HOSPICE OF THE WESTERN RESERVE INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
HOSPICE OF THE WESTERN RESERVE INC (EIN 34-1256377)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-10-14
IRS object ID
201132879349301233
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)
Timestamp2011-10-14T16:12:34-05:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1HOWARD WERSHBALE & COBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line123240 CHAGRIN BLVDAddressLine1
CityCLEVELANDCity
StateOHState
ZIP Code441225450ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN341256377EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HOSPICE OF THE WESTERN RESERVE INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHOSPNameControl
Phone2163832222Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line117876 ST CLAIR AVENUEAddressLine1
CityCLEVELANDCity
StateOHState
ZIP Code44110ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN HARVAN JRName
TitleCFOTitle
Date Signed2011-10-11DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJoseph C Sbrocco CPAName
Phone2168311200Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeXAddressChange
Name Of Principal Officer PersonJOHN E HARVAN JRNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line117876 ST CLAIRAddressLine1
CityCLEVELANDCity
StateOHState
ZIP Code44110ZIPCode
FieldValueIRS element (for citing)
Gross Receipts112420254GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.HOSPICEWR.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1978YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionHOSPICE OF THE WESTERN RESERVE PROVIDES PALLIATIVE END-OF-LIFE CARE, CAREGIVER SUPPORT, AND BEREAVEMENT SERVICES THROUGHOUT NORTHERN OHIO. We strive to relieve suffering & enhance comfort in end of life care.ActivityOrMissionDescription
Nbr Voting Members Governing Body30NbrVotingMembersGoverningBody
Nbr Independent Voting Members29NbrIndependentVotingMembers
Total Nbr Employees1002TotalNbrEmployees
Total Nbr Volunteers1500TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year8526768ContributionsGrantsPriorYear
Contributions Grants Current Year5927849ContributionsGrantsCurrentYear
Program Service Revenue Prior Year82052161ProgramServiceRevenuePriorYear
Program Service Revenue CY87328489ProgramServiceRevenueCY
Investment Income Prior Year864133InvestmentIncomePriorYear
Investment Income Current Year258808InvestmentIncomeCurrentYear
Other Revenue Prior Year382682OtherRevenuePriorYear
Other Revenue Current Year385388OtherRevenueCurrentYear
Total Revenue Prior Year91825744TotalRevenuePriorYear
Total Revenue Current Year93900534TotalRevenueCurrentYear
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 Year50126158SalariesEtcPriorYear
Salaries Etc Current Year52602441SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year20000TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY7500TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year1189111TotalFundrsngExpCurrentYear
Other Expense Prior Year33319583OtherExpensePriorYear
Other Expenses Current Year36423576OtherExpensesCurrentYear
Total Expenses Prior Year83465741TotalExpensesPriorYear
Total Expenses Current Year89033517TotalExpensesCurrentYear
Revenues Less Expenses Prior Year8360003RevenuesLessExpensesPriorYear
Revenues Less Expenses CY4867017RevenuesLessExpensesCY
Total Assets BOY59642937TotalAssetsBOY
Total Assets EOY67821107TotalAssetsEOY
Total Liabilities BOY14659383TotalLiabilitiesBOY
Total Liabilities EOY15501550TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY44983554NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY52319557NetAssetsOrFundBalancesEOY
Mission DescriptionHOSPICE OF THE WESTERN RESERVE PROVIDES PALLIATIVE END-OF-LIFE CARE, CAREGIVER SUPPORT, AND BEREAVEMENT SERVICES THROUGHOUT NORTHERN OHIO. IN CELEBRATION OF THE INDIVIDUAL WORTH OF EACH LIFE, WE STRIVE TO RELIEVE SUFFERING, ENHANCE COMFORT, PROMOTE QUALITY LIFE, FOSTER CHOICE IN END-OF-LIFE CARE AND SUPPORT EFFECTIVE GRIEVING.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense76776756Expense
Revenue87713877Revenue
DescriptionHOSPICE CARE SERVICES ARE ABOUT PROVIDING PEOPLE (ADULTS AND CHILDREN) WITH A LIFE-LIMITING ILLNESS, AND THEIR FAMILIES WITH CHOICES AND DIGNITY. CARE IS PROVIDED WHEREVER THE PATIENTS LIVE; IN THEIR HOME, IN A HOSPITAL, ASSISTED LIVING/LONG-TERM CARE CACILITY OR AT THE 42-BED RESIDENTIAL FACILITY HOSPICE HOUSE. IN 2010, HOSPICE OF WESTERN RESERVE PROVIDED 455,864 PATIENT DAYS. CARE IS PROVIDED BY A TEAM OF PAID AND NON-PAID STAFF WHO ARE AVAILABLE 24-HOURS A-DAY, SEVEN DAYS A WEEK. ADDITIONALLY, BEREAVEMENT SERVICES ARE PROVIDED FOR FAMILIES FOR MORE THAN A YEAR FOLLOWING THE LOSS OF A LOVED ONE.Description
Total Program Service Expense76776756TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10961108NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1002NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members30NbrVotingGoverningBodyMembers
Number Independent Voting Members29NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledOHStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJOHN E HARVAN JRNamePerson
Telephone Number2163832222TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line117876 ST CLAIRAddressLine1
CityCLEVELANDCity
StateOHState
ZIP Code44110ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (44 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
H CLARK HARVEY JR
DIRECTOR1.0X000
JAMES L HAMBRICK
VICE CHAIR3.0X000X
PEG MILBOURN
VICE CHAIR3.0X000X
RICHARD B WHITNEY
Chair3.0X000X
CARL BALDASSARRE
Vice Chair3.0X000X
JOSEPH CARSON
DIRECTOR1.0X000
REV NEROY CARTER
DIRECTOR1.0X000
DAVID G COLE
DIRECTOR1.0X000
MARGIT DALEY
DIRECTOR1.0X000
CYNTHIA HUNDORFEAN
DIRECTOR1.0X000
JEAN E KILGORE
DIRECTOR1.0X000
HILARY MASON KING
DIRECTOR1.0X000
MARY ANN KOCURKO
Treasurer3.0X000X
CAROL G MANNING
Secretary3.0X000X
MICHAEL J MERRIMAN
DIRECTOR1.0X000
WENDY MIANO
DIRECTOR1.0X000
VIRGINIA A MOONEY
DIRECTOR1.0X000
DAVID MORDARSKI
DIRECTOR1.0X000
JANICE MURPHY
DIRECTOR1.0X000
LAURA NAVIN
DIRECTOR1.0X000
MARY L OGRINC
DIRECTOR1.0X000
SARAH ROBERTSON
DIRECTOR1.0X000
RICHARD T SPOTZ JR
DIRECTOR1.0X000
WILLIAM SPRINGER
DIRECTOR1.0X000
BRET WILLIAMS
DIRECTOR1.0X000
ELIZABETH PITORAK
DIRECTOR HOSPICE INSTITUTE40.0X345723017977
RICHARD A BARONE
DIRECTOR1.0X000
DEREK RAGHAVAN
DIRECTOR1.0X000
JAMES W ROGERSON
DIRECTOR1.0X000
TRACY K STRATFORD
DIRECTOR1.0X000
DAVID SIMPSON
CHIEF EXECUTIVE OFFICER40.0538886017948X
BRIDGET J MONTANA
CHIEF OPERATING OFFICER40.0254814015976X
JOHN E HARVAN JR
CHIEF FINANCIAL OFFICER40.0389801016710X
CHARLES V WELLMAN
CHIEF MEDICAL OFFICER40.0302644016892X
ALAN C WINE
MEDICAL DIRECTOR40.0176493012904X
SHAREEFAH SABUR
CHIEF STRATEGY OFFICER40.0163512011925X
DANN GANZHORN
MEDICAL DIRECTOR40.0193573012956X
JEFFREY SPIESS
MEDICAL DIRECTOR40.0194502013734X
JOHN WALTERS
MEDICAL DIRECTOR40.015511809036X
ROBERT P PHILLIPS PLONA
Director of Residential Serv40.013808308150X
JANICE SCHEUFLER
PHARMACIST40.011334305667X
CLEMENT HEAREY
DIRECTOR OF HUMAN RESOURCES40.014836509870X
SUSAN M FIGULA
CHIEF MARKETING & COMM OFFICER40.0131004010013X
SHARI A KOBAYAKAWA
Chief Development Officer40.013683806775X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3382699TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation186533TotalOtherCompensation
Number Individuals GT100 K20NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
VOCON PARTNERS OF OHIO LLC
3142 PROSPECT AVENUECLEVELANDOH44115ARCHITECTURAL456412
DONLEY'S INC
5430 WARNER ROADCLEVELANDOH44125BUILDING CONTRACTOR340208
LIGGETT STASHOWER
PO BOX 931456CLEVELANDOH44193ADVERTISING DESIGN216232
DR CARLA BASTER
16920 CHARDON WINDSOR ROADHUNTSBURGOH44046PHYSICIAN SERVICES136146
ACE DEMO INC
2111 CENTER STREETCLEVELANDOH44113DEMOLITION120420
FieldValueIRS element (for citing)
Number Of Contractors GT100 K6NumberOfContractorsGT100K
Federated Campaigns429314FederatedCampaigns
All Other Contributions5498535AllOtherContributions
Noncash Contributions2214990NoncashContributions
Total Contributions5927849TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionHOSPICE CARE SERVICESDescription
Business Code623000BusinessCode
Total Revenue Column87328489TotalRevenueColumn
Related Or Exempt Function Income87328489RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue87328489TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column578480TotalRevenueColumn
Exclusion$578,480ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities18200048Securities
Other0Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities18497831Securities
Other21889Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-297783Securities
Other-21889Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-319672TotalRevenueColumn
Exclusion-$319,672ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
RESALE SHOP900099295349295349
GRIEF COUNSELING REVENUE6241004050040500
MISCELLANEOUS REVENUE9000994953949539
FieldValueIRS element (for citing)
Total Other Revenue385388TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column93900534TotalRevenueColumn
Related Or Exempt Function Income87713877RelatedOrExemptFunctionIncome
Exclusion$258,808ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2861124Total
Management And General2861124ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total36364199Total
Program Services32942440ProgramServices
Management And General2841006ManagementAndGeneral
Fundraising580753Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2090918Total
Program Services1756007ProgramServices
Management And General303954ManagementAndGeneral
Fundraising30957Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7108681Total
Program Services5949027ProgramServices
Management And General1051677ManagementAndGeneral
Fundraising107977Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4177519Total
Program Services3508388ProgramServices
Management And General607280ManagementAndGeneral
Fundraising61851Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total197131Total
Management And General197131ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total27886Total
Management And General27886ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total7500Total
Fundraising7500Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1788186Total
Program Services943091ProgramServices
Management And General750199ManagementAndGeneral
Fundraising94896Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total276081Total
Program Services85993ProgramServices
Management And General167073ManagementAndGeneral
Fundraising23015Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2415069Total
Program Services1148245ProgramServices
Management And General1116469ManagementAndGeneral
Fundraising150355Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1851315Total
Program Services1312580ProgramServices
Management And General479113ManagementAndGeneral
Fundraising59622Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total97404Total
Program Services81803ProgramServices
Management And General14159ManagementAndGeneral
Fundraising1442Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total149878Total
Program Services81939ProgramServices
Management And General60019ManagementAndGeneral
Fundraising7920Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total82163Total
Program Services58253ProgramServices
Management And General21263ManagementAndGeneral
Fundraising2647Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total962125Total
Program Services720801ProgramServices
Management And General223640ManagementAndGeneral
Fundraising17684Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total266987Total
Program Services189294ProgramServices
Management And General69095ManagementAndGeneral
Fundraising8598Fundraising

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesFundraisingFundraisingManagement And GeneralManagementAndGeneral
BAD DEBT4313194270794240
MEDICAL SUPPLIES4741510472895640312151
PATIENT SERVICES186262918576971594773
NURSING FACILITIES1963146519579487167050308
PATIENT SUPPLIES714746712853611832

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total927682Total
Program Services692823ProgramServices
Management And General207498ManagementAndGeneral
Fundraising27361Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total89033517Total
Program Services76776756ProgramServices
Management And General11067650ManagementAndGeneral
Fundraising1189111Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1266BOY
EOY1416EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY4818183BOY
EOY8126279EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY7431544BOY
EOY5001959EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY9585387BOY
EOY9719391EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY535951BOY
EOY669582EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis24547305LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec5179406LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY15622950BOY
EOY19367899EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY20374152BOY
EOY23267535EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY1165948BOY
EOY1234391EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY73583BOY
EOY396345EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY33973BOY
EOY36310EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY59642937BOY
EOY67821107EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY8743907BOY
EOY10006771EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY2785000BOY
EOY3938170EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1000000BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2130476BOY
EOY1556609EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY14659383BOY
EOY15501550EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY36640249BOY
EOY45114011EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY7878403BOY
EOY6740644EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY464902BOY
EOY464902EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY44983554BOY
EOY52319557EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY59642937BOY
EOY67821107EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses4867017ReconcilationRevenueExpenses
Reconcilation Other Changes2468986ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3641093CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4254990CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8829804CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8526768CurrentTaxYearMinus1Year
Current Tax Year5927849CurrentTaxYear
Total31180504Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years65636042CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years72018845CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years73369832CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year82052161CurrentTaxYearMinus1Year
Current Tax Year87328489CurrentTaxYear
Total380405369Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years69277135CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years76273835CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years82199636CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year90578929CurrentTaxYearMinus1Year
Current Tax Year93256338CurrentTaxYear
Total411585873Total
FieldValueIRS element (for citing)
Public Support Total509411585873PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1004901CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years842135CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years801992CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year760658CurrentTaxYearMinus1Year
Current Tax Year578480CurrentTaxYear
Total3988166Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1004901CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years842135CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years801992CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year760658CurrentTaxYearMinus1Year
Current Tax Year578480CurrentTaxYear
Total3988166Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years232692CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years241893CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years326388CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year382682CurrentTaxYearMinus1Year
Current Tax Year385388CurrentTaxYear
Total1569043Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years70514728CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years77357863CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years83328016CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year91722269CurrentTaxYearMinus1Year
Current Tax Year94220206CurrentTaxYear
Total417143082Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98668PublicSupportPercentage509
Prior Year Support Percentage0.98510PriorYearSupportPercentage
Investment Income Percentage0.00956InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.01129PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

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

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance774691BeginningOfYearBalance
Investment Earnings Or Losses77471InvestmentEarningsOrLosses
End Of Year Balance852162EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance790588BeginningOfYearBalance
Investment Earnings Or Losses-15897InvestmentEarningsOrLosses
End Of Year Balance774691EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance464902BeginningOfYearBalance
Investment Earnings Or Losses37729InvestmentEarningsOrLosses
Other Expenditures37729OtherExpenditures
End Of Year Balance464902EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.54556PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.45444TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis7528120OtherCostOrOtherBasis
Book Value7528120BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis7812510OtherCostOrOtherBasis
Depreciation2767171Depreciation
Book Value5045339BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis99771OtherCostOrOtherBasis
Depreciation29570Depreciation
Book Value70201BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis2674410OtherCostOrOtherBasis
Depreciation1166122Depreciation
Book Value1508288BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis6432494OtherCostOrOtherBasis
Depreciation1216543Depreciation
Book Value5215951BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings19367899TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ANNUITY OBLIGATIONS$84,241
DEFERRED COMPENSATION OBLIGATION$1,472,368
FieldValueIRS element (for citing)
Total Of Amounts1556609TotalOfAmounts
Total Revenue93900534TotalRevenue
Total Expenses89033517TotalExpenses
Excess Or Deficit For Year4867017ExcessOrDeficitForYear
Net Unrealized GL On Investments2464049NetUnrealizedGLOnInvestments
Other$4,937OtherAmount
Total Adjustments2468986TotalAdjustments
Excess Or Deficit Per FS7336003ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt97686649TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments2464049NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities1317129DonatedSrvcAndUseOfFacilities
Other Revenues4937OtherRevenues
Revenue Not Rptd F9903786115RevenueNotRptdF990
Revenue Subtotal93900534RevenueSubtotal
Total Revenue Per Form99093900534TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt90350646TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities1317129DonatedServicesUseOfFacilities
Expenses Not Rptd F9901317129ExpensesNotRptdF990
Expenses Subtotal89033517ExpensesSubtotal
Total Expenses Per Form99089033517TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
CHANGES IN NET ASSETSSCHEDULE D, PART XI, #8Change in Split Value Interest Agreements - $4,937.
OTHER REVENUESCHEDULE D, PART XII, #2DChange in Split Value Interest Agreements - $4,937.
INTENDED USES OF ENDOWMENT FUNDSSCHEDULE D, PART V, #4DONOR-IMPOSED STIPULATIONS INDICATING THAT THE FUNDS BE MAINTAINED PERMANENTLY BY THE ORGANIZATION AND THAT ALLOW THE INCOME EARNED ON ANY RELATED INVESTMENT TO BE USED FOR GENERAL PURPOSES.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 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
ELIZABETH PITORAK
1485440206000176579014700032770363700000
CHARLES V WELLMAN
257544028600016500013960029320319536000
ALAN C WINE
17589306000009627032770189397000
SHAREEFAH SABUR
11841202860001650008648032770175437000
DANN GANZHORN
19303305400009679032770206529000
JEFFREY SPIESS
193902060000010606031280208236000
JOHN WALTERS
15451806000009036000164154000
DAVID SIMPSON
32182706000216459014671032770556834000
BRIDGET J MONTANA
209714028600016500012699032770270790000
JOHN E HARVAN JR
2114860286000149715013582031280406511000
CLEMENT HEAREY
11626501560001650006593032770158235000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierParticipate in, receive payment from, supplemental nonqualified retirementIdentifier
Return Referenceschedule J, part I, #4BReturnReference
ExplanationDavid Simpson, CEO - $216,459. John Harvan, Jr, CFO - $133,215. Elizabeth Pitorak, Director Hospice Institute - $160,079.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1CLEVELAND-CUYAHOGA COUNTY PORT AUTHORITYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN341029691IssuerEIN
CUSIP Number999999999CUSIPNumber
Date Issued2010-12-30DateIssued
Issue Price21565000IssuePrice
Description Of Purposeretire 1999 bonds & construct faciDescriptionOfPurpose
DefeasedtrueDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired2566826AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds21565000TotalProceeds
Amount In Reserve Fund0AmountInReserveFund
Capitalized Interest229577CapitalizedInterest
Refunding Escrow2566826RefundingEscrow
Issuance Costs From Proceeds371345IssuanceCostsFromProceeds
Credit Enhancement0CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures18397252CapitalExpenditures
Other Spent Proceeds0OtherSpentProceeds
Amount Unspent0AmountUnspent
Year Of Subst Completion2013YearOfSubstCompletion
Current RefundingtrueCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Bond Counsel Routinely EngagedtrueBondCounselRoutinelyEngaged
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Post Issuance Compliance ProcdrstruePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuetrueVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatefalseExceptionToRebate

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
RICHARD SPOTZ JR
DIRECTOR6299PROVIDED LEGAL SERVICESfalse
JOHN E HARVAN JR
CFO1800ANNUAL ORGANIZATION DUESfalse

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArt
Art Historical TreasuresArtHistoricalTreasures
Art Fractional InterestArtFractionalInterest
Books And PublicationsBooksAndPublications
Clothing And Household GoodsClothingAndHouseholdGoods
Cars And Other VehiclesCarsAndOtherVehicles
Boats And PlanesBoatsAndPlanes
Intellectual PropertyIntellectualProperty
Securities Publicly TradedSecuritiesPubliclyTraded
Securities Closely Held StockSecuritiesCloselyHeldStock
Securities Prtnrshp Trust IntrstsSecuritiesPrtnrshpTrustIntrsts
Securities MiscellaneousSecuritiesMiscellaneous
Qualified Contrib Hist StructQualifiedContribHistStruct
Qualified Contrib OtherQualifiedContribOther
Real Estate ResidentialRealEstateResidential

Real Estate Commercial RealEstateCommercial

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F9901169994NoncashContribsRptdF990
Method Of Determining RevenuesfmvMethodOfDeterminingRevenues

Real Estate Other RealEstateOther

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions2NumberOfContributions
Noncash Contribs Rptd F9901044996NoncashContribsRptdF990
Method Of Determining RevenuesfmvMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
CollectiblesCollectibles
Food InventoryFoodInventory
Drugs And Medical SuppliesDrugsAndMedicalSupplies
TaxidermyTaxidermy
Historical ArtifactsHistoricalArtifacts
Scientific SpecimensScientificSpecimens
Archaeological ArtifactsArchaeologicalArtifacts
Number Of8283 Received0NumberOf8283Received
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftstrueReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DOCUMENTS AVAILABLE TO PUBLICPAGE 6, PART VI, SECTION C, #19HOSPICE OF THE WESTERN RESERVE DOES MAKE ITS FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC BY PROVIDING COPIES UPON REQUEST, INSPECTION AT THE HEADQUARTERS OFFICE AND BY PROVIDING FINANCIAL DATA IN ANNUAL REPORTS WHICH ARE AVAILABLE ON HOSPICE OF THE WESTERN RESERVE'S WEBSITE. HOSPICE OF THE WESTERN RESERVE DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE GENERAL PUBLIC AT THIS TIME.
PROCESS FOR DETERMINING COMPENSATIONPAGE 6, PART VI, SECTION B, #15A & 15BTHE COMPENSATION OF THE CEO IS BASED ON ANNUAL LABOR MARKET DATA FROM BOTH LOCAL AND NATIONAL SOURCES. WITH THE HELP OF THE HUMAN RESOURCES TEAM, THE ORGANIZATION PARTICIPATES IN ANNUAL AND SPECIAL COMPENSATION SURVEYS AND THE RESULTING DATA IS SHARED WITH THE BOARD OF DIRECTORS. COMPENSATION INFORMATION IS ALSO OBTAINED FROM FORM 990'S FROM OTHER COMPARABLE NOT-FOR-PROFIT HOSPICES. IN ADDITION, EACH BOARD DIRECTOR IS ASKED TO RESPOND TO A QUESTIONNAIRE EVALUATING THE CEO'S PERFORMANCE COMPARED TO GOALS ESTABLISHED DURING THE PREVIOUS YEAR'S EVALUATION. THE RESULTS OF THE QUESTIONNAIRES ARE TABULATED AND SHARED WITH THE BOARD'S EXECUTIVE COMMITTEE. BASED ON THE THE LABOR MARKET DATA AND ANNUAL PERFORMANCE EVALUATION PROCESS, THE EXECUTIVE COMMITTEE THEN ESTABLISHES THE CEO'S COMPENSATION LEVEL AS WELL AS ANY PERFORMANCE BONUS THAT MAY BE PROVIDED. FOR OTHER KEY OFFICERS, THE PROCESS IS SIMILAR TO THE PROCESS NOTED ABOVE. THE ORGANIZATION OBTAINS ANNUAL LABOR MARKET DATA FROM BOTH LOCAL AND NATIONAL SOURCES. THE ORGANIZATION PARTICIPATES IN ANNUAL AND SPECIAL COMPENSATION SURVEYS AND THE RESULTING DATA IS SHARED WITH THE CEO. IN ADDITION, THE INTERNAL ALIGNMENT OF OUR POSITIONS IS PERIODICALLY REVIEWED. RATES OF PAY ARE REVIEWED AND ESTABLISHED FOR INTERNAL POSITIONS BASED ON EQUITABLE RELATIONSHIPS AND THE DIFFICULTY AND RESPONSIBILITY OF WORK PERFORMED. RECOMMENDATIONS FOR REQUISITE CHANGES ARE DISCUSSED WITH THE CEO. THE OFFICER'S PERFORMANCE IS REVIEWED ON AN ANNUAL BASIS BY THE CEO. BASED ON THE INDIVIDUAL'S ANNUAL PERFORMANCE AND GOALS ACHIEVED, AND THE INTERNAL AND EXTERNAL DATA, THE CEO WILL ESTABLISH THE COMPENSATION LEVEL FOR HIS OFFICERS. THIS PROCESS HELPS US MAINTAIN THE ORGANIZATION'S INTERNAL ALIGNMENT AND EXTERNAL COMPETITIVENESS. THE ABOVE PROCESSES ARE DOCUMENTED AT THE TIME THE DECISIONS ARE MADE.
FAMILY OR BUSINESS RELATIONSHIPSPAGE 6, PART VI, SECTION A, #2MRS. MARGARET MENDENHALL SIMPSON, THE WIFE OF HOSPICE OF THE WESTERN RESERVE'S CEO, MR. DAVID A. SIMPSON, IS AN EMPLOYEE OF ZIEGLER, METZER, MILLER, LLP. (THE LAW FIRM PROVIDED LEGAL ADVICE AND SERVICES TO THE ORGANIZATION DURING 2010.) MR. RICHARD T. SPOTZ, JR. IS A BOARD MEMBER OF HOSPICE OF THE WESTERN RESERVE AND THE MANAGING PARTNER AT ZIEGLER, METZER, MILLER, LLP.
FORM 990 REVIEW PROCESSPAGE 6, PART VI, SECTION A, #11BTHE FINANCE AND AUDIT COMMITTEE OF THE BOARD RECEIVES A COPY OF THE FORM 990 FOR REVIEW, FEEDBACK, AND APPROVAL PRIOR TO SUBMISSION TO THE IRS.
BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONSSCHEDULE L, PART IVMR. RICHARD T. SPOTZ, JR. IS AN ATTORNEY AND LONG STANDING MEMBER OF THE BOARD OF DIRECTORS. MR. SPOTZ IS A PARTNER AT THE LAW FIRM, ZIEGLER, METZER, MILLER, LLP, IN CLEVELAND, OHIO. IN 2010, THAT FIRM PROVIDED LEGAL ADVICE AND SERVICES TO HOSPICE OF THE WESTERN RESERVE AND WAS PAID $6,299. HOSPICE OF THE WESTERN RESERVE IS A MEMBER OF THE HOSPICE ALLIANCE OF OHIO (ANNUAL DUES PAID IN 2010 OF $1,800). HOSPICE ALLIANCE OF OHIO, AN OHIO 501(C)(6) ORGANIZATION, IS A GROUP OF NINETEEN HOSPICES THROUGHOUT THE STATE THAT COLLECTIVELY NEGOTIATE CONTRACTS WITH HEALTHCARE INSURANCES FOR HOSPICE SERVICES AND NETWORKS WITH EACH OTHER. MR. JOHN E. HARVAN, JR., CFO OF HOSPICE OF THE WESTERN RESERVE, IS A BOARD MEMBER OF THE HOSPICE ALLIANCE OF OHIO AND SERVES IN THE ROLE AS ITS TREASURER.
MONITOR AND ENFORCE CONFLICT OF INTEREST POLICYPAGE 6, PART VI, SECTION B, #12CAll Board members and employees are required to submit a disclosure statement at the beginning of employment and annually thereafter. If a matter arises which a Board member or employee has a conflict of interest, it shall be promptly disclosed to the Board or Chief Executive Officer as appropriate. Staff may initiate disclosure through their supervisor. However, the Board member or employee shall not participate in the discussion or vote to determine whether a conflict exists unless requested to do so. The Human Resources Committee shall be available to the Chief Executive Officer for review of conflict situations.

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