2012-12-13T15:21:21-06:00 2012-06-30 310905417 VONLEHMAN & COMPANY INC 250 GRANDVIEW DR SUITE 300 FT MITCHELL KY 41017 990 2011-07-01 311004692 HOSPICE OF DARKE COUNTY INC DBA STATE OF THE HEART HOSPICE HOSP 9375482999 1350 N BROADWAY GREENVILLE OH 45331 LISA GASPER 9375486994 2012-12-03 1 BETH VICE P00545816 8593313300 2011 2016-02-24 21:20:13Z JIM STAMCOFF 1350 N BROADWAY GREENVILLE OH 45331 7495942 0 X WWW.STATEOFTHEHEARTCARE.ORG X 1981 OH HOSPICE OF DARKE COUNTY, INC. WORKS TO MAINTAIN THE VALUE AND DIGNITY OF HUMAN LIFE BY PROVIDING A CHOICE FOR HIGH QUALITY, COMPASSIONATE CARE AND SUPPORT SERVICES TO PATIENTS AND FAMILIES WITH LIFE LIMITING ILLNESS, TO PROMOTE THE EMOTIONAL, PSYCHOLOGICAL, SPIRITUAL AND PHYSICAL WELL BEING OF SURVIVORS AFFECTED BY DEATH, DYING AND GRIEF, TO SUPPORT ALL MEMBERS OF THE COMMUNITY IN THE KNOWLEDGE AND CARE OF THOSE PERSONS EXPERIENCING END-OF-LIFE ISSUES. 12 12 106 112 0 0 172204 196369 7635356 7132535 83006 122357 34605 27021 7925171 7478282 0 0 0 0 3655200 3833570 0 0 87789 3700330 3494799 7355530 7328369 569641 149913 7869876 8305452 579263 809164 7290613 7496288 X HOSPICE OF DARKE COUNTY, INC. WORKS TO MAINTAIN THE VALUE AND DIGNITY OF HUMAN LIFE BY PROVIDING A CHOICE FOR HIGH QUALITY, COMPASSIONATE CARE AND SUPPORT SERVICES TO PATIENTS AND FAMILIES WITH LIFE LIMITING ILLNESS, TO PROMOTE THE EMOTIONAL, PSYCHOLOGICAL, SPIRITUAL AND PHYSICAL WELL BEING OF SURVIVORS AFFECTED BY DEATH, DYING AND GRIEF, TO SUPPORT ALL MEMBERS OF THE COMMUNITY IN THE KNOWLEDGE AND CARE OF THOSE PERSONS EXPERIENCING END-OF-LIFE ISSUES. 0 0 5932316 7133954 HOSPICE OF DARKE COUNTY, INC. WORKS TO MAINTAIN THE VALUE AND DIGNITY OF HUMAN LIFE BY PROVIDING A CHOICE FOR HIGH QUALITY, COMPASSIONATE CARE AND SUPPORT SERVICES TO PATIENTS AND FAMILIES WITH LIFE LIMITING ILLNESS, TO PROMOTE THE EMOTIONAL, PSYCHOLOGICAL, SPIRITUAL AND PHYSICAL WELL BEING OF SURVIVORS AFFECTED BY DEATH, DYING AND GRIEF, TO SUPPORT ALL MEMBERS OF THE COMMUNITY IN THE KNOWLEDGE AND CARE OF THOSE PERSONS EXPERIENCING END-OF-LIFE ISSUES. 5932316 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 4 0 106 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 OH IN X ABBY THOMAS 9375482999 1350 N BROADWAY GREENVILLE OH 45331 LISA GASPER 2.00 X 0 0 0 PAULA COX 2.00 X 0 0 0 GAIL DUES 2.00 X 0 0 0 JIM STAMCOFF 2.00 X X 0 0 0 TONI HEGGIE 2.00 X X 0 0 0 TRACY HAINES 2.00 X X 0 0 0 ILZE KOCH 2.00 X 0 0 0 CINDY MCCALLISTER 2.00 X 0 0 0 GINGER GODFREY 2.00 X 0 0 0 DIANE SWALLOW 2.00 X 0 0 0 MIKE RIEMAN 2.00 X 0 0 0 WENDY STUKEY 2.00 X 0 0 0 THEODORE BAUER 40.00 X 72455 0 0 ABBY THOMAS 40.00 X 80872 0 0 ELAINE SEGER 40.00 X 80952 0 0 234279 0 0 0 0 0 0 PROCARE PBM 1267 PROFESSIONAL PARKWAY GAINSVILLE GA 30507 PHARMACEUTICAL COMPANY 337517 RESTHAVEN 1096 N OHIO ST GREENVILLE OH 45331 PATIENT ROOM AND BOARD 231946 KAUP PHARMACY INC PO BOX 605 FT RECOVERY OH 45846 DURABLE MEDICAL EQUIPMENT 209441 BRETHREN RETIREMENT COMMUNITY 750 CHESTNUT ST GREENVILLE OH 45331 PATIENT ROOM AND BOARD 188249 QUALIS MANAGEMENT PO BOX 7458 ROCKY MOUNT NC 27804 DURABLE MEDICAL EQUIPMENT 166054 11 196369 196369 PATIENT CARE REVENUE 900099 7132535 7132535 7132535 126420 126420 4063 -4063 -4063 -4063 39199 13597 25602 25602 MISCELLANEOUS INCOME 900099 1419 1419 1419 7478282 7133954 0 147959 234279 182737 46856 4686 3001811 2341413 600362 60036 50389 27361 23028 297026 275012 22014 250065 177863 72202 54462 54462 114080 54983 53431 5666 126585 37779 80150 8656 189786 67957 121829 31329 9399 20930 1000 ROOM AND BOARD EXPENSE 1370225 1370225 MEDICAL SUPPLIES & DRUG 762888 762888 MILEAGE 237573 203469 26359 7745 UTILITIES, TELEPHONE, A 194520 92024 102496 413351 329206 84145 7328369 5932316 1308264 87789 340 175 1327260 1356580 750 0 861552 809963 33958 30025 3259224 1255090 2160047 2004134 3485969 4104575 7869876 8305452 579263 809164 579263 809164 X 6772737 6949344 517876 546944 7290613 7496288 7869876 8305452 X 149913 55762 X X 0 1 1 X 0 X 204927 178449 162287 172204 196369 914236 204927 178449 162287 172204 196369 914236 914236 185619 101140 95912 83006 126420 592097 90401 31788 22534 34605 179328 1685661 0.54240 0.54310 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 242530 242530 1984963 498868 1486095 1031731 756222 275509 2004134 MUTUAL FUNDS 4104575 F 4104575 7478282 7328369 149913 55762 55762 205675 7608011 55762 60370 13597 129729 7478282 0 7478282 7402336 60370 13597 73967 7328369 0 7328369 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE U.S. INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. IN ADDITION, THE ORGANIZATION IS NOT A PRIVATE FOUNDATION AS DEFINED IN SECTION 509(A)(1) OF THE U.S. INTERNAL REVENUE CODE. THE ORGANIZATION HAS ADOPTED THE PROVISIONS OF THE ACCOUNTING PRONOUNCEMENT RELATED TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE ORGANIZATION RECOGNIZED NO INTEREST OR PENALTIES IN THE STATEMENTS OF ACTIVITIES FOR BOTH YEARS ENDED JUNE 30, 2012 AND 2011. IF THE SITUATION AROSE IN WHICH THE ORGANIZATION WOULD HAVE INTEREST TO RECOGNIZE, IT WOULD RECOGNIZE THIS AS INTEREST EXPENSE AND PENALTIES WOULD BE RECOGNIZED IN OTHER EXPENSES. TAX YEARS STILL OPEN UNDER FEDERAL AND STATE STATUTE OF LIMITATIONS REMAIN SUBJECT TO REVIEW AND CHANGE. BASED ON THE EVALUATION OF THE ORGANIZATION'S TAX POSITIONS, MANAGEMENT BELIEVES ALL POSITIONS TAKEN WOULD BE UPHELD UNDER AN EXAMINATION. THEREFORE, NO PROVISION FOR THE EFFECTS OF UNCERTAIN TAX POSITIONS HAS BEEN RECORDED FOR BOTH YEARS ENDED JUNE 30, 2012 AND 2011. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 13,597. PART XIII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 13,597. GOLF OUTING 32764 32764 11722 32764 32764 11722 11722 21042 LORRI KAUP FORMER BOARD MEMBER 209441 PURCHASE OF DURABLE MEDICAL EQUIPMENT 0 FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 IS PRESENTED TO THE FINANCE BOARD AND THEN RECOMMENDED FOR PRESENTATION TO THE BOARD OF DIRECTORS. THE BOARD THEN REVIEWS AND APPROVES THE FORM 990 AT ITS REGULAR MEETING. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY THE BOARD OF TRUSTEES REVIEW A VENDOR AND FINANCIAL INSTITUTION LIST. THE BOARD OF TRUSTEES REVIEW THIS LIST IDENTIFYING ANY POTENTIAL VIOLATIONS OF THE CONFLICT OF INTEREST POLICY. EACH BOARD MEMBER IS GIVEN THE CONFLICT OF INTEREST POLICY TO READ AND CERTIFICATION SHEET TO SIGN ANNUALLY. ALL AFFILIATIONS ARE REQUIRED TO BE DISCLOSED AND DESCRIBED ON THE AGENCY'S CONFLICT OF INTEREST DISCLOSURE DOCUMENT. THE BOARD OF TRUSTEES ANNUALLY REVIEW AND DOCUMENT ANY DISCLOSED AFFILIATIONS TO DETERMINE IF A POSSIBLE CONFLICT OF INTEREST EXISTS. FORM 990, PART VI, SECTION B, LINE 15A THE PROCESS FOR DETERMINING COMPENSATION FOR THE EXECUTIVE DIRECTOR INCLUDES THE REVIEW AND APPROVAL BY THE GOVERNING BODY. INFORMATION CONSIDERED DURING THIS PROCESS INCLUDES COMPARATIVE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN COMPARATIVE POSITIONS AT SIMILAR ORGANIZATIONS. DOCUMENTATION AND RECORD KEEPING WITH RESPECT TO THIS REVIEW PROCESS ARE MAINTAINED THROUGHOUT THE PROCESS. FORM 990, PART VI, SECTION C, LINE 19 THE AGENCY'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND ANNUAL AUDITED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT OUR FRONT DESK IN WHICH THE INFORMATION WILL BE MAILED TO THE ADDRESS PROVIDED. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 55,762. AUDIT COMMITTE PART XII, LINE 2C THERE HAVE BEEN NO CHANGES IN THE METHOD OF CHOOSING AN INDIVIDUAL AUDITOR OR METHOD OF OVERSIGHT.