HOSPICE FOUNDATION OF JEFFERSON COUNTY INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
HOSPICE FOUNDATION OF JEFFERSON COUNTY INC (EIN 16-1541636)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-07-25
IRS object ID
201122069349300132
Schema version
2009v1.7
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)
Timestamp2011-07-25T16:01:35-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Bonadio & Co LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1580 SSalina StreetAddressLine1
CitySyracuseCity
StateNYState
ZIP Code13202ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN161541636EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Hospice Foundation of Jefferson County IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHOSPNameControl
Phone3157887323Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1425 Washington streetAddressLine1
CitywatertownCity
StateNYState
ZIP Code13601ZIPCode

Officer Officer

FieldValueIRS element (for citing)
Namestephen p lymanName
TitleCEOTitle
Phone3157887323Phone
Date Signed2011-07-25DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBettina LipphardtName
Phone3154227109Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSTEPHEN P LYMANNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1425 Washington streetAddressLine1
CitywatertownCity
StateNYState
ZIP Code13601ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1107030GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.JEFFersonHOSPICE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1993YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionTo ensure Hospice services remain strong and fiscally viable to serve as an integral component of our community's healthcare delivery system.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers35TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year949251ContributionsGrantsPriorYear
Contributions Grants Current Year523007ContributionsGrantsCurrentYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year-54260InvestmentIncomePriorYear
Investment Income Current Year78762InvestmentIncomeCurrentYear
Other Revenue Prior Year4663OtherRevenuePriorYear
Other Revenue Current Year35821OtherRevenueCurrentYear
Total Revenue Prior Year899654TotalRevenuePriorYear
Total Revenue Current Year637590TotalRevenueCurrentYear
Grants And Similar Amnts CY97330GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year116838SalariesEtcPriorYear
Salaries Etc Current Year57644SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year28537TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year67117TotalFundrsngExpCurrentYear
Other Expense Prior Year170135OtherExpensePriorYear
Other Expenses Current Year234000OtherExpensesCurrentYear
Total Expenses Prior Year315510TotalExpensesPriorYear
Total Expenses Current Year388974TotalExpensesCurrentYear
Revenues Less Expenses Prior Year584144RevenuesLessExpensesPriorYear
Revenues Less Expenses CY248616RevenuesLessExpensesCY
Total Assets BOY2731956TotalAssetsBOY
Total Assets EOY2969960TotalAssetsEOY
Total Liabilities BOY77136TotalLiabilitiesBOY
Total Liabilities EOY7371TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY2654820NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2962589NetAssetsOrFundBalancesEOY
Mission DescriptionTo ensure Hospice services remain strong and fiscally viable to serve as an integral component of our community's healthcare delivery system.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense32524Expense
DescriptionSoliciting, receiving, and acknowledging all forms of charitable gifts from individuals, organizations and foundations via fundraising events and mail solicitations.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense3320Expense
DescriptionPROVIDEd 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.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense97330Expense
DescriptionFinancial support for hospice of Jefferson county, inc. and its operations to provide medical care and treatment to the terminally ill.Description
FieldValueIRS element (for citing)
Total Program Service Expense133174TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
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 Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
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 Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10969NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
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 FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1SUE WARNERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3157887323TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1425 WASHINGTON STREETAddressLine1
CityWATERTOWNCity
StateNYState
ZIP Code13601ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
Robert WaRDWELL
PRESIDENT1.00XX000
Nickolas Darling
VICE PRESIDENT1.00XX000
JeFFREY BARNARD
TREASURER1.00XX000
Maureen O'DONNELL
SECRETARY1.00XX000
GAIL CHRISTENSEN
ASST. SECRETARY1.00XX000
WILLIAM BONISTEEL
BOARD MEMBER1.00X000
TODD CLOPPER
BOARD MEMBER1.00X000
RONDA CLOPPER
BOARD MEMBER1.00X000
ROBERT FREEMAN
BOARD MEMBER1.00X000
STEPHEN JENNINGS
BOARD MEMBER1.00X000
Holly bush
BOARD MEMBER1.00X000
MAUREEN LUNDY-WAY
BOARD MEMBER1.00X000
John Deans
BOARD MEMBER1.00X000
madeline moore
BOARD MEMBER1.00X000
rachel lewis
BOARD MEMBER1.00X000
LINDA SHARLOW
FOUNDATION DIRECTOR40.00X5590207826
stephen lyman
hospice ceo34.00X650000405
susan warner
hospice director of finance40.00X6369007826
FieldValueIRS element (for citing)
Total Reportable Comp From Org184592TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation16057TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Fundraising Events138055FundraisingEvents
All Other Contributions384952AllOtherContributions
Noncash Contributions134346NoncashContributions
Total Contributions523007TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column46552TotalRevenueColumn
Exclusion$46,552ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real22000Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real22000Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column22000TotalRevenueColumn
Exclusion$22,000ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities459865Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities427655Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities32210Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column32210TotalRevenueColumn
Related Or Exempt Function Income32210RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Gross Income Fundraising Events55606GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events138055CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses41785FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column13821TotalRevenueColumn
Exclusion$13,821ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column637590TotalRevenueColumn
Related Or Exempt Function Income32210RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$82,373ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total97330Total
Program Services97330ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total57644Total
Management And General57644ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total62360Total
Management And General62360ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total154Total
Management And General154ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total5663Total
Management And General5663ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total12921Total
Management And General12921ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total51221Total
Program Services5524ProgramServices
Fundraising45697Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total19853Total
Management And General19853ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total9194Total
Management And General9194ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total1309Total
Management And General1309ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1426Total
Management And General1426ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total12745Total
Management And General12745ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total2892Total
Management And General2892ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesFundraisingFundraising
BAD DEBT2700027000
Fundraising2142021420
Palliative Care33203320

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2522Total
Management And General2522ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total388974Total
Program Services133174ProgramServices
Management And General188683ManagementAndGeneral
Fundraising67117Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY97481BOY
EOY476642EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY414257BOY
EOY280049EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY3400BOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY5149BOY
EOY1776EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3810BOY
EOY3905EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis660031LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec160491LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY360971BOY
EOY499540EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY1846888BOY
EOY1708048EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2731956BOY
EOY2969960EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY12324BOY
EOY6621EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY64812BOY
EOY750EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY77136BOY
EOY7371EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2002237BOY
EOY2248273EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY652583BOY
EOY714316EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2654820BOY
EOY2962589EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2731956BOY
EOY2969960EOY
FieldValueIRS element (for citing)
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 Years296891CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years79440CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years408286CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year406893CurrentTaxYearMinus1Year
Current Tax Year523007CurrentTaxYear
Total1714517Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years296891CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years79440CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years408286CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year406893CurrentTaxYearMinus1Year
Current Tax Year523007CurrentTaxYear
Total1714517Total
FieldValueIRS element (for citing)
Public Support Total1701714517PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years86329CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years74500CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years78127CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year65841CurrentTaxYearMinus1Year
Current Tax Year68552CurrentTaxYear
Total373349Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years15805CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year606CurrentTaxYearMinus1Year
Total16411Total
FieldValueIRS element (for citing)
Total Support2104277TotalSupport
Public Support Pertcentage1700.81480PublicSupportPertcentage170
Public Support Pertcent Prior Year0.78810PublicSupportPertcentPriorYear
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

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis64500OtherCostOrOtherBasis
Book Value64500BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis312560OtherCostOrOtherBasis
Depreciation99229Depreciation
Book Value213331BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis65637OtherCostOrOtherBasis
Depreciation61262Depreciation
Book Value4375BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis217334OtherCostOrOtherBasis
Book Value217334BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings499540TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO HOSPICE OF JEFFERSON COUNTY, INC.Description
Amount$750Amount
FieldValueIRS element (for citing)
Total Of Amounts750TotalOfAmounts
Total Revenue637590TotalRevenue
Total Expenses388974TotalExpenses
Excess Or Deficit For Year248616ExcessOrDeficitForYear
Net Unrealized GL On Investments59153NetUnrealizedGLOnInvestments
Total Adjustments59153TotalAdjustments
Excess Or Deficit Per FS307769ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt738528TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments59153NetUnrealizedGainsInvestments
Other Revenues41785OtherRevenues
Revenue Not Rptd F990100938RevenueNotRptdF990
Revenue Subtotal637590RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form990637590TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt430759TotExpensesEtcAuditedFinclStmt
Other Expenses Included41785OtherExpensesIncluded
Expenses Not Rptd F99041785ExpensesNotRptdF990
Expenses Subtotal388974ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990388974TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part X:Description of Uncertain Tax Positions Under FIN 48:GENERALLY ACCEPTED ACCOUNTING PRINCIPLES REQUIRE ENTITIES TO DISCLOSE IN THEIR FINANCIAL STATEMENTS THE NATURE OF ANY UNCERTAINTIES IN THEIR TAX POSITION. 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. THE ORGANIZATION's CURRENT ACCOUNTING POLICY FOR EVALUATING UNCERTAIN TAX POSITIONS IS IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES AS iT RELATEs TO ACCOUNTING FOR CONTINGENCIES. THE ORGANIZATION HAs NOT RECOGNIZED ANY BENEFITS FROM UNCERTAIN TAX POSITIONS IN 2009 AND BELIEVEs it has NO UNCERTAIN TAX POSITIONS FOR WHICH IT IS REASONABLY POSSIBLE THAT THE TOTAL AMOUNTS OF UNRECOGNIZED TAX BENEFITS WILL SIGNIFICANTLY INCREASE OR DECREASE WITHIN 12 MONTHS OF THE BALANCE SHEET DATE.
Part XII, Line 2d - Other Adjustments:SPECIAL EVENTS EXPENSE: 41785.
Part XIII, Line 2d - Other Adjustments:SPECIAL EVENTS EXPENSE: 41785.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Golf TournamentNameOfEvent1
Gross Receipts Event1121203GrossReceiptsEvent1
Charitable Contributions Event171530CharitableContributionsEvent1
Gross Revenue Event149673GrossRevenueEvent1
Cash Prizes Event16166CashPrizesEvent1
Non Cash Prizes Event1450NonCashPrizesEvent1
Rent Facility Costs Event17600RentFacilityCostsEvent1
Other Direct Expenses Event119672OtherDirectExpensesEvent1
Name Of Event2RegattaNameOfEvent2
Gross Receipts Event223870GrossReceiptsEvent2
Charitable Contributions Event217937CharitableContributionsEvent2
Gross Revenue Event25933GrossRevenueEvent2
Other Direct Expenses Event26400OtherDirectExpensesEvent2
Total Number Of Other Events3TotalNumberOfOtherEvents
Gross Receipts Other Events48588GrossReceiptsOtherEvents
Charitable Contrib Other Events48588CharitableContribOtherEvents
Other Direct Expenses Other Events1497OtherDirectExpensesOtherEvents
Gross Receipts Total193661GrossReceiptsTotal
Charitable Contributions Total138055CharitableContributionsTotal
Gross Revenue Total Events55606GrossRevenueTotalEvents
Cash Prizes Total Events6166CashPrizesTotalEvents
Non Cash Prizes Total Events450NonCashPrizesTotalEvents
Rent Facility Costs Total Events7600RentFacilityCostsTotalEvents
Other Direct Expenses Total Events27569OtherDirectExpensesTotalEvents
Direct Expense Summary Events41785DirectExpenseSummaryEvents
Net Income Summary13821NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained0RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1Hospice of Jefferson County IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1425 Washington StreetAddressLine1
CitywatertownCity
StateNYState
ZIP Code13601ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient161266041EINOfRecipient
IRC Section501(c)(3)IRCSection
Amount Of Cash Grant97330AmountOfCashGrant
Purpose Of GrantTo support the operations of the Hospice of jefferson county, inc. in accordance with the Foundation's mission.PurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTraded

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F990254346NoncashContribsRptdF990
Method Of Determining Revenuesprice p/sh at donationMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts1ReviewProcessUnusualNCGifts
Third Parties Used1ThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

FieldValueIRS element (for citing)
IdentifierThird Party Use:Identifier
Return ReferencePart I, Line 32b:ReturnReference
ExplanationA broker was used to see the donated stock.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section A, line 2Board members todd clopper and ronda clopper are related.
Form 990, Part VI, Section A, line 7aSole corporate member, Hospice of Jefferson County, Inc. elects board members.
Form 990, Part VI, Section A, line 7bJefferson 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 11the 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 12cconflict 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 15the 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 19a 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.
The board of directors selects and meets with the independent auditors to discuss the results of the audit.selection and oversight of independent auditors

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1hospice of jefferson countyBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1425 washington streetAddressLine1
CitywatertownCity
StateNYState
ZIP Code13601ZIPCode
FieldValueIRS element (for citing)
EIN161266041EIN
Primary Activitieshospice carePrimaryActivities
Legal Domicile StateNYLegalDomicileState
Exempt Code Section501(c)(3)ExemptCodeSection
Public Charity Status9PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1hospice of jefferson county incBusinessNameLine1
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 Org0GiftGrantOrCapContrFrOtherOrg
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 Orgs1RentalOfFacilitiesToOtherOrgs
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 Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1hospice of jefferson county incBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeNTransactionType

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