MONTGOMERY HOSPICE INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MONTGOMERY HOSPICE INC (EIN 52-1114719)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-12
- IRS object ID
- 201203179349303015
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-12T20:07:16-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410746749 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4250 N FAIRFAX DRIVE SUITE 1020 | AddressLine1 |
| City | ARLINGTON | City |
| State | VA | State |
| ZIP Code | 22203 | 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 | 521114719 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONTGOMERY HOSPICE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MONT | NameControl |
| Phone | 3019214400 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1355 PICCARD DRIVE NO 100 | AddressLine1 |
| City | ROCKVILLE | City |
| State | MD | State |
| ZIP Code | 20850 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ANN MITCHELL | Name |
| Title | PRESIDENT & CEO | Title |
| Phone | 3019214400 | Phone |
| Date Signed | 2012-11-05 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KAREN GRIES | Name |
| PTIN | P00078514 | PTIN |
| Phone | 5712279500 | Phone |
| 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 | ANN MITCHELL | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1355 PICCARD DRIVE NO 100 | AddressLine1 |
| City | ROCKVILLE | City |
| State | MD | State |
| ZIP Code | 20850 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 22112542 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MONTGOMERYHOSPICE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1979 | YearFormation |
| State Legal Domicile | MD | StateLegalDomicile |
| Activity Or Mission Description | TO GENTLE THE JOURNEY THROUGH SERIOUS ILLNESS AND LOSS WITH SKILL AND COMPASSION. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 23 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 22 | NbrIndependentVotingMembers |
| Total Nbr Employees | 291 | TotalNbrEmployees |
| Total Nbr Volunteers | 287 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 317088 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1143592 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 17038437 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 20961488 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1945 | InvestmentIncomePriorYear |
| Investment Income Current Year | 5025 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 2356 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2437 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 17359826 | TotalRevenuePriorYear |
| Total Revenue Current Year | 22112542 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 11349391 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 13762497 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 69568 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 5100106 | OtherExpensePriorYear |
| Other Expenses Current Year | 6811584 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 16449497 | TotalExpensesPriorYear |
| Total Expenses Current Year | 20574081 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 910329 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1538461 | RevenuesLessExpensesCY |
| Total Assets BOY | 7079103 | TotalAssetsBOY |
| Total Assets EOY | 9241669 | TotalAssetsEOY |
| Total Liabilities BOY | 1827464 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2361569 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 5251639 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 6880100 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO GENTLE THE JOURNEY THROUGH SERIOUS ILLNESS AND LOSS WITH SKILL AND COMPASSION. SIGNIFICANT ACTIVITIES INCLUDE HOSPICE SERVICES AS WELL AS BEREAVEMENT SUPPORT, PASTORAL CARE, ADMINISTRATIVE ASSISTANCE, COMMMUNITY EDUCATION AND OUTREACH. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 17015032 | Expense |
| Revenue | 20963925 | Revenue |
| Description | HOSPICE AND BEREAVEMENT SERVICES: THE ORGANIZATION PROVIDES SPECIALIZED MEDICAL AND PSYCHOSOCIAL END-OF-LIFE CARE TO MONTGOMERY COUNTY, MD RESIDENTS LIVING WITH A LIFE-LIMITING ILLNESS, AS WELL AS THEIR FAMILIES, WITH AN INTERDISCIPLINARY TEAM OF TRAINED PROFESSIONALS (AND VOLUNTEERS). IN 2011, MONTGOMERY HOSPICE SERVED MORE THAN 2,000 PATIENTS AND THEIR FAMILIES. OUR INPATIENT UNIT, CASEY HOUSE, IS THE ONLY ALL-HOSPICE ACUTE CARE FACILITY IN MONTGOMERY COUNTY. IN 2011, MORE THAN 550 PATIENTS WITH SERIOUS PAIN OR OTHER SYMPTOMS RECEIVED INTENSIVE NURSING AND MEDICAL CARE AND ATTENTION AT CASEY HOUSE. MONTGOMERY HOSPICE ALSO PROVIDED BEREAVEMENT SERVICES TO ALMOST 9,000 INDIVIDUALS, AND END-OF-LIFE CARE EDUCATION TO MORE THAN 7,000 CLINICIANS AND PEOPLE IN THE LAY COMMUNITY. | Description |
| Total Program Service Expense | 17015032 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 16 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 291 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 23 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 22 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MD | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MARTHA FLORY | NamePerson |
| Telephone Number | 3019214400 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1355 PICCARD DRIVE NO 100 | AddressLine1 |
| City | ROCKVILLE | City |
| State | MD | State |
| ZIP Code | 20850 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (27 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| PAUL E ALPUCHE JR | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| ARNOLD J KOHN | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| JASON A KIRSCH | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| ANN MITCHELL | ||||||||
| PRESIDENT | 53.00 | X | 201183 | 0 | 13460 | X | ||
| PAUL S NICHOLSON | ||||||||
| CHAIRMAN | 1.00 | X | 0 | 0 | 0 | X | ||
| MICHAEL G BANKS ESQ | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| RICHARD A BINDER MD | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| BRIAN A CARPENTER MD | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| ALEXANDER A ZUKIWSKI M | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| JOSEPH KAPLAN MD | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| BERYL L FEINBERG | ||||||||
| VICE CHAIRMAN | 1.00 | X | 0 | 0 | 0 | X | ||
| DAVID J KRESSLER PHD | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| BARRY R MEIL | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| SHEILA E BOLAND | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| STERLING KING JR DRP | ||||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | X | ||
| JOSE A QUIROS MD | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| ALICIA B JIMENEZ | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| CATHERINE S LEGGETT | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| HON PAUL A MCGUCKIAN | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| WILLIAM M SCHLOSSENBERG | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| SEN LENOARD H TEITELBAUM | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| RONALD M WOLFSHEIMER | ||||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | X | ||
| SEN ROGER MANNO | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| GEOFFREY COLEMAN | ||||||||
| MEDICAL DIRECTOR | 47.00 | 169621 | 0 | 9019 | X | |||
| ROBERT WASHINGTON | ||||||||
| VP COUNSELING SERVICES | 45.00 | 117836 | 0 | 10839 | X | |||
| JANET CAUFFIEL | ||||||||
| VP OF HUMAN RESOURCES | 45.00 | 129948 | 0 | 5104 | X | |||
| MONICA ESCALANTE | ||||||||
| CFO/VP COMMUNITY EDUCATION | 45.00 | 135849 | 0 | 5028 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 754437 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 43450 | TotalOtherCompensation |
| Number Individuals GT100 K | 5 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| CENTER FOR NON-PROFIT ADVANCEMENT | |||||
| 1666 K ST NW 440 | WASHINGTON | DC | 20006 | EMPLOYEE HEALTH INS | 948835 |
| ROBERT HOME MEDICAL | |||||
| 20465 SENECA MEADOW PKWY | GERMANTOWN | MD | 20876 | DURABLE MED EQUIP | 885231 |
| PRO CARE PBM | |||||
| 3090 PREMIERE PKWY STE 100 | DULUTH | GA | 30097 | PHARMACY | 771813 |
| FIRST CHOICE MEDICAL SUPPLY | |||||
| 127 INTERSTATE DR | RICHLAND | MS | 39218 | MEDICAL SUPPLIES | 340425 |
| SUNCOAST SOLUTIONS | |||||
| 5771 ROOSEVELT BLVD | CLEARWATER | FL | 33760 | COMPUTER APP SUPPORT | 134847 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| Related Organizations | 1143592 | RelatedOrganizations |
| Total Contributions | 1143592 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICE REVENU | Description |
| Business Code | 624100 | BusinessCode |
| Total Revenue Column | 20961488 | TotalRevenueColumn |
| Related Or Exempt Function Income | 20961488 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 20961488 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5025 | TotalRevenueColumn |
| Exclusion | $5,025 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| MEALS - NON-PATIENT | 624100 | 2333 | 2333 |
| OTHER MISCELLANEOUS | 624100 | 104 | 104 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2437 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 22112542 | TotalRevenueColumn |
| Related Or Exempt Function Income | 20963925 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $5,025 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 393283 | Total |
| Program Services | 232301 | ProgramServices |
| Management And General | 96589 | ManagementAndGeneral |
| Fundraising | 64393 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11467247 | Total |
| Program Services | 10215232 | ProgramServices |
| Management And General | 1252015 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 185100 | Total |
| Program Services | 142742 | ProgramServices |
| Management And General | 37183 | ManagementAndGeneral |
| Fundraising | 5175 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 860664 | Total |
| Program Services | 808761 | ProgramServices |
| Management And General | 51903 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 856203 | Total |
| Program Services | 762844 | ProgramServices |
| Management And General | 93359 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 284835 | Total |
| Management And General | 284835 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46086 | Total |
| Management And General | 46086 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 560577 | Total |
| Program Services | 553345 | ProgramServices |
| Management And General | 7232 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 142604 | Total |
| Program Services | 120007 | ProgramServices |
| Management And General | 22597 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 510400 | Total |
| Management And General | 510400 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 142991 | Total |
| Management And General | 142991 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 573843 | Total |
| Program Services | 217286 | ProgramServices |
| Management And General | 356557 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 326099 | Total |
| Program Services | 322519 | ProgramServices |
| Management And General | 3580 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71476 | Total |
| Program Services | 49215 | ProgramServices |
| Management And General | 22261 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1481 | Total |
| Management And General | 1481 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 218848 | Total |
| Management And General | 218848 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 313891 | Total |
| Management And General | 313891 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL EQUIPMENT, SUPL | 2048190 | 2048190 | |
| TRANSFER INTERCOMPANY D | 1449234 | 1449234 | |
| LAUNDRY AND LINEN SUPPL | 58761 | 58761 | |
| MISCELLANEOUS EXPENSE | 29723 | 29096 | 627 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32545 | Total |
| Program Services | 5499 | ProgramServices |
| Management And General | 27046 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20574081 | Total |
| Program Services | 17015032 | ProgramServices |
| Management And General | 3489481 | ManagementAndGeneral |
| Fundraising | 69568 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 767 | BOY |
| EOY | 767 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 515233 | BOY |
| EOY | 3321698 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3586475 | BOY |
| EOY | 2807608 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 150184 | BOY |
| EOY | 280311 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 5268907 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2438496 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2825258 | BOY |
| EOY | 2830411 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1186 | BOY |
| EOY | 874 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7079103 | BOY |
| EOY | 9241669 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1638033 | BOY |
| EOY | 2217689 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 189431 | BOY |
| EOY | 143880 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1827464 | BOY |
| EOY | 2361569 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5251639 | BOY |
| EOY | 6880100 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5251639 | BOY |
| EOY | 6880100 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7079103 | BOY |
| EOY | 9241669 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1538461 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 90000 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | 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 | 1123939 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 166309 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 368239 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 317078 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1143592 | CurrentTaxYear |
| Total | 3119157 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 10036727 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 10628977 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 13140770 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 17038437 | CurrentTaxYearMinus1Year |
| Current Tax Year | 20961488 | CurrentTaxYear |
| Total | 71806399 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 11160666 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 10795286 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 13509009 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 17355515 | CurrentTaxYearMinus1Year |
| Current Tax Year | 22105080 | CurrentTaxYear |
| Total | 74925556 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 74925556 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 9289 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 5627 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1772 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1945 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5025 | CurrentTaxYear |
| Total | 23658 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 9289 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 5627 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1772 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1945 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5025 | CurrentTaxYear |
| Total | 23658 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1753 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2841 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 9163 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1856 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2437 | CurrentTaxYear |
| Total | 18050 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 11171708 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 10803754 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 13519944 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 17359316 | CurrentTaxYearMinus1Year |
| Current Tax Year | 22112542 | CurrentTaxYear |
| Total | 74967264 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99940 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99900 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00030 | 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 D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3147870 | BeginningOfYearBalance |
| Contributions | 326203 | Contributions |
| Investment Earnings Or Losses | 326792 | InvestmentEarningsOrLosses |
| Other Expenditures | 105120 | OtherExpenditures |
| End Of Year Balance | 3695745 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1216353 | BeginningOfYearBalance |
| Contributions | 1931517 | Contributions |
| Investment Earnings Or Losses | 121488 | InvestmentEarningsOrLosses |
| Other Expenditures | 121488 | OtherExpenditures |
| End Of Year Balance | 3147870 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.11890 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.83660 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.04450 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 593216 | OtherCostOrOtherBasis |
| Book Value | 593216 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2357518 | OtherCostOrOtherBasis |
| Depreciation | 711934 | Depreciation |
| Book Value | 1645584 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 756346 | OtherCostOrOtherBasis |
| Depreciation | 504853 | Depreciation |
| Book Value | 251493 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 551530 | OtherCostOrOtherBasis |
| Depreciation | 373179 | Depreciation |
| Book Value | 178351 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1010297 | OtherCostOrOtherBasis |
| Depreciation | 848530 | Depreciation |
| Book Value | 161767 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2830411 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DEFERRED RENT PAYABLE - LEASE | Description |
| Amount | $143,880 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 143880 | TotalOfAmounts |
| Total Revenue | 22112542 | TotalRevenue |
| Total Expenses | 20574081 | TotalExpenses |
| Excess Or Deficit For Year | 1538461 | ExcessOrDeficitForYear |
| Other | $90,000 | OtherAmount |
| Total Adjustments | 90000 | TotalAdjustments |
| Excess Or Deficit Per FS | 1628461 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 22112542 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 22112542 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 22112542 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 20484081 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 20484081 | ExpensesSubtotal |
| Other Expenses Not Included | 90000 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 90000 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 20574081 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE HOSPICE IS A TAX-EXEMPT ENTITY AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPICE HAS NO SIGNIFICANT UNRELATED BUSINESS INCOME; HOWEVER, SUCH STATUS IS SUBJECT TO FINAL DETERMINATION UPON EXAMINATION OF THE RELATED INCOME TAX RETURNS BY THE APPROPRIATE TAXING AUTHORITIES. THE TAX RETURNS FOR THE FISCAL YEARS ENDED 2008 THROUGH 2010 ARE OPEN TO EXAMINATION BY FEDERAL AND STATE AUTHORITIES. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | INTERCOMPANY CHARGE 90,000. | |
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: | INTERCOMPANY CHARGE 90,000. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANN MITCHELL | |||||||||||||
| 184783 | 0 | 16400 | 0 | 0 | 0 | 5839 | 0 | 7621 | 0 | 214643 | 0 | 0 | 0 |
| GEOFFREY COLEMAN | |||||||||||||
| 163221 | 0 | 6400 | 0 | 0 | 0 | 0 | 0 | 9019 | 0 | 178640 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE CONSISTS FO THE BOARD CHAIRPOERSON, VICE CHAIRPERSON, SECRETARY, TREASURER, IMMEDIATE PAST CHAIRPERSON, MONTGOMERY HOSPICE FOUNDATION BOARD CHAIRPERSON AND THE PRESIDENT/CEO, AND SUCH OTHER BOARD MEMBERS AS THE BOARD MAY DEEM APPROPRIATE. THE COMMITTEE SHALL HAVE THE AUTHORITY TO CONDUCT ESSENTIAL HOSPICE BUSINESS BETWEEN BOARD MEETINGS, WHEN DELAY IN ACTION WOULD BE DETRIMENTAL TO THE HOSPICE. THE EXECUTIVE COMMITTEE MAY NOT ACT IN THE FOLLOWING: 1. AMENDING THE ARTICLES OF INCORPORATION OR THE BYLAWS; 2. APPROVING A PLAN OF MERGER OR CONSOLIDATION; 3. FILLING VACANCIES ON THE HOSPICE BOARD OF THE FOUNDATION BOARD OR REMOVING DIRECTORS OR OFFICERS OF EACH BOARD FROM OFFICE; 4. APPOINTING OR REMOVING MEMBERS OF THE EXECUTIVE COMMITTEE; 5. APPOINTING OR REMOVING ANY OFFICER, THE MEDICAL DIRECTOR OR THE PRESIDENT/CEO, WITHOUT THE APPROVAL OF A MAJORITY OF THE BOARD; 6. APPROVING SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, THE PROPERTY OR ASSETS OF THE HOSPICE; OR 7. APPROVING VOLUNTARY DISSOLUTION OF THE HOSPICE OR FOUNDATION, OR REVOCATION OF VOLUNTARY DISSOLUTION PROCEEDINGS. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS REVIEWED BY THE PRESIDENT AND MEMBERS OF THE FINANCE COMMITTEE BEFORE FILING. THE CHAIRMAN GIVES A SUMMARY REPORT TO THE BOARD. A COPY OF THE FORM 990 IS PROVIDED TO THE GOVERNING BODY PRIOR TO FILING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL INDIVIDUALS, UPON APPOINTMENT TO THE BOARD OF DIRECTORS, ANY BOARD DESIGNATED COMMITTEE, OR MONTGOMERY HOSPICE STAFF OR VOLUNTEER POSITION, SHALL BE REQUIRED TO EXAMINE AND SIGN AN INDIVIDUAL STATEMENT REGARDING CONFLICT OF INTEREST. IN THE EVENT A CONFLICT OF INTEREST OR POTENTIAL CONFLICT ARISES, THE CONFLICT OF INTEREST STATEMENT MUST PROMPTLY BE UPDATED AND BROUGHT TO THE ATTENTION OF THE PRESIDENT/CEO AND/OR CHAIRMAN OF THE BOARD. IF THE MATTER CONCERNS A STAFF MEMBER OR VOLUNTEER, THE CHANGE SHOULD BE PRESENTED TO THE INDIVIDUAL'S SUPERVISOR. THE INDIVIDUAL BOARD MEMBERS, WHO HAVE A CONFLICT OF INTEREST WITH THEIR CURRENT BUSINESS RELATIONSHIP AND THE HOSPICE, WILL WITHDRAW THEMSELVES FROM BOARD DISCUSSIONS AND VOTING. | |
| FORM 990, PART VI, SECTION B, LINE 15A | REVIEW FOR PRESIDENT (CEO) IS CONDUCTED ANNUALLY BY THE EXECUTIVE COMMITTEE MEMBERS. MEMBERS MAY INTERVIEW PRESIDENT'S COLLEAGUES CONCERNING THEIR INTERACTION AND RELATIONSHIP WITH PRESIDENT. OTHER ANALYSIS INCLUDE WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE EXECUTIVE COMMITTEE. 2011 WAS THE MOST RECENT YEAR IN WHICH THE COMPENSATION PROCESS WAS REVIEWED. KEY EMPLOYEES ARE GIVEN ANNUAL PERFORMANCE REVIEWS BY THEIR IMMEDIATE SUPERVISOR INCLUDING CEO. THE PERFORMANCE SUMMARY IS REVIEWED AND DISCUSSED WITH THE CEO. AN ANALYSIS OF COMPARABLE STAFF POSITIONS AND SIMILAR HOSPICE ORGANIZATIONS IS DONE BY HR DEPARTMENT. DATA FROM BENCHMARK REPORTS PROVIDED BY NHPCO AND MVI ARE ALSO USED IN THIS ANALYSIS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AND ALSO SUMMARIZED ON THE ORGANIZATION'S WEBSITE. | |
| FORM 990, PART XI, LINE 5: | INTERCOMPANY CHARGE 90,000. TOTAL TO FORM 990, PART XI, LINE 5: 90,000. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2C: | THE PROCESS FOR SELECTION AND OVERSIGHT OF THE INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM PRIOR YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONTGOMERY HOSPICE FOUNDATION INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1355 PICCARD DRIVE 100 | AddressLine1 |
| City | ROCKVILLE | City |
| State | MD | State |
| ZIP Code | 20850 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 521664426 | EIN |
| Primary Activities | CHARITABLE FOUNDATION FOR THE BENEFIT OF THE HOSPICE | PrimaryActivities |
| Legal Domicile State | MD | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | LINE 11B, II | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONTGOMERY HOSPICE FOUNDATION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionType |
| Amount Involved | 1143592 | AmountInvolved |
| Method Of Amt Determination | CASH VALUE | MethodOfAmtDetermination |
Comments