HOSPICE ALLIANCE INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- HOSPICE ALLIANCE INC (EIN 39-1403883)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-06-28
- IRS object ID
- 201201809349300045
- Schema version
- 2011v1.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule I
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-06-28T15:47:47-05:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANDREA & ORENDORFF LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6300 76TH ST STE 200 | AddressLine1 |
| City | KENOSHA | City |
| State | WI | State |
| ZIP Code | 531424018 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391403883 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE ALLIANCE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HOSP | NameControl |
| Phone | 2626524400 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10220 PRAIRIE RIDGE BLVD | AddressLine1 |
| City | PLEASANT PRAIRIE | City |
| State | WI | State |
| ZIP Code | 53158 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ESTHER LETVEN | Name |
| Title | PRESIDENT | Title |
| Phone | 2626524400 | Phone |
| Date Signed | 2012-06-14 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ALLISON WRIGHT | Name |
| Phone | 2626577716 | Phone |
| Date Prepared | 2012-06-22 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | ESTHER LETVEN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10220 PRAIRIE RIDGE BLVD | AddressLine1 |
| City | PLEASANT PRAIRIE | City |
| State | WI | State |
| ZIP Code | 53158 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 9839525 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.HOSPICEALLIANCE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1981 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | HOSPICE ALLIANCE HAS SERVED OVER 5,000 TERMINALLY ILL PATIENTS AND THEIR FAMILIES SINCE 1981; SERVICING KENOSHA, EASTERN WALWORTH, AND RACINE COUNTIES. HOSPICE ALLIANCE REMAINS COMMITTED TO CARING FOR THE TERMINALLY ILL AND EMPOWERING THOSE WHO SUPPORT THEM. INCORPORATED IN 1981 IN KENOSHA, WISCONSIN, HOSPICE ALLIANCE, INC. WAS ESTABLISHED BY A GROUP OF COMMUNITY CITIZENS THAT WERE CONCERNED WITH THE LACK OF END OF LIFE CARE AVAILBLE TO TERMINALLY ILL PERSONS AND THEIR FAMILIES. THESE COMMUNITY CITIZENS BELIEVED THAT IF TERMINALLY ILL PEOPLE WERE GIVEN A CHOICE AS TO WHERE THEY WOULD LIKE TO BE, IT WOULD BE IN THEIR HOME SURROUNDED BY THE PEOPLE AND THINGS THEY LOVE. HOSPICE ALLIANCE, INC. LIVES THIS MISSION DAILY THROUGH COMMITMENT, COMPASSION, AND CHOICES. HOSPICE ALLIANCE, INC. PROVIDES CARE IN THE FOLLOWING SETTINGS: 1. IN THE PATIENT'S HOME, SURROUNDED BY THE PEOPLE AND THINGS THEY LOVE. THIS CHOICE ALLOWS FAMILY AND FRIENDS TO SUPPORT THEIR LOVED ONE IN COMFORT AND PRIVACY. 2. IN | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 16 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 15 | NbrIndependentVotingMembers |
| Total Nbr Employees | 131 | TotalNbrEmployees |
| Total Nbr Volunteers | 186 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 204304 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 316895 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 9593979 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 9429592 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 4799 | InvestmentIncomePriorYear |
| Investment Income Current Year | 3276 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 54193 | OtherRevenuePriorYear |
| Other Revenue Current Year | 89762 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 9857275 | TotalRevenuePriorYear |
| Total Revenue Current Year | 9839525 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 800000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 500000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 4598775 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5080232 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 3834156 | OtherExpensePriorYear |
| Other Expenses Current Year | 3810596 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 9232931 | TotalExpensesPriorYear |
| Total Expenses Current Year | 9390828 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 624344 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 448697 | RevenuesLessExpensesCY |
| Total Assets BOY | 2997211 | TotalAssetsBOY |
| Total Assets EOY | 3494421 | TotalAssetsEOY |
| Total Liabilities BOY | 712933 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 761446 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2284278 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2732975 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | HOSPICE ALLIANCE HAS SERVED OVER 5,000 TERMINALLY ILL PATIENTS AND THEIR FAMILIES SINCE 1981; SERVICING KENOSHA, EASTERN WALWORTH, AND RACINE COUNTIES. HOSPICE ALLIANCE REMAINS COMMITTED TO CARING FOR THE TERMINALLY ILL AND EMPOWERING THOSE WHO SUPPORT THEM. INCORPORATED IN 1981 IN KENOSHA, WISCONSIN, HOSPICE ALLIANCE, INC. WAS ESTABLISHED BY A GROUP OF COMMUNITY CITIZENS THAT WERE CONCERNED WITH THE LACK OF END OF LIFE CARE AVAILBLE TO TERMINALLY ILL PERSONS AND THEIR FAMILIES. THESE COMMUNITY CITIZENS BELIEVED THAT IF TERMINALLY ILL PEOPLE WERE GIVEN A CHOICE AS TO WHERE THEY WOULD LIKE TO BE, IT WOULD BE IN THEIR HOME SURROUNDED BY THE PEOPLE AND THINGS THEY LOVE. HOSPICE ALLIANCE, INC. LIVES THIS MISSION DAILY THROUGH COMMITMENT, COMPASSION, AND CHOICES. HOSPICE ALLIANCE, INC. PROVIDES CARE IN THE FOLLOWING SETTINGS: 1. IN THE PATIENT'S HOME, SURROUNDED BY THE PEOPLE AND THINGS THEY LOVE. THIS CHOICE ALLOWS FAMILY AND FRIENDS TO SUPPORT THEIR LOVED ONE IN COMFORT AND PRIVACY. 2. IN | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 7939987 | Expense |
| Grants | 500000 | Grants |
| Revenue | 9537903 | Revenue |
| Description | HOSPICE ALLIANCE PROVIDED 54,933 DAYS OF SERVICE WHICH INCLUDES, 2,254 DAYS OF RESIDENTIAL HOSPICE CARE IN OUR HOSPICE HOUSE AND 2,835 DAYS OF HOME HEALTH CARE IN 2011. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 73281 | Expense |
| Description | BEREAVEMENT SERVICES - HOSPICE ALLIANCE BEREAVEMENT SERVICES ARE AVAILABLE FOR 13 MONTHS FOLLOWING THE DEATH OF A LOVED ONE. COUNSELORS COMMUNICATE REGULARLY WITH FAMILY MEMBERS, FACILITATE SUPPORT GROUPS AND COORDINATE THE SOCIAL GROUP GATHERINGS. THE BEREAVEMENT DEPARTMENT ALSO HOLDS SEMI-ANNUAL MEMORIAL SERVICES AND PLANS THE ANNUAL GRIEF TELECONFERENCE. MOST IMPORTANTLY, BEREAVEMENT SERVICES ARE AVAILABLE TO ALL IN THE COMMUNITY, NOT JUST THOSE WHO HAVE LOST A LOVED ONE WHILE IN HOSPICE CARE. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 8013268 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | false | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | true | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | true | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | true | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 47 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 131 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 16 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 15 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | WI | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | LAWRENCE HAAS | NamePerson |
| Telephone Number | 2626524400 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10220 PRAIRIE RIDGE BLVD | AddressLine1 |
| City | PLEASANT PRAIRIE | City |
| State | WI | State |
| ZIP Code | 53158 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (18 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| JOSHUA BLOOM MD | ||||||
| MEDICAL DIR | 15.00 | X | 24688 | 0 | 0 | |
| ROBERT BICHLER | ||||||
| MEMBER | 0.50 | X | 0 | 0 | 0 | |
| CHUCK DUFORD | ||||||
| MEMBER | 0.50 | X | 0 | 0 | 0 | |
| RITA HAGEN | ||||||
| MEMBER | 0.50 | X | 0 | 0 | 0 | |
| SCOTT MCARTHEY | ||||||
| MEMBER | 0.50 | X | 0 | 0 | 0 | |
| SHERYL MUELLER | ||||||
| MEMBER | 0.50 | X | 0 | 0 | 0 | |
| KATHLEEN NUZZO | ||||||
| MEMBER | 0.50 | X | 0 | 0 | 0 | |
| GENE OLSON | ||||||
| MEMBER | 0.50 | X | 0 | 0 | 0 | |
| JERRY BAIN | ||||||
| MEMBER | 0.50 | X | 0 | 0 | 0 | |
| NANCY PIASECKI | ||||||
| MEMBER | 0.50 | X | 0 | 0 | 0 | |
| PAMELA THOMEY | ||||||
| MEMBER | 0.50 | X | 0 | 0 | 0 | |
| MICHAEL HAUBRICH | ||||||
| MEMBER | 0.50 | X | 0 | 0 | 0 | |
| CONNIE MATTER RN | ||||||
| EXEC DIRECTR | 40.00 | 111763 | 0 | 0 | X | |
| RICHARD REGNER | ||||||
| FORMER PRESI | 0.00 | 0 | 0 | 0 | X | |
| DENNIS MATTIOLI | ||||||
| FORMER SEC/T | 0.00 | 0 | 0 | 0 | X | |
| ESTHER LETVEN | ||||||
| PRESIDENT | 1.00 | 0 | 0 | 0 | X | |
| DANIEL HEYDEN | ||||||
| SEC / TREAS | 1.00 | 0 | 0 | 0 | X | |
| MICHAEL LANGENDORF | ||||||
| VICE PRESIDE | 1.00 | 0 | 0 | 0 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 136451 | TotalReportableCompFromOrg |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Related Organizations | 188997 | RelatedOrganizations |
| Government Grants | 27898 | GovernmentGrants |
| All Other Contributions | 100000 | AllOtherContributions |
| Noncash Contributions | 188997 | NoncashContributions |
| Total Contributions | 316895 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|
| NET PATIENT SERVICE REVENUE | 8931649 | 8931649 |
| HOSPICE HOUSE REVENUE | 497943 | 497943 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 9429592 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3276 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3276 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|
| ADMINISTRATION FEES-FDN | 71601 | 71601 |
| OTHER REVENUE | 10223 | 10223 |
| SUPPORT & SUPPLIES-FDN | 7938 | 7938 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 89762 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9839525 | TotalRevenueColumn |
| Related Or Exempt Function Income | 9522630 | RelatedOrExemptFunctionIncome |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 500000 | Total |
| Program Services | 500000 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4201018 | Total |
| Program Services | 3530969 | ProgramServices |
| Management And General | 670049 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 574048 | Total |
| Program Services | 484223 | ProgramServices |
| Management And General | 89825 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 305166 | Total |
| Program Services | 256493 | ProgramServices |
| Management And General | 48673 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12162 | Total |
| Management And General | 12162 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11000 | Total |
| Management And General | 11000 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71370 | Total |
| Program Services | 62040 | ProgramServices |
| Management And General | 9330 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 60271 | Total |
| Program Services | 9886 | ProgramServices |
| Management And General | 50385 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 148789 | Total |
| Program Services | 131794 | ProgramServices |
| Management And General | 16995 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 388966 | Total |
| Program Services | 116456 | ProgramServices |
| Management And General | 272510 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 220942 | Total |
| Program Services | 201975 | ProgramServices |
| Management And General | 18967 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44890 | Total |
| Management And General | 44890 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49794 | Total |
| Management And General | 49794 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PATIENT MEDICAL EXPENSES | 2610001 | 2610001 | |
| REPAIRS/MAINTENANCE | 77892 | 77892 | |
| MEDICAL SUPPLIES | 72870 | 72870 | |
| DUES/SUBSCRIPTIONS | 30679 | 30635 | 44 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10970 | Total |
| Program Services | 5926 | ProgramServices |
| Management And General | 5044 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9390828 | Total |
| Program Services | 8013268 | ProgramServices |
| Management And General | 1377560 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1822691 | BOY |
| EOY | 2112965 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 43862 | BOY |
| EOY | 55166 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 914669 | BOY |
| EOY | 1092271 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19551 | BOY |
| EOY | 23001 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 61292 | BOY |
| EOY | 71298 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 775344 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 635624 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 135146 | BOY |
| EOY | 139720 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2997211 | BOY |
| EOY | 3494421 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 317463 | BOY |
| EOY | 401983 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 395470 | BOY |
| EOY | 359463 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 712933 | BOY |
| EOY | 761446 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2284278 | BOY |
| EOY | 2732975 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2284278 | BOY |
| EOY | 2732975 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2997211 | BOY |
| EOY | 3494421 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 448697 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 10500 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 199897 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 204307 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 204304 | CurrentTaxYearMinus1Year |
| Current Tax Year | 316895 | CurrentTaxYear |
| Total | 935903 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 7261551 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 7782226 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 8804959 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 9652971 | CurrentTaxYearMinus1Year |
| Current Tax Year | 9522630 | CurrentTaxYear |
| Total | 43024337 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 7272051 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 7982123 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 9009266 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 9857275 | CurrentTaxYearMinus1Year |
| Current Tax Year | 9839525 | CurrentTaxYear |
| Total | 43960240 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 43960240 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 20129 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 24467 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 6856 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4799 | CurrentTaxYearMinus1Year |
| Total | 56251 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 20129 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 24467 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 6856 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4799 | CurrentTaxYearMinus1Year |
| Total | 56251 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 7292180 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 8006590 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 9016122 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 9862074 | CurrentTaxYearMinus1Year |
| Current Tax Year | 9839525 | CurrentTaxYear |
| Total | 44016491 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99870 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99860 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00000 | InvestmentIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form4720 Filed4955 Tax | false | Form4720Filed4955Tax |
| Correction Made | false | CorrectionMade |
| Form1120 Pol Filed | false | Form1120PolFiled |
| Form4720 Filed | false | Form4720Filed |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $44 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 44 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
| Form4720 Filed4912 Tax | false | Form4720Filed4912Tax |
| Substantially All Dues Nondeduct | false | SubstantiallyAllDuesNondeduct |
| Only In House Lobbying | false | OnlyInHouseLobbying |
| Agree To Carryover Prior Year | false | AgreeToCarryoverPriorYear |
Form990 Schedule C Part IV Form990ScheduleCPartIV (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| SCHEDULE C, PART I-A, LINE 1 | MEMBERSHIP DUES THROUGH NHPCO; 0.84% ARE FOR POLITICAL ACTIVITIES |
| SCHEDULE C, PART II-B, LINE 1 | THE NATIONAL HOSPICE AND PALLIATIVE CARE ORGANIZATION (NHPCO) IS AN ORGANIZATION THAT LEADS AND MOBILIZES SOCIAL CHANGE FOR IMPROVED CARE AT THE END OF LIFE. HOSPICE ALLIANCE, INC. IS A MEMBER OF THE NHPCO. NHPCO SAYS THAT 0.84% OF DUES ARE FOR LOBBYING PURPOSES, WHICH EQUATES TO 44 FOR THE YEAR. THE STATE ORGANIZATION, CALLED HOPE, DOES NOT USE MEMBERSHIP DUES FOR LOBBYING PURPOSES. |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disclosed Orgs Legal Control | false | DisclosedOrgsLegalControl |
| Disclosed For Charitable Purposes | false | DisclosedForCharitablePurposes |
| Written Policy Monitoring | false | WrittenPolicyMonitoring |
| Sect170h Requirements Satisfied | false | Sect170hRequirementsSatisfied |
| Solicited Assets For Sale | false | SolicitedAssetsForSale |
| Agent Trustee Etc | false | AgentTrusteeEtc |
| Included On FS | false | IncludedOnFS |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | false | AreRelatedOrgsListedScheduleR |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 775344 | OtherCostOrOtherBasis |
| Depreciation | 635624 | Depreciation |
| Book Value | 139720 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 139720 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ACCRUED VACATION | $182,853 |
| ACCRUED PAYROLL | $176,610 |
| DEFERRED REVENUE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 359463 | TotalOfAmounts |
| Total Revenue | 9839525 | TotalRevenue |
| Total Expenses | 9390828 | TotalExpenses |
| Excess Or Deficit For Year | 448697 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 448697 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 9839525 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 9839525 | RevenueSubtotal |
| Total Revenue Per Form990 | 9839525 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 9390828 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 9390828 | ExpensesSubtotal |
| Total Expenses Per Form990 | 9390828 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | LIABILITY UNDER FIN 48 FOOTNOTE | Identifier |
| Return Reference | SCHEDULE D, PAGE 3, PART X | ReturnReference |
| Explanation | HOSPICE QUALIFIES AS A TAX-EXEMPT NON-PROFIT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND SIMILAR STATUES OF WISCONSIN LAW. HOSPICE IS SUBJECT TO FEDERAL INCOME TAX ONLY ON NET UNRELATED BUSINESS INCOME UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. HOSPICE CURRENTLY HAS NO OBLIGATION FOR UNRELATED BUSINESS INCOME TAX. ACCORDINGLY, NO PROVISIONS FOR FEDERAL OR STATE INCOME TAXES ARE REQUIRED. HOSPICE'S FEDERAL AND STATE RETURNS ARE POTENTIALLY OPEN FOR EXAMINATIONS FOR THE YEARS 2007-2010. | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE ALLIANCE FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10220 PRAIRIE RIDGE BLVD | AddressLine1 |
| City | PLEASANT PRAIRIE | City |
| State | WI | State |
| ZIP Code | 53158 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 391822945 | EINOfRecipient |
| IRC Section | 501 | IRCSection |
| Amount Of Cash Grant | 500000 | AmountOfCashGrant |
| Method Of Valuation | BOOK | MethodOfValuation |
| Purpose Of Grant | FOR OPS FUTURE USE | PurposeOfGrant |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|
| DR JOSHUA BLOOM | ||
| BOARD MEMBER | PAID MEDICAL DIR | false |
| JOHN PLOUS | ||
| BOARD MEMBER | WIFE IS A PAID EMPL | false |
Schedule M IRS990ScheduleM
Other Non Cash Contributions Table OtherNonCashContributionsTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Description | IN-KIND RENT | Description |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 188997 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | MARKET VALUE | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990 - ORGANIZATION'S MISSION | HOSPICE ALLIANCE HAS SERVED OVER 5,000 TERMINALLY ILL PATIENTS AND THEIR FAMILIES SINCE 1981; SERVICING KENOSHA, EASTERN WALWORTH, AND RACINE COUNTIES. HOSPICE ALLIANCE REMAINS COMMITTED TO CARING FOR THE TERMINALLY ILL AND EMPOWERING THOSE WHO SUPPORT THEM. INCORPORATED IN 1981 IN KENOSHA, WISCONSIN, HOSPICE ALLIANCE, INC. WAS ESTABLISHED BY A GROUP OF COMMUNITY CITIZENS THAT WERE CONCERNED WITH THE LACK OF END OF LIFE CARE AVAILBLE TO TERMINALLY ILL PERSONS AND THEIR FAMILIES. THESE COMMUNITY CITIZENS BELIEVED THAT IF TERMINALLY ILL PEOPLE WERE GIVEN A CHOICE AS TO WHERE THEY WOULD LIKE TO BE, IT WOULD BE IN THEIR HOME SURROUNDED BY THE PEOPLE AND THINGS THEY LOVE. HOSPICE ALLIANCE, INC. LIVES THIS MISSION DAILY THROUGH COMMITMENT, COMPASSION, AND CHOICES. HOSPICE ALLIANCE, INC. PROVIDES CARE IN THE FOLLOWING SETTINGS: 1. IN THE PATIENT'S HOME, SURROUNDED BY THE PEOPLE AND THINGS THEY LOVE. THIS CHOICE ALLOWS FAMILY AND FRIENDS TO SUPPORT THEIR LOVED ONE IN COMFORT AND PRIVACY. 2. IN LONG TERM CARE AND ASSISTED LIVING FACTILITES, SUCH AS NURSING HOMES, SENIOR APARTMENTS AND GROUP HOMES. HOSPICE ALLIANCE PROFESSIONALS COMPLEMENT THE CARE ALREADY PROVIDED BY STAFF IN THESE SETTINGS. 3. THE HOSPICE ALLIANCE HOSPICE HOUSE OFFERS AN OPTION FOR THOSE WHO, FOR WHATEVER REASON, CANNOT REMAIN IN THEIR OWN HOME. THE HOUSE OPERATES AT A SIGNIFICANT LOSS DUE TO HOSPICE'S MISSION. 4. PRE-HOSPICE PALLIATIVE CARE MAY BE THE CHOICE FOR SOMEONE WHO IS NOT READY FOR THE HOSPICE PROGRAM. 5. BEREAVEMENT SERVICES AND GRIEF SUPPORT GROUPS ARE AVAILABLE WHEN THE TIME IS APPROPRIATE |
| EXPLANATION ON VOLUNTEERS AND TYPES OF SERVICES OR BENEFITS | FORM 990, PAGE 1, PART I, LINE 6 | HOSPICE ALLIANCE VOLUNTEERS ARE A VITAL PART OF THE HOSPICE TEAM. WHILE ENHANCING THE LIVES OF PATIENTS AND THEIR FAMILIES, VOLUNTEERS GAIN SATISFACTION AND ENRICHMENT IN THEIR OWN LIVES. THERE ARE MANY WAYS VOLUNTEERS HELP, INCLUDING: COMPANIONSHIP, RESPITE CARE, RUNNING ERRANDS, NURSING HOME VISITS, MAILINGS, OFFICE HELP, COMPUTER WORK, EXPOS AND HEALTH FAIRS, FUNDRAISING, GARDENING, PREPARING MEALS AND BAKING. ALL VOLUNTEERS TAKE PART IN AN EIGHT SESSION TRAINING CLASS WHICH COVERS AN INTRODUCTION TO HOSPICE SERVICES, COMMUNICATION, DISEASE PROCESS, AND THE ROLE OF HOSPICE ALLIANCE TEAM MEMBERS. IN 2011, VOLUNTEERS COMMITTED 11,066 HOURS OF THEIR TIME. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE 990 WAS REVIEWED IN DETAIL BY THE COMPTROLLER AND THEN FURTHER REVIEWED BY THE ORGANIZATION'S FINANCE COMMITTEE AND THEN APPROVED BY THE FULL BOARD OF DIRECTORS. ALL FINANCIAL INFORMATION IN THIS RETURN IS BASED OFF OF THE AUDITED FINANCIAL STATEMENTS. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | FULL DISCLOSURE, BY NOTICE IN WRITING, SHALL BE MADE BY THE INTERESTED PARTIES TO THE FULL BOARD OF DIRECTORS IN ALL CONFLICTS OF INTEREST. THIS IS DONE ON AN ANNUAL BASIS WITH BOARD MEMBERS, STAFF, AND VOLUNTEERS. IF THERE IS A POTENTIAL CONFLICT OF INTEREST, THE POLICY STATES PROCEDURES ON HOW TO HANDLE DIFFERENT SITUATIONS. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | THE EXECUTIVE DIRECTOR'S SALARY IS DETERMINED BY THE BOARD. ALL OTHER STAFF SALARIES ARE DETERMINED USING THE NATIONAL ASSOCIATION FOR HOMECARE AND HOSPICE'S HOSPICE SALARY & BENEFIT REPORT AS WELL AS STATE AND NATIONAL GOVERNMENT WAGE DATA. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION WILL FURNISH AUDITED FINANCIAL STATEMENTS UPON REQUEST. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE ALLIANCE FOUNDATION INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10220 PRAIRIE RIDGE BLVD | AddressLine1 |
| City | PLEASANT PRAIRIE | City |
| State | WI | State |
| ZIP Code | 53158 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391822945 | EIN |
| Primary Activities | FUNDRAISER | PrimaryActivities |
| Legal Domicile State | WI | LegalDomicileState |
| Exempt Code Section | 501C3 | ExemptCodeSection |
| Public Charity Status | 11A | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | false | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| HOSPICE ALLIANCE FDN INC | ||
| B | 500000 | GRANT |
| HOSPICE ALLIANCE FDN INC | ||
| C | 188997 | INKIND CONTRIB OF RENT |
| HOSPICE ALLIANCE FDN INC | ||
| J | 99996 | COST OF MONTHLY RENT |
| HOSPICE ALLIANCE FDN INC | ||
| M | 79539 | COST OF SERVICES |
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