2011-09-09T12:40:18-05:00 2010-12-31 CLARK SCHAEFER HACKETT & CO 40 N MAIN ST STE 800 KETTERING TOWE DAYTON OH 45423 990 2010-01-01 311769696 HOSPICE OF DAYTON FOUNDATION HOSP 9372564490 324 WILMINGTON AVE DAYTON OH 45420 JERRY DURST 9372564490 2011-05-23 1 KEVIN T DAVIS CPA 9372260070 2011-05-23 2010 2016-02-24 21:20:13Z KENT ANDERSON 324 WILMINGTON AVE DAYTON OH 45420 21657163 0 X HTTP://WWW.HOSPICEOFDAYTON.ORG X 2001 OH TO PROVIDE FINANCIAL SUPPORT TO ITS PARENT ORGANIZATION, THE HOSPICE OF DAYTON, INC. (31-0933339) 9 7 0 0 0 0 2488284 2073942 0 0 468253 705111 56943 322615 3013480 3101668 1444606 1177836 0 0 0 0 0 0 814486 974570 957393 2419176 2135229 594304 966439 20675265 23814881 2556 438908 20672709 23375973 X THE HOSPICE OF DAYTON FOUNDATION IS A SUPPORTIVE FOUNDATION OF THE HOSPICE OF DAYTON, INC. IT PROVIDES COUNSEL AND ASSISTANCE TO THE HOSPICE OF DAYTON, INC., BY HELPING TO IDENTIFY AND ACCESS INDIVIDUAL AND CORPORATE FINANCIAL SUPPORT WITH THE HOSPICE OF DAYTON'S SERVICE AREA; PROVIDING A COMMUNITY PERSPECTIVE ON KEY ISSUES RELEVANT TO PALLIATIVE AND HOSPICE CARE; AIDING IN THE DEVELOPMENT OF A COMPREHENSIVE COMMUNITY OUTREACH EDUCATIONAL PROGRAM; HELPING TO SHAPE KEY MESSAGES ON HOSPICE AND PALLIATIVE CARE; HELPING FORMULATE STRATEGIES TO INCREASE THE NON-EARNED REVENUE; AND MAKING FUNDING/GRANTING DECISIONS RELATIVE TO THE HOSPICE OF DAYTON, INC. 0 0 1177836 1177836 SUPPORT OF THE HOSPICE OF DAYTON, INC. (EIN. 31-0933339). GRANTS PAID SUPPORT PATHWAYS OF HOPE, FOCUSED/COMPLIMENTARY CARE, PALLIATIVE CARE, INDIGENT CARE, AS WELL AS SUPPORT OVERALL COMMUNITY BASED MODEL OF CARE. 1177836 1 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 9 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 OH X JERRY DURST 9372564490 324 WILMINGTON AVE DAYTON OH 454201891 SANDRA K PIERCE 2.00 X X 0 0 0 CAROL LEVITAN 2.00 X 0 0 0 DEBORAH DAILEY 2.00 X 0 1297543 46225 JUDY JOHNSON 2.00 X 0 0 0 PAMELA MORRIS 2.00 X 0 0 0 DONALD WECKSTEIN 2.00 X X 0 0 0 ROBERT BRETHEN 2.00 X 0 0 0 KENT ANDERSON 2.00 X 0 87842 0 WILLIAM THALER 2.00 X X 0 0 0 BRENDA HUMFLEET 40.00 X 0 238667 22491 0 1624052 68716 0 0 1 0 0 137946 18895 1917101 2073942 461208 461208 18721586 18477683 243903 243903 243903 322424 18895 77812 244612 244612 RESALE SHOP 453310 78003 78003 78003 3101668 0 0 1027726 1177836 1177836 25 25 102233 102233 28752 12491 16261 11981 11981 26729 26729 6015 6015 ALLOCATED SALARIES, BEN 528248 528248 PRINTING AND PUBLICATIO 132614 165 132449 POSTAGE AND MAILINGS 61524 61524 FUNDRAISING ACTIVITIES 13184 13184 EQUIPMENT AND COMPUTER 12315 12315 33773 1264 32509 2135229 1177836 142907 814486 750 750 1461041 1829919 912538 605127 13151362 21379085 5149574 0 20675265 23814881 2556 464 0 438444 2556 438908 X 19239731 21818087 332978 447886 1100000 1110000 20672709 23375973 20675265 23814881 X 966439 1736825 X X 0 1 1 X 0 X X 0 0 0 THE HOSPICE OF DAYTON INC 310933339 7 1 1 1 1177836 1 1177836 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 14407503 6273655 2324795 177496 22828457 7500120 6015800 1396370 504787 14407503 9640550 -2140430 7500120 0.95140 0.04860 0.00000 0 0 0 DUE TO RELATED ENTITY (THE HOSPICE OF DAYTON, INC. 31-0933339) 438444 438444 3101668 2135229 966439 1721917 14908 1736825 2703264 4910518 1721917 96446 92720 1911083 2999435 102233 102233 3101668 2207254 96446 77812 174258 2032996 102233 102233 2135229 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: ENDOWMENT FUNDS ARE MAINTAINED TO PROVIDE FINACIAL SUPPORT TO THE FOUNDATION'S PARENT ORGANIZATION, THE HOSPICE OF DAYTON, INC. (31-0933339). IT IS THE FOUNDATION'S OBJECTIVE TO UTILIZE CURRENT FUNDRAISING TO SUPPORT THE HOSPICE OF DAYTON, INC.'S PROGRAMS, TO GROW AND PROVIDE RESERVES FOR UNFORESEEN CIRCUMSTANCES OR TO FUND SIGNIFICANT NEW INITIATIVES. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION EVALUATES THE ACCOUNTING AND RECOGNITION FOR INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN INCOME TAX RETURNS FILED BY THE ORGANIZATION. THE ORGANIZATION IS EXEMPT FROM INCOME TAXES AND THEREFORE NO PROVISION FOR INCOME TAXES IS INCLUDED IN THE ACCOMPANYING FINANCIAL STATEMENTS MANAGEMENT BELIEVES THAT THE ORGANIZATION HAS NOT ENGAGED IN ANY ACTIVITIES NOT DIRECTLY RELATED TO THE ORGANIZATION'S TAX-EXEMPT PURPOSE, WHICH WOULD BE SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME OR DISQUALIFY THEM FROM TAX-EXEMPT STATUS. THE ORGANIZATION'S TAX FILINGS ARE SUBJECT TO AUDIT BY TAXING AUTHORITIES. THE ORGANIZATION'S OPEN AUDIT PERIODS ARE FOR YEARS 2007-2010. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN SPLIT INTEREST AGREEMENTS 14,908. PART XII, LINE 2D - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EXPENSE 77,812. CHANGE IN SPLIT INTEREST AGREEMENTS 14,908. PART XIII, LINE 2D - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EXPENSE 77,812. GOLF CLASSIC 106024 6400 99624 30110 FASHION SHOW 109578 12495 97083 29946 3 125717 125717 17756 341319 18895 322424 77812 77812 244612 1 THE HOSPICE OF DAYTON INC 324 WILMINGTON AVE DAYTON OH 45420 310933339 501(C)(3) 1177836 TO FACILIATE THE HOSPICE OF DAYTON, INC. PURPOSE TO PROVIDE HOSPICE CARE TO THE TERMINALLY ILL. 1 0 OTHER INFORMATION: PART IV: FORM 990, SCHEDULE F, PART I, QUESTION 2; GRANTS ARE ONLY PROVIDED TO THE HOSPICE OF DAYTON, INC. TO SUPPORT PROGRAMS IDENTIFIED AND APPROVED BY THE FOUNDATION'S BOARD OF TRUSTEES. 0 1 0 0 0 0 0 0 0 DEBORAH DAILEY 0 318246 0 62447 0 916850 0 46225 0 0 0 1343768 0 868000 BRENDA HUMFLEET 0 185042 0 53625 0 0 0 22491 0 0 0 261158 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE FINANCE COMMITTEE OF THE HOSPICE OF DAYTON, INC. TRUSTEES ARE DIRECTLY PROVIDED A COPY OF THE FORM 990 BY MANAGEMENT TO REVIEW PRIOR TO FILING. OTHER BOARD MEMBERS OF HOSPICE OF DAYTON, INC. ARE NOTIFIED AND PROVIDED ACCESS TO REVIEW THE FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE HOSPICE OF DAYTON, INC. MAINTAINS A CONFLICT OF INTEREST POLICY. THE 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 THE PRESIDENT/CEO OF THE HOSPICE OF DAYTON, INC. UTILIZES LOCAL MARKET KNOWLEDGE, DATA FROM SIMILAR HOSPICE AND MEDICAL FACILITIES, ANNUAL PERFORMANCE EVALUATIONS AND BENCHMARK DATA TO ESTABLISH COMPENSATION FOR THE PRESIDENT OF THE FOUNDATION. FORM 990, PART VI, SECTION C, LINE 19 HOSPICE OF DAYTON FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND ITS FINANCIAL STATEMENTS (INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF ITS PARENT, THE HOSPICE OF DAYTON, INC.) AVAILABLE TO THE PUBLIC UPON RECEIPT OF A WRITTEN REQUEST FOR SUCH INFORMATION. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 1,721,917. CHANGE IN SPLIT INTEREST AGREEMENTS 14,908. TOTAL TO FORM 990, PART XI, LINE 5: 1,736,825. FORM 990, PART XII, LINE 2C: THE BOARD OF TRUSTEES HAS CHARGED THE FINANCE COMMITTEE OF THE HOSPICE OF DAYTON, INC. WITH OVERSIGHT OF THE INDEPENDENT AUDIT. THIS PROCESS IS CONSISTENET WITH THE PRIOR YEAR. FORM 990, PART IX, LINE 24A: ALL COMPENSATION OF FOUNDATION EMPLOYEES IS PAID BY THE HOSPICE OF DAYTON, INC. (31-0933339) AND IS ALLOCATED TO THE FOUNDATION. THE TOTAL ALLOCATED AMOUNT OF $528,248 CONSISTS OF $437,730 OF SALARIES, $64,176 OF OTHER EMPLOYEE BENEFITS AND $26,342 OF PAYROLL TAXES. THE ALLOCATION IS BASED ON ACTUAL COST. THE HOSPICE OF DAYTON INC 324 WILMINGTON AVENUE DAYTON OH 45420 310933339 HOSPICE CARE OF TERMINALLY ILL. OH 501(C)(3) 170(B)(1)(A)(VI) N/A 0 0 1 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 THE HOSPICE OF DAYTON INC (31-0933339) B 1177836 CASH VALUE THE HOSPICE OF DAYTON INC (31-0933339) K 402416 CASH VALUE THE HOSPICE OF DAYTON INC (31-0933339) M 26729 CASH VALUE THE HOSPICE OF DAYTON INC (31-0933339) N 528248 CASH VALUE