2013-11-14T14:48:51-06:00 2012-12-31 410746749 CLIFTONLARSONALLEN LLP 8215 GREENWAY BOULEVARD SUITE 600 MIDDLETON WI 53562 990 2012-01-01 391628298 RAINBOW HOSPICE CARE INC RAIN 9206746255 147 W ROCKWELL ST JEFFERSON WI 535492048 KAREN LACKE CARRIG 9206746255 2013-10-29 1 KARI JENSEN CPA P01230655 6086628600 2013-10-29 2012 2016-02-25 16:41:14Z KAREN LACKE CARRIG 147 W ROCKWELL ST JEFFERSON WI 53549 5683455 0 X RAINBOWHOSPICECARE.ORG X 1988 WI TO PROVIDE COMFORT, CARE AND MEANING FOR PATIENTS WHO ARE AT THE END-OF-LIFE AND SUPPORT FOR THEIR FAMILY AND FRIENDS. SERVICES ARE PROVIDED REGARDLESS OF AGE, INCOME, RELIGION, ETHNICITY AND/OR CULTURAL BACKGROUND. CARE IS PROVIDED TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THE ORGANIZATION'S COMMUNITY SUPPORT POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. THIS DISCOUNT IS BASED UPON FINANCIAL INFORMATION OBTAINED FROM THE PATIENT AT THE TIMES THEY ENROLL IN THE PROGRAM OR WITH SUBSEQUENT CHANGES TO THEIR FINANCIAL CIRCUMSTANCES. BECAUSE THE ORGANIZATION DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS COMMUNITY SUPPORT, THEY ARE NOT REPORTED AS REVENUE. 12 12 104 159 0 0 83743 122305 4250338 5484210 1904 1748 41991 20247 4377976 5628510 0 0 0 0 3073079 3637537 0 0 71958 1604283 1748410 4677362 5385947 -299386 242563 9367608 9218294 1870916 1218065 7496692 8000229 X TO PROVIDE COMFORT, CARE AND MEANING FOR PATIENTS WHO ARE AT THE END-OF-LIFE AND SUPPORT FOR THEIR FAMILY AND FRIENDS. SERVICES ARE PROVIDED REGARDLESS OF AGE, INCOME, RELIGION, ETHNICITY AND/OR CULTURAL BACKGROUND. CARE IS PROVIDED TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THE ORGANIZATION'S COMMUNITY SUPPORT POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. THIS DISCOUNT IS BASED UPON FINANCIAL INFORMATION OBTAINED FROM THE PATIENT AT THE TIMES THEY ENROLL IN THE PROGRAM OR WITH SUBSEQUENT CHANGES TO THEIR FINANCIAL CIRCUMSTANCES. BECAUSE THE ORGANIZATION DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS COMMUNITY SUPPORT, THEY ARE NOT REPORTED AS REVENUE. 0 0 4791387 5484210 HOSPICE CARE:RAINBOW HOSPICE CARE OFFERS COMPREHENSIVE END-OF-LIFE CARE TO PATIENTS AND FAMILES. THIS EXPERT CARE IS PROVIDED BY A TEAM OF PROFESSIONALS INCLUDING NURSES, CERTIFIED NURSING ASSISTANTS, SOCIAL WORKERS, CHAPLAINS, GRIEF COUNSELORS, PHYSICIANS, PHARMACISTS AND VOLUNTEERS. OUR STAFF AND VOLUNTEERS FOCUS ON EACH PATIENT'S INDIVIDUAL NEEDS WITH AN EMPHASIS ON PROVIDING COMFORT AND DIGNITY DURING THIS LAST PART OF THEIR LIFE'S JOURNEY. FAMILIES ARE SUPPORTED WITH THEIR CARE GIVING OF THE PATIENT AND GRIEF SUPPORT IS PROVIDED FOR A MINIMUM OF THIRTEEN MONTHS FOLLOWING THE PATIENT'S PASSING. IN 2012, THE ORGANIZATION PROVIDED HOSPICE & PALLIATIVE CARE TO 512 INDIVIDUALS INCLUDING $38,367 OF UNCOMPENSATED SERVICES TO INDIVIDUALS WITH NO MEANS OF PAYMENT. APPROXIMATELY 159 COMMUNITY MEMBERS VOLUNTEERED OVER 6,000 HOURS DURING THE YEAR. 4791387 1 1 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 24 0 1 104 1 0 0 0 0 0 1 1 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X MICHAEL R MAIER II 9206746255 147 W ROCKWELL ST JEFFERSON WI 535492048 DENNIS MUDLER 4.00 X X 0 0 0 KAY WIPPERFURTH 2.00 X 0 0 0 JAMES SHULKIN 2.00 X 0 0 0 JOHN GRAF 2.00 X 0 0 0 TINA CRAVE 2.00 X 0 0 0 J THOMAS MACK 2.00 1.00 X 0 0 0 MARTIN HARRISON 2.00 X 0 0 0 DIXIE STETSON 2.00 X 0 0 0 JOHN UTTECH 2.00 X 0 0 0 PHILIP MERTENS 4.00 1.00 X X 0 0 0 DR FRED GREMMELS 2.00 X 0 0 0 DEBRA RANGUETTE 2.00 X 0 0 0 KAREN LACKE CARRIG 40.00 4.00 X 115498 0 29536 MICHAEL R MAIER II 40.00 4.00 X 73302 0 34771 CHARLES FRANDSON 8.00 32.00 X 80661 0 22275 269461 0 86582 1 0 0 0 FORT HEALTHCARE INC 611 SHERMAN AVENUE FORT ATKINSON WI 53538 HEALTHCARE SERVICES 125025 1 22403 32642 67260 20542 122305 PATIENT SERVICES 623000 5484210 5484210 5484210 1748 1748 75192 32642 54945 20247 20247 5628510 5484210 0 21995 268704 229519 39185 2595482 2408761 183261 3460 51202 47519 3615 68 486319 451333 34338 648 235830 218737 14484 2609 6050 4840 1210 11300 9040 2260 144872 144872 33123 22576 5478 5069 138734 132263 2318 4153 41719 40086 1633 106448 99564 6884 177260 160182 13719 3359 30492 25350 4735 407 60197 60197 265540 252934 12606 25073 22991 2082 MEDICAL & TRANSPORTATIO 604522 604522 CONTINUING EDUCATION 42729 42729 DUES & SUBSCRIPTIONS 13535 13535 46816 29356 4460 13000 5385947 4791387 522602 71958 126238 133087 240711 481112 4175 36175 632394 530733 20645 31126 6037985 592244 5626291 5445741 2717154 2560320 9367608 9218294 399916 418065 871000 0 600000 800000 1870916 1218065 X 7496692 7967729 32500 7496692 8000229 9367608 9218294 X 242563 260974 X 0 1 X 0 0 X 206725 698971 567126 83743 122305 1678870 2620851 2647967 3520549 4250338 5484210 18523915 71992 66488 79592 75913 75192 369177 2899568 3413426 4167267 4409994 5681707 20571962 115649 599174 543980 68959 87403 1415165 0 115649 599174 543980 68959 87403 1415165 19156797 19814 13237 6399 1904 1748 43102 19814 13237 6399 1904 1748 43102 2919382 3426663 4173666 4411898 5683455 20615064 0.92930 0.89580 0.00210 0.00470 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 500000 500000 4062992 171313 3891679 7296 1834 5462 1315445 325058 990387 152252 94039 58213 5445741 INVESTMENT IN RAINBOW HOSPICARE AFFILIATES 2560320 C 2560320 NOTE PAYABLE TO HOSPICE FOUNDATION 800000 800000 GOLF OUTING 82326 32642 49684 20809 4740 5449 5758 END OF LIFE CONFERENCE 22331 22331 2557 5573 7988 1416 104657 32642 72015 20809 7297 11022 7988 7174 54290 17725 FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 IS EITHER PRESENTED TO OR E-MAILED TO ALL MEMBERS OF THE BOARD OF DIRECTORS. THE MEMBERS OF THE FINANCE & AUDIT COMMITTEE REVIEW THE FORMS WITH THE CFO AND CEO AT A REGULARLY SCHEDULED MEETING. AN OVERVIEW IS THEN GIVEN TO THE FULL BOARD AT A REGULAR MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES OFFICERS, DIRECTORS AND KEY EMPLOYEES TO DOCUMENT AND SIGN THE CONFLICT OF INTEREST POLICY ANNUALLY DURING A REGULAR MEETING. THE CEO REVIEWS THE STATEMENTS FOR ANY DISCLOSURES AND WOULD BRING ANY LISTED CONFLICTS TO THE FULL BOARDS ATTENTION. IF ANY CONFLICTS EXIST THAN THAT PERSON WOULD NOT BE ALLOWED TO VOTE OR NEGOTIATE CONTRACTS RELATED TO THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 ALL DIRECTORS ARE ASKED TO COMPLETE AN ANNUAL PERFORMANCE REVIEW OF THE CEO. THE PERSONNEL COMMITTEE REVIEWS THE COMPLETED EVALUATIONS AND DISCUSSES CHANGES IN COMPENSATION. INDUSTRY SPECIFIC BENCHMARK DATA COMPLILED ANNUALLY BY A THIRD PARTY AGENCY IS USED FOR COMPARABILITY. THE CHAIRMAN OF THE BOARDS MEETS WITH THE CEO TO DISCUSS THE RESULTS OF THE REVIEWS AND TO OUTLINE ANY SALARY CHANGES. THE REVIEWS AND A SALARY CHANGE FORM ARE MAINTAINED IN THE CEO'S PERSONNEL FOLDER. THE CEO PERFORMS ANNUAL PERFORMANCE REVIEWS OF THE OTHER OFFICERS WHICH ARE DOCUMENTED AT KEPT IN THE EMPLOYEE'S PERSONNEL FILE. ANNUAL WAGE ADJUSTMENTS ARE DETERMINED BY THE PERSONNEL COMMITTEE AND APPROVED AS PART OF THE OPERATING BUDGET FOR ALL EMPLOYEES. ANY DEVIATION FROM THE STANDARD INCREASE WOULD BE REVIEWED BY THE BOARD AS PART OF THE BUDGET PROCESS. INDUSTRY SPECIFIC BENCKMARK DATA COMPILED BY A THIRD PARTY AGENCY IS USED FOR COMPARABILITY. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION MAKES ITS DOCUMENTS AVAILABLE FOR PUBLIC INSPECTION ON GUIDESTAR.COM FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS DOCUMENTS AVAILABLE FOR PUBLIC INSPECTION ON GUIDESTAR.COM CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: EQUITY TRANSFERRED FROM RAINBOW HOSPICE FOUNDATION 417,808. CHANGES IN INVESTMNET IN RHI SUBSIDIARIES -156,834. RAINBOW HOSPICE CARE HOLDING LLC 147 W ROCKWELL ST JEFFERSON WI 53549 SUB-DIVISION DEVELOPMENT RELATED TO THE NEW INPATIENT FACILITY WI 0 798682 RAINBOW HOSPICE CARE INC RAINBOW HOSPICE FOUNDATION INC 147 W ROCKWELL ST JEFFERSON WI 53549 260229434 FUNDRAISING/SUPPORTING RAINBOW HOSPICE CARE INC. WI 501(C)(3) 509(A)(3) RAINBOW HOSPICE CARE INC 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 RAINBOW HOSPICE FOUNDATION INC C 500001 CASH RAINBOW HOSPICE FOUNDATION INC E 200000 CASH RAINBOW HOSPICE FOUNDATION INC O 82192 CASH RAINBOW HOSPICE FOUNDATION INC Q 23007 CASH RAINBOW HOSPICE FOUNDATION INC S 59098 CASH RAINBOW HOSPICE FOUNDATION INC P 48566 CASH