STEIN HOSPICE SERVICES INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: STEIN HOSPICE SERVICES INC (EIN 34-1411008)
Tax period: 2011-01-01 to 2011-12-31
Filed: 2012-08-14
IRS object ID: 201222279349303142
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 J
Schedule L
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-08-14T14:34:12-05:00	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	PAYNE NICKLES & COMPANY	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	257 BENEDICT AVENUE BLDG D	AddressLine1
City	NORWALK	City
State	OH	State
ZIP Code	44857	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	341411008	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	STEIN HOSPICE SERVICE INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	STEI	NameControl
Phone	4196255269	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1200 SYCAMORE LINE	AddressLine1
City	SANDUSKY	City
State	OH	State
ZIP Code	44870	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	JAN W BUCHOLZ	Name
Title	CEO	Title
Phone	4196255269	Phone
Date Signed	2012-08-14	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	DAVID W BRINK CPA	Name
Phone	4196682552	Phone
Date Prepared	2012-08-14	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	JAN BUCHOLZ	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	1200 SYCAMORE LINE	AddressLine1
City	SANDUSKY	City
State	OH	State
ZIP Code	44870	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	33839448	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.STEINHOSPICE.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1983	YearFormation
State Legal Domicile	OH	StateLegalDomicile
Activity Or Mission Description	CARE FOR THE TERMINALLY ILL	ActivityOrMissionDescription
Nbr Voting Members Governing Body	18	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	17	NbrIndependentVotingMembers
Total Nbr Employees	404	TotalNbrEmployees
Total Nbr Volunteers	200	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	542486	ContributionsGrantsPriorYear
Contributions Grants Current Year	552355	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	24824164	ProgramServiceRevenuePriorYear
Program Service Revenue CY	29034340	ProgramServiceRevenueCY
Investment Income Prior Year	109490	InvestmentIncomePriorYear
Investment Income Current Year	528808	InvestmentIncomeCurrentYear
Other Revenue Prior Year	86607	OtherRevenuePriorYear
Other Revenue Current Year	173392	OtherRevenueCurrentYear
Total Revenue Prior Year	25562747	TotalRevenuePriorYear
Total Revenue Current Year	30288895	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	14916441	SalariesEtcPriorYear
Salaries Etc Current Year	16844629	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	435621	TotalFundrsngExpCurrentYear
Other Expense Prior Year	10632301	OtherExpensePriorYear
Other Expenses Current Year	12703602	OtherExpensesCurrentYear
Total Expenses Prior Year	25548742	TotalExpensesPriorYear
Total Expenses Current Year	29548231	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	14005	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	740664	RevenuesLessExpensesCY
Total Assets BOY	8416513	TotalAssetsBOY
Total Assets EOY	8978630	TotalAssetsEOY
Total Liabilities BOY	2452412	TotalLiabilitiesBOY
Total Liabilities EOY	2792237	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	5964101	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	6186393	NetAssetsOrFundBalancesEOY
Mission Description	CARE FOR THE TERMINALLY ILL	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	27452465	Expense
Revenue	29034340	Revenue
Description	DURING 2011 STEIN HOSPICE SERVICE, INC. SERVED OVER 1501 INDIVIDUALS BY PROVIDING HOSPICE AND BEREAVEMENT SERVICES TO MEET THE PHYSICIAL, EMOTIONAL AND SPIRITUAL NEEDS OF TERMINALLY ILL PATIENTS AND THEIR FAMILIES.	Description
Total Program Service Expense	27452465	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	false	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	false	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	true	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	true	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	true	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	true	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	28	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	404	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	true	QuidProQuoContributions
Quid Pro Quo Disclosure	true	QuidProQuoDisclosure
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	18	NbrVotingGoverningBodyMembers
Number Independent Voting Members	17	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	false	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
States Where Copy Of Return Is Filed	OH	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	JAN BUCHOLZ	NamePerson
Telephone Number	4196255769	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1200 SYCAMORE LINE	AddressLine1
City	SANDUSKY	City
State	OH	State
ZIP Code	44870	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Highest Compensated EmployeeHighestCompensatedEmployee
JAN BUCHOLZ
CEO	40.00	X	X	127848	0	5365
JOHN R BALL
TRUSTEE	18.00	X		0	0	0
RYAN CHANDLER
TRUSTEE	18.00	X		0	0	0
ERLE DAIL
TRUSTEE	18.00	X		0	0	0
MARCIA GOFF
TRUSTEE	18.00	X		0	0	0
MATTHEW C GROSS
TRUSTEE	18.00	X		0	0	0
TAYLOR HART
TRUSTEE	18.00	X		0	0	0
JOHN KAISER JR
TRUSTEE	18.00	X		0	0	0
DRU MEREDITH
TRUSTEE	18.00	X		0	0	0
THOMAS W MUELLER
TRUSTEE	18.00	X		0	0	0
JANET RUNNER
TRUSTEE	18.00	X		0	0	0
GARY SCHIMMEL
TRUSTEE	18.00	X		0	0	0
CHERIE M SPRAGG
TRUSTEE	18.00	X		0	0	0
DENNIS SOKOL
TRUSTEE	18.00	X		0	0	0
KEITH ADDY
PRESIDENT	18.00	X	X	0	0	0
PAUL DAUGHERTY
SECRETARY	18.00	X	X	0	0	0
JAMES C LONZ DVM
TREASURER	18.00	X	X	0	0	0
THOMAS M WOLF
VICE PRESIDE	18.00	X	X	0	0	0
JANE BRUCK
DIRECTOR OF	40.00		X	94511	0	21150
DR JAMES PRESTON
ASSOC. MEDIC	40.00			163268	0	18880	X
CHRIS SMITH
PHARMACIST	40.00			145180	0	22113	X
DR WILLIAM INGLIS
MEDICAL DIR.	40.00			110911	0	10056	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	641718	TotalReportableCompFromOrg
Total Other Compensation	77564	TotalOtherCompensation
Number Individuals GT100 K	4	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
ANTHEM
PO BOX 105673	ATLANTA	GA	303485673	INSURANCE	2308000
OHIO VETERANS HOME
3416 COLUMBUS AVE	SANDUSKY	OH	44870	SUPPORT SERVICE	750000
MARK ADVERTISING
PO BOX 413	SANDUSKY	OH	44870	ADVERTISING	630000
NORWALK MEMORIAL HOME
272 BENEDICT AVE	NORWALK	OH	44857	SUPPORT SERVICE	625000
FIRELANDS REGINAL MEDICAL CENTER
1111 HAYES AVE	SANDUSKY	OH	44870	SUPPORT SERVICE	620000

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	21	NumberOfContractorsGT100K
Federated Campaigns	4683	FederatedCampaigns
Fundraising Events	27091	FundraisingEvents
All Other Contributions	520581	AllOtherContributions
Total Contributions	552355	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICARE	621610	22865949	22865949
MEDICAID	621610	4221525	4221525
INSURANCE	621610	1033442	1033442
NON REIMBURSABLE SERVICE	621610	538612	538612
MISCELLANEOUS PATIENT REVENUE	621610	353618	353618

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	21194	TotalRevenueColumn
Related Or Exempt Function Income	21194	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	29034340	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	68579	TotalRevenueColumn
Exclusion	$68,579	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	3929181	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	3463461	Securities
Other	5491	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	465720	Securities
Other	-5491	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	460229	TotalRevenueColumn
Related Or Exempt Function Income	460229	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	254993	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	27091	CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses	81601	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	173392	TotalRevenueColumn
Exclusion	$173,392	ExclusionAmount

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	30288895	TotalRevenueColumn
Related Or Exempt Function Income	29494569	RelatedOrExemptFunctionIncome
Exclusion	$241,971	ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	248874	Total
Program Services	228964	ProgramServices
Management And General	14933	ManagementAndGeneral
Fundraising	4977	Fundraising

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	12990410	Total
Program Services	11916690	ProgramServices
Management And General	823136	ManagementAndGeneral
Fundraising	250584	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	229338	Total
Program Services	210991	ProgramServices
Management And General	13761	ManagementAndGeneral
Fundraising	4586	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	1984469	Total
Program Services	1825712	ProgramServices
Management And General	119067	ManagementAndGeneral
Fundraising	39690	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	1391538	Total
Program Services	1280215	ProgramServices
Management And General	83492	ManagementAndGeneral
Fundraising	27831	Fundraising

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	15711	Total
Management And General	15711	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	36966	Total
Program Services	388	ProgramServices
Management And General	36578	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	13019	Total
Management And General	13019	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	253534	Total
Program Services	91475	ProgramServices
Management And General	162059	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	679308	Total
Program Services	543446	ProgramServices
Management And General	67931	ManagementAndGeneral
Fundraising	67931	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	163758	Total
Program Services	114056	ProgramServices
Management And General	40197	ManagementAndGeneral
Fundraising	9505	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	143921	Total
Program Services	107941	ProgramServices
Management And General	28784	ManagementAndGeneral
Fundraising	7196	Fundraising

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	464784	Total
Program Services	404362	ProgramServices
Management And General	55774	ManagementAndGeneral
Fundraising	4648	Fundraising

Travel Travel

Field	Value	IRS element (for citing)
Total	146430	Total
Program Services	117144	ProgramServices
Management And General	29286	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	31876	Total
Program Services	25501	ProgramServices
Management And General	6375	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	16462	Total
Program Services	13170	ProgramServices
Management And General	3292	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	431676	Total
Program Services	366925	ProgramServices
Management And General	64751	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	93382	Total
Program Services	84044	ProgramServices
Management And General	9338	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
MEDICAID ROOM AND BOARD	3473207	3473207
MEDICATIONS	1199200	1199200
MEDICAL EQUIPMENT	853508	853508
IN-PATIENT DAYS	795014	795014

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	3891846	Total
Program Services	3800512	ProgramServices
Management And General	72661	ManagementAndGeneral
Fundraising	18673	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	29548231	Total
Program Services	27452465	ProgramServices
Management And General	1660145	ManagementAndGeneral
Fundraising	435621	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	327	BOY
EOY	268	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	749694	BOY
EOY	1164368	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	2731679	BOY
EOY	3306287	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	299668	BOY
EOY	106661	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	4040732	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	2099397	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	2183623	BOY
EOY	1941335	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	2377874	BOY
EOY	2389028	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	73648	BOY
EOY	70683	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	8416513	BOY
EOY	8978630	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	2452412	BOY
EOY	2442237	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
EOY	350000	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	2452412	BOY
EOY	2792237	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	4461788	BOY
EOY	4697699	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	60901	BOY
EOY	113499	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1441412	BOY
EOY	1375195	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	5964101	BOY
EOY	6186393	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	8416513	BOY
EOY	8978630	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	740664	ReconcilationRevenueExpenses
Reconcilation Other Changes	-518372	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
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	585654	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	754318	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	676380	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	542486	CurrentTaxYearMinus1Year
Current Tax Year	552355	CurrentTaxYear
Total	3111193	Total

Total170 Total170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	585654	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	754318	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	676380	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	542486	CurrentTaxYearMinus1Year
Current Tax Year	552355	CurrentTaxYear
Total	3111193	Total

Field	Value	IRS element (for citing)
Public Support Total170	3111193	PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	99090	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	89845	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	77919	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	89780	CurrentTaxYearMinus1Year
Current Tax Year	68579	CurrentTaxYear
Total	425213	Total

Other Income170 OtherIncome170

Field	Value	IRS element (for citing)
Current Tax Year Minus1 Year	158722	CurrentTaxYearMinus1Year
Current Tax Year	254993	CurrentTaxYear
Total	413715	Total

Field	Value	IRS element (for citing)
Total Support	3950121	TotalSupport
Gross Receipts From Admissions Etc	29034340	GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage170	0.78760	PublicSupportPertcentage170
Public Support Pertcent Prior Year	0.83980	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	1415161	BeginningOfYearBalance
Investment Earnings Or Losses	8452	InvestmentEarningsOrLosses
Other Expenditures	65580	OtherExpenditures
Administrative Expenses	7421	AdministrativeExpenses
End Of Year Balance	1350612	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1370279	BeginningOfYearBalance
Investment Earnings Or Losses	121700	InvestmentEarningsOrLosses
Other Expenditures	69012	OtherExpenditures
Administrative Expenses	7806	AdministrativeExpenses
End Of Year Balance	1415161	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1196310	BeginningOfYearBalance
Investment Earnings Or Losses	254501	InvestmentEarningsOrLosses
Other Expenditures	73152	OtherExpenditures
Administrative Expenses	7380	AdministrativeExpenses
End Of Year Balance	1370279	EndOfYearBalance

Field	Value	IRS element (for citing)
Permanent Endowment EOY Balance	1.00000	PermanentEndowmentEOYBalance
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	75000	OtherCostOrOtherBasis
Book Value	75000	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1059414	OtherCostOrOtherBasis
Depreciation	461499	Depreciation
Book Value	597915	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	775241	OtherCostOrOtherBasis
Depreciation	363712	Depreciation
Book Value	411529	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	2076630	OtherCostOrOtherBasis
Depreciation	1244439	Depreciation
Book Value	832191	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	54447	OtherCostOrOtherBasis
Depreciation	29747	Depreciation
Book Value	24700	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	1941335	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	SHORT TERM DEBT	Description
Amount	$350,000	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	350000	TotalOfAmounts
Total Revenue	30288895	TotalRevenue
Total Expenses	29548231	TotalExpenses
Excess Or Deficit For Year	740664	ExcessOrDeficitForYear
Net Unrealized GL On Investments	-518372	NetUnrealizedGLOnInvestments
Total Adjustments	-518372	TotalAdjustments
Excess Or Deficit Per FS	222292	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	29141444	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	-518372	NetUnrealizedGainsInvestments
Other Revenues	-710680	OtherRevenues
Revenue Not Rptd F990	-1229052	RevenueNotRptdF990
Revenue Subtotal	30370496	RevenueSubtotal
Other Revenues Not Included	-81601	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	-81601	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	30288895	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	28919152	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	-629079	OtherExpensesIncluded
Expenses Not Rptd F990	-629079	ExpensesNotRptdF990
Expenses Subtotal	29548231	ExpensesSubtotal
Total Expenses Per Form990	29548231	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
INTENDED USES FOR ENDOWMENT FUNDS	SCHEDULE D, PAGE 2, PART V, LINE 4	TO PROVIDE PERPETUAL INCOME WHICH WILL FURTHER THE ORGANIZATION'S MISSION.
RECONCILIATION OF CHANGES - OTHER	SCHEDULE D, PAGE 4, PART XI, LINE 8	FUNDRAISING EXPENSE 0 NON-REIMBURSABLE SERVICES EXPENSE -538,612 BAD DEBTS -10,904 CONTRACTUAL ADJUSTMENTS -161,164 DIRECT EXPENSES FROM FUNDRAISING EVENTS 81,601 DIRECT EXPENSES FROM FUNDRAISING EVENTS -81,601 NON-REIMBURSABLE SERVICE EXPENSES 538,612 BAD DEBTS 10,904 CONTRACTUAL ADJUSTMENTS 161,164
REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHER	SCHEDULE D, PAGE 4, PART XII, LINE 2D	FUNDRAISING EXPENSE 0 NON-REIMBURSABLE SERVICES EXPENSE -538,612 BAD DEBTS -10,904 CONTRACTUAL ADJUSTMENTS -161,164
REVENUE AMOUNTS INCLUDED ON RETURN - OTHER	SCHEDULE D, PAGE 4, PART XII, LINE 4B	DIRECT EXPENSES FROM FUNDRAISING EVENTS -81,601
EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHER	SCHEDULE D, PAGE 4, PART XIII, LINE 2D	DIRECT EXPENSES FROM FUNDRAISING EVENTS 81,601 NON-REIMBURSABLE SERVICE EXPENSES -538,612 BAD DEBTS -10,904 CONTRACTUAL ADJUSTMENTS -161,164

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	CHARITY GOLF CL	NameOfEvent1
Gross Receipts Event1	87818	GrossReceiptsEvent1
Charitable Contributions Event1	25091	CharitableContributionsEvent1
Gross Revenue Event1	62727	GrossRevenueEvent1
Other Direct Expenses Event1	14884	OtherDirectExpensesEvent1
Name Of Event2	LIGHT UP A LIFE	NameOfEvent2
Gross Receipts Event2	51979	GrossReceiptsEvent2
Gross Revenue Event2	51979	GrossRevenueEvent2
Other Direct Expenses Event2	7510	OtherDirectExpensesEvent2
Total Number Of Other Events	7	TotalNumberOfOtherEvents
Gross Receipts Other Events	124205	GrossReceiptsOtherEvents
Charitable Contrib Other Events	2000	CharitableContribOtherEvents
Gross Revenue Other Events	122205	GrossRevenueOtherEvents
Other Direct Expenses Other Events	45965	OtherDirectExpensesOtherEvents
Gross Receipts Total	264002	GrossReceiptsTotal
Charitable Contributions Total	27091	CharitableContributionsTotal
Gross Revenue Total Events	236911	GrossRevenueTotalEvents
Other Direct Expenses Total Events	68359	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	68359	DirectExpenseSummaryEvents
Net Income Summary	168552	NetIncomeSummary

Field	Value	IRS element (for citing)
States Where Gaming Conducted	OH	StatesWhereGamingConducted

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	false	SeverancePayment
Supplemental Nonqual Retire Plan	false	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	false	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	false	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	false	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Deferred Comp Filing OrgDeferredCompFilingOrg	Total Compensation Filing OrgTotalCompensationFilingOrg
DR JAMES PRESTON
163268	18880	182148
CHRIS SMITH
145180	22113	167293

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
DAVE BRUCK IDS LLC
HUSBAND OF MGMT	125004	CUSTOM PROGRAMMING	false
NORTH CENTRAL EMS
BOARD MEMBER	150725	AMBULANCE SERVICES	false

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11B	A COPY OF THE 990 IS GIVEN TO FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. THE FINANCE COMMITTEE REVIEWED THE 990 FOR ACCURACY AND APPROVED THE 990 TO BE FILED.
ENFORCEMENT OF CONFLICTS POLICY	FORM 990, PAGE 6, PART VI, LINE 12C	BOARD MEMBERS, DIRECTOR LEVEL POSITIONS AND ALL EMPLOYEES ARE ALL COVERED UNDER THIS POLICY. BOARD MEMBERS SIGN THE STATEMENT ANNUALLY. FOR BOARD MEMBERS AND DIRECTOR LEVEL POSITIONS, CONFLICT DETERMINATIONS AND ACTUAL CONFLICTS WOULD BE HANDLED BY THE BOARD EITHER BY DISCUSSION, FORMAL ACTION, FOR POLICY REVISION(S) AND/OR CHANGES TO POLICIES, IF REQUIRED. IN THE EVENT THERE WOULD BE RESTRICTIONS IMPOSED BASED UPON EXISTING OR NEW CONFLICTS, THE RESPECTIVE BOARD COMMITTEE CHAIR WOULD BE RESPONSIBLE FOR ASKING THE INDIVIDUAL TO EXCUSE THEMSELVES OR ABSTAIN FROM VOTING PRIVILEDGES. EACH EMPLOYEE SIGNS A CONFLICT OF INTEREST POLICY DISCLOSURE STATEMENT THAT WOULD COVER DIRECTOR LEVEL POSITIONS WITHIN THE ORGANIZATION, FROM THERE POTENTIAL CONFLICTS AND CONFLICTS FLOW TO HR AND THEN THE CEO IF REQUIRED. BEYOND THE CEO, THE BOARD WOULD DELIBERATE THE SITUATION AND/OR ISSUE SURROUNDING THE POTENTIAL CONFLICT OR CONFLICT IN THE SAME MANNER THE BOARD POLICES ITSELF. UPON HIRE, EMPLOYEES SIGN FOR RECEIPT OF THE CONFLICT OF INTEREST POLICY. REFUSAL TO COMPLY WITH COMPLIANCE DIRECTIVES OF THE BOARD COULD RESULT IN SUSPENSION AND/OR REMOVAL FROM THEIR RESPECTIVE POSITIONS.
COMPENSATION PROCESS FOR TOP OFFICIAL	FORM 990, PAGE 6, PART VI, LINE 15A	ANNUALLY THE EXECUTIVE DIRECTOR'S SALARY IS REVIEWED, A SURVEY OF THE DIRECTOR'S PERFORMANCE IS SENT TO ALL BOARD MEMEBERS WITH THE RESULTS BEING TABULATED BY A FINANCE COMMITTEE MEMBER AND ANY INCREASE IS FIRST RECOMMENDED BY THE PRESIDENT OF THE BOARD BASED ON THE SURVEY AND APPROVED BY THE BOARD OF TRUSTEES BASED ON INFORMATION USED FROM THE HOSPICE SALARY AND BENEFITS REPORT.
COMPENSATION PROCESS FOR OFFICERS	FORM 990, PAGE 6, PART VI, LINE 15B	ANNUALLY MANAGEMENT REVIEWS THE PAY SCALES FOR ALL EMPLOYEES AND COMPARES CURRENT PAY TO HOSPICE SALARY AND BENEFITS REPORT.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION	FORM 990, PAGE 6, PART VI, LINE 19	GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
OTHER EXPENSES	FORM 990, PART IX, LINE 24E	MILEAGE 657,199 MEDICAL SUPPLIES 644,803 NON-REIMBURSABLE SERVICE 538,612 OXYGEN 373,422 MOBILE PHONES AND PAGERS 360,062 CONTINUING EDUCATION 273,705 CONTRACTUAL ADJUSTMENTS 161,164 AMBULANCE 160,314 THERAPIES 137,559 DIETARY SUPPLEMENTS 98,686 RESPITE CARE 96,585 DUES AND LICENSES 88,369 LAB 87,950 IMAGING SERVICES 52,374 POSTAGE 35,100 EMERGENCY ROOM 24,383 TELEPHONE 22,281 BEREAVEMENT 20,405 MISCELLANEOUS 14,658 VOLUNTEER RECOGNITION 11,951 PATIENT SPECIAL NEEDS 11,499 BAD DEBTS 10,904 PHYSICIAN SERVICES 9,861
ADDITIONAL INFORMATION	FORM 990, PART XI	LINE 5, OTHER CHANGES IN NET ASSETS: UNREALIZED LOSS