2012-07-02T14:45:35-05:00 2011-12-31 351178661 BLUE & CO LLC 106 COMMUNITY DR SEYMOUR IN 47274 990 2011-01-01 351479425 HOSPICE OF SOUTH CENTRAL INDIANA INC HOSP 8123148000 2626 E 17TH STREET COLUMBUS IN 47201 SANDRA CARMICHAEL 8123148000 2012-06-25 1 KANDY L WISCHMEIER CPA P00118327 8125228416 2012-06-11 2011 2016-02-24 21:20:13Z SANDRA CARMICHAEL 2626 E 17TH STREET COLUMBUS IN 47201 10587472 0 X WWW.HOSPICEOFSOUTHCENTRALINDIANA.ORG X 1980 IN HOSPICE OF SOUTH CENTRAL INDIANA, INC. (HSCI) IS AN INDEPENDENT, NOT-FOR-PROFIT ORGANIZATION PROVIDING SERVICES TO THE TERMINALLY ILL IN A 15-COUNTY SERVICE AREA. SINCE ITS INCEPTION 31 YEARS AGO, HOSPICE HAS EXPANDED TO MEET THE NEEDS FOR END-OF-LIFE CARE IN SOUTHERN INDIANA. 15 15 159 228 0 0 496162 435840 10107114 9862917 10345 3424 186801 142897 10800422 10445078 0 0 0 0 7975631 7367696 0 0 241115 3004907 2735651 10980538 10103347 -180116 341731 8862871 8946911 1512415 1254724 7350456 7692187 X HOSPICE OF SOUTH CENTRAL INDIANA, INC. (HSCI) IS AN INDEPENDENT, NOT-FOR-PROFIT ORGANIZATION PROVIDING SERVICES TO THE TERMINALLY ILL IN A 15-COUNTY SERVICE AREA. SINCE ITS INCEPTION 31 YEARS AGO, HOSPICE HAS EXPANDED TO MEET THE NEEDS FOR END-OF-LIFE CARE IN SOUTHERN INDIANA. 0 0 8966177 9879118 HOSPICE OF SOUTH CENTRAL INDIANA, INC. (HSCI) IS AN INDEPENDENT, NOT-FOR-PROFIT ORGANIZATION PROVIDING SERVICES TO THE TERMINALLY ILL IN A 15-COUNTY SERVICE AREA. SINCE ITS INCEPTION 32 YEARS AGO, HOSPICE HAS EXPANDED TO MEET THE NEEDS FOR END-OF-LIFE CARE IN SOUTHERN INDIANA, AND CURRENTLY HAS THREE OFFICE LOCATIONS, AS WELL AS A 14-BED INPATIENT FACILITY, LOCATED IN COLUMBUS, INDIANA. HOSPICE EXISTS TO PROVIDE CARE AND SUPPORT TO INDIVIDUALS AND THEIR FAMILIES IN THE LAST PHASES OF AN INCURABLE DISEASE SO THAT THEY MAY LIVE AS FULLY AND COMFORTABLY AS POSSIBLE. BEREAVEMENT SERVICES ARE PROVIDED TO FAMILY MEMBERS AND/OR SIGNIFICANT OTHERS FOR 13 MONTHS FOLLOWING A DEATH. AN INTERDISCIPLINARY TEAM CARES FOR THE PHYSICAL, PSYCHOSOCIAL, SPIRITUAL AND EMOTIONAL NEEDS OF THOSE WHO CHOOSE HSCI, WHETHER IT IS A MATTER OF DAYS, WEEKS, OR MONTHS. SERVICES ARE PROVIDED IN A VARIETY OF SETTINGS, INCLUDING THE PATIENT'S HOME, A LONG-TERM CARE FACILITY, AN ASSISTED LIVING FACILITY OR THE HOSPICE INPATIENT FACILITY. A TEAM OF HIGHLY SKILLED PROFESSIONALS AND VOLUNTEERS ARE AVAILABLE 24-HOURS A DAY, 7 DAYS A WEEK.HSCI IS LICENSED BY THE STATE OF INDIANA AND CERTIFIED BY THE FEDERAL GOVERNMENT. MEDICARE, MEDICAID AND PRIVATE INSURANCE COVER MOST SERVICES. ADDITIONAL FUNDS ARE RAISED THROUGH MEMORIALS, PRIVATE DONATIONS, FUND-RAISING ACTIVITIES, GRANTS AND THE UNITED WAY. TO ENSURE THAT CARE CAN BE PROVIDED REGARDLESS OF ABILITY TO PAY, HSCI IS A COMMUNITY RESOURCE FOR END-OF-LIFE CARE. HOSPICE PROFESSIONALS AND VOLUNTEERS ARE AVAILABLE TO PARTICIPATE IN EDUCATIONAL OFFERINGS IN A VARIETY OF SETTINGS, INCLUDING CHURCHES, SCHOOLS, CIVIC ORGANIZATIONS, AND OTHER HEALTH CARE PROVIDERS. IN 2011, OVER 682 PEOPLE WERE REACHED THROUGH PRESENTATIONS IN THE COMMUNITIES WE SERVE.IN 2011, 1,062 PATIENTS AND FAMILIES RECEIVED 60,637 DAYS OF CARE. ADDITIONALLY, BEREAVEMENT SERVICES WERE PROVIDED TO 2,736 INDIVIDUALS. APPROXIMATELY 9% OF HSCI'S ANNUAL BUDGET IS RAISED EACH YEAR TO PROVIDE THE SPECIALIZED CARE NEEDED BY THE TERMINALLY ILL AND THEIR FAMILIES. YOU ARE WELCOME TO VISIT OUR WEBSITE AT WWW.HOSPICEOFSOUTHCENTRALINDIANA.ORG FOR ADDITIONAL INFORMATION AND TO VIEW PHOTOS OF THE INPATIENT FACILITY. 8966177 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 10 1 1 159 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 1 0 IN X X SANDRA CARMICHAEL 8123148000 2626 E 17TH STREET COLUMBUS IN 47201 JEFF WASHBURN 1.00 X X 0 0 0 TOM DOWD 1.00 X X 0 0 0 MARLENE WEATHERWAX 1.00 X X 0 0 0 REV DENNIS AUD 1.00 X 0 0 0 JAMES BICKEL 1.00 X 0 0 0 DAVID FINKEL 1.00 X 0 0 0 SLADE CROWDER MD 1.00 X 0 0 0 RICHARD A KRAMER 1.00 X 0 0 0 JANE DAVEE 1.00 X 0 0 0 PAT MYERS 1.00 X 0 0 0 HUTCH SCHUMAKER PAST PRESIDENT 1.00 X 0 0 0 JOE SHEEHY MD 1.00 X 0 0 0 KAREN SHAW RN 1.00 X 0 0 0 SUZANNE WELLS 1.00 X 0 0 0 DAVID M THOMPSON 1.00 X 0 0 0 SANDRA CARMICHAEL 40.00 X 154346 0 18134 ROY GOODE MD 24.00 X 139315 0 24670 293661 0 42804 2 0 1 0 0 66612 46850 322378 435840 NET PATIENT SERVICE RE 624100 9846516 9846516 BAD DEBT RECOVERIES 624100 16401 16401 9862917 3424 3424 231460 131394 100066 100066 37630 11000 26630 26630 OTHER INCOME 900099 16201 16201 16201 10445078 9879118 0 130120 172480 151783 15523 5174 5454233 4799725 490881 163627 279996 246396 25200 8400 1023818 900959 92144 30715 437169 384709 39345 13115 54288 54288 22356 20791 1565 166437 131745 26869 7823 55320 48681 4979 1660 141215 103087 29655 8473 173269 171764 1505 246023 189438 56585 76281 69416 6865 PATIENT SERVICE EXPENSE 1521369 1521369 REPAIRS AND MAINTENANCE 240273 194621 45652 MISCELLANEOUS 20763 18271 1869 623 DUES SUBSCRIPTIONS BOOK 17431 13422 4009 626 626 10103347 8966177 896055 241115 1794309 2129845 1279980 1269485 5207 4988 79364 69780 7998615 2574017 5660082 5424598 43929 48215 8862871 8946911 1512415 1254724 1512415 1254724 X 7337795 7686525 12661 5662 7350456 7692187 8862871 8946911 341731 0 X X 0 1 1 X 0 X 617831 473380 580971 496162 435840 2604184 617831 473380 580971 496162 435840 2604184 169029 2435155 82270 55848 26678 10345 3424 178565 3856 12535 9941 2877 16201 45410 2828159 49634930 0.86100 0.84750 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7998615 2574017 5424598 5424598 10445078 10103347 341731 341731 10655610 84539 142394 226933 10428677 16401 16401 10445078 10313879 84539 125993 210532 10103347 0 10103347 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY HOSPICE AND RECOGNIZE A TAX LIABILITY IF HOSPICE HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY HOSPICE, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2011 AND 2010, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. HOSPICE IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENTS EXPENSE 142,394. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT RECOVERIES 16,401. PART XIII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENTS EXPENSES 142,394. BAD DEBT RECOVERIES -16,401. CONCERT 119777 119777 11950 89156 JENNINGS GALA 35483 35483 6922 76200 76200 500 22866 231460 231460 12450 118944 131394 100066 37630 11000 0 37630 11000 11000 26630 IN 1 0 0 0 1.00000 PHIL BUSH 2626 E 17TH STREET COLUMBUS IN 47201 0 SANDRA CARMICHAEL OVERALL RESPONSIBILITY FOR THE OPERATION AND CONDUCT OF THE GAMING EVENT X 0 X 0 0 0 0 0 0 0 0 0 SANDRA CARMICHAEL 154346 0 0 0 0 0 0 0 18134 0 172480 0 0 0 ROY GOODE MD 139315 0 0 0 0 0 0 0 24670 0 163985 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE EXECUTIVE COMMITTEE OF THE BOARD DELEGATED AUTHORITY TO THE FINANCE COMMITTEE OF THE BOARD TO APPROVE THE FORM 990. THE FINANCE COMMITTEE OF THE BOARD WILL REVIEW THE ENTIRE FORM 990. ONCE APPROVED BY THE FINANCE COMMITTEE OF THE BOARD, A FULL COPY OF THE FORM 990 WAS MADE AVAILABLE TO EVERY BOARD MEMBER FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EFFECTIVE 2006, BOARD MEMBERS, KEY EMPLOYEES, DIRECTORS AND OFFICERS SIGNED A CONFLICT OF INTEREST STATEMENT, STATING THAT THEY HAVE READ AND UNDERSTOOD THE STATEMENT. SINCE THAT TIME, ORIENTATION FOR NEW BOARD MEMBERS, KEY EMPLOYEES, OFFICERS AND DIRECTORS, INCLUDES REVIEW AND SIGNATURE OF A CONFLICT OF INTEREST STATEMENT. THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY THE COMPLIANCE OFFICER WITH FOLLOW-UP BY THE COMPLIANCE COMMITTEE IF ANY POTENTIAL CONFLICTS ARE IDENTIFIED. FORM 990, PART VI, SECTION B, LINE 15 EACH POSITION HAS A SALARY RANGE. COMPENSATION AT HIRE IS DETERMINED BY SEVERAL FACTORS, INCLUDING THE APPLICANT'S EXPERIENCE, EDUCATION, APPLICANT'S SALARY AT THEIR MOST RECENT EMPLOYMENT AND WHERE THE PROPOSED SALARY WOULD FALL WITHIN THE SALARY RANGE OF OTHER MEMBERS OF THE HOSPICE TEAM WHO ARE IN SIMILAR POSITIONS. INCREASES IN SALARY DURING 2011 WERE MADE DUE TO MARKET WAGE ADJUSTMENTS, OR BASED ON PERFORMANCE. IN 2011, HOSPICE DEVELOPED A PRESIDENT'S COMPENSATION POLICY. THE POLICY STIPULATED THAT INCREASES FOR THE PRESIDENT'S POSITION WOULD NEED TO BE APPROVED BY THE BOARD PRESIDENT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST STATEMENT, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C THE PROCESS OF SELECTING AN INDEPENDENT ACCOUNTANT AND OVERSIGHT OF THE AUDIT HAS NOT CHANGED FROM PRIOR YEAR.