2012-09-27T15:33:43-05:00 2011-12-31 133385019 O'CONNOR DAVIES MUNNS & DOBBINS LLP 555 HUDSON VALLEY AVENUE SUITE 106 NEW WINDSOR NY 12553 990 2011-01-01 141703185 HOSPICE OF ORANGE AND SULLIVAN COUNTIES INC HOSP 8455616111 800 STONY BROOK COURT NEWBURGH NY 12550 DAN GRADY 8455616111 2012-09-20 1 GARRETT HIGGINS P00543209 8452202400 2011 2016-02-24 21:20:13Z DAN GRADY 800 STONY BROOK COURT NEWBURGH NY 12550 13920632 0 X HOSPICEOFORANGE.COM X 1988 NY THE PRINCIPAL PURPOSE OF THE ORGANIZATION IS TO PROVIDE HOSPICE SERVICES. 21 21 177 166 0 0 716385 921031 9941895 10803439 535621 182402 177171 38433 11371072 11945305 0 0 0 0 5489037 6110857 0 0 87639 5353738 5432683 10842775 11543540 528297 401765 13092364 13156799 4188174 4142499 8904190 9014300 X HOSPICE OF ORANGE AND SULLIVAN COUNTIES, INC. PROVIDES PHYSICAL, EMOTIONAL AND SPIRITUAL CARE FOR PATIENTS WITH LIFE LIMITING DISEASES AND THEIR FAMILIES. SERVICES ARE COORDINATED THROUGH A TEAM OF PROFESSIONALS, WHICH INCLUDES NURSES, SOCIAL WORKERS, PHYSICIANS, PASTORAL CARE, VOLUNTEERS AND RELATED THERAPISTS. 0 0 9334879 10803439 HOSPICE OF ORANGE & SULLIVAN COUNTIES, INC. IS A SPECIALIZED PATIENT CARE PROGRAM THAT PROVIDES PHYSICAL, EMOTIONAL, AND SPIRITUAL CARE FOR PATIENTS WITH LIFE LIMITING DISEASES AND THEIR FAMILIES. IN 2011, HOSPICE PROVIDED 49,712 DAYS OF CARE TO 1,048 PATIENTS AND THEIR FAMILIES. HOSPICE ALSO HAS THE KAPLAN FAMILY HOSPICE RESIDENCE WHICH CAN HOUSE UP TO 11 PATIENTS AT ONE TIME. IN 2011, THE KAPLAN FAMILY HOSPICE RESIDENCE SERVED 159 PATIENTS OVER 3,300 PATIENT DAYS. 9334879 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 72 0 0 177 1 0 0 0 0 0 1 1 0 0 0 0 X 21 21 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X X JEANNE MALTES 8455616111 800 STONY BROOK COURT NEWBURGH NY 12550 A VINCENT MAZZIE 5.00 X X 0 0 0 BARBARA NARU 5.00 X X 0 0 0 CHARLES MILICH 1.00 X 0 0 0 THOMAS P SULLIVAN 1.00 X X 0 0 0 DR JOSEPH LAUTERSTEIN 1.00 X 0 0 0 FRANK PHILLIPS 1.00 X 0 0 0 GLEN L HELLER 5.00 X X 0 0 0 HON ANTHONY T KANE 4.00 X X 0 0 0 HON JEFFERY G BERRY 1.00 X X 0 0 0 IAN RIEGER 1.00 X 0 0 0 JOAN P KAPLAN 2.00 X X 0 0 0 JOHN D'AMBROSIO 2.00 X X 0 0 0 LEWIS KLUGMAN 1.00 X 0 0 0 MARY BONURA 5.00 X 0 0 0 PRESTON L FELTON 1.00 X 0 0 0 RONALD BARTON 3.00 X X 0 0 0 SUE NAJORK 2.00 X 0 0 0 WILLIAM RICHARDS 2.00 X 0 0 0 JOSEPH SMITH 3.00 X 0 0 0 ANN SAKAC SR 1.00 X 0 0 0 MYRIAM LOOR 1.00 X 0 0 0 DANIEL GRADY 37.50 X 170385 0 19866 GAIL BURTON 37.50 X 123061 0 10108 293446 0 29974 2 0 1 0 SULLIVAN COUNTY ADULT CARE CENTER PO BOX 671 LIBERTY NY 12754 NURSING HOME SERVICES 241249 UNIDINE CORPORATION PO BOX 60479 CHARLOTTE NC 282600479 FOOD SERVICE 134605 HUDSON VALEY HOSPITAL PHYSICIANS PLLC 707 EAST MAIN STREET MIDDLETOWN NY 10940 PHYSICIAN SERVICES 118008 NEW HOPE COMMUNITY INC PO BOX 289 LOCH SHELDRAKE NY 12759 NURSING HOME SERVICES 105962 ELANT AT GOSHEN INC 46 HARRIMAN DRIVE GOSHEN NY 10924 NURSING HOME SERVICES 104530 5 37328 247775 40224 595704 921031 HOSPICE SERVICES 900099 10803439 10803439 10803439 200637 200637 1788677 1806912 -18235 -18235 -18235 105977 247775 143415 -37438 -37438 54180 25000 29180 29180 BAD DEBT RECOVERY 900099 37953 37953 OTHER INCOME 900099 8738 8738 46691 11945305 10803439 0 220835 323330 99367 209499 14464 4619111 3611601 955913 51597 88929 69613 18307 1009 615501 473582 134672 7247 463986 335310 122864 5812 52935 52935 21000 21000 1421 1421 627890 597754 30136 70672 70672 321405 235370 85688 347 162592 26364 136228 123875 93588 29530 757 271061 250899 19010 1152 14069 14069 67479 40487 26317 675 286486 171891 111730 2865 53302 31981 20788 533 INPATIENT SERVICES 918363 918363 PHARMACY 885458 885458 NURSING HOME ROOM AND B 862670 862670 DURABLE MEDICAL EQUIPME 552341 552341 139664 78240 60243 1181 11543540 9334879 2121022 87639 35296 35055 958702 1375845 458313 232898 1638976 1601214 103771 49768 6861755 1599519 5127673 5262236 4766087 4596237 3546 3546 13092364 13156799 1765575 1814369 90662 47928 2318852 1911088 13085 12948 0 356166 4188174 4142499 X 5256288 5175522 357714 596406 3290188 3242372 8904190 9014300 13092364 13156799 X 401765 -291655 X X 0 1 1 X 0 X 950488 953376 623490 716385 921031 4164770 8998333 8878338 9828761 10251112 10963596 48920140 9948821 9831714 10452251 10967497 11884627 53084910 50000 25887 75887 0 50000 25887 75887 53009023 223921 247874 228723 225430 200637 1126585 223921 247874 228723 225430 200637 1126585 3683 846 9212 46691 60432 10176425 10080434 10690186 11192927 12131955 54271927 0.97670 0.94910 0.02080 0.02000 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME BAD DEBT RECOVERY RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 0 0 1 3645 3645 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: OTHER LOBBYING ACTIVITIES INCLUDE DUES PAID TO THE NATIONAL AND STATE HOSPICE AND PALLIATIVE CARE ASSOCIATIONS. IN ADDITION, THE CEO SPENT TIME IN WASHINGTON DC LOBBYING THE NATIONAL HOSPICE AND PALLIATIVE CARE ORGANIZATION TO SET THE 2011 PRIORITIES FOR THE PUBLIC POLICY INITIATIVE. 4967375 197233 -310190 71000 4783418 4583588 22436 402209 5008233 3891794 106630 585164 4583588 4679272 188503 -975981 3891794 0.24000 0.76000 0 0 388933 388933 5271531 902951 4368580 885535 504189 381346 315756 192379 123377 5262236 WORKERS' COMPENSATION TRUST OBLIGATION 356166 356166 11945305 11543540 401765 -314730 23075 -291655 110110 11592622 -314730 -314730 11907352 37953 37953 11945305 11505587 0 11505587 37953 37953 11543540 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: HOSPICE MAINTAINS VARIOUS DONOR-RESTRICTED ENDOWMENT FUNDS AND BOARD DESIGNATED QUASI-ENDOWMENT FUNDS WHOSE PURPOSE IS TO PROVIDE LONG TERM SUPPORT FOR HOSPICE PROGRAMS. DURING 2011, HOSPICE CORRECTED ERRORS IN THE CLASSIFICATION OF ITS NET ASSETS REPORTED AT DECEMBER 31, 2010. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: HOSPICE RECOGNIZES THE EFFECTS OF INCOME TAX POSITIONS ONLY IF THEY ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT HOSPICE HAS NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION AND/OR DISCLOSURE. HOSPICE IS NO LONGER SUBJECT TO EXAMINATIONS BY APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO DECEMBER 31, 2008. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT RECOVERY 37,953. PART XIII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT RECOVERY 37,953. PART XI, LINE 7: DURING 2011, THE HOSPICE CORRECTED ERRORS IN THE CLASSIFICATION OF ITS NET ASSETS REPORTED AT DECEMBER 31, 2010. THESE ERRORS RESULTED IN A $23,075 PRIOR PERIOD ADJUSTMENT. GOLF OUTING 63800 49700 14100 5555 8896 5193 ANNUAL GALA 157575 114785 42790 245 39072 3800 6130 6 132377 83290 49087 74524 353752 247775 105977 245 5555 47968 3800 85847 143415 -37438 54180 25000 0 54180 25000 25000 29180 NY 1 0 0 0 1.00000 JEANNE MALTES 800 STONY BROOK COURT NEWBURGH NY 12550 0 0 X X X X 0 0 0 0 0 0 0 0 0 DANIEL GRADY 170385 0 0 0 0 0 3408 0 16458 0 190251 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 HOSPICE OF ORANGE AND SULLIVAN COUNTIES, INC. HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. WHEN THE FORM 990 HAS BEEN PREPARED, REVIEWED BY THE OUTSIDE ACCOUNTANTS AND IS READY TO BE FILED WITH THE INTERNAL REVENUE SERVICE, IT IS ELECTRONICALLY SENT TO THE VP OF FINANCE OF THE ORGANIZATION. ANY QUESTIONS OR CHANGES ARE PROVIDED TO THE OUTSIDE ACCOUNTANTS. A REVISED COPY OF THE FORM 990 IS THEN ELECTRONICALLY SENT TO THE TREASURER AND CHAIRMAN OF THE BOARD FOR REVIEW. AFTER THEIR REVIEW IS COMPLETE, A COPY IS PROVIDED TO THE BOARD MEMBERS, AND THE RETURN IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS APPLICABLE TO ALL HOSPICE PERSONNEL, AS WELL AS MEMBERS OF THE GOVERNING BODY AND ADVISORY BOARDS. EACH MEMBER OF THE GOVERNING BODY IS REQUIRED TO SIGN AN ANNUAL DISCLOSURE STATEMENT WHICH STATES IF THEY BELIEVE THAT THEY HAVE ANY ACTUAL OR POTENTIAL CONFLICTS. IF A CONFLICT WERE TO ARISE DURING THE YEAR, THE INDIVIDUAL MUST MAKE THE PRESIDENT/CEO OF THE ORGANIZATION AWARE OF THE CONFLICT IN WRITING. THE PRESIDENT/CEO MAKES A DECISION ON HOW TO PROCEED WITH THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION FOR THE ORGANIZATION'S CEO AND VICE PRESIDENT/COO IS APPROVED BY THE BOARD AFTER AN INTERNAL REVIEW IS COMPLETED. THE ORGANIZATION USES THE FOLLOWING ITEMS TO HELP AID IN DETERMINING THE APPROPRIATE COMPENSATION: FORM 990S OF OTHER ORGANIZATION THAT ARE SIMILAR IN SIZE AND OPERATIONS, AND A COMPENSATION SURVEY OR STUDY. AFTER THE BOARD REVIEWS THIS INFORMATION, AN APPROPRIATE SALARY IS DETERMINED BY THE BOARD FOR THAT POSITION AND APPROVED. THIS PROCESS WAS LAST UNDERTAKEN IN 2011. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. THE RETURN IS POSTED ON GUIDESTAR.ORG AND OTHER SIMILAR TYPES OF WEBSITES. IN ADDITION, THE FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, ARTICLES OF INCORPORATION AND BY-LAWS ARE ALSO AVAILABLE UPON WRITTEN REQUEST OR BY CALLING THE ORGANIZATION DIRECTLY. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -314,730. PRIOR PERIOD ADJUSTMENTS: 23,075. TOTAL TO FORM 990, PART XI, LINE 5: -291,655. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS DID NOT CHANGE FROM THE PRIOR YEAR.