AGRACE HOSPICECARE FOUNDATION INCORPORATED: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
AGRACE HOSPICECARE FOUNDATION INCORPORATED (EIN 30-0001703)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-06-26
IRS object ID
201341779349300044
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)
Timestamp2013-06-26T16:00:05-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CROWE HORWATH LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line170 West Madison StreetAddressLine1
Address Line2Suite 700AddressLine2
CityChicagoCity
StateILState
ZIP Code606024903ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN300001703EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1AGRACE HOSPICECARE FOUNDATION INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlAGRANameControl
Phone6082764660Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line15395 E Cheryl ParkwayAddressLine1
CityMadisonCity
StateWIState
ZIP Code53711ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLYNNE MYERSName
TitlePRESIDENT/CEOTitle
Date Signed2013-06-20DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKristin FickerName
PTINP01254056PTIN
Phone3128997000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

Name Of Principal Officer Business NameOfPrincipalOfficerBusiness

FieldValueIRS element (for citing)
Business Name Line1LYNNE MYERSBusinessNameLine1

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line15395 E Cheryl ParkwayAddressLine1
CityMadisonCity
StateWIState
ZIP Code53711ZIPCode
FieldValueIRS element (for citing)
Gross Receipts9335491GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.AGRACE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2001YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionOUR MISSION, "ENHANCING QUALITY OF LIFE AT THE END OF LIFE," LIVES IN THE CARE PROVIDED TO PATIENTS AND FAMILIES FACING LIFE-LIMITING ILLNESS. (CONTINUED IN SCHEDULE O)ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees15TotalNbrEmployees
Total Nbr Volunteers233TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2671638ContributionsGrantsPriorYear
Contributions Grants Current Year4344233ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year663478InvestmentIncomePriorYear
Investment Income Current Year791260InvestmentIncomeCurrentYear
Other Revenue Prior Year689712OtherRevenuePriorYear
Other Revenue Current Year781679OtherRevenueCurrentYear
Total Revenue Prior Year4024828TotalRevenuePriorYear
Total Revenue Current Year5917172TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year717491GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY543738GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year1269985SalariesEtcPriorYear
Salaries Etc Current Year1298070SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year819175TotalFundrsngExpCurrentYear
Other Expense Prior Year532920OtherExpensePriorYear
Other Expenses Current Year414331OtherExpensesCurrentYear
Total Expenses Prior Year2520396TotalExpensesPriorYear
Total Expenses Current Year2256139TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1504432RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3661033RevenuesLessExpensesCY
Total Assets BOY41234696TotalAssetsBOY
Total Assets EOY45574022TotalAssetsEOY
Total Liabilities BOY177680TotalLiabilitiesBOY
Total Liabilities EOY150883TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY41057016NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY45423139NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionAGRACE HOSPICECARE FOUNDATION, INC.'S MISSION IS "ENHANCING THE QUALITY OF LIFE AT THE END OF LIFE" BY PROVIDING FINANCIAL SUPPORT FOR THE CARE PROVIDED TO PATIENTS AND FAMILIES FACING LIFE-LIMITING ILLNESS. (CONTINUED IN SCHEDULE O)MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense244804Expense
Grants244804Grants
DescriptionCHARITY CARE - THE FOUNDATION PROVIDES GRANTS TO AGRACE HOSPICECARE, INC. TO COVER THE COST OF HOSPICE CARE FOR INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED TO THE EXTENT THAT THEY DO NOT HAVE THE ABILITY TO PAY FOR HOSPICE CARE PRIVATELY.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense235021Expense
Grants235021Grants
DescriptionOTHER PROGRAM SERVICES: THE FOUNDATION PROVIDES GRANTS TO AGRACE HOSPICECARE, INC. TO SUPPORT OTHER PROGRAM SERVICES, INCLUDING: 1) PATIENT ASSISTANCE FUND - GRANTS USED TO ASSIST PATIENTS AND FAMILIES BY IMPROVING QUALITY OF LIFE AND FULFILLING END OF LIFE GOALS. EXAMPLES INCLUDE BUYING A BURIAL DRESS OR PROVIDING A BIRTHDAY CAKE. 2) PALLIATIVE CARE FELLOWSHIP - GRANTS FOR THE COLLABORATIVE PALLIATIVE CARE FELLOWSHIP PROGRAM, WITH THE GOAL OF TRAINING THE NEXT GENERATION OF PALLIATIVE CARE PHYSICIANS. 3) STAFF LEARNING, SUPPORT AND APPRECIATION - GRANTS TO FUND CONTINUING EDUCATION, STAFF APPRECIATION AND ACADEMIC ROTATIONS. 4) GARDEN AND GROUNDS - GRANTS TO SUPPORT THE ONGOING MANAGEMENT OF THE AGRACE HOSPICECARE GARDENS AND GROUNDS, WHICH PROVIDE A PEACEFUL, SOOTHING SETTING FOR PATIENTS AND FAMILIES. 5) RESPITE CARE: THE FOUNDATION PROVIDES GRANTS TO AGRACE HOSPICECARE, INC. TO SUPPORT THE COSTS OF INPATIENT RESPITE CARE. RESPITE CARE PROVIDES A MUCH NEEDED BREAK FOR CAREGIVERS AND HELPS TO PREVENT CAREGIVER BREAKDOWN.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense63913Expense
Grants63913Grants
DescriptionCOMMUNITY GRIEF SERVICES: THE FOUNDATION PROVIDES GRANTS TO AGRACE HOSPICECARE, INC. TO SUPPORT THE COSTS OF COMMUNITY BEREAVEMENT SUPPORT GROUPS AND COUNSELING SERVICES OFFERED BY AGRACE HOSPICECARE, INC. TO ANYONE IN THE COMMUNITY FREE OF CHARGE.Description
FieldValueIRS element (for citing)
Total Program Service Expense543738TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingtrueGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Info In Schedule O Part VXInfoInScheduleOPartV
Number Forms Transmitted With109623NumberFormsTransmittedWith1096
Number W2 G Included4NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees15NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Excess Business HoldingsfalseExcessBusinessHoldings
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Joyce ZeasmanBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6082764660TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line15395 EAST CHERYL PARKWAYAddressLine1
CityMADISONCity
StateWIState
ZIP Code53711ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per Week RelatedAverageHoursPerWeekRelated
JAMES CRIPE
CHAIR1.00XX000
KEN THOMPSON
VICE CHAIR1.00XX000
MICHAEL SMITH
TREASURER1.00XX000
STEVE DITULLIO
SECRETARY1.00XX000
GORDON DERZON
DIRECTOR1.00X0001.00
JACK BOLZ
DIRECTOR1.00X000
KATHY CULLEN
DIRECTOR1.00X000
LOTTIE FRANK
DIRECTOR1.00X000
LOU BERNHARDT
DIRECTOR1.00X000
PETER LUNDBERG
DIRECTOR1.00X000
RALPH CAGLE
DIRECTOR1.00X000
RICK LANGER
DIRECTOR1.00X000
SUSAN RICHARDSON
DIRECTOR1.00X000
TOM BOLGER
DIRECTOR1.00X000
TOM RAGATZ
DIRECTOR1.00X000
VIRGINIA WYSS
DIRECTOR - PARTIAL YEAR1.00X000
JOYCE ZEASMAN
VP OF FINANCE5.00X01687942882935.00
JULIA HOUCK
VP HR AND L&D/ACTING PRESIDENT5.00X02091832980835.00
LYNNE MYERS
PRESIDENT/CEO5.00X0136682465635.00
MARCIA M WHITTINGTON
VP FOUNDATION & HOLDINGS35.00X700031050042708513.00
SUSAN PHILLIPS
CEO - PART YEAR5.00X0482432572735.00
FieldValueIRS element (for citing)
Total Reportable Comp From Org70003TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1102095TotalReportableCompFrmRltdOrgs
Total Other Compensation96105TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Federated Campaigns12468FederatedCampaigns
Fundraising Events349616FundraisingEvents
All Other Contributions3982149AllOtherContributions
Noncash Contributions931987NoncashContributions
Total Contributions4344233TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

Total Revenue ColumnTotalRevenueColumn
0
0
0
0
0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue0TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column519616TotalRevenueColumn
Exclusion$519,616ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities3437144Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities3165500Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities271644Securities
Other0Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column271644TotalRevenueColumn
Exclusion$271,644ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events58016GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events349616CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses141515FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-83499TotalRevenueColumn
Exclusion-$83,499ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Gaming158401GrossIncomeGaming
Gaming Direct Expenses111304GamingDirectExpenses

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column47097TotalRevenueColumn
Exclusion$47,097ExclusionAmount
FieldValueIRS element (for citing)
Gross Sales Of Inventory817053GrossSalesOfInventory

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column817053TotalRevenueColumn
Exclusion$817,053ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
OTHER REVENUE9000991028$1,028
0
0

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue1028TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column5917172TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,572,939ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total543738Total
Program Services543738ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total88045Total
Fundraising88045Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total893520Total
Management And General475409ManagementAndGeneral
Fundraising418111Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total36307Total
Management And General18935ManagementAndGeneral
Fundraising17372Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total192838Total
Management And General100571ManagementAndGeneral
Fundraising92267Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total87360Total
Management And General45561ManagementAndGeneral
Fundraising41799Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total2275Total
Management And General2275ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total2750Total
Management And General2750ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total38553Total
Management And General38553ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total14226Total
Fundraising14226Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total66411Total
Management And General17701ManagementAndGeneral
Fundraising48710Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total573Total
Management And General573ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total177227Total
Management And General177227ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total16725Total
Management And General6236ManagementAndGeneral
Fundraising10489Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total3534Total
Management And General3534ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total703Total
Management And General703ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalFundraisingFundraisingManagement And GeneralManagementAndGeneral
UNCOLLECTIBLE PLEDGES3584935849
BANK AND CREDIT CARD FEES20251170533198
DUES, FEES, LICENSES67116711
DONATION DEVELOPMENT2854328543

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total2256139Total
Program Services543738ProgramServices
Management And General893226ManagementAndGeneral
Fundraising819175Fundraising

Total Joint Costs TotalJointCosts

FieldValueIRS element (for citing)
Total0Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY868516BOY
EOY2716755EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3503BOY
EOY15533EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY1238512BOY
EOY1993165EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY0BOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY49012BOY
EOY46956EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis14700LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec5623LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY9780BOY
EOY9077EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY10762515BOY
EOY13305470EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY28302858BOY
EOY27487066EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY41234696BOY
EOY45574022EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY39061BOY
EOY37372EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY29243BOY
EOY16915EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY109376BOY
EOY96596EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY177680BOY
EOY150883EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY39533536BOY
EOY41060427EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1461454BOY
EOY4278259EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY62026BOY
EOY84453EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY41057016BOY
EOY45423139EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY41234696BOY
EOY45574022EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses3661033ReconcilationRevenueExpenses
Reconciliation Unrealized Invest502029ReconciliationUnrealizedInvest
Reconcilation Prior Adjustment0ReconcilationPriorAdjustment
Reconcilation Other Changes203061ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1AGRACE HOSPICECARE INCBusinessNameLine1
FieldValueIRS element (for citing)
EIN391319537EIN
Type Of Organization9TypeOfOrganization
Listed In Governing DoctrueListedInGoverningDoc
Supported Organization NotifiedtrueSupportedOrganizationNotified
Organized In UStrueOrganizedInUS
Amount$534,109Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts534109SumOfAmounts

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 Balance62026BeginningOfYearBalance
Contributions22427Contributions
End Of Year Balance84453EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance549776BeginningOfYearBalance
Other Expenditures487750OtherExpenditures
End Of Year Balance62026EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance472208BeginningOfYearBalance
Contributions14510Contributions
Investment Earnings Or Losses66356InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures3298OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance549776EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance460319BeginningOfYearBalance
Contributions0Contributions
Investment Earnings Or Losses11889InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures0OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance472208EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.00000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Book Value0BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis14700OtherCostOrOtherBasis
Depreciation5623Depreciation
Book Value9077BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Book Value0BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Book Value0BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings9077TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM AFFILIATES26663
BENEFICIAL INTEREST IN ASSETS HELD BY COMMUNITY FOUNDATIONS133709
INTEREST IN NET ASSETS OF AFFILIATE27326694
FieldValueIRS element (for citing)
Total Book Value Other Assets27487066TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO AFFILIATESDescription
Amount$96,596Amount
FieldValueIRS element (for citing)
Total Of Amounts96596TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1PHIL HELMUTH EVENTNameOfEvent1
Gross Receipts Event177451GrossReceiptsEvent1
Charitable Contributions Event148400CharitableContributionsEvent1
Gross Revenue Event129051GrossRevenueEvent1
Cash Prizes Event10CashPrizesEvent1
Non Cash Prizes Event10NonCashPrizesEvent1
Rent Facility Costs Event11500RentFacilityCostsEvent1
Food And Beverage Event119609FoodAndBeverageEvent1
Entertainment Event15000EntertainmentEvent1
Other Direct Expenses Event130342OtherDirectExpensesEvent1
Name Of Event2GALANameOfEvent2
Gross Receipts Event2113390GrossReceiptsEvent2
Charitable Contributions Event2100450CharitableContributionsEvent2
Gross Revenue Event212940GrossRevenueEvent2
Cash Prizes Event20CashPrizesEvent2
Non Cash Prizes Event20NonCashPrizesEvent2
Rent Facility Costs Event20RentFacilityCostsEvent2
Food And Beverage Event213644FoodAndBeverageEvent2
Entertainment Event22650EntertainmentEvent2
Other Direct Expenses Event28348OtherDirectExpensesEvent2
Total Number Of Other Events6TotalNumberOfOtherEvents
Gross Receipts Other Events216791GrossReceiptsOtherEvents
Charitable Contrib Other Events200766CharitableContribOtherEvents
Gross Revenue Other Events16025GrossRevenueOtherEvents
Cash Prizes Other Events0CashPrizesOtherEvents
Non Cash Prizes Other Events0NonCashPrizesOtherEvents
Rent Facility Costs Other Events1750RentFacilityCostsOtherEvents
Food And Beverage Other Events5567FoodAndBeverageOtherEvents
Entertainment Other Events0EntertainmentOtherEvents
Other Direct Expenses Other Events53105OtherDirectExpensesOtherEvents
Gross Receipts Total407632GrossReceiptsTotal
Charitable Contributions Total349616CharitableContributionsTotal
Gross Revenue Total Events58016GrossRevenueTotalEvents
Cash Prizes Total Events0CashPrizesTotalEvents
Non Cash Prizes Total Events0NonCashPrizesTotalEvents
Rent Facility Costs Total Events3250RentFacilityCostsTotalEvents
Food And Beverage Total Events38820FoodAndBeverageTotalEvents
Entertainment Total Events7650EntertainmentTotalEvents
Other Direct Expenses Total Events91795OtherDirectExpensesTotalEvents
Direct Expense Summary Events141515DirectExpenseSummaryEvents
Net Income Summary-83499NetIncomeSummary

Gaming Information GamingInformation

FieldValueIRS element (for citing)
Gross Revenue Other Gaming158401GrossRevenueOtherGaming
Cash Prizes Other Gaming8500CashPrizesOtherGaming
Non Cash Prizes Other Gaming76653NonCashPrizesOtherGaming
Other Direct Expenses Other Gaming34651OtherDirectExpensesOtherGaming
Volunteer Labor Other GamingtrueVolunteerLaborOtherGaming
Volunteer Labor Prcnt Other Gaming0.85VolunteerLaborPrcntOtherGaming
Gross Revenue Total Gaming158401GrossRevenueTotalGaming
Cash Prizes Total Gaming8500CashPrizesTotalGaming
Non Cash Prizes Total Gaming76653NonCashPrizesTotalGaming
Rent Facility Costs Total Gaming0RentFacilityCostsTotalGaming
Other Direct Expenses Total Gaming34651OtherDirectExpensesTotalGaming
Direct Expense Summary Gaming119804DirectExpenseSummaryGaming
Net Gaming Income Summary38597NetGamingIncomeSummary
FieldValueIRS element (for citing)
States Where Gaming ConductedWIStatesWhereGamingConducted
LicensedtrueLicensed
License Suspended EtcfalseLicenseSuspendedEtc
Gaming With NonmembersfalseGamingWithNonmembers
Member Of Other EntityfalseMemberOfOtherEntity
Percentage Of Gaming Own Facility0PercentageOfGamingOwnFacility
Percentage Of Gaming Othr Facility1PercentageOfGamingOthrFacility

Name Of Gaming Rec Keeper Bus NameOfGamingRecKeeperBus

FieldValueIRS element (for citing)
Business Name Line1DEBBIE BRADLEY AGRACE HOSPICECARE INCBusinessNameLine1

Address Of Gaming Rec Keeper US AddressOfGamingRecKeeperUS

FieldValueIRS element (for citing)
Address Line15395 E CHERYL PARKWAYAddressLine1
CityMADISONCity
StateWIState
ZIP Code53711ZIPCode
FieldValueIRS element (for citing)
Contract With3rd Party For Gam RevfalseContractWith3rdPartyForGamRev

Gaming Manager Name Business GamingManagerNameBusiness

FieldValueIRS element (for citing)
Business Name Line1FINANCE DEPARTMENT EMPLOYEESBusinessNameLine1
FieldValueIRS element (for citing)
Gaming Manager Compensation0GamingManagerCompensation
Gaming Manager Services ProvidedACCOUNTING AND RECORDKEEPINGGamingManagerServicesProvided

Form990 Schedule G Part IV Form990ScheduleGPartIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
FUNDRAISING EVENTSSCHEDULE G, PART IITHE FOUNDATION'S FUNDRAISING EVENT TOTAL IS $313,213 WHICH AGREES WITH AUDITED INFORMATION AND IS THE SUM OF LINES 1C, 8C AND 9C.
FUNDRAISING EVENTSSCHEDULE G, PART II, LINE 11THE FOUNDATION'S FUNDRAISING EVENT TOTAL ON LINE 11, COLUMN (D) EXCLUDES $349,616 OF CHARITABLE CONTRIBUTIONS WHICH IS REPORTED ON LINE 2, COLUMN (D). FUNDRAISING EVENT TOTAL INCOME, INCLUDING THIS CHARITABLE CONTRIBUTION AMOUNT PRODUCES A POSITIVE NET INCOME OF $266,117.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistancePurpose Of GrantPurposeOfGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistance
AGRACE HOSPICECARE INC
5395 E CHERYL PKWYMADISONWI53711391319537501(C)(3)543738N/AN/ATO PROVIDE FINANCIAL SUPPORT TO AGRACE HOSPICECARE, INC.
AGRACE HOSPICECARE HOLDINGS INC
5395 E CHERYL PKWYMADISONWI53711300001715501(C)(3)FMVGRILL DONATIONGENERAL SUPPORT1677
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (4 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
MARCIA M WHITTINGTON
VP FOUNDATION & HOLDINGS6054190812927313909189283286142917973119608083712125500
SUSAN PHILLIPS
CEO - PART YEAR01079300047163900057270488159018169
JULIA HOUCK
VP HR AND L&D/ACTING PRESIDENT0173923034440082008314021494023899100
JOYCE ZEASMAN
VP OF FINANCE0145598022500069606942021887019762300

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Arrangement used to establish the top management official's compensationSchedule J, Part I, Line 3THE ORGANIZATION RELIED ON AGRACE HOSPICECARE, INC., A RELATED TAX-EXEMPT ORGANIZATION TO DETERMINE THE COMPENSATION OF ITS OFFICERS AND KEY EMPLOYEES. BELOW IS THE PROCESS USED BY AGRACE HOSPICECARE, INC. FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S OTHER OFFICERS AND KEY EMPLOYEES. EACH YEAR THE ORGANIZATION GATHERS MARKET DATA FOR COMPENSATION OF THE EXECUTIVE LEADERSHIP TEAM. THIS DATA INCLUDES BENCHMARKS OF NATIONAL, REGIONAL, AND LOCAL COMPENSATION THAT ARE PROVIDED FROM INDEPENDENT COMPENSATION CONSULTANTS. EXECUTIVE LEADERSHIP PAY IS ADJUSTED BASED ON: 1) YEARS OF EXPERIENCE; 2) MARKET DATA FOR THE POSITION, AND; 3) PERFORMANCE. THE VICE PRESIDENT OF HUMAN RESOURCES PRESENTS THE MARKET DATA INFORMATION TO THE EXECUTIVE COMMITTEE OF THE BOARD. BASED ON THIS INFORMATION, THE EXECUTIVE COMMITTEE OF THE BOARD APPROVES THE PAY STRUCTURE FOR THE EXECUTIVE LEADERSHIP TEAM AND ALL OTHER EMPLOYEES AND DOCUMENTS THEIR APPROVAL IN WRITING. THIS PROCESS WAS LAST UNDERTAKEN IN JANUARY 2013.
Severance or change-of-control paymentSchedule J, Part I, Line 4aSEVERANCE PAYMENTS MADE DURING 2012 WERE: SUSAN PHILLIPS $455,392.
Supplemental nonqualified retirement planSchedule J, Part I, Line 4bLYNNE MYERS PARTICIPATED IN A 457(F) DEFERRED COMPENSATION PLAN UNDER AGRACE HOSPICECARE, INC., A RELATED ORGANIZATION.

Schedule M IRS990ScheduleM

Clothing And Household Goods ClothingAndHouseholdGoods

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Noncash Contribs Rptd F990817053NoncashContribsRptdF990
Method Of Determining RevenuesMARKET VALUEMethodOfDeterminingRevenues

Securities Publicly Traded SecuritiesPubliclyTraded

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions10NumberOfContributions
Noncash Contribs Rptd F99065896NoncashContribsRptdF990
Method Of Determining RevenuesMARKET VALUEMethodOfDeterminingRevenues

Other Non Cash Contributions Table OtherNonCashContributionsTable

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
DescriptionSPECIAL EVENT RELATED ITEMS AS GIVEAWAY PRIZESDescription
Number Of Contributions20NumberOfContributions
Noncash Contribs Rptd F99049038NoncashContribsRptdF990
Method Of Determining RevenuesMARKET VALUEMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Number Of8283 Received0NumberOf8283Received
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftstrueReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Explanations of reporting method for number of contributionsSchedule M, Part IOTHER: AGRACE HOSPICECARE FOUNDATION, INC. IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED IN 2012. SECURITIES - PUBLICLY TRADED: AGRACE HOSPICECARE FOUNDATION, INC. IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED IN 2012. CLOTHING AND HOUSEHOLD GOODS: AGRACE HOSPICECARE FOUNDATION, INC. IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED IN 2012. THIS AMOUNT REPRESENTS A VERY HIGH NUMBER OF RELATIVELY LOW-VALUE THRIFT STORE ITEMS.
Number of contributions or items contributed.Schedule M, part I, column (b), Line other=SPECIAL EVENT RELATED ITEMS AS GIVEAWAY PRIZESAGRACE HOSPICECARE FOUNDATION, INC. IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED IN 2012.
Number of contributions or items contributed.Schedule M, part I, column (b), Line 9AGRACE HOSPICECARE FOUNDATION, INC. IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED IN 2012.
Number of contributions or items contributed.Schedule M, part I, column (b), Line 5AGRACE HOSPICECARE FOUNDATION, INC. IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED IN 2012. THIS AMOUNT REPRESENTS A VERY HIGH NUMBER OF RELATIVELY LOW-VALUE THRIFT STORE ITEMS.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (14 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
BRIEF MISSION (CONTINUED)FORM 990, PART I, LINE 1ALTHOUGH THE COST OF BASIC HOSPICE SERVICES IS COVERED BY MEDICARE, MEDICAID AND MOST COMMERCIAL INSURERS, A NUMBER OF ESSENTIAL AGRACE PROGRAMS ARE UNDER-FUNDED OR NOT FUNDED AT ALL BY THESE SOURCES. FUNDS RAISED ARE USED TO SUPPORT CARE PROVIDED BY AGRACE HOSPICECARE, INC., A RELATED TAX-EXEMPT ORGANIZATION.
CONTRIBUTIONSFORM 990, PART I, LINE 8THE CONSOLIDATED AGRACE ENTITIES' CONTRIBUTIONS FOR 2012 ARE $5,402,092 WHICH DOESN'T INCLUDE 203,000 OF DONATED IN-KIND SERVICES. THE $4,344,233 OF CONTRIBUTIONS REPORTED ON LINE 8 OF PAGE OF THIS FORM 990 DOES NOT INCLUDED DONATED MERCHANDISE SALES PROCEEDS OF $817,053 WHICH IS INCLUDED ON LINE 10. THE BALANCE OF THE $241,000 OF CONSOLIDATED CONTRIBUTIONS RELATES TO DONATIONS MADE DIRECTLY TO ONE OF THE OTHER AGRACE AFFILIATES: AGRACE HOSPICECARE, INC. AND AGRACE HOSPICECARE HOLDINGS.
ORGANIZATION'S MISSIONFORM 990, PART III, LINE 1AGRACE HOSPICECARE FOUNDATION IS OPERATED EXCLUSIVELY FOR THE SUPPORT AND BENEFIT OF AGRACE HOSPICECARE, INC., WHICH IS A RELATED 501(C)(3) ORGANIZATION THAT PROVIDES CARE AND SUPPORT TO PATIENTS AND FAMILIES FACING LIFE-LIMITING ILLNESS. THE AGRACE HOSPICECARE FOUNDATION IS SUPPORTED BY A COMMUNITY OF DONORS WHO SHARE THE VISION OF ACCESS TO A QUALITY END-OF-LIFE JOURNEY FOR EVERYONE. THE FOUNDATION'S SUPPORT HAS HELPED AGRACE HOSPICECARE ENHANCE THE QUALITY OF ITS SERVICE AND EXPAND ITS REACH TO THOSE WHO NEED AGRACE HOSPICECARE SERVICES THROUGHOUT SOUTH CENTRAL WISCONSIN. IN ADDITION TO THE GRANT SUPPORT THAT THE FOUNDATION PROVIDES TO AGRACE HOSPICECARE, INC. AND AGRACE HOSPICECARE HOLDINGS, INC., THE FOUNDATION HAS BEEN WORKING TO BUILD A SIX MONTH OPERATING RESERVE FUND TO HELP AGRACE HOSPICECARE, INC. WEATHER FINANCIAL CHALLENGES.
FORMS W-2FORM 990, PART V, LINE 1ATHE NUMBER OF FORMS W-2 REPORTED BY THE ORGANIZATION WERE SUBMITTED UNDER THE FEIN OF AGRACE HOSPICECARE, INC. WHO SERVES AS A PAYROLL AGENT FOR THE ORGANIZATION.
Classes of members or stockholdersForm 990, Part VI, Section A, Line 6AGRACE HOSPICECARE, INC. A RELATED 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF AGRACE HOSPICECARE FOUNDATION, INC. AND HAS THE AUTHORITY TO APPOINT, REMOVE, AND REPLACE ANY DIRECTOR ON FOUNDATION BOARD. AGRACE HOSPICECARE, INC. ALSO HAS THE SOLE AUTHORITY TO AMEND THE AGRACE HOSPICECARE FOUNDATION BYLAWS AND ARTICLES OF INCORPORATION. AGRACE HOSPICECARE, INC. HAS NO OTHER RESPONSIBILITIES OR VOTING RIGHTS WITH RESPECT TO THE OPERATIONS OF AGRACE HOSPICECARE FOUNDATION.
Members or stockholders electing members of governing bodyForm 990, Part VI, Section A, Line 7aPLEASE SEE NARRATIVE FOR PART VI, LINE 6
Review of form 990 by governing bodyForm 990, Part VI, Section B, Line 11bTHE CONTROLLER AND VP OF FINANCE PERFORMED A DETAILED REVIEW OF FORM 990 AND THE RELATED SCHEDULES PRIOR TO FILING THE RETURN. THIS INCLUDED VERIFICATION OF ALL AMOUNTS FOR ACCURACY AND COMPLETENESS. THE FORM AND SCHEDULES WERE ALSO REVIEWED FOR CONTENT, PRESENTATION AND REASONABLENESS. THE ENTIRE FORM 990 IS MADE AVAILABLE TO THE ENTIRE EXECUTIVE LEADERSHIP TEAM AND AN ENTITY SPECIFIC HIGHLIGHTS SUMMARY IS PROVIDED. THE ENTIRE FORM 990 IS PROVIDED TO THE ENTIRE BOARD OF DIRECTORS PRIOR TO FILING AND IS ACCOMPANIED BY A 990 HIGHLIGHT SUMMARY. THE AUDIT COMMITTEE REVIEWED THE FORM 990 AND RELATED SCHEDULES FOR REASONABLENESS. REPRESENTATIVES FROM THE ACCOUNTING FIRM OF CROWE HORWATH PREPARED A DETAILED SUMMARY OF THE FORM 990 THAT WAS PRESENTED TO THE BOARD OF DIRECTORS BY CROWE HORWATH.
Conflict of interest policyForm 990, Part VI, Section B, Line 12cDIRECTORS, OFFICERS AND KEY EMPLOYEES (INTERESTED PERSONS) ARE REQUIRED TO ANNUALLY REVIEW THE ORGANIZATION'S CODE OF CONDUCT, INCLUDING THE CONFLICT OF INTEREST POLICY/STATEMENT. INTERESTED PERSONS ARE REQUIRED TO DISCLOSE POTENTIAL OR ACTUAL CONFLICTS WITH THE ORGANIZATION IN WRITING VIA THE ANNUAL QUESTIONNAIRE DISTRIBUTED ELECTRONICALLY TO EACH INTERESTED PERSON. IF A CONFLICT OF INTEREST IS DISCOVERED THAT WAS NOT DISCLOSED BY THE INTERESTED PERSON, THE ISSUE WOULD BE DIRECTED TO THE EXECUTIVE COMMITTEE FOR RESOLUTION. THE EXECUTIVE COMMITTEE IS CHARGED WITH REGULAR REVIEW OF THE INTERESTED PERSONS PRACTICES AND QUESTIONNAIRES REGARDING CONFLICTS OF INTEREST AND SUGGESTS IMPROVEMENTS AS NEEDED. THE CONFLICT OF INTEREST QUESTIONNAIRES ARE REVIEWED BY THE CONTROLLER AND GOVERNANCE COORDINATOR. THE CONTROLLER AND GOVERNANCE COORDINATOR DETERMINE WHETHER A POTENTIAL CONFLICT EXISTS BASED ON THE COMPLETED QUESTIONNAIRES SUBMITTED BY EACH INTERESTED PERSON.
PROCESS USED TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIALFORM 990, PART VI, LINE 15ATHE ORGANIZATION RELIED ON AGRACE HOSPICECARE, A RELATED TAX-EXEMPT ORGANIZATION, TO DETERMINE THE COMPENSATION OF ITS CEO. BELOW IS THE PROCESS USED BY AGRACE HOSPICECARE FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL. EACH YEAR THE ORGANIZATION GATHERS MARKET DATA FOR DETERMINING COMPENSATION OF THE CHIEF EXECUTIVE OFFICER. THIS INCLUDES BENCHMARKS OF NATIONAL, REGIONAL, AND LOCAL COMPENSATION THAT ARE PROVIDED FROM INDEPENDENT COMPENSATION SURVEYS. IN FEBRUARY OF EACH YEAR, THE VICE PRESIDENT OF WORKFORCE DEVELOPMENT PRESENTS THIS INFORMATION TO THE EXECUTIVE COMMITTEE OF THE BOARD, ALONG WITH A 990 ANALYSIS OF COMPENSATION REPORTING BY SIMILAR SIZED NON-PROFIT HOSPICES. BASED ON THIS INFORMATION, THE EXECUTIVE COMMITTEE SETS AND APPROVES THE PAY FOR THE CHIEF EXECUTIVE OFFICER FOR THE YEAR AND CONTEMPORANEOUSLY DOCUMENTS THEIR APPROVAL IN WRITING. THIS PROCESS WAS UNDERTAKEN IN FEBRUARY 2013.
Process used to establish compensation of other officers/key employeesForm 990, Part VI, Section B, Line 15bTHE ORGANIZATION RELIED ON AGRACE HOSPICECARE, A RELATED TAX-EXEMPT ORGANIZATION, TO DETERMINE THE COMPENSATION OF ITS OTHER OFFICERS AND KEY EMPLOYEES. BELOW IS THE PROCESS USED BY AGRACE HOSPICECARE FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S OTHER OFFICERS AND KEY EMPLOYEES. EACH YEAR THE ORGANIZATION GATHERS MARKET DATA FOR COMPENSATION OF THE EXECUTIVE LEADERSHIP TEAM. THIS DATA INCLUDES BENCHMARKS OF NATIONAL, REGIONAL, AND LOCAL COMPENSATION THAT ARE PROVIDED FROM INDEPENDENT COMPENSATION SURVEYS. EXECUTIVE LEADERSHIP PAY IS ADJUSTED BASED ON: 1) YEARS OF EXPERIENCE; 2) MARKET DATA FOR THE POSITION; 3) PERFORMANCE; AND 4) MARKET DATA FOR THE 65TH PERCENTILE OF TOTAL COMPENSATION FOR THE POSITION. THE VICE PRESIDENT OF WORKFORCE DEVELOPMENT PRESENTS THE MARKET DATA INFORMATION TO THE EXECUTIVE COMMITTEE OF THE BOARD. BASED ON THIS INFORMATION, THE EXECUTIVE COMMITTEE OF THE BOARD APPROVES THE PAY STRUCTURE FOR THE EXECUTIVE LEADERSHIP TEAM AND ALL OTHER EMPLOYEES AND DOCUMENTS THEIR APPROVAL IN WRITING. THIS PROCESS WAS LAST UNDERTAKEN IN FEBRUARY 2013.
PROCESS USED TO ESTABLISH COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEESFORM 990, PART VI, LINE 15BTHE ORGANIZATION RELIED ON AGRACE HOSPICECARE, A RELATED TAX-EXEMPT ORGANIZATION, TO DETERMINE THE COMPENSATION OF ITS OTHER OFFICERS AND KEY EMPLOYEES. BELOW IS THE PROCESS USED BY AGRACE HOSPICECARE FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S OTHER OFFICERS AND KEY EMPLOYEES. EACH YEAR THE ORGANIZATION GATHERS MARKET DATA FOR COMPENSATION OF THE EXECUTIVE LEADERSHIP TEAM. THIS DATA INCLUDES BENCHMARKS OF NATIONAL, REGIONAL, AND LOCAL COMPENSATION THAT ARE PROVIDED FROM INDEPENDENT COMPENSATION SURVEYS. EXECUTIVE LEADERSHIP PAY IS ADJUSTED BASED ON: 1) YEARS OF EXPERIENCE; 2) MARKET DATA FOR THE POSITION; 3) PERFORMANCE; AND 4) MARKET DATA FOR THE 65TH PERCENTILE OF TOTAL COMPENSATION FOR THE POSITION. THE VICE PRESIDENT OF WORKFORCE DEVELOPMENT PRESENTS THE MARKET DATA INFORMATION TO THE EXECUTIVE COMMITTEE OF THE BOARD. BASED ON THIS INFORMATION, THE EXECUTIVE COMMITTEE OF THE BOARD APPROVES THE PAY STRUCTURE FOR THE EXECUTIVE LEADERSHIP TEAM AND ALL OTHER EMPLOYEES AND DOCUMENTS THEIR APPROVAL IN WRITING. THIS PROCESS WAS LAST UNDERTAKEN IN FEBRUARY 2013.
Governing documents, conflict of interest policy and financial statements available to the publicForm 990, Part VI, Section C, Line 19FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS MAY BE MADE AVAILABLE TO THE PUBLIC UPON RECEIPT OF A WRITTEN REQUEST.
AVERAGE HOURS PER WEEKFORM 990, PART VII, SECTION A, LINE 1A, COLUMN (B)ALL AGRACE EMPLOYEES REPORTED ON THIS 990 WORK ON AVERAGE A MINIMUM OF 40 HOURS PER WEEK, BUT IN MOST CASES MORE THAN 40 HOURS PER WEEK.
Other changes in net assets or fund balancesForm 990 , Part XI, Line 9CHANGE IN NET ASSETS OF AFFLIATE - 143061; CHANGE IN VALUE OF ANNUITY - 60000;

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1AGRACE HOSPICECARE THRIFT STORE LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line15395 E CHERYL PARKWAYAddressLine1
CityMADISONCity
StateWIState
ZIP Code53711ZIPCode
FieldValueIRS element (for citing)
EIN300001703EIN
Primary ActivitiesTHRIFT STOREPrimaryActivities
Legal Domicile StateWILegalDomicileState
Total Income816054TotalIncome
EOY Assets416878EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodePrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
AGRACE HOSPICECARE INC
5395 E CHERYL PARKWAYMADISONWI53711HEALTHCAREWI501(C)(3)N/ANAfalse
AGRACE HOSPICECARE HOLDINGS INC
5395 E CHERYL PARKWAYMADISONWI53711PROPERTY HOLDINGWI501(C)(3)Type IAHCIfalse
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

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