THE HOSPICE OF DAYTON INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
THE HOSPICE OF DAYTON INC (EIN 31-0933339)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-10-13
IRS object ID
201242879349300009
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)
Timestamp2012-10-13T12:30:26-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN310800053EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLARK SCHAEFER HACKETT COBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line110100 INNOVATION DRIVE SUITE 400AddressLine1
CityDAYTONCity
StateOHState
ZIP Code45342ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN310933339EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1THE HOSPICE OF DAYTON INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHOSPNameControl
Phone9372564490Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1324 WILMINGTON AVEAddressLine1
CityDAYTONCity
StateOHState
ZIP Code45420ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJERRY DURSTName
TitleCFOTitle
Phone9372564490Phone
Date Signed2012-10-12DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKEVIN T DAVIS CPAName
PTINP00039883PTIN
Phone9372260070Phone
Date Prepared2012-10-12DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKENT ANDERSONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1324 WILMINGTON AVEAddressLine1
CityDAYTONCity
StateOHState
ZIP Code45420ZIPCode
FieldValueIRS element (for citing)
Gross Receipts61676912GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteHTTP://WWW.HOSPICEOFDAYTON.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1978YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HOSPICE CARE FOR TERMINALLY ILL INDIVIDUALSActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees783TotalNbrEmployees
Total Nbr Volunteers614TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1177836ContributionsGrantsPriorYear
Contributions Grants Current Year2151665ContributionsGrantsCurrentYear
Program Service Revenue Prior Year42675955ProgramServiceRevenuePriorYear
Program Service Revenue CY47479554ProgramServiceRevenueCY
Investment Income Prior Year1728571InvestmentIncomePriorYear
Investment Income Current Year1596590InvestmentIncomeCurrentYear
Other Revenue Prior Year20249OtherRevenuePriorYear
Other Revenue Current Year356439OtherRevenueCurrentYear
Total Revenue Prior Year45602611TotalRevenuePriorYear
Total Revenue Current Year51584248TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year29258073SalariesEtcPriorYear
Salaries Etc Current Year33991004SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year12879234OtherExpensePriorYear
Other Expenses Current Year16278419OtherExpensesCurrentYear
Total Expenses Prior Year42137307TotalExpensesPriorYear
Total Expenses Current Year50269423TotalExpensesCurrentYear
Revenues Less Expenses Prior Year3465304RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1314825RevenuesLessExpensesCY
Total Assets BOY64261331TotalAssetsBOY
Total Assets EOY72954335TotalAssetsEOY
Total Liabilities BOY5600968TotalLiabilitiesBOY
Total Liabilities EOY15086698TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY58660363NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY57867637NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE HOSPICE OF DAYTON, INC. IS COMMITTED TO MAKING QUALITY HOSPICE CARE AVAILABLE AND ACCESSIBLE TO TERMINALLY ILL PERSONS AND THEIR FAMILIES, REGARDLESS OF ABILITY TO PAY, AND IN A MANNER CONSISTENT WITH THE HIGHEST HOSPICE STANDARDS. OUR COMMITMENT TO THE HOSPICE PHILOSOPHY OF CARE INCLUDES A COMPASSIONATE STAFF PLEDGED TO CONTINUOUSLY IMPROVE AND ENHANCE THE CARE WE PROVIDE, RESPECT THE PATIENTS' CHOICES OF CARE, RESPOND TO CHANGING COMMUNITY NEEDS, AND SERVE AS A RESOURCE TO OTHERS FOR IMPROVING THE AVAILABILITY OF QUALITY HOSPICE CARE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense41392342Expense
Revenue47835993Revenue
DescriptionCOORDINATES A PROGRAM OF HOME, OUTPATIENT, AND INPATIENT HOSPICE CARE THAT PROVIDES PALLIATIVE CARE, SUPPORTIVE MEDICAL SERVICES, AND OTHER SUPPORT SERVICES TO TERMINALLY ILL PERSONS AND THEIR FAMILIES, REGARDLESS OF ABILITY TO PAY.Description
Total Program Service Expense41392342TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096239NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees783NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledOHStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JERRY DURSTBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9372564490TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1324 WILMINGTON AVEAddressLine1
CityDAYTONCity
StateOHState
ZIP Code454201891ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
KENT ANDERSON
PRESIDENT/CEO40.00XX34291704108
GARY LEROY MD
BOARD MEMBER2.00X000
PAMELA MORRIS
BOARD MEMBER - CHAIR2.00XX000
LISA HANAUER
BOARD MEMBER2.00X000
CLAIRE RODEHAVER
BOARD MEMBER - SECRETARY2.00XX000
TONI SPRINKEL
BOARD MEMBER2.00X000
LOIS SUTHERLAND
BOARD MEMBER2.00X000
GREG TOMAN
BOARD MEMBER - VICE CHAIR2.00XX000
LARRY ZUMSTEIN
BOARD MEMBER2.00X000
DANIEL ERLANDSON
BOARD MEMBER2.00X000
THOMAS MANN
BOARD MEMBER - TREASURER2.00XX000
PAULA MACILWAINE
BOARD MEMBER2.00X000
RATNA PALAKODETI MD
BOARD MEMBER2.00X000
THOMAS DUNCAN
BOARD MEMBER2.00X000
LINDSAY M JOHNSON ESQ
BOARD MEMBER2.00X000
JERRY DURST
CFO40.00X165688016622
BRENDA HUMFLEET
MKTG DIRECTOR/ HODF PRES.2.00X190292017350
JULES SHERMAN
CHIEF MEDICAL OFFICER40.00253673016750X
RUTH THOMSON
VP OF MEDICAL SERVICES40.00363737010233X
WENDY SCHMITZ
ASSOC. MEDICAL DIRECTOR40.0021389905564X
CHIRAG PATEL
PHYSICIAN40.0024989406233X
RANAPREET PATEL
PHYSICIAN40.0022001109600X
MARY MURPHY
VP OF CLINICAL OPERATIONS40.00184112017058X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2184223TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation103518TotalOtherCompensation
Number Individuals GT100 K16NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
EXCELLERX
1601 CHERRY STPHILADELPHIAPA19102PHARMACEUTICAL2389456
THERAPY SUPPORT INC
2803 N OAK GROVE AVESPRINGFIELDMO658034976THERAPY1876261
KETTERING MEDICAL CENTER
PO BOX 713086COLUMBUSOH432713086HOSPITAL510285
MIAMI VALLEY HOSPITAL
PO BOX 713073COLUMBUSOH432713073HOSPITAL375743
ANNE M REDDY MD
8501 OLD TROY PIKEHUBER HEIGHTSOH45424PHYSICIAN275455
FieldValueIRS element (for citing)
Number Of Contractors GT100 K17NumberOfContractorsGT100K
Related Organizations2151665RelatedOrganizations
Total Contributions2151665TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICEDescription
Business Code624100BusinessCode
Total Revenue Column47479554TotalRevenueColumn
Related Or Exempt Function Income47479554RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue47479554TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column759667TotalRevenueColumn
Exclusion$759,667ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities10929587Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities10092664Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities836923Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column836923TotalRevenueColumn
Exclusion$836,923ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUS INCOMEDescription
Business Code900099BusinessCode
Total Revenue Column356439TotalRevenueColumn
Related Or Exempt Function Income356439RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue356439TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column51584248TotalRevenueColumn
Related Or Exempt Function Income47835993RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,596,590ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1007400Total
Program Services270423ProgramServices
Management And General529335ManagementAndGeneral
Fundraising207642Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total26839227Total
Program Services23997909ProgramServices
Management And General2598411ManagementAndGeneral
Fundraising242907Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total338637Total
Program Services293494ProgramServices
Management And General41850ManagementAndGeneral
Fundraising3293Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3756863Total
Program Services2914445ProgramServices
Management And General776981ManagementAndGeneral
Fundraising65437Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2048877Total
Program Services1610093ProgramServices
Management And General411172ManagementAndGeneral
Fundraising27612Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total106233Total
Management And General106233ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1325734Total
Program Services5980ProgramServices
Management And General705486ManagementAndGeneral
Fundraising614268Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total638634Total
Program Services181672ProgramServices
Management And General456962ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total121236Total
Program Services3567ProgramServices
Management And General117669ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total473410Total
Program Services62191ProgramServices
Management And General369399ManagementAndGeneral
Fundraising41820Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total239268Total
Program Services44562ProgramServices
Management And General194706ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1350858Total
Program Services1013144ProgramServices
Management And General337714ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total182994Total
Management And General182994ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
MEDICATIONS & SUPPLIES3569148356914800
EQUIPMENT RENTAL AND MA278741919312668561530
CONTRACTED SERVICES15731257211528519730
GENERAL INPATIENT EXPEN1261751126175100

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2648609Total
Program Services3511545ProgramServices
Management And General340043ManagementAndGeneral
Fundraising-1202979Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total50269423Total
Program Services41392342ProgramServices
Management And General8877081ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY719BOY
EOY969EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY6163802BOY
EOY2534956EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY4813499BOY
EOY7060209EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY233837BOY
EOY47584EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis28982361LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec11209725LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY11623577BOY
EOY17772636EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY17611480BOY
EOY21457091EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY23814417BOY
EOY24080890EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY64261331BOY
EOY72954335EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY5259780BOY
EOY14656348EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY341188BOY
EOY430350EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY5600968BOY
EOY15086698EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY57102477BOY
EOY56303799EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY447886BOY
EOY453838EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1110000BOY
EOY1110000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY58660363BOY
EOY57867637EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY64261331BOY
EOY72954335EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1314825ReconcilationRevenueExpenses
Reconcilation Other Changes-2107551ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2524373CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2637407CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1444606CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1177836CurrentTaxYearMinus1Year
Current Tax Year2151665CurrentTaxYear
Total9935887Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2524373CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2637407CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1444606CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1177836CurrentTaxYearMinus1Year
Current Tax Year2151665CurrentTaxYear
Total9935887Total
FieldValueIRS element (for citing)
Public Support Total1709935887PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2109807CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years-2969807CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years460081CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1728571CurrentTaxYearMinus1Year
Current Tax Year1596590CurrentTaxYear
Total2925242Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years109120CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years111487CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years62753CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year20249CurrentTaxYearMinus1Year
Current Tax Year356439CurrentTaxYear
Total660048Total
FieldValueIRS element (for citing)
Total Support13521177TotalSupport
Gross Receipts From Admissions Etc198469113GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.73480PublicSupportPertcentage170
Public Support Pertcent Prior Year0.78000PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance22828457BeginningOfYearBalance
Contributions1890Contributions
Investment Earnings Or Losses38869InvestmentEarningsOrLosses
Other Expenditures1890OtherExpenditures
End Of Year Balance22867326EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance14407503BeginningOfYearBalance
Contributions6273655Contributions
Investment Earnings Or Losses2324795InvestmentEarningsOrLosses
Other Expenditures177496OtherExpenditures
End Of Year Balance22828457EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance7500120BeginningOfYearBalance
Contributions6015800Contributions
Investment Earnings Or Losses1396370InvestmentEarningsOrLosses
Other Expenditures504787OtherExpenditures
End Of Year Balance14407503EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance9640550BeginningOfYearBalance
Investment Earnings Or Losses-2140430InvestmentEarningsOrLosses
End Of Year Balance7500120EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.95150BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.04850PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.00000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R0AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis930854OtherCostOrOtherBasis
Book Value930854BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis23415064OtherCostOrOtherBasis
Depreciation8911879Depreciation
Book Value14503185BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis4523549OtherCostOrOtherBasis
Depreciation2249356Depreciation
Book Value2274193BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis112894OtherCostOrOtherBasis
Depreciation48490Depreciation
Book Value64404BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings17772636TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
BENEFICIAL INTEREST IN SUBSIDIARY FOUNDATION22938969
DUE FROM RELATED ENTITY (HOSPICE OF DAYTON FDTN. 31-1769696)1141921
FieldValueIRS element (for citing)
Total Book Value Other Assets24080890TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionRETIREMENT PLAN LIABILITYDescription
Amount$430,350Amount
FieldValueIRS element (for citing)
Total Of Amounts430350TotalOfAmounts
Total Revenue51584248TotalRevenue
Total Expenses50269423TotalExpenses
Excess Or Deficit For Year1314825ExcessOrDeficitForYear
Net Unrealized GL On Investments-1670547NetUnrealizedGLOnInvestments
Other-$437,004OtherAmount
Total Adjustments-2107551TotalAdjustments
Excess Or Deficit Per FS-792726ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt52729323TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-1670547NetUnrealizedGainsInvestments
Other Revenues2921855OtherRevenues
Revenue Not Rptd F9901251308RevenueNotRptdF990
Revenue Subtotal51478015RevenueSubtotal
Investment Expenses Not Included106233InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt106233RevenueNotRptdOnFinStmt
Total Revenue Per Form99051584248TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt53522049TotExpensesEtcAuditedFinclStmt
Other Expenses Included3358859OtherExpensesIncluded
Expenses Not Rptd F9903358859ExpensesNotRptdF990
Expenses Subtotal50163190ExpensesSubtotal
Investment Expenses Not Included2106233InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt106233ExpensesNotRptdOnFinStmt
Total Expenses Per Form99050269423TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD FAIL TO BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. AS DISCUSSED ABOVE, THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES AND MANAGEMENT BELIEVES THE ORGANIZATION HAS NOT ENGAGED IN ANY ACTIVITIES THAT WOULD DISQUALIFY IT FROM TAX-EXEMPT STATUS OR INCUR A TAX OBLIGATION FOR THE YEARS ENDED DECEMBER 31, 2011 AND 2010. THE ORGANIZATION BELIEVES THEIR ESTIMATES ARE APPROPRIATE BASED ON CURRENT FACTS AND CIRCUMSTANCES. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE ORGANIZATION BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS ENDED PRIOR TO DECEMBER 31, 2008. THE ORGANIZATION'S POLICY WITH REGARD TO INTEREST AND PENALTY, IF INCURRED, IS TO RECOGNIZE INTEREST THROUGH INTEREST EXPENSE AND PENALTIES THROUGH OTHER EXPENSE.
PART XI, LINE 8 - OTHER ADJUSTMENTS:CHANGE IN NET ASSETS OF BENEFICIAL INTEREST IN RELATED ENTITY (31-1769696) -437,004.
PART XII, LINE 2D - OTHER ADJUSTMENTS:ELIMINATION OF NET REVENUE ACTIVITY OF SUBSIDIARY FOUNDATION 2,921,855.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:ELIMINATION OF NET EXPENSE ACTIVITY OF SUBSIDIARY FOUNDATION 3,358,859.
PART V, LINE 4: ENDOWMENT FUNDS ARE MAINTAINED BY A RELATED ORGANIZATION, HOSPICE OF DAYTON FOUNDATION (31-1769696). ENDOWMENT FUNDS ARE MAINTAINED BY THE FOUNDATION TO SUPPORT THE HOSPICE OF DAYTON, INC., THE FOUNDATION'S PARENT ORGANIZATION. IT IS THE FOUNDATION'S OBJECTIVE TO UTILIZE CURRENT FUNDRAISING TO SUPPORT PROGRAMS OF THE HOSPICE OF DAYTON, INC., TO GROW AND PROVIDE RESERVES FOR UNFORESEEN CIRCUMSTANCES, OR TO FUND SIGNIFICANT NEW INITIATIVES. THE BENEFICIAL INTEREST IN SUBSIDIARY FOUNDATION REPORTED ON SCHEDULE D, PART IX INCLUDES THE ENDOWMENT ASSETS SHOWN ON SCHEDULE D, PART V.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
KENT ANDERSON
2725170704000000041080347025000
JERRY DURST
14318802250000012514041080182310000
BRENDA HUMFLEET
16305502723700013242041080207642000
JULES SHERMAN
2536730000012642041080270423000
RUTH THOMSON
2991660645710006125041080373970000
WENDY SCHMITZ
213899000001456041080219463000
CHIRAG PATEL
249894000002125041080256127000
RANAPREET PATEL
220011000005492041080229611000
MARY MURPHY
16011202400000012950041080201170000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return ReferencePART IIIReturnReference
ExplanationFORM 990, SCHEDULE J, PART I, ITEM 4B: CONTRIBUTIONS OF $8,250 EACH WERE MADE TO 457(B) DEFERRED COMPENSATION PLANS ON BEHALF OF B. HUMFLEET, J. DURST, J. SHERMAN & M. MURPHY.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11THE BOARD OF TRUSTEES IS PROVIDED A COPY OF FORM 990 TO REVIEW PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE BOARD OF TRUSTEES ANNUALLY REPORTS ON ANY ACTIVITY THAT COULD GIVE RISE TO POTENTIAL CONFLICTS OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15A & B THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES UTILIZES LOCAL MARKET KNOWLEDGE, ANNUAL PERFORMANCE EVALUATIONS AND BENCHMARK DATA TO ESTABLISH COMPENSATION FOR THE PRESIDENT/CEO. THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS ESTABLISHED BY THE PRESIDENT/CEO UNDER GUIDELINES ESTABLISHED BY THE BOARD OF TRUSTEES AS PART OF THE BUDGET PROCESS.
FORM 990, PART VI, SECTION C, LINE 19HOSPICE OF DAYTON, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON RECEIPT OF A WRITTEN REQUEST FOR SUCH INFORMATION.
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -1,670,547. CHANGE IN NET ASSETS OF BENEFICIAL INTEREST IN RELATED ENTITY (31-1769696) -437,004. TOTAL TO FORM 990, PART XI, LINE 5: -2,107,551.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 2C:THE BOARD OF TRUSTEES HAS CHARGED THE FINANCE COMMITTEE WITH OVERSIGHT OF THE INDEPENDENT AUDIT. THIS PROCESS IS CONSISTENT WITH THE PRIOR YEAR.
FORM 990, PART IX, LINE 24F:ALL COMPENSATION OF EMPLOYEES OF HOSPICE OF DAYTON FOUNDATION (31-1769696) IS PAID BY HOSPICE OF DAYTON, INC. AND IS ALLOCATED TO THE FOUNDATION, CONSISTING OF $441,449 OF SALARIES, $77,830 OF EMPLOYEE BENEFITS AND $27,612 OF PAYROLL TAXES. IN ADDITION, $614,268 OF FOUNDATION ACTIVITIES AND $41,820 OF FOUNDATION OCCUPANCY COSTS WERE PAID BY THE HOSPICE OF DAYTON, INC. AND ALLOCATED TO THE FOUNDATION. ALL ALLOCATIONS ARE BASED ON ACTUAL COSTS OF FOUNDATION OPERATIONS. THE TOTAL AMOUNT ALLOCATED TO THE FOUNDATION IS $1,202,979.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1HOSPICE OF DAYTON FOUNDATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1324 WILMINGTON AVENUEAddressLine1
CityDAYTONCity
StateOHState
ZIP Code45420ZIPCode
FieldValueIRS element (for citing)
EIN311769696EIN
Primary ActivitiesTO PROVIDE FINANCIAL SUPPORT TO ITS PARENT, HOSPICE OF DAYTONPrimaryActivities
Legal Domicile StateOHLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status170(B)(1)(A)(VI)PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1HOSPICE OF DAYTON INCBusinessNameLine1
FieldValueIRS element (for citing)
Controlled Org1ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
HOSPICE OF DAYTON FOUNDATION (31-1769696)
C2151665CASH VALUE
HOSPICE OF DAYTON FOUNDATION (31-1769696)
L614268CASH VALUE
HOSPICE OF DAYTON FOUNDATION (31-1769696)
M41820CASH VALUE
HOSPICE OF DAYTON FOUNDATION (31-1769696)
N546891CASH VALUE

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