HOSPICE OF THE HIGHLAND RIM FOUNDATION INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
HOSPICE OF THE HIGHLAND RIM FOUNDATION INC (EIN 62-1874162)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-06-14
IRS object ID
201221669349300727
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

FieldValueIRS element (for citing)
Timestamp2012-06-14T13:59:27-00:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Anchor Accounting and Financial Services PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1925 N Washington StreetAddressLine1
CityTullahomaCity
StateTNState
ZIP Code37388ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN621874162EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Hospice of the Highland Rim Foundation IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHOSPNameControl
Phone9314559118Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1110 East Lauderdale StreetAddressLine1
CityTullahomaCity
StateTNState
ZIP Code37388ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMerry WeisName
TitlePresidentTitle
Date Signed2012-06-14DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameCameron L Ray CPAName
Phone9314551380Phone
Date Prepared2012-06-14DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMerry WeisNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1110 East Lauderdale StreetAddressLine1
CityTullahomaCity
StateTNState
ZIP Code37388ZIPCode
FieldValueIRS element (for citing)
Gross Receipts527473GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Year Formation2006YearFormation
State Legal DomicileTNStateLegalDomicile
Activity Or Mission DescriptionThe Hospice Foundation provides for medical expenses for individuals who are in the last stages of terminal illnesses.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees1TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year24615ProgramServiceRevenuePriorYear
Program Service Revenue CY23336ProgramServiceRevenueCY
Investment Income Prior Year-33873InvestmentIncomePriorYear
Investment Income Current Year80605InvestmentIncomeCurrentYear
Other Revenue Prior Year3519OtherRevenuePriorYear
Other Revenue Current Year11630OtherRevenueCurrentYear
Total Revenue Prior Year-5739TotalRevenuePriorYear
Total Revenue Current Year115571TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year22133GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY26439GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year30470SalariesEtcPriorYear
Salaries Etc Current Year29371SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year14503OtherExpensePriorYear
Other Expenses Current Year12567OtherExpensesCurrentYear
Total Expenses Prior Year67106TotalExpensesPriorYear
Total Expenses Current Year68377TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-72845RevenuesLessExpensesPriorYear
Revenues Less Expenses CY47194RevenuesLessExpensesCY
Total Assets BOY1064142TotalAssetsBOY
Total Assets EOY1111336TotalAssetsEOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1064142NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1111336NetAssetsOrFundBalancesEOY
Mission DescriptionTo assist families who are dealing with terminal illnesses by providing in home medical support.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense57439Expense
DescriptionThe Hospice Foundation assisted 51 terminally ill patients in the final stages of lifeDescription
Total Program Service Expense57439TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingtrueProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddresstrueOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledTNStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMerry WeisNamePerson
Telephone Number9314559118TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1110 East Lauderdale StreetAddressLine1
CityTullahomaCity
StateTNState
ZIP Code37388ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (4 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployee
Merry Weis
President010.00XX000
Fran Gray
Secretary010.00XX000
Joan Gladney
Treasurer010.00XX000
Jennifer Lazenby
Office040.002496000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org24960TotalReportableCompFromOrg
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionMedical paymentsDescription
Business Code621610BusinessCode
Total Revenue Column23336TotalRevenueColumn
FieldValueIRS element (for citing)
Total Program Service Revenue23336TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column104087TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities387500Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities410982Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-23482Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-23482TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Income Fundraising Events12550GrossIncomeFundraisingEvents
Fundraising Direct Expenses920FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column11630TotalRevenueColumn

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column115571TotalRevenueColumn

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total26439Total
Program Services26439ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total24960Total
Program Services24960ProgramServices

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total0Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3000Total
Program Services3000ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1411Total
Program Services1411ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total790Total
Management And General790ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Fees For Services Prof FundraisingFeesForServicesProfFundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total471Total
Management And General471ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2593Total
Management And General2593ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total897Total
Program Services897ProgramServices

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total6250Total
Management And General6250ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total304Total
Management And General304ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total430Total
Management And General430ManagementAndGeneral

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Supplies732732
Non-Profit Registration Fee100100

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total68377Total
Program Services57439ProgramServices
Management And General10938ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
EOY12346EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY1064142BOY
EOY1098990EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1064142BOY
EOY1111336EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1064142BOY
EOY1111336EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1064142BOY
EOY1111336EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1064142BOY
EOY1111336EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses47194ReconcilationRevenueExpenses
Method Of Accounting CashXMethodOfAccountingCash
Accountant Compile Or ReviewtrueAccountantCompileOrReview
FS AuditedfalseFSAudited
Audit CommitteefalseAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years37812CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year24615CurrentTaxYearMinus1Year
Current Tax Year34966CurrentTaxYear
Total97393Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years37812CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year24615CurrentTaxYearMinus1Year
Current Tax Year34966CurrentTaxYear
Total97393Total
FieldValueIRS element (for citing)
Public Support Total17097393PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years30312CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year687CurrentTaxYearMinus1Year
Current Tax Year80605CurrentTaxYear
Total111604Total
FieldValueIRS element (for citing)
Total Support208997TotalSupport
Public Support Pertcentage1700.00000PublicSupportPertcentage170

Total509 Total509

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total5090PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Total0Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Total0Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
First5 Years509XFirst5Years509
Public Support Percentage5090.00000PublicSupportPercentage509
Investment Income Percentage0.00000InvestmentIncomePercentage

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsXMailSolicitations
Agreement Ref FundraisingfalseAgreementRefFundraising
Licensed StatesTNLicensedStates

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained
No Grant More Than5000XNoGrantMoreThan5000

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantMedical AssistanceTypeOfGrant
Number Of Recipients51NumberOfRecipients
Amount Of Cash Grant200AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierIIdentifier
Return Reference1ReturnReference
ExplanationAssistance to individuals does not usually exceed more than 200Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990 Part VI11Copies of Form 990 was distributed to Board of Directors in person.
Form 990 Part VI Line 11 Copies of Form 990 was distributed to Board of Directors in person.

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