FURP.ORG / PUBLIC DATA EXPLORER

CARE PARTNERS: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
CARE PARTNERS (EIN 93-0836166)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-14
IRS object ID
201143189349304394
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)
Timestamp2011-11-14T15:36:13-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1JONES & ROTH PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line15635 NE ELAM YOUNG PKWY STE 100AddressLine1
CityHILLSBOROCity
StateORState
ZIP Code971246488ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN930836166EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HOSPICE AND PALLIATIVE CARE OFBusinessNameLine1
Business Name Line2WASHINGTON COUNTYBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlHOSPNameControl
Phone5036489565Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1900 SE OAK ST STE 202AddressLine1
CityHILLSBOROCity
StateORState
ZIP Code97123ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCHRISTINE LARCHName
TitleEXECUTIVE DIRECTORTitle
Phone5036489565Phone
Date Signed2011-10-28DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJAMIE L ZOLEZZIName
Phone5036480521Phone
Date Prepared2011-11-09DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonCHRISTINE LARCHNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1900 SE OAK ST STE 202AddressLine1
CityHILLSBOROCity
StateORState
ZIP Code97123ZIPCode
FieldValueIRS element (for citing)
Gross Receipts5325268GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.HOSPICEWC.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1982YearFormation
State Legal DomicileORStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE MEDICAL, PSYCHOLOGICAL, AND SPIRITUAL SERVICES TO TERMINALLY ILL PATIENTS AND THEIR FAMILIES.ActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees63TotalNbrEmployees
Total Nbr Volunteers40TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year43667ContributionsGrantsPriorYear
Contributions Grants Current Year136530ContributionsGrantsCurrentYear
Program Service Revenue Prior Year3419759ProgramServiceRevenuePriorYear
Program Service Revenue CY3812521ProgramServiceRevenueCY
Investment Income Prior Year-215355InvestmentIncomePriorYear
Investment Income Current Year51551InvestmentIncomeCurrentYear
Other Revenue Prior Year-6640OtherRevenuePriorYear
Other Revenue Current Year-7014OtherRevenueCurrentYear
Total Revenue Prior Year3241431TotalRevenuePriorYear
Total Revenue Current Year3993588TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year567393GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1381281GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year2520271SalariesEtcPriorYear
Salaries Etc Current Year2502431SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year953977OtherExpensePriorYear
Other Expenses Current Year1010288OtherExpensesCurrentYear
Total Expenses Prior Year4041641TotalExpensesPriorYear
Total Expenses Current Year4894000TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-800210RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-900412RevenuesLessExpensesCY
Total Assets BOY2780575TotalAssetsBOY
Total Assets EOY1956050TotalAssetsEOY
Total Liabilities BOY190826TotalLiabilitiesBOY
Total Liabilities EOY211867TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY2589749NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1744183NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO PROVIDE MEDICAL, PSYCHOLOGICAL, AND SPIRITUAL SERVICES TO TERMINALLY ILL PATIENTS AND THEIR FAMILIES.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense3054658Expense
Grants1071842Grants
Revenue3232637Revenue
DescriptionHOSPICE: PROVIDE MEDICAL, PSYCHOLOGICAL, AND SPIRITUAL SERVICES TO TERMINALLY ILL PATIENTS AND THEIR FAMILIES AT THE PATIENT'S HOME. IN 2010, APPROXIMATELY 418 PATIENTS AND THEIR FAMILIES WERE SERVED.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense309439Expense
Grants309439Grants
Revenue497915Revenue
DescriptionTRANSITIONS: SERVICES FOR INDIVIDUALS WITH A LIFE LIMITING DISEASE WHO DO NOT QUALIFY FOR OTHER HEALTHCARE BENEFITS. IN 2010, APPROXIMATELY 105 PATIENTS AND THEIR FAMILIES WERE SERVED.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense21585Expense
Revenue34694Revenue
DescriptionINPATIENT: PROVIDE MEDICAL, PSYCHOLOGICAL, AND SPIRITUAL SERVICES TO TERMINALLY ILL PATIENTS AND THEIR FAMILIES IN AN INPATIENT FACILITY OPERATED BY A THIRD PARTY.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense29458Expense
Revenue47275Revenue
DescriptionBEREAVEMENT OUTREACH: PROVIDE COMPREHENSIVE COUNSELING AND GRIEF SUPPORT TO FAMILY MEMBERS, FRIENDS, AND LOVED ONES, AND PROVIDING THEM THE SUPPORT NEEDED TO ADJUST AND RESUME THEIR LIVES AFTER THE LOSS OF A LOVED ONE.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp29458TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev47275TotalOfOtherProgramServiceRev
Total Program Service Expense3415140TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
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 StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
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 ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109610NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees63NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
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 BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledORStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1HOSPICE AND PALLIATIVE CARE OFBusinessNameLine1
Business Name Line2WASHINGTON COUNTYBusinessNameLine2
FieldValueIRS element (for citing)
Telephone Number5036489565TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1900 SE OAK STREETAddressLine1
Address Line2SUITE 202AddressLine2
CityHILLSBOROCity
StateORState
ZIP Code97123ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
RON POWNE
PRESIDENT1.00XX000
KAY KIRKBRIDE
VICE PRESIDE1.00XX000
MICHAEL MCCALL
SECRETARY1.00XX000
JOHN RISTOW
TREASURER1.00XX000
TRACY VILLARREAL
BOARD MEMBER1.00X000
JEFF HOYT
BOARD MEMBER1.00X000
RICK ROBY
BOARD MEMBER1.00X000
TERRY GARDNER
BOARD MEMBER1.00X000
KATHLEEN LEATHAM
BOARD MEMBER1.00X000
ERIN EVERS
BOARD MEMBER1.00X000
CHRISTINE LARCH
EXEC. DIREC.40.00X111612013059
FieldValueIRS element (for citing)
Total Reportable Comp From Org111612TotalReportableCompFromOrg
Total Other Compensation13059TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Fundraising Events14044FundraisingEvents
All Other Contributions122486AllOtherContributions
Total Contributions136530TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionINSURANCEDescription
Total Revenue Column3812521TotalRevenueColumn
Related Or Exempt Function Income3812521RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue3812521TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column28083TotalRevenueColumn
Exclusion$28,083ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1348134Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1324666Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities23468Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column23468TotalRevenueColumn
Related Or Exempt Function Income23468RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Cntrbtns Rprtd Fundraising Events14044CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses7014FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-7014TotalRevenueColumn

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column3993588TotalRevenueColumn
Related Or Exempt Function Income3835989RelatedOrExemptFunctionIncome
Exclusion$28,083ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1045000Total
Program Services1045000ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total336281Total
Program Services336281ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total124671Total
Management And General124671ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1996637Total
Program Services1241531ProgramServices
Management And General755106ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total33387Total
Program Services16731ProgramServices
Management And General16656ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total182271Total
Program Services126880ProgramServices
Management And General55391ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total165465Total
Program Services98639ProgramServices
Management And General66826ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total8312Total
Management And General8312ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total19005Total
Management And General19005ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total11326Total
Program Services1051ProgramServices
Management And General10275ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total36911Total
Management And General36911ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total114342Total
Program Services7295ProgramServices
Management And General107047ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total168124Total
Management And General168124ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total54715Total
Program Services46298ProgramServices
Management And General8417ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total88Total
Program Services29ProgramServices
Management And General59ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total33941Total
Management And General33941ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total15036Total
Management And General15036ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
DRUGS AND BIOLOGICALS230381230381
DURABLE MEDICAL EQUIPMENT156005156005
CONTRACT LABOR5122251222
TELEPHONE356421273322909
INPATIENT CARE2964329643

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total45595Total
Program Services15421ProgramServices
Management And General30174ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total4894000Total
Program Services3415140ProgramServices
Management And General1478860ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY975638BOY
EOY295532EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY653294BOY
EOY505160EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY242042BOY
EOY524032EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY2300BOY
EOY87604EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY13400EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY27348BOY
EOY39119EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis222059LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec136015LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY111573BOY
EOY86044EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY768001BOY
EOY405159EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY379BOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2780575BOY
EOY1956050EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY66762BOY
EOY75746EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY124064BOY
EOY136121EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY190826BOY
EOY211867EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2589749BOY
EOY1744183EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2589749BOY
EOY1744183EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2780575BOY
EOY1956050EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-900412ReconcilationRevenueExpenses
Reconcilation Other Changes54846ReconcilationOtherChanges
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)
Hospital170b1 AiiiXHospital170b1Aiii

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)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis222059OtherCostOrOtherBasis
Depreciation136015Depreciation
Book Value86044BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings86044TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionACCRUED SALARIES AND BENEFITSDescription
Amount$136,121Amount
FieldValueIRS element (for citing)
Total Of Amounts136121TotalOfAmounts
Total Revenue3993588TotalRevenue
Total Expenses4894000TotalExpenses
Excess Or Deficit For Year-900412ExcessOrDeficitForYear
Net Unrealized GL On Investments54846NetUnrealizedGLOnInvestments
Total Adjustments54846TotalAdjustments
Excess Or Deficit Per FS-845566ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt4058248TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments54846NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities2800DonatedSrvcAndUseOfFacilities
Other Revenues7014OtherRevenues
Revenue Not Rptd F99064660RevenueNotRptdF990
Revenue Subtotal3993588RevenueSubtotal
Total Revenue Per Form9903993588TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt4903814TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities2800DonatedServicesUseOfFacilities
Other Expenses Included7014OtherExpensesIncluded
Expenses Not Rptd F9909814ExpensesNotRptdF990
Expenses Subtotal4894000ExpensesSubtotal
Total Expenses Per Form9904894000TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
RECONCILIATION OF CHANGES - OTHERSCHEDULE D, PAGE 4, PART XI, LINE 8LIGHT UP A LIFE - DIRECT EXPENSES 7,014 LIGHT UP A LIFE - DIRECT EXPENSES -7,014
REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XII, LINE 2DLIGHT UP A LIFE - DIRECT EXPENSES 7,014
EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XIII, LINE 2DLIGHT UP A LIFE - DIRECT EXPENSES 7,014

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedfalseRecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1WASHINGTON COUNTY HOSPICE FDTNBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1990 SE OAK ST STE 202AddressLine1
CityHILLSBOROCity
StateORState
ZIP Code971234287ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient943197744EINOfRecipient
IRC Section3IRCSection
Amount Of Cash Grant1045000AmountOfCashGrant
Purpose Of GrantFOUNDATION SUPPORTPurposeOfGrant

Form990 Schedule I Part III Form990ScheduleIPartIII (2 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrant
CHARITY CARE - HOSPICE626842
CHARITY CARE - TRANSITION6309439

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
ERIN EVERS
BOARD MEMBER3312LEGAL FEESfalse
RON POWNE
BOARD MEMBER4945ASSET MGMT FEESfalse
RICK ROBY
BOARD MEMBER798584BANK DEPOSITSfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
EXPLANATION ON VOLUNTEERS AND TYPES OF SERVICES OR BENEFITSFORM 990, PAGE 1, PART I, LINE 6VOLUNTEERS PROVIDE LIGHT HOUSEWORK, VERY BASIC CARE NEEDS, VISITATION AND READING ALOUD.
ALL OTHER ACHIEVEMENTS DESCRIPTIONFORM 990, PAGE 2, PART III, LINE 4DBEREAVEMENT OUTREACH: PROVIDE COMPREHENSIVE COUNSELING AND GRIEF SUPPORT TO FAMILY MEMBERS, FRIENDS, AND LOVED ONES, AND PROVIDING THEM THE SUPPORT NEEDED TO ADJUST AND RESUME THEIR LIVES AFTER THE LOSS OF A LOVED ONE.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BTHE ORGANIZATION'S CEO WILL REVIEW FORM 990 BEFORE IT IS SIGNED AND FILED. A COPY OF THE RETURN WILL BE PROVIDED TO BOARD MEMBERS FOR REVIEW.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CANNUAL STATEMENTS ARE SIGNED AND KEPT ON FILE. EACH YEAR A STAFF MEMBER REVIEWS THESE STATEMENTS AND MAKES SURE THAT THEY ARE UP TO DATE.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE BOARD OF DIRECTORS PERFORMS AN ANNUAL PERFORMANCE REVIEW OF THE CEO. AS PART OF THIS REVIEW COMPENSATION IS EVALUATED. A COMPARABILITY STUDY WITH OTHER LOCAL HOSPICES IS USED TO DETERMINE REASONABLE COMPENSATION FOR THE CEO.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19THE ORGANIZATION WILL MAKE IT'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1WASHINGTON COUNTY HOSPICE FDTNBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1900 SE OAK ST STE 202AddressLine1
CityHILLSBOROCity
StateORState
ZIP Code971234287ZIPCode
FieldValueIRS element (for citing)
EIN943197744EIN
Primary ActivitiesFOUNDATIONPrimaryActivities
Legal Domicile StateORLegalDomicileState
Exempt Code Section3ExemptCodeSection
Public Charity Status11CPublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled OrgfalseControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
WASHINGTON COUNTY HOSPICE FDTN
B1045000
WASHINGTON COUNTY HOSPICE FDTN
P15696
WASHINGTON COUNTY HOSPICE FDTN
D87604