IOWA CITY HOSPICE INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: IOWA CITY HOSPICE INC (EIN 42-1154098)
Tax period: 2011-01-01 to 2011-12-31
Filed: 2012-05-15
IRS object ID: 201211369349301321
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 D
Schedule G
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-05-15T09:34:48-05:00	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	WINKEL PARKER & FOSTER CPA PC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	1301 19TH AVE NW	AddressLine1
City	CLINTON	City
State	IA	State
ZIP Code	52732	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	421154098	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	IOWA CITY HOSPICE INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	IOWA	NameControl
Phone	3193515665	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1025 WADE STREET	AddressLine1
City	IOWA CITY	City
State	IA	State
ZIP Code	52240	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	MARGRET ELLIOTT	Name
Title	EXECUTIVE DIRECTOR	Title
Phone	3193515665	Phone
Date Signed	2012-05-04	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	PATRICK W PARKER CPA	Name
Phone	5632423440	Phone
Date Prepared	2012-05-15	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	MARGRET ELLIOTT	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	1025 WADE STREET	AddressLine1
City	IOWA CITY	City
State	IA	State
ZIP Code	52240	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	7087540	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.IOWACITYHOSPICE.COM	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1980	YearFormation
State Legal Domicile	IA	StateLegalDomicile
Activity Or Mission Description	TO BE THE LEADERS IN PROVIDING EXCEPTIONAL PATIENT-CENTERED, END-OF-LIFE CARE AND GRIEF SUPPORT TO ANYONE AFFECTED BY A TERMINAL ILLNESS.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	13	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	13	NbrIndependentVotingMembers
Total Nbr Employees	87	TotalNbrEmployees
Total Nbr Volunteers	600	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	607518	ContributionsGrantsPriorYear
Contributions Grants Current Year	548653	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	5248338	ProgramServiceRevenuePriorYear
Program Service Revenue CY	6509182	ProgramServiceRevenueCY
Investment Income Prior Year	24591	InvestmentIncomePriorYear
Investment Income Current Year	29705	InvestmentIncomeCurrentYear
Other Revenue Current Year	0	OtherRevenueCurrentYear
Total Revenue Prior Year	5880447	TotalRevenuePriorYear
Total Revenue Current Year	7087540	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	2684500	SalariesEtcPriorYear
Salaries Etc Current Year	3189506	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	121402	TotalFundrsngExpCurrentYear
Other Expense Prior Year	2948669	OtherExpensePriorYear
Other Expenses Current Year	3280321	OtherExpensesCurrentYear
Total Expenses Prior Year	5633169	TotalExpensesPriorYear
Total Expenses Current Year	6469827	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	247278	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	617713	RevenuesLessExpensesCY
Total Assets BOY	3268319	TotalAssetsBOY
Total Assets EOY	4119267	TotalAssetsEOY
Total Liabilities BOY	945938	TotalLiabilitiesBOY
Total Liabilities EOY	1171160	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	2322381	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	2948107	NetAssetsOrFundBalancesEOY
Mission Description	TO BE THE LEADERS IN PROVIDING EXCEPTIONAL PATIENT-CENTERED, END-OF-LIFE CARE AND GRIEF SUPPORT TO ANYONE AFFECTED BY A TERMINAL ILLNESS.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	5248137	Expense
Revenue	6509182	Revenue
Description	COORDINATION, FACILITATION, AND PROVISION OF SERVICES TO TERMINALLY ILL PATIENTS PRIMARILY AT HOME PROVISION OF BEREAVEMENT COUNSELING AND SERVICES TO FAMILY AND CLOSE FRIENDS OF TERMINALLY ILL PATIENTS.	Description
Total Program Service Expense	5248137	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	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	true	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	true	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	true	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	false	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	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	false	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	3	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	87	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
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Form8899 Filed	false	Form8899Filed
Form1098 C Filed	false	Form1098CFiled
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	13	NbrVotingGoverningBodyMembers
Number Independent Voting Members	13	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	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	MARGRET ELLIOTT	NamePerson
Telephone Number	3196884212	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1025 WADE STREET	AddressLine1
City	IOWA CITY	City
State	IA	State
ZIP Code	52240	ZIPCode

Field	Value	IRS element (for citing)
No Listed Persons Compensated	X	NoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer
MARY ADAMEK
DIRECTOR	1.00	X	0	0	0
TARA CLARK
DIRECTOR	1.00	X	0	0	0
DEAN CARRINGTON
DIRECTOR	1.00	X	0	0	0
ALLISON LAW
DIRECTOR	1.00	X	0	0	0
ELIZABETH COULTER
SECRETARY	1.00	X	0	0	0	X
BRAD LANGGUTH
DIRECTOR	1.00	X	0	0	0
ELI WYNES
DIRECTOR	1.00	X	0	0	0
LORI LEGGINS
CHAIR-ELECT	1.00	X	0	0	0	X
CINDY PENNEY
CHAIR	1.00	X	0	0	0	X
STEVE ROE
PAST-CHAIR	1.00	X	0	0	0	X
DOUG RUPPERT
DIRECTOR	1.00	X	0	0	0
BRUCE VANHOUWELING
DIRECTOR	1.00	X	0	0	0
MIKE MESSIER
TREASUER	1.00	X	0	0	0	X

Field	Value	IRS element (for citing)
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources
Fundraising Events	265813	FundraisingEvents
All Other Contributions	282840	AllOtherContributions
Total Contributions	548653	TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICARE/MEDICAID PAYMENTS	6115258	6115258
PRIVATE INSURANCE	393924	393924

Field	Value	IRS element (for citing)
Total Program Service Revenue	6509182	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	29705	TotalRevenueColumn
Exclusion	$29,705	ExclusionAmount

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	7087540	TotalRevenueColumn
Related Or Exempt Function Income	6509182	RelatedOrExemptFunctionIncome
Exclusion	$29,705	ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	2596560	Total
Program Services	1875456	ProgramServices
Management And General	665873	ManagementAndGeneral
Fundraising	55231	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	370259	Total
Program Services	273755	ProgramServices
Management And General	89113	ManagementAndGeneral
Fundraising	7391	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	222687	Total
Program Services	160843	ProgramServices
Management And General	57107	ManagementAndGeneral
Fundraising	4737	Fundraising

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	12228	Total
Management And General	12228	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	49941	Total
Program Services	49941	ProgramServices

Advertising Advertising

Field	Value	IRS element (for citing)
Total	114805	Total
Program Services	41836	ProgramServices
Management And General	20466	ManagementAndGeneral
Fundraising	52503	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	193530	Total
Program Services	55421	ProgramServices
Management And General	138109	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	27995	Total
Management And General	27995	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	179439	Total
Program Services	172358	ProgramServices
Management And General	7081	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	35884	Total
Program Services	35884	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	158828	Total
Program Services	119327	ProgramServices
Management And General	39501	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
MEDICAL SUPPLIES	853071	853071
NURSING HOME FEES	610085	610085
HOSPITAL INPATIENT	518817	518817
MEDICATIONS	365855	365855

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	159843	Total
Program Services	115488	ProgramServices
Management And General	42815	ManagementAndGeneral
Fundraising	1540	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	6469827	Total
Program Services	5248137	ProgramServices
Management And General	1100288	ManagementAndGeneral
Fundraising	121402	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	1110	BOY
EOY	1410	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	787699	BOY
EOY	1284818	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	744229	BOY
EOY	619747	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	5118	BOY
EOY	5184	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	1824301	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	705222	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	1011901	BOY
EOY	1119079	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	718262	BOY
EOY	1089029	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	3268319	BOY
EOY	4119267	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	368812	BOY
EOY	434706	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	577126	BOY
EOY	736454	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	945938	BOY
EOY	1171160	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	2314229	BOY
EOY	2925438	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	8152	BOY
EOY	22669	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	2322381	BOY
EOY	2948107	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	3268319	BOY
EOY	4119267	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	617713	ReconcilationRevenueExpenses
Reconcilation Other Changes	8013	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org170b1 Avi	X	PubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	631719	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	900918	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	624865	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	607518	CurrentTaxYearMinus1Year
Current Tax Year	548653	CurrentTaxYear
Total	3313673	Total

Total170 Total170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	631719	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	900918	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	624865	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	607518	CurrentTaxYearMinus1Year
Current Tax Year	548653	CurrentTaxYear
Total	3313673	Total

Field	Value	IRS element (for citing)
Public Support Total170	3313673	PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	19601	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	28704	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	25090	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	24591	CurrentTaxYearMinus1Year
Current Tax Year	29705	CurrentTaxYear
Total	127691	Total

Field	Value	IRS element (for citing)
Total Support	3441364	TotalSupport
Gross Receipts From Admissions Etc	6509182	GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage170	0.96290	PublicSupportPertcentage170
Public Support Pertcent Prior Year	0.96010	PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170	X	ThirtyThreePercntTestsCY170

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

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

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	718262	BeginningOfYearBalance
Contributions	368748	Contributions
Investment Earnings Or Losses	14848	InvestmentEarningsOrLosses
Administrative Expenses	12829	AdministrativeExpenses
End Of Year Balance	1089029	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	632184	BeginningOfYearBalance
Contributions	13860	Contributions
Investment Earnings Or Losses	81806	InvestmentEarningsOrLosses
Administrative Expenses	9588	AdministrativeExpenses
End Of Year Balance	718262	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	522800	BeginningOfYearBalance
Contributions	620	Contributions
Investment Earnings Or Losses	117575	InvestmentEarningsOrLosses
Administrative Expenses	8811	AdministrativeExpenses
End Of Year Balance	632184	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	1.00000	BoardDesignatedEOYBalance
Endowments Held By Unrelated Orgs	true	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	false	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	false	AreRelatedOrgsListedScheduleR

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	140000	OtherCostOrOtherBasis
Book Value	140000	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	500401	OtherCostOrOtherBasis
Depreciation	193945	Depreciation
Book Value	306456	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1183900	OtherCostOrOtherBasis
Depreciation	511277	Depreciation
Book Value	672623	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	1119079	TotalOfBookValueLandBuildings

Other Assets OtherAssets

Field	Value	IRS element (for citing)
Description	BENEFICIAL INTEREST IN ENDOWMENT	Description
Book Value	1089029	BookValue

Field	Value	IRS element (for citing)
Total Book Value Other Assets	1089029	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescription	AmountAmount
LEASE PAYABLE	$599,608
ACCRUED PTO	$116,664
ACCRUED WAGES	$20,182

Field	Value	IRS element (for citing)
Total Of Amounts	736454	TotalOfAmounts
Total Revenue	7087540	TotalRevenue
Total Expenses	6469827	TotalExpenses
Excess Or Deficit For Year	617713	ExcessOrDeficitForYear
Prior Period Adjustments	10827	PriorPeriodAdjustments
Other	-$2,814	OtherAmount
Total Adjustments	8013	TotalAdjustments
Excess Or Deficit Per FS	625726	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	7084726	TotRevenueEtcAuditedFinclStmt
Other Revenues	-2814	OtherRevenues
Revenue Not Rptd F990	-2814	RevenueNotRptdF990
Revenue Subtotal	7087540	RevenueSubtotal
Total Revenue Per Form990	7087540	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	6459000	TotExpensesEtcAuditedFinclStmt
Prior Year Adjustments	-10827	PriorYearAdjustments
Expenses Not Rptd F990	-10827	ExpensesNotRptdF990
Expenses Subtotal	6469827	ExpensesSubtotal
Total Expenses Per Form990	6469827	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
INTENDED USES FOR ENDOWMENT FUNDS	SCHEDULE D, PAGE 2, PART V, LINE 4	THE ENDOWMENT FUNDS WAS ESTABLISHED TO SERVE AS THE REPOSITORY OF GIFTS SPECIFICALLY DESIGNATED TO SUCH FUND. THE FUND IS MAINTAINED IN PERPETUITY. ANNUALLY THE BOARD OF DIRECTORS DETERMINE WHAT PORTION OF THE NET APPRECIATION OF THE ENDOWMENT FUND WILL BE MADE AVAILABLE TO THE ORGANIZATION FOR OPERATIONAL PURPOSES.
LIABILITY UNDER FIN 48 FOOTNOTE	SCHEDULE D, PAGE 3, PART X	THE ORGANIZATION ADOPTED THE FASB'S REQUIREMENTS FOR ACCOUNTING FOR UNCERTAIN TAX POSITIONS ON JANUARY 1, 2009. THE ORGANIZATION DETERMINED THAT IT WAS NOT REQUIRED TO RECORD A LIABILITY RELATED TO CERTAIN TAX POSITIONS AS A RESULT OF IMPLEMENTING THE NEW REQUIREMENTS.
RECONCILIATION OF CHANGES - OTHER	SCHEDULE D, PAGE 4, PART XI, LINE 8	CHANGE IN BENEFICIAL INTEREST IN ASSETS HELD BY COMM FOUND -2,814
REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHER	SCHEDULE D, PAGE 4, PART XII, LINE 2D	CHANGE IN BENEFICIAL INTEREST IN ASSETS HELD BY COMM FOUND -2,814

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	990PTVIII1C	NameOfEvent1
Gross Receipts Event1	265813	GrossReceiptsEvent1
Charitable Contributions Event1	265813	CharitableContributionsEvent1
Gross Receipts Total	265813	GrossReceiptsTotal
Charitable Contributions Total	265813	CharitableContributionsTotal

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11B	THE EXECUTIVE DIRECTOR EMAILS THE FINAL COPY OF THE FORM 990 TO THE EXECUTIVE COMMITTEE TO REVIEW BEFORE IT IS FILED.
ENFORCEMENT OF CONFLICTS POLICY	FORM 990, PAGE 6, PART VI, LINE 12C	ALL BOARD MEMBERS AND EMPLOYEES ARE REQUIRED TO DECLARE ALL CONFLICTS AT LEAST ANNUALLY.
COMPENSATION PROCESS FOR TOP OFFICIAL	FORM 990, PAGE 6, PART VI, LINE 15A	THE EXECUTIVE DIRECTOR'S COMPENSATION IS SET BY THE BOARD OF DIRECTORS.
COMPENSATION PROCESS FOR OFFICERS	FORM 990, PAGE 6, PART VI, LINE 15B	THERE ARE NO OTHER OFFICERS OR BOARD MEMBERS THAT ARE COMPENSATED.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION	FORM 990, PAGE 6, PART VI, LINE 19	IOWA CITY HOSPICE MAKES THEIR GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND FORM 990 AVAILABLE TO THE PUBLIC THROUGH REQUEST DURING NORMAL OPERATING HOURS.

IOWA CITY HOSPICE INC: Form 990, tax year 2011

Return header ReturnHeader

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Preparer Firm US Address PreparerFirmUSAddress

Filer Filer

Name Name

US Address USAddress

Officer Officer

Preparer Preparer

Form 990 IRS990

Address Principal Officer US AddressPrincipalOfficerUS

The Books Are In Care Of TheBooksAreInCareOf

Address US AddressUS

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

Program Service Revenue ProgramServiceRevenue (2 entries)

Investment Income InvestmentIncome

Total Revenue TotalRevenue

Other Salaries And Wages OtherSalariesAndWages

Other Employee Benefits OtherEmployeeBenefits

Payroll Taxes PayrollTaxes

Fees For Services Accounting FeesForServicesAccounting

Fees For Services Other FeesForServicesOther

Advertising Advertising

Office Expenses OfficeExpenses

Occupancy Occupancy

Travel Travel

Interest Interest

Depreciation Depletion DepreciationDepletion

Other Expenses OtherExpenses (4 entries)

All Other Expenses AllOtherExpenses

Total Functional Expenses TotalFunctionalExpenses

Cash Non Interest Bearing CashNonInterestBearing

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Pledges And Grants Receivable PledgesAndGrantsReceivable

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Other Assets Total OtherAssetsTotal

Total Assets TotalAssets

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Other Liabilities OtherLiabilities

Total Liabilities TotalLiabilities

Unrestricted Net Assets UnrestrictedNetAssets

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Schedule A IRS990ScheduleA

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

Total170 Total170

Gross Investment Income170 GrossInvestmentIncome170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Contributor Name Business ContributorNameBusiness

Contributor Address US ContributorAddressUS

Schedule D IRS990ScheduleD

Current Year CurrentYear

Current Year Minus1 Year CurrentYearMinus1Year

Current Year Minus2 Years CurrentYearMinus2Years

Land Land

Buildings Buildings

Equipment Equipment

Other Assets OtherAssets

Other Liabilities OtherLiabilities (3 entries)

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

Schedule G IRS990ScheduleG

Events Information EventsInformation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

Comments