2013-11-15T09:41:39-06:00 2013-06-30 341145015 WILLIAM VAUGHAN COMPANY 145 CHESTERFIELD LANE MAUMEE OH 435373836 990 2012-07-01 382532215 ARBOR HOSPICE INC ARBO 7346625999 2366 OAK VALLEY DRIVE ANN ARBOR MI 48103 BRUCE F CARTY 7346625999 2013-11-13 1 JACK C HAGMEYER P00051646 4198911040 2012 2015-11-30 17:44:51Z GLORIA BROOKS 2366 OAK VALLEY DRIVE ANN ARBOR MI 48103 19085022 0 X WWW.ARBORHOSPICE.ORG X 1984 MI PROVIDE SERVICES FOR TERMINALLY ILL PATIENTS AND THEIR FAMILIES. 19 18 293 308 0 0 78345 1075857 18154704 17973997 662 166 313049 35002 18546760 19085022 0 0 0 0 11112258 11468230 0 0 28432 7582102 7387399 18694360 18855629 -147600 229393 8221949 7957954 6325509 5830713 1896440 2127241 X TO GIVE COMFORT, ASSURANCE AND CARE TO FAMILIES AND PATIENTS WHO HAVE LIFE-LIMITING ILLNESSES AND TO EDUCATE AND NURTURE OTHERS IN THIS CARE. 1 0 10091340 14359491 HOSPICE FIELD: CARE RENDERED TO TERMINALLY ILL PATIENTS IN THEIR OWN HOME. 83,995 PATIENT DAYS OF CARE WERE PROVIDED. 4186028 3589630 HOSPICE RESIDENCE: 24-HOUR NURSING CARE PROVIDED IN THE ARBOR HOSPICE RESIDENCE, OUR 30-BED LICENSED IN-PATIENT FACILITY FOR PATIENTS WITH TERMINAL ILLNESSES. 8,640 PATIENT DAYS OF CARE WERE PROVIDED. 337417 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. 276236 24876 PALLIATIVE CARE: IN-HOME CONSULTATIVE SERVICE TO RELIEVE PAIN AND OTHER SYMPTOMS DUE TO SERIOUS ILLNESS AND IMPROVE QUALITY OF LIFE. 276236 24876 14891021 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 70 0 1 293 1 0 0 0 0 0 0 0 0 0 0 X 19 18 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 1.40 X X 0 0 0 JACKIE SILHANEK 1.40 X X 0 0 0 ROSEMARY BERARDI 1.40 X X 0 0 0 CINDY LIVESAY 1.40 X X 0 0 0 DR CAROL BARKER 1.40 X 0 0 0 LINDA BLOOM 1.40 X 0 0 0 STEPHEN DAVIS 1.40 X 0 0 0 ANGEL GIBSON 1.40 X 0 0 0 GREGORY HAWKINS 1.40 X 0 0 0 PAT JANNAUSCH 1.40 0.80 X 0 0 0 KURT KOBILJAK 1.40 X 0 0 0 KATHRIN E KUDNER 1.40 X 0 0 0 SWATEE KULKARNI 1.40 X 0 0 0 BUD LAUDERBACH 1.40 X 0 0 0 DR SUSAN URBA 1.40 X 0 0 0 KATHLEEN WADE 1.40 X 0 0 0 REV RODRICK GREEN 1.40 X 0 0 0 DR JOHN NICKLAS 1.40 X 0 0 0 GLORIA DANNA BROOKS 36.00 4.00 X X 166948 0 3138 BRUCE CARTY 36.00 4.00 X 160908 0 5304 PENNY MURPHY 40.00 X 127034 0 9047 ANATHEA COLLAR 40.00 X 114947 0 13053 MARGARET ADRAIN 40.00 X 106340 0 13294 HEIDI GRIX 4.00 36.00 X 101686 0 1005 777863 0 44841 6 0 1 0 UNIVERSITY OF MICHIGAN HEALTH SYSTEM GERIATRICS CENTER 300 N INGALLS ANN ARBOR MI 48109 PHYSICIAN SERVICES 247824 1 1075857 1075857 PROGRAM REVENUE 623000 17973997 17973997 17973997 166 166 MISCELLANEOUS 623990 35002 35002 35002 19085022 18008999 0 166 X 377206 377206 9218059 7162865 2048582 6612 79840 62501 17290 49 953714 699714 253448 552 839411 627363 211552 496 408431 408431 41937 41937 25202 25202 3089193 2978507 110686 40991 40991 311005 78100 232902 3 98090 4318 93772 502837 400441 92186 10210 593177 525480 67683 14 10037 4806 5231 289618 212634 68779 8205 89832 66143 21398 2291 MEDICINE AND SUPPLIES 1366008 1364216 1792 BAD DEBTS 177479 177479 DIETARY SERVICES 110747 110747 MARKETING & PROMOTION 94924 3571 91353 137891 3705 134186 18855629 14891021 3936176 28432 853968 878418 81454 105470 2030540 1885808 260909 245968 9023957 4255422 4921749 4768535 73329 73755 8221949 7957954 850944 882914 3795000 3400000 1679565 1547799 6325509 5830713 X 1896440 2127241 1896440 2127241 8221949 7957954 229393 1408 0 X X 0 1 X 1 0 X 499655 811502 798684 78345 1075857 3264043 499655 811502 798684 78345 1075857 3264043 3264043 6208 6375 9088 142 166 21979 45860 28035 47073 313049 35002 469019 3755041 84740873 0.86920 0.73310 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 850904 100000 92588 44148 999344 763812 100000 -12176 732 850904 587891 100000 76283 362 763812 472703 110000 19438 14250 587891 385747 100000 -3456 9588 472703 0.97480 0.02520 1 1 1 575493 575493 6331151 2563941 3767210 255084 190138 64946 1331706 1071794 259912 530523 429549 100974 4768535 DEPOSITS PAYABLE 687979 ACCRUED PAYROLL 819797 INTEREST PAYABLE 336 INTERCOMPANY PAYABLE 39687 1547799 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: $30,844 TO SUPPORT THE UPKEEP OF THE GARDENS ON THE GROUNDS OF ARBOR HOSPICE, INC. $48,791 TO SUPPORT A CAMP DESIGNED TO HELP ADULTS AND CHILDREN COPE WITH THE LOSS OF A LOVED ONE. $894,537 TO SUPPORT THE GENERAL OPERATIONS OF ARBOR HOSPICE, INC. $25,172 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: $827,140 BEGINNING OF YEAR BALANCE; $100,000 CONTRIBUTIONS, $91,180 INVESTMENT EARNINGS, $44,148 EXPENDITURES, $974,172 END OF YEAR BALANCE. X X X 1 1 0 0 0 1 0 0 0 GLORIA DANNA BROOKS 156720 0 10228 0 0 0 0 0 3138 0 170086 0 0 0 BRUCE CARTY 154629 0 6279 0 0 0 0 0 5304 0 166212 0 0 0 PART I, LINES 4A-B PART I, LINES 4A-B: SEVERANCE PAYMENT PENNY MURPHY - $25,385 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN MARGARET ADRAIN GLORIA BROOKS BRUCE CARTY ANATHEA COLLAR HEIDI GRIX PENNY MURPHY 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. A 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 A 4800000 57665 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 1 0 0 0 0 A 0 NEW PROGRAM SERVICES FORM 990, PART III, LINE 2 PALLIATIVE CARE: IN-HOME CONSULTATIVE SERVICE TO RELIEVE PAIN AND OTHER SYMPTOMS DUE TO SERIOUS ILLNESS AND IMPROVE QUALITY OF LIFE. 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. OTHER FEES FORM 990, PART IX, LINE 11G MISCELLANEOUS: PROGRAM SERVICE EXPENSES 2,978,507. MANAGEMENT AND GENERAL EXPENSES 110,686. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,089,193. 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 $1,408 UNREALIZED GAINS 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 0 1 0 0 0 1 0 0 THE ARBOR HOSPICE FOUNDATION C 1075857 ACTUAL COSTS THE ARBOR HOSPICE FOUNDATION M 519346 ACTUAL COSTS THE ARBOR HOSPICE FOUNDATION Q 347145 ACTUAL COSTS