONTE HOSPITAL TWO DIRECTORS ARE MANAGERS / NURSING MANAGER AT THE ORGANIZATION 56871 THE VENDOR PROVIDES MEDICAL SERVICES TO THE ORGANIZATION. 0 OFFICE FURNITURE USA DIRECTOR OWNS THE VENDOR 152887 THE VENDOR PROVIDES OFFICE FURNITURE TO THE ORGANIZATION. 0 TOWN SQUARE BANK DIRECTOR IS THE PRESIDENT OF THE BANK. 266017 THE ORGANIZATION OWNS A CERTIFICATE OF DEPOSIT FROM THE BANK. 0 MCMEANS PHARMACY DIRECTOR OWNS THE VENDOR 1025 THE VENDOR PROVIDES PHARMACEUTICALS. 0 FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR, THE DIRECTOR OF FINANCE, AND THE FINANCE COMMITTEE. THE GOVERNING BOARD IS THEN NOTIFIED THAT THE RETURN IS COMPLETED AND THEY ARE NOTIFIED OF THE DUE DATE AND THAT THE RETURN IS AVAILABLE TO THEM FOR REVIEW IF THEY DEEM NECESSARY IN THE BUSINESS OFFICE. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST FORMS ARE COMPLETED WHEN FIRST JOINING THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 COPIES ARE PROVIDED AT OUR ADMINISTRATIVE OFFICES UPON REQUEST. ALL OTHER FUNCTIONAL EXPENSES FORM 990, PART IX, LINE 24E MEDICAL SUPPLIES: PROGRAM SERVICE EXPENSES 218,786. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 218,786. MAINTENANCE AND REPAIRS: PROGRAM SERVICE EXPENSES 169,172. MANAGEMENT AND GENERAL EXPENSES 42,493. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 211,665. OTHER MEDICAL PAYMENTS: PROGRAM SERVICE EXPENSES 195,541. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 195,541. UTILITIES: PROGRAM SERVICE EXPENSES 108,266. MANAGEMENT AND GENERAL EXPENSES 17,304. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 125,570. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 75,564. MANAGEMENT AND GENERAL EXPENSES 43,887. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 119,451. TELEPHONE: PROGRAM SERVICE EXPENSES 59,849. MANAGEMENT AND GENERAL EXPENSES 21,778. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 81,627. PROPERTY TAXES AND INSURANCE: PROGRAM SERVICE EXPENSES 55,495. MANAGEMENT AND GENERAL EXPENSES 13,567. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 69,062. OFFICE SUPPLIES: PROGRAM SERVICE EXPENSES 30,638. MANAGEMENT AND GENERAL EXPENSES 17,426. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 48,064. DUES AND SUBSCRIPTIONS: PROGRAM SERVICE EXPENSES 32,609. MANAGEMENT AND GENERAL EXPENSES 13,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 45,609. CONFERENCES & CONT. ED: PROGRAM SERVICE EXPENSES 29,863. MANAGEMENT AND GENERAL EXPENSES 10,105. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 39,968. TRAINING: PROGRAM SERVICE EXPENSES 36,840. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 36,840. NEWSLETTER: PROGRAM SERVICE EXPENSES 25,061. MANAGEMENT AND GENERAL EXPENSES 9,990. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 35,051. STAFF DEVELOPMENT: PROGRAM SERVICE EXPENSES 24,228. MANAGEMENT AND GENERAL EXPENSES 8,348. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,576. COMPUTER SUPPLIES: PROGRAM SERVICE EXPENSES 12,972. MANAGEMENT AND GENERAL EXPENSES 8,881. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,853. FOOD PURCHASED: PROGRAM SERVICE EXPENSES 21,396. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,396. HOUSEKEEPING SUPPLIES: PROGRAM SERVICE EXPENSES 18,814. MANAGEMENT AND GENERAL EXPENSES 2,493. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,307. POSTAGE: PROGRAM SERVICE EXPENSES 5,383. MANAGEMENT AND GENERAL EXPENSES 4,783. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,166. PHARMACY SUPPLIES: PROGRAM SERVICE EXPENSES 5,230. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,230. PRINTING: PROGRAM SERVICE EXPENSES 2,892. MANAGEMENT AND GENERAL EXPENSES 1,907. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,799. LOSS ON DISPOSAL OF ASSETS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,644. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,644. FORM 990. PART XII, LINE 2C NO CHANGE IN THE CURRENT YEAR.