2011-10-14T16:12:34-05:00 2010-12-31 HOWARD WERSHBALE & CO 23240 CHAGRIN BLVD CLEVELAND OH 441225450 990 2010-01-01 341256377 HOSPICE OF THE WESTERN RESERVE INC HOSP 2163832222 17876 ST CLAIR AVENUE CLEVELAND OH 44110 JOHN HARVAN JR 2011-10-11 true Joseph C Sbrocco CPA 2168311200 2010 2016-03-07 17:11:31Z X JOHN E HARVAN JR 17876 ST CLAIR CLEVELAND OH 44110 112420254 false X www.HOSPICEWR.ORG X 1978 OH HOSPICE 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. 30 29 1002 1500 0 8526768 5927849 82052161 87328489 864133 258808 382682 385388 91825744 93900534 0 0 0 0 50126158 52602441 20000 7500 1189111 33319583 36423576 83465741 89033517 8360003 4867017 59642937 67821107 14659383 15501550 44983554 52319557 HOSPICE 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. false false 76776756 87713877 HOSPICE 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. 76776756 true true false false false false false false true true false false false true false true false false false false false false false false false false false false true true false false false false false false false true false true true false false false false false false false false false true 1108 0 true 1002 true false false false false false false false false false false X 30 29 true false false false false false false true true false false true true true true true true true true false OH X JOHN E HARVAN JR 2163832222 17876 ST CLAIR CLEVELAND OH 44110 H CLARK HARVEY JR 1.0 X 0 0 0 JAMES L HAMBRICK 3.0 X X 0 0 0 PEG MILBOURN 3.0 X X 0 0 0 RICHARD B WHITNEY 3.0 X X 0 0 0 CARL BALDASSARRE 3.0 X X 0 0 0 JOSEPH CARSON 1.0 X 0 0 0 REV NEROY CARTER 1.0 X 0 0 0 DAVID G COLE 1.0 X 0 0 0 MARGIT DALEY 1.0 X 0 0 0 CYNTHIA HUNDORFEAN 1.0 X 0 0 0 JEAN E KILGORE 1.0 X 0 0 0 HILARY MASON KING 1.0 X 0 0 0 MARY ANN KOCURKO 3.0 X X 0 0 0 CAROL G MANNING 3.0 X X 0 0 0 MICHAEL J MERRIMAN 1.0 X 0 0 0 WENDY MIANO 1.0 X 0 0 0 VIRGINIA A MOONEY 1.0 X 0 0 0 DAVID MORDARSKI 1.0 X 0 0 0 JANICE MURPHY 1.0 X 0 0 0 LAURA NAVIN 1.0 X 0 0 0 MARY L OGRINC 1.0 X 0 0 0 SARAH ROBERTSON 1.0 X 0 0 0 RICHARD T SPOTZ JR 1.0 X 0 0 0 WILLIAM SPRINGER 1.0 X 0 0 0 BRET WILLIAMS 1.0 X 0 0 0 ELIZABETH PITORAK 40.0 X 345723 0 17977 RICHARD A BARONE 1.0 X 0 0 0 DEREK RAGHAVAN 1.0 X 0 0 0 JAMES W ROGERSON 1.0 X 0 0 0 TRACY K STRATFORD 1.0 X 0 0 0 DAVID SIMPSON 40.0 X 538886 0 17948 BRIDGET J MONTANA 40.0 X 254814 0 15976 JOHN E HARVAN JR 40.0 X 389801 0 16710 CHARLES V WELLMAN 40.0 X 302644 0 16892 ALAN C WINE 40.0 X 176493 0 12904 SHAREEFAH SABUR 40.0 X 163512 0 11925 DANN GANZHORN 40.0 X 193573 0 12956 JEFFREY SPIESS 40.0 X 194502 0 13734 JOHN WALTERS 40.0 X 155118 0 9036 ROBERT P PHILLIPS PLONA 40.0 X 138083 0 8150 JANICE SCHEUFLER 40.0 X 113343 0 5667 CLEMENT HEAREY 40.0 X 148365 0 9870 SUSAN M FIGULA 40.0 X 131004 0 10013 SHARI A KOBAYAKAWA 40.0 X 136838 0 6775 3382699 0 186533 20 false true false VOCON PARTNERS OF OHIO LLC 3142 PROSPECT AVENUE CLEVELAND OH 44115 ARCHITECTURAL 456412 DONLEY'S INC 5430 WARNER ROAD CLEVELAND OH 44125 BUILDING CONTRACTOR 340208 LIGGETT STASHOWER PO BOX 931456 CLEVELAND OH 44193 ADVERTISING DESIGN 216232 DR CARLA BASTER 16920 CHARDON WINDSOR ROAD HUNTSBURG OH 44046 PHYSICIAN SERVICES 136146 ACE DEMO INC 2111 CENTER STREET CLEVELAND OH 44113 DEMOLITION 120420 6 429314 5498535 2214990 5927849 HOSPICE CARE SERVICES 623000 87328489 87328489 87328489 578480 578480 0 0 18200048 0 18497831 21889 -297783 -21889 -319672 -319672 0 0 0 RESALE SHOP 900099 295349 295349 GRIEF COUNSELING REVENUE 624100 40500 40500 MISCELLANEOUS REVENUE 900099 49539 49539 385388 93900534 87713877 258808 0 0 0 0 2861124 2861124 0 36364199 32942440 2841006 580753 2090918 1756007 303954 30957 7108681 5949027 1051677 107977 4177519 3508388 607280 61851 0 197131 197131 27886 27886 0 7500 7500 0 1788186 943091 750199 94896 276081 85993 167073 23015 2415069 1148245 1116469 150355 0 0 1851315 1312580 479113 59622 97404 81803 14159 1442 0 149878 81939 60019 7920 82163 58253 21263 2647 0 962125 720801 223640 17684 266987 189294 69095 8598 BAD DEBT 431319 427079 4240 MEDICAL SUPPLIES 4741510 4728956 12151 403 PATIENT SERVICES 1862629 1857697 4773 159 NURSING FACILITIES 19631465 19579487 50308 1670 PATIENT SUPPLIES 714746 712853 1832 61 927682 692823 207498 27361 89033517 76776756 11067650 1189111 1266 1416 4818183 8126279 7431544 5001959 9585387 9719391 535951 669582 24547305 5179406 15622950 19367899 20374152 23267535 1165948 1234391 73583 396345 33973 36310 59642937 67821107 8743907 10006771 2785000 3938170 1000000 0 2130476 1556609 14659383 15501550 X 36640249 45114011 7878403 6740644 464902 464902 44983554 52319557 59642937 67821107 X 4867017 2468986 X false true true X false X false false false 3641093 4254990 8829804 8526768 5927849 31180504 65636042 72018845 73369832 82052161 87328489 380405369 69277135 76273835 82199636 90578929 93256338 411585873 411585873 1004901 842135 801992 760658 578480 3988166 1004901 842135 801992 760658 578480 3988166 232692 241893 326388 382682 385388 1569043 70514728 77357863 83328016 91722269 94220206 417143082 0.98668 0.98510 0.00956 0.01129 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 774691 77471 852162 790588 -15897 774691 464902 37729 37729 464902 0.54556 0.45444 false false 0 7528120 7528120 0 7812510 2767171 5045339 0 99771 29570 70201 0 2674410 1166122 1508288 0 6432494 1216543 5215951 19367899 0 ANNUITY OBLIGATIONS 84241 DEFERRED COMPENSATION OBLIGATION 1472368 1556609 93900534 89033517 4867017 2464049 4937 2468986 7336003 97686649 2464049 1317129 4937 3786115 93900534 93900534 90350646 1317129 1317129 89033517 89033517 CHANGES IN NET ASSETS SCHEDULE D, PART XI, #8 Change in Split Value Interest Agreements - $4,937. OTHER REVENUE SCHEDULE D, PART XII, #2D Change in Split Value Interest Agreements - $4,937. INTENDED USES OF ENDOWMENT FUNDS SCHEDULE D, PART V, #4 DONOR-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. X X X false true false false false false false false false ELIZABETH PITORAK 148544 0 20600 0 176579 0 14700 0 3277 0 363700 0 0 0 CHARLES V WELLMAN 257544 0 28600 0 16500 0 13960 0 2932 0 319536 0 0 0 ALAN C WINE 175893 0 600 0 0 0 9627 0 3277 0 189397 0 0 0 SHAREEFAH SABUR 118412 0 28600 0 16500 0 8648 0 3277 0 175437 0 0 0 DANN GANZHORN 193033 0 540 0 0 0 9679 0 3277 0 206529 0 0 0 JEFFREY SPIESS 193902 0 600 0 0 0 10606 0 3128 0 208236 0 0 0 JOHN WALTERS 154518 0 600 0 0 0 9036 0 0 0 164154 0 0 0 DAVID SIMPSON 321827 0 600 0 216459 0 14671 0 3277 0 556834 0 0 0 BRIDGET J MONTANA 209714 0 28600 0 16500 0 12699 0 3277 0 270790 0 0 0 JOHN E HARVAN JR 211486 0 28600 0 149715 0 13582 0 3128 0 406511 0 0 0 CLEMENT HEAREY 116265 0 15600 0 16500 0 6593 0 3277 0 158235 0 0 0 Participate in, receive payment from, supplemental nonqualified retirement schedule J, part I, #4B David Simpson, CEO - $216,459. John Harvan, Jr, CFO - $133,215. Elizabeth Pitorak, Director Hospice Institute - $160,079. CLEVELAND-CUYAHOGA COUNTY PORT AUTHORITY 341029691 999999999 2010-12-30 21565000 retire 1999 bonds & construct faci true false false 2566826 0 21565000 0 229577 2566826 371345 0 0 18397252 0 0 2013 true false true true false false false false true 0.00000 0.00000 0.00000 true false true false false false false RICHARD SPOTZ JR DIRECTOR 6299 PROVIDED LEGAL SERVICES false JOHN E HARVAN JR CFO 1800 ANNUAL ORGANIZATION DUES false X 1 1169994 fmv X 2 1044996 fmv 0 false true false DOCUMENTS AVAILABLE TO PUBLIC PAGE 6, PART VI, SECTION C, #19 HOSPICE 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 COMPENSATION PAGE 6, PART VI, SECTION B, #15A & 15B THE 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 RELATIONSHIPS PAGE 6, PART VI, SECTION A, #2 MRS. 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 PROCESS PAGE 6, PART VI, SECTION A, #11B THE 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 PERSONS SCHEDULE L, PART IV MR. 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 POLICY PAGE 6, PART VI, SECTION B, #12C All 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.