2013-04-10T17:02:37-05:00 2012-06-30 341145015 WILLIAM VAUGHAN COMPANY 145 CHESTERFIELD LANE MAUMEE OH 435373836 990 2011-07-01 382532215 ARBOR HOSPICE INC ARBO 7346625999 2366 OAK VALLEY DRIVE ANN ARBOR MI 48103 BRUCE F CARTY 7346625999 2013-04-10 1 JACK C HAGMEYER P00051646 4198911040 2011 2016-02-25 16:41:14Z GLORIA BROOKS 2366 OAK VALLEY DRIVE ANN ARBOR MI 48103 18546760 0 X WWW.ARBORHOSPICE.ORG X 1984 MI PROVIDE SERVICES FOR TERMINALLY ILL PATIENTS AND THEIR FAMILIES. 22 20 280 273 0 0 798684 78345 16694299 18154704 80920 662 47073 313049 17620976 18546760 0 0 0 0 10068786 11112258 0 0 26410 7067779 7582102 17136565 18694360 484411 -147600 8954511 8221949 6910021 6325509 2044490 1896440 TO GIVE COMFORT, ASSURANCE AND CARE TO FAMILIES AND PATIENTS WHO HAVE LIFE-LIMITING ILLNESSES AND TO EDUCATE AND NURTURE OTHERS IN THIS CARE. 0 0 9630164 14604063 HOSPICE FIELD: CARE RENDERED TO TERMINALLY ILL PATIENTS IN THEIR OWN HOME. 82,598 PATIENT DAYS OF CARE WERE PROVIDED. 4410092 3550641 HOSPICE RESIDENCE: 24-HOUR NURSING CARE PROVIDED IN THE ARBOR HOSPICE RESIDENCE, OUR 30-BED LICENSED IN-PATIENT FACILITY FOR PATIENTS WITH TERMINAL ILLNESSES. 8,518 PATIENT DAYS OF CARE WERE PROVIDED. 337209 GRIEF SUPPORT SERVICES: PROGRAMS OFFERED BY THE AGENCY ON A COMPREHENSIVE BASIS TO THE SURVIVING FAMILY MEMBERS AFTER THE DEATH OF A LOVED ONE. SPECIAL PROGRAMS ARE ALSO OFFERED FOR CHILDREN WHO HAVE SUFFERED THE LOSS OF A LOVED ONE. 14377465 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 76 0 1 280 1 0 0 0 0 0 0 0 0 0 0 X 22 20 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 0 0 X X BRUCE CARTY 7346625999 2366 OAK VALLEY DRIVE ANN ARBOR MI 48103 DR DAVID SMITH 1.50 X X 0 0 0 JACKIE SILHANEK 1.50 X X 0 0 0 ROSEMARY BERARDI 1.50 X X 0 0 0 CINDY LIVESAY 1.50 X X 0 0 0 DR CAROL BARKER 1.50 X 0 0 0 LINDA BLOOM 1.50 X 0 0 0 JANET CALLAWAY 1.50 X 0 0 0 STEPHEN DAVIS 1.50 X 0 0 0 GENE EAVY 1.50 X 0 0 0 ANGEL GIBSON 1.50 X 0 0 0 ED GOLDMAN 1.50 X 0 0 0 GREGORY HAWKINS 1.50 X 0 0 0 PAT JANNAUSCH 1.50 X 0 0 0 KURT KOBILJAK 1.50 X 0 0 0 KATHRIN E KUDNER 1.50 X 0 0 0 BUD LAUDERBACH 1.50 X 0 0 0 SANDI J NIELSEN-GESSERT 1.50 X 0 0 0 DR ANJANETTE STOLTZ 1.50 X 0 0 0 ANNETTE TENERELLI-LEMKE 1.50 X 0 0 0 KATHLEEN WADE 1.50 X 0 0 0 MICHAEL MARTIN 1.50 X 0 0 0 GLORIA DANNA BROOKS 40.00 X X 237145 0 2979 BRUCE CARTY 40.00 X 156118 0 4661 MARY WISELY 32.00 X 196952 0 5708 PENNY MURPHY 40.00 X 111680 0 11007 ANATHEA COLLAR 40.00 X 109455 0 12099 MARGARET ADRAIN 40.00 X 111625 0 12739 HEIDI GRIX 40.00 X 108508 0 1000 1031483 0 50193 7 0 1 0 UNIVERSITY OF MICHIGAN HEALTH SYSTEM GERIATRICS CENTER 300 N INGALLS ANN ARBOR MI 48109 PHYSICIAN SERVICES 238079 INTELLATRIAGE INC 781 S MIDLOTHIAN RD 314 MUNDELEIN IL 60060 TRIAGE/ONCALL SERVICES 119090 CRITICORE NURSING AGENCY 5773 CANTON CENTER RD SUITE 5 CANTON MI 48187 CLINICAL SERVICES 111206 3 78345 78345 PROGRAM REVENUE 623000 18154704 18154704 18154704 142 142 520 0 520 520 520 MISCELLANEOUS 623990 313049 313049 313049 18546760 18467753 0 662 371596 371596 8984387 6607620 2371524 5243 87478 63668 23759 51 862080 597948 263658 474 806717 570055 236210 452 313678 313678 5926 5926 32006 32006 3463428 3313963 149169 296 56440 56440 294553 162310 132203 40 89388 4188 85200 476968 374384 93699 8885 548754 439586 109156 12 15222 4511 10710 1 346621 249117 88499 9005 83394 60019 21424 1951 MEDICINE AND SUPPLIES 1342115 1337605 4510 BAD DEBTS 154135 154135 MARKETING & PROMOTION 128350 120 128230 DIETARY SERVICES 121884 121884 109240 2674 106566 18694360 14377465 4290485 26410 1458737 853968 77756 81454 1891269 2030540 227402 260909 8930983 4009234 5151071 4921749 148276 73329 8954511 8221949 1138494 850944 4180000 3795000 1591527 1679565 6910021 6325509 X 2044490 1896440 2044490 1896440 8954511 8221949 X -147600 -450 X X 0 1 1 X 0 X 197540 499655 811502 798684 78345 2385726 197540 499655 811502 798684 78345 2385726 2385726 24067 6208 6375 9088 142 45880 388675 45860 28035 47073 313049 822692 3254298 80047168 0.73310 0.78920 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 763812 100000 -12176 732 850904 587891 100000 76283 362 763812 472703 110000 19438 14250 587891 385747 100000 -3456 9588 472703 0.97210 0.02790 1 1 1 575493 575493 6324092 2398736 3925356 255084 170779 84305 1323460 1038522 284938 452854 401197 51657 4921749 DEPOSITS PAYABLE 656111 ACCRUED PAYROLL 884873 INTEREST PAYABLE 723 INTERCOMPANY PAYABLE 137858 1679565 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: $30,313 TO SUPPORT THE UPKEEP OF THE GARDENS ON THE GROUNDS OF ARBOR HOSPICE, INC. $44,186 TO SUPPORT A CAMP DESIGNED TO HELP ADULTS AND CHILDREN COPE WITH THE LOSS OF A LOVED ONE. $752,641 TO SUPPORT THE GENERAL OPERATIONS OF ARBOR HOSPICE, INC. $23,764 TO SUPPORT CHILDREN'S SERVICES PROVIDED BY ARBOR HOSPICE, INC. PART V: ENDOWMENT ADMINISTERED BY RELATED ORGANIZATION INCLUDED IN ENDOWMENT FUNDS ARE FUNDS HELD AND ADMINISTERED BY THE ARBOR HOSPICE FOUNDATION IN THE FOLLOWING AMOUNTS: $739,598 BEGINNING OF YEAR BALANCE; $100,000 CONTRIBUTIONS, $11,726 INVESTMENT LOSSES, $732 EXPENDITURES, $827,140 END OF YEAR BALANCE. X X X 0 1 0 0 0 1 0 0 0 GLORIA DANNA BROOKS 157130 0 80015 0 0 0 0 0 2979 0 240124 0 0 0 BRUCE CARTY 139675 0 16443 0 0 0 0 0 4661 0 160779 0 0 0 MARY WISELY 196546 0 406 0 0 0 0 0 5708 0 202660 0 0 0 PART I, LINE 4B MARGARET ADRAIN GLORIA BROOKS BRUCE CARTY ANATHEA COLLAR HEIDI GRIX NO PAYMENTS WERE RECEIVED BY THE PARTICIPANTS. PART I, LINE 6 MEMBERS OF THE EXECUTIVE TEAM PARTICIPATE IN AN INCENTIVE COMPENSATION PLAN THAT CONSISTS OF MANY ELEMENTS, ONE OF WHICH IS NET INCOME OF THE ORGANIZATION. THE ECONOMIC DEVELOPMENT CORPORATION OF THE CHARTER TOWNSHIP OF PITTSFIELD 382490613 725570AG0 2007-01-02 4800000 REFUND AN OUTSTANDING PORTION OF A 2005 TAXABLE VARIABLE RATE DEMAND NOTE 0 0 0 4800000 57665 1 0 1 1 0 0 0 0 1 0 1 0 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED BY CFO PRIOR TO BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS OF THE BOARD OF DIRECTORS MUST ATTEST IN WRITING ON AN ANNUAL BASIS THAT THEY HAVE COMPLIED WITH THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION OF THE ORGANIZATION'S CEO IS DETERMINED BY A COMPENSATION COMMITTEE USING COMPARABILITY STUDIES AND APPROVED BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -450. FORM 990, PART XII, LINE 2C: THE PROCESS HAS REMAINED UNCHANGED. CHANGE IN NET ASSETS: FORM 990, PART 1, LINE 22 THE CHANGE FROM BEGINNING TO ENDING UNRESTRICTED NET ASSETS INCLUDES $450 UNREALIZED LOSSES ON INVESTMENTS. THE ARBOR HOSPICE FOUNDATION 2366 OAK VALLEY DR ANN ARBOR MI 48103 320045893 TO SUPPORT ARBOR HOSPICE, INC. MI 501(C)(3) 509(A)(3) TYPE I N/A 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 THE ARBOR HOSPICE FOUNDATION C 78345 ACTUAL COSTS THE ARBOR HOSPICE FOUNDATION L 423085 ACTUAL COSTS THE ARBOR HOSPICE FOUNDATION P 275307 ACTUAL COSTS