STRATEGY STUDIO / PUBLIC DATA EXPLORER

FRIENDS OF HOSPICE WAYNE COUNTY OHIO: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
FRIENDS OF HOSPICE WAYNE COUNTY OHIO (EIN 20-1370925)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-11-12
IRS object ID
202323169349300637
Schema version
2022v5.0
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)
Return2023-11-12T13:56:49-06:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN341818258PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MEADEN & MOORE LTDBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12363 EAGLE PASS SUITE AAddressLine1Txt
CityWOOSTERCityNm
State AbbreviationOHStateAbbreviationCd
ZIP446915344ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN201370925EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FRIENDS OF HOSPICEBusinessNameLine1Txt
Business Name Line2WAYNE COUNTY OHIOBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlFRIEBusinessNameControlTxt
Phone3302622012PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1223 W LIBERTY STREETAddressLine1Txt
CityWOOSTERCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44691ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARLENE BARKHEIMERPersonNm
Person TitleTREASURERPersonTitleTxt
Phone3302622012PhoneNum
Signature2023-11-08SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMARLENEPersonFirstNm
Person LastBARKHEIMERPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonANDREA HOBANPreparerPersonNm
PTINP01911681PTIN
Phone3302647307PhoneNum
Preparation2023-11-04PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMARLENE BARKHEIMERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line111 SOUTH MAIN STREETAddressLine1Txt
CityWEST SALEMCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44287ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$671,443GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.FRIENDTIQUE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2004FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionFRIENDS OF HOSPICE, WAYNE COUNTY OHIO OPENED ITS DOORS ON SEPTEMBER 20, 2004. IT IS A SELF-SUSTAINING STORE SELLING FURNITURE, HOUSEHOLD ITEMS AND CLOTHING WHERE THE PROFITS ARE GIVEN TO LIFECARE HOSPICE TO PROVIDE AN ON-GOING SOURCE OF REVENUE FOR PATIENT CARE. THE ORGANIZATION CLEANS AND REPAIRS DONATIONS AND HOLDS THEM FOR SALE. THE ORGANIZATION HAS A LARGE VOLUNTEER STAFF, AND IS ABLE TO OPERATE WITH TWO FULL-TIME EMPLOYEES AND SEVEN PART-TIME EMPLOYEES. THE BOARD OF DIRECTORS IN COMPRISED OF SIX NON-COMPENSATED MEMBERS.ActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee11TotalEmployeeCnt
Total Volunteers60TotalVolunteersCnt
Total Gross UBI$20,068TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$11,908NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,560PYContributionsGrantsAmt
CY Contributions Grants$64,293CYContributionsGrantsAmt
PY Program Service Revenue$581,947PYProgramServiceRevenueAmt
CY Program Service Revenue$574,917CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$51,793PYOtherRevenueAmt
CY Other Revenue$20,321CYOtherRevenueAmt
PY Total Revenue$635,300PYTotalRevenueAmt
CY Total Revenue$659,531CYTotalRevenueAmt
PY Grants And Similar Paid$35,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$85,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$207,325PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$218,371CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$255,532PYOtherExpensesAmt
CY Other Expenses$260,832CYOtherExpensesAmt
PY Total Expenses$497,857PYTotalExpensesAmt
CY Total Expenses$564,203CYTotalExpensesAmt
PY Revenues Less Expenses$137,443PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$95,328CYRevenuesLessExpensesAmt
Total Assets BOY$1,829,805TotalAssetsBOYAmt
Total Assets EOY$1,881,710TotalAssetsEOYAmt
Total Liabilities BOY$930,665TotalLiabilitiesBOYAmt
Total Liabilities EOY$887,242TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$899,140NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$994,468NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionFRIENDS OF HOSPICE, WAYNE COUNTY OHIO OPENED ITS DOORS ON SEPTEMBER 20, 2004. IT IS A SELF-SUSTAINING STORE SELLING FURNITURE, HOUSEHOLD ITEMS AND CLOTHING WHERE THE PROFITS ARE GIVEN TO LIFECARE HOSPICE TO PROVIDE AN ON- GOING SOURCE OF REVENUE FOR PATIENT CARE. MOST OF THE INVENTORY AT THE STORE IS DONATED BY THE PUBLIC. THE ORGANIZATION CLEANS AND REPAIRS DONATIONS AND HOLDS THEM FOR SALE. THE ORGANIZATION HAS A LARGE VOLUNTEER STAFF, AND IS ABLE TO OPERATE WITH TWO FULL-TIME EMPLOYEES AND SEVEN PART-TIME EMPLOYEES. THE BOARD OF DIRECTORS IS COMPRISED OF SIX NON-COMPENSATED MEMBERS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$560,598ExpenseAmt
Grant$85,000GrantAmt
Revenue$575,170RevenueAmt
DescFURNITURE, HOUSEHOLD ITEMS AND CLOTHING ARE DONATED BY THE PUBLIC SORTED AND PROCESSED AND ARE THEN SOLD BACK TO THE PUBLIC. PROFITS OF WHICH ARE GIVEN TO LIFECARE HOSPICE TO PROVIDE ON-GOING CARE TO THEIR PATIENTS. DURING 2022 PROFITS OF $85,000 WERE GIVEN.Desc
Total Program Service Expenses$560,598TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee11EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members6GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn0AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc0RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldOHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MARLENE BARKHEIMERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3302622012PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line111 SOUTH MAIN STREETAddressLine1Txt
CityWEST SALEMCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44287ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
DAWN SCHIRM
EXECUTIVE DIRECTOR40.00Yes (X)$64,250$0$0
JOHN STANFORED
BOARD MEMBER1.00Yes (X)$0$0$0
PAMELA TAYLOR
BOARD MEMBER1.00Yes (X)$0$0$0
GAGE RIGHTER
BOARD MEMBER1.00Yes (X)$0$0$0
RON LEATHERMAN
PRESIDENT1.00$0$0$0Yes (X)
FRAN SAMSON
SECRETARY1.00$0$0$0Yes (X)
MARLENE BARKHEIMER
TREASURER1.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$64,250TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
All Other Contributions$64,293AllOtherContributionsAmt
Total Contributions$64,293TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescDONATED GOODS/RETAILDesc
Business459510BusinessCd
Total Revenue Column$574,917TotalRevenueColumnAmt
Related Or Exempt Func Income$574,917RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$574,917TotalProgramServiceRevenueAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$31,980RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$11,912RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$20,068RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$20,068TotalRevenueColumnAmt
Unrelated Business Revenue$20,068UnrelatedBusinessRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISC INCOMEDesc
Business990009BusinessCd
Total Revenue Column$253TotalRevenueColumnAmt
Related Or Exempt Func Income$253RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$253OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$659,531TotalRevenueColumnAmt
Related Or Exempt Func Income$575,170RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$20,068UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$85,000TotalAmt
Program Services$85,000ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$64,250TotalAmt
Program Services$64,250ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$137,254TotalAmt
Program Services$137,254ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$16,867TotalAmt
Program Services$16,867ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$3,365TotalAmt
Management And General$3,365ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$5,555TotalAmt
Program Services$5,555ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$117,313TotalAmt
Program Services$117,313ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$33,006TotalAmt
Program Services$33,006ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$36,538TotalAmt
Program Services$36,538ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$9,061TotalAmt
Program Services$9,061ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
MERCHANT FEES$18,228$18,228
VEHICLE EXPENSES$14,089$14,089
STORE SUPPLIES$8,466$8,466
AUCTION PURCHASES - RES$6,433$6,433

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$8,778TotalAmt
Program Services$8,538ProgramServicesAmt
Management And General$240ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$564,203TotalAmt
Program Services$560,598ProgramServicesAmt
Management And General$3,605ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$255,715BOYAmt
EOY$346,668EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$4,131BOYAmt
EOY$6,591EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,829,192LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$300,741LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,569,959BOYAmt
EOY$1,528,451EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,829,805BOYAmt
EOY$1,881,710EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$921,929BOYAmt
EOY$880,940EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,736BOYAmt
EOY$6,302EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$930,665BOYAmt
EOY$887,242EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$899,140BOYAmt
EOY$994,468EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$899,140BOYAmt
EOY$994,468EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,829,805BOYAmt
EOY$1,881,710EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$95,328ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$305CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$642CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$133CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,560CurrentTaxYearMinus1YearAmt
Current Tax Year$124CurrentTaxYearAmt
Total$2,764TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$486,298CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$521,658CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$369,112CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$581,947CurrentTaxYearMinus1YearAmt
Current Tax Year$547,917CurrentTaxYearAmt
Total$2,506,932TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$486,603CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$522,300CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$369,245CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$583,507CurrentTaxYearMinus1YearAmt
Current Tax Year$548,041CurrentTaxYearAmt
Total$2,509,696TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$2,509,696PublicSupportTotal509Amt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$7,475CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,192CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$9,719CurrentTaxYearMinus1YearAmt
Current Tax Year$9,407CurrentTaxYearAmt
Total$35,793TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$7,475CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,192CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$9,719CurrentTaxYearMinus1YearAmt
Current Tax Year$9,407CurrentTaxYearAmt
Total$35,793TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$34,817CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$36,298CurrentTaxYearMinus1YearAmt
Total$71,115TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$486,603CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$529,775CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$413,254CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$629,524CurrentTaxYearMinus1YearAmt
Current Tax Year$557,448CurrentTaxYearAmt
Total$2,616,604TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.95910PublicSupportCY509Pct
Public Support PY5090.96080PublicSupportPY509Pct
Investment Income CY0.01370InvestmentIncomeCYPct
Investment Income PY0.01060InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$347,858OtherCostOrOtherBasisAmt
Book Value$347,858BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,446,934OtherCostOrOtherBasisAmt
Depreciation$269,354DepreciationAmt
Book Value$1,177,580BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$19,004OtherCostOrOtherBasisAmt
Depreciation$15,991DepreciationAmt
Book Value$3,013BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,396OtherCostOrOtherBasisAmt
Depreciation$15,396DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,528,451TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescPAYROLL LIABILITIESDesc
Amt$6,302Amt
FieldValueIRS element (for citing)
Total Liability$6,302TotalLiabilityAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1LIFECARE HOSPICEBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11900 AKRON ROADAddressLine1Txt
CityWOOSTERCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44691ZIPCd
FieldValueIRS element (for citing)
Recipient EIN341352875RecipientEIN
IRC Section3IRCSectionDesc
Cash Grant$85,000CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt
Purpose Of GrantPATIENT CAREPurposeOfGrantTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BREVIEWED BY THE TREASURER AND EXECUTIVE DIRECTOR PRIOR TO FILING. REVIEWED BY THE BOARD OF DIRECTORS AFTER FILING.
FORM 990, PART VI, SECTION B, LINE 15ATHE BOARD REVIEWS THE SALARIES AND COMPARES THEM TO SIMILAR NON-PROFITS WITH COMPARABLE INCOME TYPES AND SALES FIGURES.
FORM 990, PART VI, SECTION C, LINE 19DOCUMENTS ARE MADE AVAILABLE UPON REQUEST.
FORM 990, PART VI - ADDITIONAL INFORMATIONMARLENE BARKHEIMER IS THE PRESIDENT/CEO OF FARMERS STATE BANK AND ALSO THE TREASURER OF FRIENDS OF HOSPICE. FRIENDS OF HOSPICE MAINTAINS CASH AND A LOAN WITH FARMERS STATE BANK. IT IS BOARD POLICY FOR ALL ACCOUNTS TO GO OUT FOR BID AND THE BOARD MUST APPROVE THE TRANSACTIONS. MS. BARKHEIMER ABSTAINS FROM VOTING ON THESE ACTIVITIES. ALL FEES/INTEREST CHARGED BY FARMERS STATE BANK TO FRIENDS OF HOSPICE ARE AT NORMAL CUSTOMARY RATES CHARGED TO ALL CUSTOMERS. FARMERS STATE BANK RENTS A BUILDING FROM FRIENDS OF HOSPICE. THE RENT IS AT MARKET VALUE AND WAS APPROVED BY THE BOARD. RENT IS AT $2,500 A MONTH.