HOSPICE OF CLEVELAND COUNTY INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- HOSPICE OF CLEVELAND COUNTY INC (EIN 56-1452373)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-05-16
- IRS object ID
- 201141369349300219
- Schema version
- 2010v3.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-16T07:37:27-05:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LARSONALLEN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 N TRYON STREET SUITE 1000 | AddressLine1 |
| City | CHARLOTTE | City |
| State | NC | State |
| ZIP Code | 28246 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561452373 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE OF CLEVELAND COUNTY INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HOSP | NameControl |
| Phone | 7044874677 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 951 WENDOVER HEIGHTS DRIVE | AddressLine1 |
| City | SHELBY | City |
| State | NC | State |
| ZIP Code | 28150 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MYRA MCGINNIS | Name |
| Title | PRESIDENT/CEO | Title |
| Phone | 7044874677 | Phone |
| Date Signed | 2011-05-11 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7049985200 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE CLEVELAND COUNTY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MYRA MCGINNIS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 951 WENDOVER HEIGHTS DRIVE | AddressLine1 |
| City | SHELBY | City |
| State | NC | State |
| ZIP Code | 28150 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 11180096 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.HOSPICECARES.CC | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1984 | YearFormation |
| State Legal Domicile | NC | StateLegalDomicile |
| Activity Or Mission Description | HOSPICE OF CLEVELAND COUNTY PROVIDES CARE AND SUPPORT TO PATIENTS WITH A LIFE-LIMITING ILLNESS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 21 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 21 | NbrIndependentVotingMembers |
| Total Nbr Employees | 153 | TotalNbrEmployees |
| Total Nbr Volunteers | 244 | TotalNbrVolunteers |
| Total Gross UBI | -395 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 923415 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 791144 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 9754830 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 10320132 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 85611 | InvestmentIncomePriorYear |
| Investment Income Current Year | 40682 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 12958 | OtherRevenuePriorYear |
| Other Revenue Current Year | 14979 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 10776814 | TotalRevenuePriorYear |
| Total Revenue Current Year | 11166937 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 4218629 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5343213 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4411428 | OtherExpensePriorYear |
| Other Expenses Current Year | 4325138 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 8630057 | TotalExpensesPriorYear |
| Total Expenses Current Year | 9668351 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2146757 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1498586 | RevenuesLessExpensesCY |
| Total Assets BOY | 15307862 | TotalAssetsBOY |
| Total Assets EOY | 16424316 | TotalAssetsEOY |
| Total Liabilities BOY | 1671624 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1289492 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 13636238 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 15134824 | NetAssetsOrFundBalancesEOY |
| Mission Description | HOSPICE OF CLEVELAND COUNTY, INC. EXISTS TO PROVIDE HIGH QUALITY SKILLED COMPASSIONATE CARE AND SUPPORT FOR INDIVIDUALS WITH A LIFE-LIMITING ILLNESS, THEIR FAMILIES, AND THE COMMUNITY, REGARDLESS OF THEIR ABILITY TO PAY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 6259421 | Expense |
| Revenue | 7518492 | Revenue |
| Description | HOSPICE CLEVELAND COUNTY PROVIDES COMPREHENSIVE END OF LIFE HEALTHCARE FOR TERMINALLY ILL PATIENTS AND THEIR FAMILIES DURING THE FINAL STAGES OF ILLNESS. DURING 2010, HOSPICE CLEVELAND COUNTY PROVIDED 44,036 DAYS OF HOMECARE INCLUDING 11,576 DAYS OF NURSING HOME AND HOSPITAL INPATIENT CARE. HOSPICE CLEVELAND COUNTY SERVED 673 HOMECARE PATIENTS IN 2010. HOSPICE CLEVELAND COUNTY'S INTERDISCIPLINARY TEAMS CONSISTING OF PHYSICIANS, NURSES, HOSPICE AIDES, SOCIAL WORKERS, AND OTHER SUPPORTIVE PERSONNEL PROVIDED OVER 31,000 VISITS DURING 2010. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1858340 | Expense |
| Revenue | 2583692 | Revenue |
| Description | HOSPICE CLEVELAND COUNTY OWNS AND OPERATES TWO HOSPICE HOUSES THAT PROVIDE HOSPICE INPATIENT AND RESIDENTIAL CARE FOR TERMINALLY ILL PATIENTS DURING THE FINAL STAGES OF ILLNESS. THE WENDOVER HOSPICE HOUSE HAS 14 BEDS. THE KINGS MOUNTAIN HOSPICE HOUSE HAS 8 BEDS AND OPENED IN MAY 2010. DURING 2010, HOSPICE CLEVELAND COUNTY PROVIDED 6,911 DAYS OF CARE IN THESE FACILITIES. HOSPICE CLEVELAND COUNTY SERVED 293 PATIENTS IN THE HOSPICE HOUSES IN 2010. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 332523 | Expense |
| Revenue | 217948 | Revenue |
| Description | PALLIATIVE CARE CLEVELAND COUNTY PROVIDES A PROGRAM OF PAIN CONTROL, SYMPTOM MANAGEMENT AND ASSISTANCE WITH DIFFICULT DECISION MAKING. DURING 2010, PALLIATIVE CARE CLEVELAND COUNTY SERVED 642 PATIENTS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 8450284 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 39 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 153 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 21 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 21 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NC | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PAM BENFIELD | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7044874677 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 951 WENDOVER HEIGHTS DRIVE | AddressLine1 |
| City | SHELBY | City |
| State | NC | State |
| ZIP Code | 28150 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (25 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| LALLAGE CAROUTHERS | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| EDDIE HOLBROOK | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| EARL LUTZ | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| JEFF LEDFORD | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| DR BECKY LOVE | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| DOUG SATTERFIELD | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| JOSEPH TYSINGER | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| ROSLYN CRUMP | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| DR ROBERT GOSSETT | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| KARLA HAYNES-ELMORE | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| DR FORREST THOMPSON | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| ADRIAN CAMP | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| CHARLES WEBBER | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| JT SCRUGGS | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| DR JEFF CARLEY | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| TIM MATHIS | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| KATHY WILSON | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| ANDREA LESLIE-FITE | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| LARRY FOX | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| JENNIE LAMBERT | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| STEVE PADGETT | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| MYRA MCGINNIS | |||||||
| PRESIDENT/CEO | 49.00 | 0 | 125117 | 38911 | X | ||
| DR DAVID BARKER | |||||||
| HOSPICE PHYSICIAN | 44.50 | 159986 | 0 | 32957 | X | ||
| DR JAMES POTTS | |||||||
| HOSPICE MEDICAL DIRECTOR | 51.30 | 139108 | 0 | 28656 | X | ||
| DR SANGYA PATEL | |||||||
| PALLIATIVE CARE MEDICAL DIRECTOR | 44.40 | 139314 | 0 | 28699 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 438408 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 125117 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 129223 | TotalOtherCompensation |
| Number Individuals GT100 K | 3 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MORRISON CONSTRUCTION COMPANY | |||||
| PO BOX 1488 | SHELBY | NC | 28151 | CONSTRUCTION SERVICES | 1592114 |
| CLEVELAND COUNTY HEALTHCARE SYSTEM | |||||
| 201 E GROVER STREET | SHELBY | NC | 28150 | MANAGEMENT SERVICES | 274264 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| Federated Campaigns | 78153 | FederatedCampaigns |
| All Other Contributions | 712991 | AllOtherContributions |
| Total Contributions | 791144 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT REVENUE | Description |
| Business Code | 621610 | BusinessCode |
| Total Revenue Column | 10320132 | TotalRevenueColumn |
| Related Or Exempt Function Income | 10320132 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 10320132 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 40682 | TotalRevenueColumn |
| Exclusion | $40,682 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 34553 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 13159 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 21394 | TotalRevenueColumn |
| Exclusion | $21,394 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|
| UNRELATED BUSINESS INC | 452000 | -395 | -395 | |
| DISPOSAL OF ASSET | 900099 | -6020 | -$6,020 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | -6415 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11166937 | TotalRevenueColumn |
| Related Or Exempt Function Income | 10320132 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | -395 | UnrelatedBusinessRevenue |
| Exclusion | $56,056 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4430021 | Total |
| Program Services | 3907004 | ProgramServices |
| Management And General | 523017 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 90189 | Total |
| Program Services | 79541 | ProgramServices |
| Management And General | 10648 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 503570 | Total |
| Program Services | 444118 | ProgramServices |
| Management And General | 59452 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 319433 | Total |
| Program Services | 281720 | ProgramServices |
| Management And General | 37713 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34416 | Total |
| Management And General | 34416 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 260857 | Total |
| Program Services | 17427 | ProgramServices |
| Management And General | 243430 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27995 | Total |
| Program Services | 27995 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 106913 | Total |
| Program Services | 45622 | ProgramServices |
| Management And General | 61291 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 66073 | Total |
| Program Services | 25253 | ProgramServices |
| Management And General | 40820 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 208114 | Total |
| Program Services | 91581 | ProgramServices |
| Management And General | 116533 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 154498 | Total |
| Program Services | 147799 | ProgramServices |
| Management And General | 6699 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22477 | Total |
| Program Services | 13189 | ProgramServices |
| Management And General | 9288 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 507804 | Total |
| Program Services | 507804 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 45778 | Total |
| Management And General | 45778 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| PURCHASED SERVICES | 1775241 | 1775241 |
| SUPPLIES | 778180 | 778180 |
| BAD DEBT EXPENSES | 182949 | 182949 |
| PROFESSIONAL FEES | 32228 | 32228 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 121615 | Total |
| Program Services | 92633 | ProgramServices |
| Management And General | 28982 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9668351 | Total |
| Program Services | 8450284 | ProgramServices |
| Management And General | 1218067 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4246022 | BOY |
| EOY | 6075486 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2396788 | BOY |
| EOY | 833526 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 804114 | BOY |
| EOY | 726953 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1094028 | BOY |
| EOY | 1080466 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3271 | BOY |
| EOY | 5328 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58301 | BOY |
| EOY | 62382 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 9729167 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2101844 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6659919 | BOY |
| EOY | 7627323 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 45419 | BOY |
| EOY | 12852 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15307862 | BOY |
| EOY | 16424316 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1437696 | BOY |
| EOY | 952477 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 233928 | BOY |
| EOY | 337015 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1671624 | BOY |
| EOY | 1289492 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12832124 | BOY |
| EOY | 14407871 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 804114 | BOY |
| EOY | 726953 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13636238 | BOY |
| EOY | 15134824 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15307862 | BOY |
| EOY | 16424316 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 1498586 | ReconcilationRevenueExpenses |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 393628 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 366454 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1180647 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 923415 | CurrentTaxYearMinus1Year |
| Current Tax Year | 791778 | CurrentTaxYear |
| Total | 3655922 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 393628 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 366454 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1180647 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 923415 | CurrentTaxYearMinus1Year |
| Current Tax Year | 791778 | CurrentTaxYear |
| Total | 3655922 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 307491 | AmountsSubstContributorsTotal |
| Public Support Total170 | 3348431 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 209278 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 284653 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 187882 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 85611 | CurrentTaxYearMinus1Year |
| Current Tax Year | 40682 | CurrentTaxYear |
| Total | 808106 | Total |
Net UBI NetUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | -70 | CurrentTaxYearMinus1Year |
| Current Tax Year | -395 | CurrentTaxYear |
| Total | -465 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 18296 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | -2761 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 10608 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 13028 | CurrentTaxYearMinus1Year |
| Current Tax Year | -6019 | CurrentTaxYear |
| Total | 33152 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 4496715 | TotalSupport |
| Gross Receipts From Admissions Etc | 42268351 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.74460 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.56020 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $410 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 410 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF OTHER LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1I: | ReturnReference |
| Explanation | THE ORGANIZATION BELONGS TO THE NATIONAL HOSPICE AND PALLIATIVE CARE ORGANIZATION WHICH DETERMINED THAT 8.10% OF ITS PROVIDER DUES WERE USED FOR SPECIFIC LOBBYING PURPOSES. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 295737 | OtherCostOrOtherBasis |
| Book Value | 295737 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7354906 | OtherCostOrOtherBasis |
| Depreciation | 1279948 | Depreciation |
| Book Value | 6074958 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1445570 | OtherCostOrOtherBasis |
| Depreciation | 656104 | Depreciation |
| Book Value | 789466 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 632954 | OtherCostOrOtherBasis |
| Depreciation | 165792 | Depreciation |
| Book Value | 467162 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 7627323 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ESTIMATED THIRD PARTY LIABILITY | Description |
| Amount | $337,015 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 337015 | TotalOfAmounts |
| Total Revenue | 11166937 | TotalRevenue |
| Total Expenses | 9668351 | TotalExpenses |
| Excess Or Deficit For Year | 1498586 | ExcessOrDeficitForYear |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | 1498586 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 11244098 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 644915 | OtherRevenues |
| Revenue Not Rptd F990 | 644915 | RevenueNotRptdF990 |
| Revenue Subtotal | 10599183 | RevenueSubtotal |
| Other Revenues Not Included | 567754 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 567754 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 11166937 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 9668351 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 9668351 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 9668351 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RELEASE FROM RESTRICTION 644,915. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | RESTRICTED PLEDGES RECEIVED 546,995. CHANGE IN DISCOUNT ON PLEDGES RECEIVABLE 20,759. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | VARIOUS | NameOfEvent1 |
| Gross Receipts Event1 | 34553 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 34553 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 13159 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 34553 | GrossReceiptsTotal |
| Gross Revenue Total Events | 34553 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 13159 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 13159 | DirectExpenseSummaryEvents |
| Net Income Summary | 21394 | NetIncomeSummary |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MYRA MCGINNIS | |||||||||||||
| 0 | 110363 | 0 | 14754 | 0 | 0 | 0 | 0 | 0 | 38911 | 0 | 164028 | 0 | 0 |
| DR DAVID BARKER | |||||||||||||
| 158520 | 0 | 0 | 0 | 1466 | 0 | 0 | 0 | 32957 | 0 | 192943 | 0 | 0 | 0 |
| DR JAMES POTTS | |||||||||||||
| 138096 | 0 | 0 | 0 | 1012 | 0 | 0 | 0 | 28656 | 0 | 167764 | 0 | 0 | 0 |
| DR SANGYA PATEL | |||||||||||||
| 138456 | 0 | 0 | 0 | 858 | 0 | 0 | 0 | 28699 | 0 | 168013 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 1A | ReturnReference |
| Explanation | HOSPICE OF CLEVELAND COUNTY, INC. PAYS ALL OR A PORTION OF MONTHLY DUES FOR EMPLOYEES WHO CHOOSE TO JOIN THE LOCAL YMCA PROGRAM. THIS IS REPORTED AS TAXABLE FRINGE IN THE EMPLOYEES PAYROLL EARNINGS AND TAXED APPROPRIATELY. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | HOSPICE OF CLEVELAND COUNTY, INC. HAS AN AGREEMENT WITH CLEVELAND REGIONAL MEDICAL CENTER TO PROVIDE MANAGEMENT SERVICES FOR DAY-TO-DAY OPERATIONS. | |
| FORM 990, PART VI, SECTION A, LINE 7A | MEMBERS OF THE ORGANIZATION HAVE VOTING RIGHTS IN ELECTION OF THE BOARD MEMBERS AT THE ANNUAL MEETING HELD IN MARCH OF EACH YEAR. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE ORGANIZATION'S EXECUTIVE DIRECTOR WILL REVIEW AND APPROVE FORM 990 AND WILL PRESENT IT TO THE FINANCE COMMITTEE BEFORE IT IS FILED. THE FINANCE COMMITTEE WILL THEN PRESENT THE PREPARED FORM 990 TO THE BOARD OF DIRECTORS FOR REVIEW. | |
| THE ORGANIZATION MAINTAINS A CONFLICT OF INTEREST POLICY THAT COVERS ALL EMPLOYEES AND BOARD MEMBERS. EACH YEAR THE CONFLICT OF INTEREST POLICY IS REVIEWED AT ONE OF THE MONTHLY STAFF MEETINGS WITH ALL EMPLOYEES. SENIOR LEADERSHIP AND ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE, SIGN AND DATE AN ANNUAL CONFLICT OF INTEREST DISCLOSURE FORM. ALL DISCLOSURES BY BOARD MEMBERS ARE REVIEWED AND APPROVED BY THE CLEVELAND COUNTY HEATHCARE SYSTEM COMPLIANCE DIRECTOR. | FORM 990, PART VI, SECTION B, LINE 12C | |
| THE PROCESS FOR DETERMINING COMPENSATION OF THE EXECUTIVE DIRECTOR AND SENIOR LEADERSHIP WAS LAST REVIEWED IN 2010. | FORM 990, PART VI, SECTION B, LINE 15 | |
| REQUESTS FOR REVIEW OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS MUST BE SUBMITTED TO HOSPICE OF CLEVELAND COUNTY, INC. IN WRITING AND MUST INCLUDE THE NAME, ADDRESS, AND TELEPHONE NUMBER OF THE INDIVIDUAL OR ENTITY MAKING THE REQUEST. ALL REQUESTS ARE SUBMITTED TO THE EXECUTIVE DIRECTOR FOR APPROVAL. UPON APPROVAL, THE DOCUMENTS ARE MADE AVAILABLE WITHIN TWO WEEKS OF RECEIPT OF THE WRITTEN REQUEST. THE DOCUMENTS ARE AVAILABLE FOR REVIEW AT THE HOSPICE OF CLEVELAND COUNTY, INC. ADMINISTRATIVE OFFICE BUILDING. | FORM 990, PART VI, SECTION C, LINE 19 | |
| THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. | FORM 990, PART XII, LINE 2C: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLEVELAND REGIONAL MEDICAL CENTER | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 E GROVER ST | AddressLine1 |
| City | SHELBY | City |
| State | NC | State |
| ZIP Code | 28150 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560654386 | EIN |
| Primary Activities | GOVERNMENTAL HOSPITAL | PrimaryActivities |
| Legal Domicile State | NC | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 170(B)(1)(A)(III) | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| CLEVELAND REGIONAL MEDICAL CENTER | |
| O | 61933 |
| CLEVELAND REGIONAL MEDICAL CENTER | |
| L | 274264 |
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