2012-03-26T16:21:35-05:00 2011-09-30 BONADIO & CO LLP 115 SOLAR STREET SYRACUSE NY 13204 990 2010-10-01 161541636 HOSPICE FOUNDATION OF JEFFERSON COUNTY INC HOSP 3157887323 425 WASHINGTON STREET WATERTOWN NY 13601 STEPHEN P LYMAN 3157887323 2012-03-24 1 BETTINA LIPPHARDT 3152147575 2010 2016-02-24 21:20:13Z STEPHEN P LYMAN 425 WASHINGTON STREET WATERTOWN NY 13601 4731075 0 X WWW.JEFFHOSPICE.ORG X 1993 NY TO ENSURE THE HOSPICE SERVICES REMAIN STRONG AND FISCALLY VIABLE TO SERVE AS AN INTEGRAL COMPONENT OF OUR COMMUNITY'S HEALTHCARE DELIVERY SYSTEM. 15 15 0 86 0 0 523007 3613265 0 0 78762 88052 35821 83147 637590 3784464 97330 28333 0 0 57644 58133 0 0 40678 234000 197176 388974 283642 248616 3500822 2969960 6404633 7371 27310 2962589 6377323 TO ENSURE THAT HOSPICE SERVICES REMAIN STRONG AND FISCALLY VIABLE TO SERVE AS AN INTEGRAL COMPONENT OF OUR COMMUNITY'S HEALTHCARE DELIVERY SYSTEM. 0 0 28333 FINANCIAL SUPPORT HOSPICE OF JEFFERSON COUNTY, INC. IN ITS OPERATIONS TO PROVIDE MEDICAL CARE AND TREATMENT TO THE TERMINALLY ILL. 180 PROVIDED SUPPORT FOR MEDICAL CARE TO PATIENTS IN ORDER TO REDUCE THE EFFECTS OF THE SEVERITY OF SYMPTOMS OF A DISEASE. SUCH CARE IS NOT DEPENDENT ON THE PROGNOSIS OF THE PATIENT. 5600 SOLICITING, RECEIVING, AND ACKNOWLEDGING ALL FORMS OF CHARITABLE GIFTS FROM INDIVIDUALS, ORGANIZATIONS AND FOUNDATIONS VIA FUNDRAISING EVENTS AND MAIL SOLICITATIONS. 34113 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 2 0 1 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X SUE WARNER 3157887323 425 WASHINGTON STREET WATERTOWN NY 13601 ROBERT WARDWELL 1.00 X X 0 0 0 NICKOLAS DARLING 1.00 X X 0 0 0 JEFFREY BARNARD 1.00 X X 0 0 0 MAUREEN O'DONNELL 1.00 X X 0 0 0 GAIL CHRISTENSEN 1.00 X X 0 0 0 ROXANNE BURNS 1.00 X 0 0 0 HOLLY BUSH 1.00 X 0 0 0 STEVE JENNINGS 1.00 X 0 0 0 MARC LADOUCEUR 1.00 X 0 0 0 RACHEL LEWIS 1.00 X 0 0 0 MAUREEN LUNDY-WAY 1.00 X 0 0 0 BARBARA MADDOCKS 1.00 X 0 0 0 MADELINE MOORE 1.00 X 0 0 0 DELTRA WILLIS 1.00 X 0 0 0 JOHN DEANS 1.00 X 0 0 0 LINDA SHARLOW 40.00 X 0 49821 8312 STEPHEN LYMAN 40.00 X 0 65000 4592 SUSAN WARNER 40.00 X 0 64407 8899 0 179228 21803 0 0 0 0 0 118671 3109691 384903 87178 3613265 40464 40464 22000 22000 22000 22000 921120 873532 47588 47588 47588 133634 118671 73079 60555 60555 MISCELLANEOUS 900099 592 592 592 3784464 0 0 171199 28333 28333 58133 58133 84030 84030 1912 1912 4975 4975 14288 14288 24245 600 23645 20246 20246 7406 7406 348 348 1398 1398 11598 11598 2927 2927 FUNDRAISING 17033 17033 BAD DEBT 5000 5000 PALLIATIVE CARE 180 180 1590 1590 283642 34113 208851 40678 476642 1021231 280049 267558 600552 1776 0 3905 4004 3631220 172089 499540 3459131 1708048 1052157 2969960 6404633 6621 27310 750 0 7371 27310 X 2248273 5244142 714316 1133181 2962589 6377323 2969960 6404633 X 3500822 -86088 X X 0 1 1 X 0 X 79440 408286 406893 523007 3547555 4965181 79440 408286 406893 523007 3547555 4965181 4965181 74500 78127 65841 68552 62464 349484 15805 606 592 17003 5331668 0.93130 0.78770 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 64500 64500 330260 108824 221436 66227 63265 2962 3170233 3170233 3459131 3784464 283642 3500822 -86088 -86088 3414734 3771455 -86088 73079 -13009 3784464 0 3784464 356721 73079 73079 283642 0 283642 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: FOR TAX-EXEMPT ENTITIES, THEIR TAX-EXEMPT STATUS ITSELF IS DEEMED TO BE AN UNCERTAINTY, SINCE EVENTS COULD POTENTIALLY OCCUR TO JEOPARDIZE THEIR TAX-EXEMPT STATUS. AS OF SEPTEMBER 30, 2011 AND 2010, THE ORGANIZATIONS DO NOT HAVE A LIABILITY FOR UNRECOGNIZED TAX BENEFITS. THE ORGANIZATIONS FILE INCOME TAX RETURNS IN THE U.S. FEDERAL JURISDICTION AND NEW YORK STATE. THE ORGANIZATIONS ARE GENERALLY NO LONGER SUBJECT TO U.S. FEDERAL AND STATE INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2008. PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENTS EXPENSE 73,079. PART XIII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENTS 73,079. GOLF TOURNAMENT 111550 65710 45840 11196 7216 27400 AUCTION 116691 52961 63730 23148 3 24064 24064 4119 252305 118671 133634 11196 7216 54667 73079 60555 0 HOSPICE OF JEFFERSON COUNTY INC 425 WASHINGTON STREET WATERTOWN NY 13601 161266041 501(C)(3) 28333 TO SUPPORT THE OPERATIONS OF THE HOSPICE OF JEFFERSON COUNTY, INC. IN ACCORDANCE WITH THE FOUNDATION'S MISSION 1 X MISCELLANEOUS 113 87178 COST 0 1 0 METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: PART I, COLUMN (B): NUMEROUS SMALL CONTRIBUTIONS FOR SPECIAL EVENTS AND OTHER EVENTS. FORM 990, PART VI, SECTION A, LINE 7A SOLE CORPORATE MEMBER, HOSPICE OF JEFFERSON COUNTY, INC. ELECTS BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B JEFFERSON COUNTY HOSPICE HAS THE EXCLUSIVE POWER AND AUTHORITY TO AMEND, REPEAL, OR ADOPT BY-LAWS OF THE FOUNDATION. IN ADDITION THE JEFFERSON COUNTY HOSPICE HAS ALL RIGHTS AND POWERS RELATED TO ELECTION OF FOUNDATION DIRECTORS, AMENDING THE CERTIFICATE OF INCORPORATION OF THE FOUNDATION, APPROVE ANY MERGER OR CONSOLIDATION OF THE FOUNDATION, APPROVE THE DISSOLUTION OF THE FOUNDATION, AND APPROVE THE SALE OR ENCUMBRANCE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE FOUNDATION. FORM 990, PART VI, SECTION B, LINE 11 THE FOUNDATION PROVIDES DRAFT COPIES OF THE IRS FORM 990 TO THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO COMPLETION AND FILING WITH THE INTERNAL REVENUE SERVICE AT THEIR REGULARLY SCHEDULED MEETINGS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE COMPLETED ANNUALLY. THE EXECUTIVE DIRECTOR AND BOARD PRESIDENT REVIEW AND FOLLOW UP ON DISCLOSURES OF CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS ANNUALLY REVIEWS THE EXECUTIVE DIRECTOR. ALL OTHER EMPLOYEES ARE EVALUATED ANNUALLY BY MANAGEMENT. AN ANNUAL SURVEY OF LOCAL HEALTHCARE AGENCIES AND CENTRAL NEW YORK HOSPICES IS PERFORMED FOR PAY SCALES AT ALL STAFFING LEVELS. FORM 990, PART VI, SECTION C, LINE 19 A HIGH LEVEL FINANCIAL PICTURE IS PROVIDED IN THE ANNUAL REPORT, WHICH IS AVAILABLE TO THE PUBLIC. OTHER FINANCIAL DATA AND POLICY INFORMATION IS AVAILABLE UPON REQUEST AND ON A NEED TO KNOW BASIS. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -86,088. SELECTION AND OVERSIGHT OF INDEPENDENT AUDITORS FORM 990, PART XII, LINE 2C THE BOARD OF DIRECTORS SELECTS AND MEETS WITH THE INDEPENDENT AUDITORS TO DISCUSS THE RESULTS OF THE AUDIT. HOSPICE OF JEFFERSON COUNTY 425 WASHINGTON STREET WATERTOWN NY 13601 161266041 HOSPICE CARE NY 501(C)(3) 9 HOSPICE OF JEFFERSON COUNTY INC 0 0 0 0 0 0 0 0 0 1 0 1 0 1 1 1 0 0 0