2012-08-14T14:34:12-05:00 2011-12-31 PAYNE NICKLES & COMPANY 257 BENEDICT AVENUE BLDG D NORWALK OH 44857 990 2011-01-01 341411008 STEIN HOSPICE SERVICE INC STEI 4196255269 1200 SYCAMORE LINE SANDUSKY OH 44870 JAN W BUCHOLZ 4196255269 2012-08-14 true DAVID W BRINK CPA 4196682552 2012-08-14 2011 2016-02-24 21:20:13Z JAN BUCHOLZ 1200 SYCAMORE LINE SANDUSKY OH 44870 33839448 false X WWW.STEINHOSPICE.ORG X 1983 OH CARE FOR THE TERMINALLY ILL 18 17 404 200 0 542486 552355 24824164 29034340 109490 528808 86607 173392 25562747 30288895 0 0 14916441 16844629 0 435621 10632301 12703602 25548742 29548231 14005 740664 8416513 8978630 2452412 2792237 5964101 6186393 CARE FOR THE TERMINALLY ILL false false 27452465 29034340 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. 27452465 true true false false false false false false false true true false false false true false true false false false false false false false true false false false false true false false false false false true true true false false false false false false false false false false true 28 0 404 true false false false false false true true false false false false X 18 17 false false false false false false false true true false false false true true true true true true true false OH X JAN BUCHOLZ 4196255769 1200 SYCAMORE LINE SANDUSKY OH 44870 JAN BUCHOLZ 40.00 X X 127848 0 5365 JOHN R BALL 18.00 X 0 0 0 RYAN CHANDLER 18.00 X 0 0 0 ERLE DAIL 18.00 X 0 0 0 MARCIA GOFF 18.00 X 0 0 0 MATTHEW C GROSS 18.00 X 0 0 0 TAYLOR HART 18.00 X 0 0 0 JOHN KAISER JR 18.00 X 0 0 0 DRU MEREDITH 18.00 X 0 0 0 THOMAS W MUELLER 18.00 X 0 0 0 JANET RUNNER 18.00 X 0 0 0 GARY SCHIMMEL 18.00 X 0 0 0 CHERIE M SPRAGG 18.00 X 0 0 0 DENNIS SOKOL 18.00 X 0 0 0 KEITH ADDY 18.00 X X 0 0 0 PAUL DAUGHERTY 18.00 X X 0 0 0 JAMES C LONZ DVM 18.00 X X 0 0 0 THOMAS M WOLF 18.00 X X 0 0 0 JANE BRUCK 40.00 X 94511 0 21150 DR JAMES PRESTON 40.00 X 163268 0 18880 CHRIS SMITH 40.00 X 145180 0 22113 DR WILLIAM INGLIS 40.00 X 110911 0 10056 641718 77564 4 false true false 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 21 4683 27091 520581 552355 MEDICARE 621610 22865949 22865949 MEDICAID 621610 4221525 4221525 INSURANCE 621610 1033442 1033442 NON REIMBURSABLE SERVICE 621610 538612 538612 MISCELLANEOUS PATIENT REVENUE 621610 353618 353618 21194 21194 29034340 68579 68579 3929181 3463461 5491 465720 -5491 460229 460229 254993 27091 81601 173392 173392 30288895 29494569 241971 248874 228964 14933 4977 12990410 11916690 823136 250584 229338 210991 13761 4586 1984469 1825712 119067 39690 1391538 1280215 83492 27831 15711 15711 36966 388 36578 13019 13019 253534 91475 162059 679308 543446 67931 67931 163758 114056 40197 9505 143921 107941 28784 7196 464784 404362 55774 4648 146430 117144 29286 31876 25501 6375 16462 13170 3292 431676 366925 64751 93382 84044 9338 MEDICAID ROOM AND BOARD 3473207 3473207 MEDICATIONS 1199200 1199200 MEDICAL EQUIPMENT 853508 853508 IN-PATIENT DAYS 795014 795014 3891846 3800512 72661 18673 29548231 27452465 1660145 435621 327 268 749694 1164368 2731679 3306287 299668 106661 4040732 2099397 2183623 1941335 2377874 2389028 73648 70683 8416513 8978630 2452412 2442237 350000 2452412 2792237 X 4461788 4697699 60901 113499 1441412 1375195 5964101 6186393 8416513 8978630 X 740664 -518372 X false true true X false X 585654 754318 676380 542486 552355 3111193 585654 754318 676380 542486 552355 3111193 3111193 99090 89845 77919 89780 68579 425213 158722 254993 413715 3950121 29034340 0.78760 0.83980 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false 1415161 8452 65580 7421 1350612 1370279 121700 69012 7806 1415161 1196310 254501 73152 7380 1370279 1.00000 true false false 75000 75000 1059414 461499 597915 775241 363712 411529 2076630 1244439 832191 54447 29747 24700 1941335 SHORT TERM DEBT 350000 350000 30288895 29548231 740664 -518372 -518372 222292 29141444 -518372 -710680 -1229052 30370496 -81601 -81601 30288895 28919152 -629079 -629079 29548231 29548231 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 CHARITY GOLF CL 87818 25091 62727 14884 LIGHT UP A LIFE 51979 51979 7510 7 124205 2000 122205 45965 264002 27091 236911 68359 68359 168552 OH X X false false false false false false false false false DR JAMES PRESTON 163268 18880 182148 CHRIS SMITH 145180 22113 167293 DAVE BRUCK IDS LLC HUSBAND OF MGMT 125004 CUSTOM PROGRAMMING false NORTH CENTRAL EMS BOARD MEMBER 150725 AMBULANCE SERVICES false 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