OUR HOSPICE OF SOUTH CENTRAL INDIANA INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
OUR HOSPICE OF SOUTH CENTRAL INDIANA INC (EIN 35-1479425)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-09-29
IRS object ID
201132729349300618
Schema version
2010v3.4
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)
Timestamp2011-09-29T13:02:27-05:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BLUE & CO LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1106 COMMUNITY DRAddressLine1
CitySEYMOURCity
StateINState
ZIP Code47274ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN351479425EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HOSPICE OF SOUTH CENTRAL INDIANA INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHOSPNameControl
Phone8123148000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12626 E 17TH STREETAddressLine1
CityCOLUMBUSCity
StateINState
ZIP Code47201ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSANDRA CARMICHAELName
TitlePRESIDENTTitle
Phone8123148000Phone
Date Signed2011-09-28DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKANDY L WISCHMEIER CPAName
Phone8125228416Phone
Date Prepared2011-09-28DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSANDRA CARMICHAELNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12626 E 17TH STREETAddressLine1
CityCOLUMBUSCity
StateINState
ZIP Code47201ZIPCode
FieldValueIRS element (for citing)
Gross Receipts10915172GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.HOSPICEOFSOUTHCENTRALINDIANA.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1980YearFormation
State Legal DomicileINStateLegalDomicile
Activity Or Mission DescriptionHOSPICE OF SOUTH CENTRAL INDIANA, INC. (HSCI) IS AN INDEPENDENT, NOT-FOR-PROFIT ORGANIZATION PROVIDING SERVICES TO THE TERMINALLY ILL IN A 15-COUNTY SERVICE AREA. SINCE ITS INCEPTION 31 YEARS AGO, HOSPICE HAS EXPANDED TO MEET THE NEEDS FOR END-OF-LIFE CARE IN SOUTHERN INDIANA.ActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees165TotalNbrEmployees
Total Nbr Volunteers239TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year580971ContributionsGrantsPriorYear
Contributions Grants Current Year496162ContributionsGrantsCurrentYear
Program Service Revenue Prior Year9978157ProgramServiceRevenuePriorYear
Program Service Revenue CY10107114ProgramServiceRevenueCY
Investment Income Prior Year26678InvestmentIncomePriorYear
Investment Income Current Year10345InvestmentIncomeCurrentYear
Other Revenue Prior Year209269OtherRevenuePriorYear
Other Revenue Current Year186801OtherRevenueCurrentYear
Total Revenue Prior Year10795075TotalRevenuePriorYear
Total Revenue Current Year10800422TotalRevenueCurrentYear
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 Year7790758SalariesEtcPriorYear
Salaries Etc Current Year7975631SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year261377TotalFundrsngExpCurrentYear
Other Expense Prior Year3223224OtherExpensePriorYear
Other Expenses Current Year3004907OtherExpensesCurrentYear
Total Expenses Prior Year11013982TotalExpensesPriorYear
Total Expenses Current Year10980538TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-218907RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-180116RevenuesLessExpensesCY
Total Assets BOY8876999TotalAssetsBOY
Total Assets EOY8862871TotalAssetsEOY
Total Liabilities BOY1346427TotalLiabilitiesBOY
Total Liabilities EOY1512415TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY7530572NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY7350456NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionHOSPICE OF SOUTH CENTRAL INDIANA, INC. (HSCI) IS AN INDEPENDENT, NOT-FOR-PROFIT ORGANIZATION PROVIDING SERVICES TO THE TERMINALLY ILL IN A 15-COUNTY SERVICE AREA. SINCE ITS INCEPTION 31 YEARS AGO, HOSPICE HAS EXPANDED TO MEET THE NEEDS FOR END-OF-LIFE CARE IN SOUTHERN INDIANA.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense9786759Expense
Revenue10109991Revenue
DescriptionHOSPICE OF SOUTH CENTRAL INDIANA, INC. (HSCI) IS AN INDEPENDENT, NOT-FOR-PROFIT ORGANIZATION PROVIDING SERVICES TO THE TERMINALLY ILL IN A 15-COUNTY SERVICE AREA. SINCE ITS INCEPTION 31 YEARS AGO, HOSPICE HAS EXPANDED TO MEET THE NEEDS FOR END-OF-LIFE CARE IN SOUTHERN INDIANA, AND CURRENTLY HAS FOUR OFFICE LOCATIONS, AS WELL AS A 14-BED INPATIENT FACILITY, LOCATED IN COLUMBUS, INDIANA. HOSPICE EXISTS TO PROVIDE CARE AND SUPPORT TO INDIVIDUALS AND THEIR FAMILIES IN THE LAST PHASES OF AN INCURABLE DISEASE SO THAT THEY MAY LIVE AS FULLY AND COMFORTABLY AS POSSIBLE. BEREAVEMENT SERVICES ARE PROVIDED TO FAMILY MEMBERS AND/OR SIGNIFICANT OTHERS FOR 13 MONTHS FOLLOWING A DEATH. AN INTERDISCIPLINARY TEAM CARES FOR THE PHYSICAL, PSYCHOSOCIAL, SPIRITUAL AND EMOTIONAL NEEDS OF THOSE WHO CHOOSE HSCI, WHETHER IT IS A MATTER OF DAYS, WEEKS, OR MONTHS. SERVICES ARE PROVIDED IN A VARIETY OF SETTINGS, INCLUDING THE PATIENT'S HOME, A LONG-TERM CARE FACILITY, AN ASSISTED LIVING FACILITY OR THE HOSPICE INPATIENT FACILITY. A TEAM OF HIGHLY SKILLED PROFESSIONALS AND VOLUNTEERS ARE AVAILABLE 24-HOURS A DAY, 7 DAYS A WEEK.HSCI IS LICENSED BY THE STATE OF INDIANA AND CERTIFIED BY THE FEDERAL GOVERNMENT. MEDICARE, MEDICAID AND PRIVATE INSURANCE COVER MOST SERVICES. ADDITIONAL FUNDS ARE RAISED THROUGH MEMORIALS, PRIVATE DONATIONS, FUND-RAISING ACTIVITIES, GRANTS AND THE UNITED WAY. TO ENSURE THAT CARE CAN BE PROVIDED REGARDLESS OF ABILITY TO PAY, HSCI IS A COMMUNITY RESOURCE FOR END-OF-LIFE CARE. HOSPICE PROFESSIONALS AND VOLUNTEERS ARE AVAILABLE TO PARTICIPATE IN EDUCATIONAL OFFERINGS IN A VARIETY OF SETTINGS, INCLUDING CHURCHES, SCHOOLS, CIVIC ORGANIZATIONS, AND OTHER HEALTH CARE PROVIDERS. IN 2010, OVER 667 PEOPLE WERE REACHED THROUGH PRESENTATIONS IN THE COMMUNITIES WE SERVE.IN 2010, 1,068 PATIENTS AND FAMILIES RECEIVED 62,318 DAYS OF CARE. ADDITIONALLY, BEREAVEMENT SERVICES WERE PROVIDED TO 2,438 INDIVIDUALS. APPROXIMATELY 9% OF HSCI'S ANNUAL BUDGET IS RAISED EACH YEAR TO PROVIDE THE SPECIALIZED CARE NEEDED BY THE TERMINALLY ILL AND THEIR FAMILIES. YOU ARE WELCOME TO VISIT OUR WEBSITE AT WWW.HOSPICEOFSOUTHCENTRALINDIANA.ORG FOR ADDITIONAL INFORMATION AND TO VIEW PHOTOS OF THE INPATIENT FACILITY.Description
Total Program Service Expense9786759TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming1Gaming
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 Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10961NumberFormsTransmittedWith1096
Number W2 G Included1NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees165NumberOfEmployees
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 Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
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 Policy0WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledINStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSANDRA CARMICHAELNamePerson
Telephone Number8123148000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12626 E 17TH STREETAddressLine1
CityCOLUMBUSCity
StateINState
ZIP Code47201ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
HUTCH SCHUMAKER
BOARD PRESIDENT1.00XX000
JEFF WASHBURN
VICE PRESIDENT1.00XX000
RICHARD KRAMER
SECRETARY/TREASURER1.00XX000
DAVID THOMPSON MD
BOARD MEMBER1.00X000
WILLIAM ALLOY
BOARD MEMBER1.00X000
DAVID FINKEL
BOARD MEMBER1.00X000
REV DENNIS AUD
BOARD MEMBER1.00X000
JAMES BICKEL
BOARD MEMBER1.00X000
PAT MYERS
BOARD MEMBER1.00X000
JANE DAVEE
BOARD MEMBER1.00X000
KAREN SHAW
BOARD MEMBER1.00X000
JOE SHEEHY MD
BOARD MEMBER1.00X000
EDWIN WATKINS MD
BOARD MEMBER1.00X000
SLADE CROWDER MD
BOARD MEMBER1.00X000
TOM DOWD
BOARD MEMBER1.00X000
MARLENE WEATHERWAX
BOARD MEMBER1.00X000
SANDRA CARMICHAEL
PRESIDENT40.00X150211026144
ROY GOODE MD
MEDICAL DIRECTOR24.00129616031847X
FieldValueIRS element (for citing)
Total Reportable Comp From Org279827TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation57991TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Federated Campaigns74228FederatedCampaigns
Government Grants46345GovernmentGrants
All Other Contributions375589AllOtherContributions
Total Contributions496162TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICE REDescription
Business Code624100BusinessCode
Total Revenue Column10107114TotalRevenueColumn
Related Or Exempt Function Income10107114RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue10107114TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column10345TotalRevenueColumn
Exclusion$10,345ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events258174GrossIncomeFundraisingEvents
Fundraising Direct Expenses102067FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column156107TotalRevenueColumn
Exclusion$156,107ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Gaming40500GrossIncomeGaming
Gaming Direct Expenses12683GamingDirectExpenses

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column27817TotalRevenueColumn
Exclusion$27,817ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOTHER INCOMEDescription
Business Code900099BusinessCode
Total Revenue Column2877TotalRevenueColumn
Related Or Exempt Function Income2877RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue2877TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column10800422TotalRevenueColumn
Related Or Exempt Function Income10109991RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$194,269ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total176355Total
Program Services155193ProgramServices
Management And General15872ManagementAndGeneral
Fundraising5290Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total5964171Total
Program Services5248471ProgramServices
Management And General536775ManagementAndGeneral
Fundraising178925Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total291075Total
Program Services256146ProgramServices
Management And General26197ManagementAndGeneral
Fundraising8732Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1085729Total
Program Services955441ProgramServices
Management And General97716ManagementAndGeneral
Fundraising32572Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total458301Total
Program Services403305ProgramServices
Management And General41247ManagementAndGeneral
Fundraising13749Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total35369Total
Management And General35369ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total18601Total
Program Services17299ProgramServices
Management And General1302ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total156922Total
Program Services121397ProgramServices
Management And General27607ManagementAndGeneral
Fundraising7918Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total44723Total
Program Services39356ProgramServices
Management And General4025ManagementAndGeneral
Fundraising1342Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total159032Total
Program Services116093ProgramServices
Management And General33397ManagementAndGeneral
Fundraising9542Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total178225Total
Program Services176443ProgramServices
Fundraising1782Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total14102Total
Program Services14102ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total235637Total
Program Services181440ProgramServices
Management And General54197ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total81892Total
Program Services74522ProgramServices
Management And General7370ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
PATIENT SERVICE EXPENSE17532631753263
REPAIRS AND MAINTENANCE21625517516741088
MISCELLANEOUS508494474845761525
BAD DEBT EXPENSES3541035410
DUES SUBSCRIPTIONS BOOK24627189635664

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total10980538Total
Program Services9786759ProgramServices
Management And General932402ManagementAndGeneral
Fundraising261377Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1682746BOY
EOY1794309EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1237556BOY
EOY1279980EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY5845BOY
EOY5207EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY88094BOY
EOY79364EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis7989310LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2329228LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY5827231BOY
EOY5660082EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY35527BOY
EOY43929EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY8876999BOY
EOY8862871EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1346427BOY
EOY1512415EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1346427BOY
EOY1512415EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY7524912BOY
EOY7337795EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY5660BOY
EOY12661EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7530572BOY
EOY7350456EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8876999BOY
EOY8862871EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-180116ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review1AccountantCompileOrReview
FS Audited0FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
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 Years517581CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years617831CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years473380CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year580971CurrentTaxYearMinus1Year
Current Tax Year496162CurrentTaxYear
Total2685925Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years517581CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years617831CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years473380CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year580971CurrentTaxYearMinus1Year
Current Tax Year496162CurrentTaxYear
Total2685925Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total171384AmountsSubstContributorsTotal
Public Support Total1702514541PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years71753CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years82270CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years55848CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year26678CurrentTaxYearMinus1Year
Current Tax Year10345CurrentTaxYear
Total246894Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5062CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3856CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12535CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9941CurrentTaxYearMinus1Year
Current Tax Year2877CurrentTaxYear
Total34271Total
FieldValueIRS element (for citing)
Total Support2967090TotalSupport
Gross Receipts From Admissions Etc48875147GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.84750PublicSupportPertcentage170
Public Support Pertcent Prior Year0.83760PublicSupportPertcentPriorYear
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

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7989310OtherCostOrOtherBasis
Depreciation2329228Depreciation
Book Value5660082BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings5660082TotalOfBookValueLandBuildings
Total Revenue10800422TotalRevenue
Total Expenses10980538TotalExpenses
Excess Or Deficit For Year-180116ExcessOrDeficitForYear
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS-180116ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt10992973TotRevenueEtcAuditedFinclStmt
Donated Srvc And Use Of Facilities77801DonatedSrvcAndUseOfFacilities
Other Revenues114750OtherRevenues
Revenue Not Rptd F990192551RevenueNotRptdF990
Revenue Subtotal10800422RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99010800422TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt11173089TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities77801DonatedServicesUseOfFacilities
Other Expenses Included114750OtherExpensesIncluded
Expenses Not Rptd F990192551ExpensesNotRptdF990
Expenses Subtotal10980538ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99010980538TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierExplanationExplanation
PART XII, LINE 2D - OTHER ADJUSTMENTS:SPECIAL EVENTS EXPENSE 114,750.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:SPECIAL EVENTS EXPENSES 114,750.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1CONCERTNameOfEvent1
Gross Receipts Event1124738GrossReceiptsEvent1
Gross Revenue Event1124738GrossRevenueEvent1
Other Direct Expenses Event164590OtherDirectExpensesEvent1
Name Of Event2GOLF OUTINGNameOfEvent2
Gross Receipts Event236215GrossReceiptsEvent2
Gross Revenue Event236215GrossRevenueEvent2
Other Direct Expenses Event24718OtherDirectExpensesEvent2
Gross Receipts Other Events97221GrossReceiptsOtherEvents
Gross Revenue Other Events97221GrossRevenueOtherEvents
Other Direct Expenses Other Events32759OtherDirectExpensesOtherEvents
Gross Receipts Total258174GrossReceiptsTotal
Gross Revenue Total Events258174GrossRevenueTotalEvents
Other Direct Expenses Total Events102067OtherDirectExpensesTotalEvents
Direct Expense Summary Events102067DirectExpenseSummaryEvents
Net Income Summary156107NetIncomeSummary

Gaming Information GamingInformation

FieldValueIRS element (for citing)
Gross Revenue Other Gaming40500GrossRevenueOtherGaming
Cash Prizes Other Gaming11950CashPrizesOtherGaming
Other Direct Expenses Other Gaming733OtherDirectExpensesOtherGaming
Volunteer Labor Other Gaming0VolunteerLaborOtherGaming
Gross Revenue Total Gaming40500GrossRevenueTotalGaming
Cash Prizes Total Gaming11950CashPrizesTotalGaming
Other Direct Expenses Total Gaming733OtherDirectExpensesTotalGaming
Direct Expense Summary Gaming12683DirectExpenseSummaryGaming
Net Gaming Income Summary27817NetGamingIncomeSummary
FieldValueIRS element (for citing)
States Where Gaming ConductedINStatesWhereGamingConducted
Licensed1Licensed
License Suspended Etc0LicenseSuspendedEtc
Gaming With Nonmembers0GamingWithNonmembers
Member Of Other Entity0MemberOfOtherEntity
Percentage Of Gaming Othr Facility1.00000PercentageOfGamingOthrFacility
Name Of Gaming Rec Keeper PersonPHIL BUSHNameOfGamingRecKeeperPerson

Address Of Gaming Rec Keeper US AddressOfGamingRecKeeperUS

FieldValueIRS element (for citing)
Address Line12626 E 17TH STREETAddressLine1
CityCOLUMBUSCity
StateINState
ZIP Code47201ZIPCode
FieldValueIRS element (for citing)
Contract With3rd Party For Gam Rev0ContractWith3rdPartyForGamRev
Gaming Manager Name PersonSANDRA CARMICHAELGamingManagerNamePerson
Gaming Manager Compensation100GamingManagerCompensation
Gaming Manager Services ProvidedOVERALL RESPONSIBILITY FOR THE OPERATION AND CONDUCT OF THE GAMING EVENTGamingManagerServicesProvided
Gaming Manager Is EmployeeXGamingManagerIsEmployee
Charitable Distrib Required0CharitableDistribRequired

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalXBoardOrCommitteeApproval
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 (2 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
SANDRA CARMICHAEL
1502110000000261440176355000
ROY GOODE MD
1296160000000318470161463000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION B, LINE 11THE EXECUTIVE COMMITTEE OF THE BOARD DELEGATED AUTHORITY TO THE FINANCE COMMITTEE OF THE BOARD TO APPROVE THE FORM 990. THE FINANCE COMMITTEE OF THE BOARD WILL REVIEW THE ENTIRE FORM 990. ONCE APPROVED BY THE FINANCE COMMITTEE OF THE BOARD, A FULL COPY OF THE FORM 990 WAS MADE AVAILABLE TO EVERY BOARD MEMBER FOR REVIEW PRIOR TO FILING.
EFFECTIVE 2006, BOARD MEMBERS, KEY EMPLOYEES, DIRECTORS AND OFFICERS SIGNED A CONFLICT OF INTEREST STATEMENT, STATING THAT THEY HAVE READ AND UNDERSTOOD THE STATEMENT. SINCE THAT TIME, ORIENTATION FOR NEW BOARD MEMBERS, KEY EMPLOYEES, OFFICERS AND DIRECTORS, INCLUDES REVIEW AND SIGNATURE OF A CONFLICT OF INTEREST STATEMENT. THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY THE COMPLIANCE OFFICER WITH FOLLOW-UP BY THE COMPLIANCE COMMITTEE IF ANY POTENTIAL CONFLICTS ARE IDENTIFIED.FORM 990, PART VI, SECTION B, LINE 12C
EACH POSITION HAS A SALARY RANGE. COMPENSATION AT HIRE IS DETERMINED BY SEVERAL FACTORS, INCLUDING THE APPLICANT'S EXPERIENCE, EDUCATION, APPLICANT'S SALARY AT THEIR MOST RECENT EMPLOYMENT AND WHERE THE PROPOSED SALARY WOULD FALL WITHIN THE SALARY RANGE OF OTHER MEMBERS OF THE HOSPICE TEAM WHO ARE IN SIMILAR POSITIONS. EACH YEAR, HOSPICE EMPLOYEES ARE GIVEN A 3% MERIT INCREASE IN SALARY. ANY INCREASES IN SALARY ABOVE THE 3% MERIT WOULD BE MADE DUE TO A MARKET WAGE ADJUSTMENT, OR BASED ON PERFORMANCE. CURRENTLY, HOSPICE IS DEVELOPING A PRESIDENT'S COMPENSATION POLICY. THIS POLICY WILL STIPULATE THAT APPROVAL OF INCREASE ABOVE 3% MERIT INCREASE FOR THE PRESIDENT'S POSITION WOULD NEED TO BE APPROVED BY THE EXECUTIVE COMMITTEE OF HOSPICE'S BOARD OF DIRECTORS.FORM 990, PART VI, SECTION B, LINE 15
THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST STATEMENT, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.FORM 990, PART VI, SECTION C, LINE 19
THE PROCESS OF SELECTING AN INDEPENDENT ACCOUNTANT AND OVERSIGHT OF THE AUDIT HAS NOT CHANGED FROM PRIOR YEARS.FORM 990, PART XII, LINE 2C

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.