OHIOS HOSPICE FOUNDATION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
OHIOS HOSPICE FOUNDATION (EIN 31-1769696)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-05
IRS object ID
201323099349300437
Schema version
2012v2.1
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)
Timestamp2013-11-05T11:06:01-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN310800053EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLARK SCHAEFER HACKETT & COBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line110100 INNOVATION DRIVE SUITE 400AddressLine1
CityDAYTONCity
StateOHState
ZIP Code45342ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN311769696EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HOSPICE OF DAYTON FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHOSPNameControl
Phone9372564490Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1324 WILMINGTON AVEAddressLine1
CityDAYTONCity
StateOHState
ZIP Code45420ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJERRY DURSTName
TitleCFOTitle
Phone9372564490Phone
Date Signed2013-06-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKEVIN T DAVIS CPAName
PTINP00039883PTIN
Phone9372260070Phone
Date Prepared2013-06-13DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonBRENDA HUMFLEETNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1324 WILMINGTON AVEAddressLine1
CityDAYTONCity
StateOHState
ZIP Code45420ZIPCode
FieldValueIRS element (for citing)
Gross Receipts38971892GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteHTTP://WWW.HOSPICEOFDAYTON.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2001YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE FINANCIAL SUPPORT TO ITS PARENT ORGANIZATION, THE HOSPICE OF DAYTON, INC. (31-0933339)ActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2465639ContributionsGrantsPriorYear
Contributions Grants Current Year3091534ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year1436056InvestmentIncomePriorYear
Investment Income Current Year1530788InvestmentIncomeCurrentYear
Other Revenue Prior Year222457OtherRevenuePriorYear
Other Revenue Current Year228405OtherRevenueCurrentYear
Total Revenue Prior Year4124152TotalRevenuePriorYear
Total Revenue Current Year4850727TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year2151665GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY2779667GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year1786131TotalFundrsngExpCurrentYear
Other Expense Prior Year1202979OtherExpensePriorYear
Other Expenses Current Year2077106OtherExpensesCurrentYear
Total Expenses Prior Year3354644TotalExpensesPriorYear
Total Expenses Current Year4856773TotalExpensesCurrentYear
Revenues Less Expenses Prior Year769508RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-6046RevenuesLessExpensesCY
Total Assets BOY24080890TotalAssetsBOY
Total Assets EOY26672848TotalAssetsEOY
Total Liabilities BOY1141921TotalLiabilitiesBOY
Total Liabilities EOY2707313TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY22938969NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY23965535NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionHOSPICE OF DAYTON FOUNDATION IS A SUPPORTIVE FOUNDATION OF THE HOSPICE OF DAYTON, INC. IT PROVIDES COUNSEL AND ASSISTANCE TO THE HOSPICE OF DAYTON, INC., BY HELPING TO IDENTIFY AND ACCESS INDIVIDUAL AND CORPORATE FINANCIAL SUPPORT WITH THE HOSPICE OF DAYTON'S SERVICE AREA; PROVIDING A COMMUNITY PERSPECTIVE ON KEY ISSUES RELEVANT TO PALLIATIVE AND HOSPICE CARE; AIDING IN THE DEVELOPMENT OF A COMPREHENSIVE COMMUNITY OUTREACH EDUCATIONAL PROGRAM; HELPING TO SHAPE KEY MESSAGES ON HOSPICE AND PALLIATIVE CARE; HELPING FORMULATE STRATEGIES TO INCREASE THE NON-EARNED REVENUE; AND MAKING FUNDING/GRANTING DECISIONS RELATIVE TO THE HOSPICE OF DAYTON, INC.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense2779667Expense
Grants2779667Grants
DescriptionSUPPORT OF THE HOSPICE OF DAYTON, INC. (EIN. 31-0933339). GRANTS PAID SUPPORT PATHWAYS OF HOPE, COMPLIMENTARY CARE, PALLIATIVE CARE, AS WELL AS THE OVERALL COMMUNITY BASED MODEL OF CARE.Description
Total Program Service Expense2779667TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledOHStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JERRY DURSTBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9372564490TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1324 WILMINGTON AVEAddressLine1
CityDAYTONCity
StateOHState
ZIP Code454201891ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (19 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
CAROL LEVITAN
TRUSTEE2.00X000
BRENDA HUMFLEET
PRESIDENT40.00X018298416535X
DONALD WECKSTEIN
TRUSTEE - TERM EXPIRED 20122.00X000
KENT ANDERSON
TRUSTEE - BVOP/PRESIDENT-HOD2.00X04433199962
WILLIAM THALER
TRUSTEE - TERM EXPIRED 20122.00X000
ROBERT MUES
TRUSTEE - SEC./TREAS.2.00X000X
HOWARD MICHAELS
TRUSTEE - VICE CHAIR2.00X000X
FRANZ HOGE
TRUSTEE (AUG-DEC)2.00X000
DR JOHN M ROLL
TRUSTEE2.00X000
JERRY TATAR
TRUSTEE - CHAIR2.00X000X
ROBERT A YECK
TRUSTEE2.00X000
GARY LEROY
TRUSTEE - BVOP2.00X000
GREG TOMAN
TRUSTEE - BVOP2.00X000
ROBERT BRETHEN
TRUSTEE2.00X000
ANNE KEETON
TRUSTEE2.00X000
RICHARD WICK
TRUSTEE2.00X000
DAVID FREIMUTH
TRUSTEE2.00X000
PETER HALEY
TRUSTEE2.00X000
JERRY DURST
CFO - HOD2.00016401622717X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs790319TotalReportableCompFrmRltdOrgs
Total Other Compensation49214TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Federated Campaigns478574FederatedCampaigns
Fundraising Events11850FundraisingEvents
All Other Contributions2601110AllOtherContributions
Noncash Contributions386022NoncashContributions
Total Contributions3091534TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column691349TotalRevenueColumn
Exclusion$691,349ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities34871147Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities34031708Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities839439Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column839439TotalRevenueColumn
Exclusion$839,439ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events290977GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events11850CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses70234FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column220743TotalRevenueColumn
Exclusion$220,743ExclusionAmount
FieldValueIRS element (for citing)
Gross Sales Of Inventory26885GrossSalesOfInventory
Cost Of Goods Sold19223CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column7662TotalRevenueColumn
Related Or Exempt Function Income7662RelatedOrExemptFunctionIncome

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column4850727TotalRevenueColumn
Related Or Exempt Function Income7662RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,751,531ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total2779667Total
Program Services2779667ProgramServices

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total183088Total
Management And General183088ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total72943Total
Management And General40643ManagementAndGeneral
Fundraising32300Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total48175Total
Fundraising48175Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total43271Total
Management And General43271ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total29559Total
Management And General3323ManagementAndGeneral
Fundraising26236Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalFundraisingFundraisingManagement And GeneralManagementAndGeneral
ALLOCATED SALARIES, BEN891555891555
PRINTING AND PUBLICATIO2805332761344399
DONATED ITEM EXPENSE220284220284
POSTAGE AND MAILINGS1115341035348000

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total196164Total
Management And General8251ManagementAndGeneral
Fundraising187913Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total4856773Total
Program Services2779667ProgramServices
Management And General290975ManagementAndGeneral
Fundraising1786131Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1000BOY
EOY2496EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY326619BOY
EOY210997EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY885945BOY
EOY676879EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY22867326BOY
EOY25782476EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY24080890BOY
EOY26672848EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1382BOY
EOY422EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1140539BOY
EOY2706891EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1141921BOY
EOY2707313EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY21375131BOY
EOY22190291EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY453838BOY
EOY665244EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1110000BOY
EOY1110000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY22938969BOY
EOY23965535EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY24080890BOY
EOY26672848EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-6046ReconcilationRevenueExpenses
Reconciliation Unrealized Invest962206ReconciliationUnrealizedInvest
Reconcilation Other Changes70406ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1THE HOSPICE OF DAYTON INCBusinessNameLine1
FieldValueIRS element (for citing)
EIN310933339EIN
Type Of Organization7TypeOfOrganization
Listed In Governing Doc1ListedInGoverningDoc
Supported Organization Notified1SupportedOrganizationNotified
Organized In US1OrganizedInUS
Amount$2,779,667Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts2779667SumOfAmounts

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance22867326BeginningOfYearBalance
Investment Earnings Or Losses2309906InvestmentEarningsOrLosses
End Of Year Balance25177232EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance22828457BeginningOfYearBalance
Investment Earnings Or Losses38869InvestmentEarningsOrLosses
End Of Year Balance22867326EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance14407503BeginningOfYearBalance
Contributions6273655Contributions
Investment Earnings Or Losses2324795InvestmentEarningsOrLosses
Other Expenditures177496OtherExpenditures
End Of Year Balance22828457EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance7500120BeginningOfYearBalance
Contributions6015800Contributions
Investment Earnings Or Losses1396370InvestmentEarningsOrLosses
Other Expenditures504787OtherExpenditures
End Of Year Balance14407503EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance9640550BeginningOfYearBalance
Investment Earnings Or Losses-2140430InvestmentEarningsOrLosses
End Of Year Balance7500120EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.95590BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.04410PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.00000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO RELATED ENTITY (THE HOSPICE OF DAYTON, INC. 31-0933339)Description
Amount$2,706,891Amount
FieldValueIRS element (for citing)
Total Of Amounts2706891TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt5808229TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments962206NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities18521DonatedSrvcAndUseOfFacilities
Other Revenues159863OtherRevenues
Revenue Not Rptd F9901140590RevenueNotRptdF990
Revenue Subtotal4667639RevenueSubtotal
Investment Expenses Not Included183088InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt183088RevenueNotRptdOnFinStmt
Total Revenue Per Form9904850727TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt4781663TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities18521DonatedServicesUseOfFacilities
Other Expenses Included89457OtherExpensesIncluded
Expenses Not Rptd F990107978ExpensesNotRptdF990
Expenses Subtotal4673685ExpensesSubtotal
Investment Expenses Not Included2183088InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt183088ExpensesNotRptdOnFinStmt
Total Expenses Per Form9904856773TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:ENDOWMENT FUNDS ARE MAINTAINED TO PROVIDE FINACIAL SUPPORT TO THE FOUNDATION'S PARENT ORGANIZATION, THE HOSPICE OF DAYTON, INC. (31-0933339). IT IS THE FOUNDATION'S OBJECTIVE TO UTILIZE CURRENT FUNDRAISING TO SUPPORT THE HOSPICE OF DAYTON, INC.'S PROGRAMS, TO GROW AND PROVIDE RESERVES FOR UNFORESEEN CIRCUMSTANCES OR TO FUND SIGNIFICANT NEW INITIATIVES.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD FAIL TO BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. AS DISCUSSED ABOVE, THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES AND MANAGEMENT BELIEVES THE ORGANIZATION HAS NOT ENGAGED IN ANY ACTIVITIES THAT WOULD DISQUALIFY IT FROM TAX-EXEMPT STATUS OR INCUR A TAX OBLIGATION FOR THE YEARS ENDED DECEMBER 31, 2012 AND 2011. THE ORGANIZATION BELIEVES THEIR ESTIMATES ARE APPROPRIATE BASED ON CURRENT FACTS AND CIRCUMSTANCES. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE ORGANIZATION BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS ENDED PRIOR TO DECEMBER 31, 2009. THE ORGANIZATION'S POLICY WITH REGARD TO INTEREST AND PENALTY, IF INCURRED, IS TO RECOGNIZE INTEREST THROUGH INTEREST EXPENSE AND PENALTIES THROUGH OTHER EXPENSE.
PART XI, LINE 2D - OTHER ADJUSTMENTS:DIRECT FUNDRAISING EXPENSE 70,234. CHANGE IN SPLIT INTEREST AGREEMENTS 70,406. COST OF GOODS SOLD 19,223.
PART XII, LINE 2D - OTHER ADJUSTMENTS:DIRECT FUNDRAISING EXPENSE 70,234. COST OF GOODS SOLD 19,223.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLF CLASSICNameOfEvent1
Gross Receipts Event1100060GrossReceiptsEvent1
Charitable Contributions Event15850CharitableContributionsEvent1
Gross Revenue Event194210GrossRevenueEvent1
Other Direct Expenses Event125001OtherDirectExpensesEvent1
Name Of Event2FASHION SHOWNameOfEvent2
Gross Receipts Event294384GrossReceiptsEvent2
Charitable Contributions Event26000CharitableContributionsEvent2
Gross Revenue Event288384GrossRevenueEvent2
Other Direct Expenses Event223776OtherDirectExpensesEvent2
Total Number Of Other Events4TotalNumberOfOtherEvents
Gross Receipts Other Events108383GrossReceiptsOtherEvents
Gross Revenue Other Events108383GrossRevenueOtherEvents
Other Direct Expenses Other Events21457OtherDirectExpensesOtherEvents
Gross Receipts Total302827GrossReceiptsTotal
Charitable Contributions Total11850CharitableContributionsTotal
Gross Revenue Total Events290977GrossRevenueTotalEvents
Other Direct Expenses Total Events70234OtherDirectExpensesTotalEvents
Direct Expense Summary Events70234DirectExpenseSummaryEvents
Net Income Summary220743NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1THE HOSPICE OF DAYTON INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1324 WILMINGTON AVEAddressLine1
CityDAYTONCity
StateOHState
ZIP Code45420ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient310933339EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant2779667AmountOfCashGrant
Purpose Of GrantTO FACILIATE THE HOSPICE OF DAYTON, INC. PURPOSE TO PROVIDE HOSPICE CARE TO THE TERMINALLY ILL.PurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
ExplanationFORM 990, SCHEDULE F, PART I, QUESTION 2; GRANTS ARE ONLY PROVIDED TO THE HOSPICE OF DAYTON, INC. TO SUPPORT PROGRAMS IDENTIFIED AND APPROVED BY THE FOUNDATION'S BOARD OF TRUSTEES.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
BRENDA HUMFLEET
PRESIDENT0182984000001321403321019951900
KENT ANDERSON
TRUSTEE - BVOP/PRESIDENT-HOD03033190140000000009962045328100
JERRY DURST
CFO - HOD0164016000001275509962018673300

Schedule M IRS990ScheduleM

Clothing And Household Goods ClothingAndHouseholdGoods

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Noncash Contribs Rptd F990222322NoncashContribsRptdF990
Method Of Determining RevenuesFAIR MARKET VALUEMethodOfDeterminingRevenues

Real Estate Commercial RealEstateCommercial

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F990161000NoncashContribsRptdF990
Method Of Determining RevenuesFMV-PLEDGE A/R AT 12/31MethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11THE FINANCE COMMITTEE OF THE HOSPICE OF DAYTON, INC. TRUSTEES AND BOARD MEMBERS OF HOSPICE OF DAYTON FOUNDATION ARE PROVIDED THE FORM 990 PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE HOSPICE OF DAYTON, INC. MAINTAINS A CONFLICT OF INTEREST POLICY. THE BOARD OF TRUSTEES ANNUALLY REPORTS ON ANY ACTIVITY THAT COULD GIVE RISE TO POTENTIAL CONFLICTS OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15ATHE PRESIDENT/CEO OF THE HOSPICE OF DAYTON, INC. UTILIZES LOCAL MARKET KNOWLEDGE, DATA FROM SIMILAR HOSPICE AND MEDICAL FACILITIES, ANNUAL PERFORMANCE EVALUATIONS AND BENCHMARK DATA TO ESTABLISH COMPENSATION FOR THE PRESIDENT OF THE FOUNDATION.
FORM 990, PART VI, SECTION C, LINE 19HOSPICE OF DAYTON FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND ITS FINANCIAL STATEMENTS (INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF ITS PARENT, THE HOSPICE OF DAYTON, INC.) AVAILABLE TO THE PUBLIC UPON RECEIPT OF A WRITTEN REQUEST FOR SUCH INFORMATION.
FORM 990, PART XI, LINE 9:CHANGE IN SPLIT INTEREST AGREEMENTS 70,406.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2C:THE BOARD OF TRUSTEES HAS CHARGED THE FINANCE COMMITTEE OF THE HOSPICE OF DAYTON, INC. WITH OVERSIGHT OF THE INDEPENDENT AUDIT. THIS PROCESS IS CONSISTENET WITH THE PRIOR YEAR.
FORM 990, PART IX, LINE 24A:ALL COMPENSATION OF FOUNDATION EMPLOYEES IS PAID BY THE HOSPICE OF DAYTON, INC. (31-0933339) AND IS ALLOCATED TO THE FOUNDATION. THE TOTAL ALLOCATED AMOUNT OF $891,555 CONSISTS OF $747,089 OF SALARIES, $91,009 OF OTHER EMPLOYEE BENEFITS AND $53,457 OF PAYROLL TAXES. THE ALLOCATION IS BASED ON ACTUAL COST.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1THE HOSPICE OF DAYTON INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1324 WILMINGTON AVENUEAddressLine1
CityDAYTONCity
StateOHState
ZIP Code45420ZIPCode
FieldValueIRS element (for citing)
EIN310933339EIN
Primary ActivitiesHOSPICE CARE OF TERMINALLY ILL.PrimaryActivities
Legal Domicile StateOHLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status170(B)(1)(A)(VI)PublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
THE HOSPICE OF DAYTON INC (31-0933339)
B2779667CASH VALUE
THE HOSPICE OF DAYTON INC (31-0933339)
L1142280CASH VALUE
THE HOSPICE OF DAYTON INC (31-0933339)
N43271CASH VALUE
THE HOSPICE OF DAYTON INC (31-0933339)
O891555CASH VALUE

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