EXECUTIVE DIRECTOR

2012-05-14T18:45:00-05:00 2011-12-31 931233035 ANDERSON GROUP CPAS LLC 2165 NW PROFESSIONAL DRIVE SUITE 10 CORVALLIS OR 97330 990 2011-01-01 930742686 BENTON HOSPICE SERVICE INC BENT 5417579616 2350 NW PROFESSIONAL DRIVE CORVALLIS OR 973303881 MICKY SHIELDS EXECUTIVE DIRECTOR 5417579616 2012-05-14 1 KRISTEN GOSE CPA P00037098 5417572070 X 2011 2016-02-24 21:20:13Z MICKY SHIELDS 2350 NW PROFESSIONAL DRIVE CORVALLIS OR 97330 4253665 0 X WWW.BENTONHOSPICE.ORG X 1979 OR SUPPORT FOR THE TERMINALLY ILL 17 17 49 135 0 0 394872 192280 2749854 3215816 45514 162471 11314 14360 3201554 3584927 0 0 0 0 2337431 2375882 0 0 20846 900269 1066371 3237700 3442253 -36146 142674 4778758 4674365 186047 187921 4592711 4486444 SUPPORT FOR THE TERMINALLY ILL. 0 0 2589215 3221146 BENTON HOSPICE SERVICE, INC. PROVIDES COMPREHENSIVE CARE TO PEOPLE NEARING THE END OF LIFE. HOSPICE SERVICES INCLUDE COMPASSIONATE HEALTHCARE IN THE PATIENT'S RESIDENCE AS WELL AS SUPPORT FOR THE PATIENT'S FAMILY. 353 PATIENTS WERE SERVED DURING 2011. THE TRANSITIONS PROGRAM PROVIDES NO-COST CASE MANAGEMENT AND VOLUNTEER SUPPORT TO THOSE WITH A LIFE-LIMITING ILLNESS WHO ARE NOT YET ELIGIBLE FOR HOSPICE SERVICES. 60 CLIENTS WERE SERVED DURING 2011. 2589215 1 1 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 29 0 49 1 0 0 0 0 0 0 0 0 0 0 X 17 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 OR X MICKY SHIELDS 5417579616 2350 NW PROFESSIONAL DRIVE CORVALLIS OR 97330 JOHN BACON MSW BOARD MEMBER 1.00 X 0 0 0 COURTNEY CAMPBELL PHD BOARD MEMBER 1.00 X 0 0 0 SHEILA GOODWIN VICE CHAIR 2.00 X X 0 0 0 GARY DELANDER PHD BOARD MEMBER 1.00 X 0 0 0 DINA LINDQUIST BOARD MEMBER 1.00 X 0 0 0 SIMON JUSTICE BOARD MEMBER 1.00 X 0 0 0 JEANNE SMITH JD BOARD MEMBER 1.00 X 0 0 0 KAY SCHAFFER PHD CHAIR 2.00 X X 0 0 0 LIA MCCABE BOARD MEMBER 1.00 X 0 0 0 JASON PHILLIPS MD BOARD MEMBER 1.00 X 0 0 0 SCOTT MEEKER CPA TREASURER 2.00 X X 0 0 0 DEB ROSE BOARD MEMBER 1.00 X 0 0 0 CHRISTINE SMITH BOARD MEMBER 1.00 X 0 0 0 BARBARA SWAIN BOARD MEMBER 1.00 X 0 0 0 BRUCE THOMPSON MD BOARD MEMBER 1.00 X 0 0 0 TAMINA TORAY PHD SECRETARY 2.00 X X 0 0 0 GABRIELE FORD RN BOARD MEMBER 1.00 X 0 0 0 MICKY SHIELDS EXECUTIVE DIRECTOR 40.00 X X 92407 0 13543 LUCY NOONE EXECUTIVE DIRECTOR 40.00 X X 24688 0 3914 117095 0 17457 0 0 0 0 0 192280 3816 192280 HEALTH CARE 624100 3215816 3215816 3215816 96881 96881 535 535 732783 667491 237 65292 -237 65055 65055 10040 1010 9030 9030 MISCELLANEOUS REVENUE 624100 5330 5330 5330 3584927 3221146 0 171501 134552 131910 2642 1780342 1428173 344720 7449 133765 106392 27373 186261 138720 47171 370 140962 109053 31180 729 9086 9086 32758 32758 56306 49099 7207 15450 5794 9656 51061 24283 26778 46042 46042 24037 24037 66173 64328 1845 19956 19956 50656 28290 22366 15128 15128 PHARMACEUTICALS 214724 214724 EQUIPMENT RENTAL 118740 118740 THERAPY SERVICES 73689 73689 MEDICAL SUPPLIES 70812 70812 201753 162912 38841 3442253 2589215 832192 20846 170680 93830 4188 4190 291479 422225 991862 364064 657913 627798 3304860 3114545 296304 355092 53334 56685 4778758 4674365 183699 187921 2348 0 186047 187921 X 4590236 4486444 2475 0 4592711 4486444 4778758 4674365 X 142674 -248941 X 1 0 1 X 0 X 272740 201614 261951 394872 192280 1323457 3127152 3121109 2880747 2749854 3221146 15100008 3399892 3322723 3142698 3144726 3413426 16423465 1168 1259 2929 4008 1813 11177 32000 17825 88137 102894 240856 33168 19084 91066 106902 1813 252033 16171432 100496 113361 90555 108245 97417 510074 100496 113361 90555 108245 97417 510074 3500388 3436084 3233253 3252971 3510843 16933539 0.95500 0.94870 0.03010 0.02940 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 242043 242043 462386 117728 344658 198681 161902 36779 88752 84434 4318 627798 CERTIFICATES OF DEPOSIT 88097 F MONEY MARKET ACCOUNTS 266995 F 355092 3584927 3442253 142674 -248941 -248941 -106267 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR AND THE CHAIR OF THE FINANCE COMMITTEE OF THE BOARD PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND EXECUTIVE DIRECTOR ARE REQUIRED TO ANNUALLY DISCLOSE IN A SIGNED DOCUMENT A CONFLICT OF INTEREST STATEMENT. POTENTIAL CONFLICTS ARE BROUGHT TO THE ATTENTION OF THE CHAIR WHO IN TURN INFORMS THE BOARD. FORM 990, PART VI, SECTION C, LINE 18 AVAILABLE UPON REQUEST FROM THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST FROM THE ORGANIZATION. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -248,941.