STRATEGY STUDIO / PUBLIC DATA EXPLORER

FRIENDS OF HOSPICE WAYNE COUNTY OHIO: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
FRIENDS OF HOSPICE WAYNE COUNTY OHIO (EIN 20-1370925)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-11-16
IRS object ID
202023219349308262
Schema version
2019v5.0
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)
Return2020-11-16T11:25:54-06:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN341939640PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1LONG COOK & SAMSA INCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1505 N MARKET STAddressLine1Txt
CityWOOSTERCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44691ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

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
Signature2020-11-12SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJENNIFER M HALVORSENPreparerPersonNm
PTINP00014257PTIN
Phone3302627111PhoneNum
Preparation2020-11-16PreparationDt
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

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$644,800GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
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. 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 FOUR PART- TIME EMPLOYEE. THE BOARD OF DIRECTORS IS COMPRISED OF FOUR NON-COMPENSATED MEMBERS.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee7TotalEmployeeCnt
Total Volunteers55TotalVolunteersCnt
Total Gross UBI$11,437TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$9,462NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$305PYContributionsGrantsAmt
CY Contributions Grants$100,642CYContributionsGrantsAmt
PY Program Service Revenue$486,298PYProgramServiceRevenueAmt
CY Program Service Revenue$521,658CYProgramServiceRevenueAmt
PY Investment Income-$8,844PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
CY Other Revenue$11,437CYOtherRevenueAmt
PY Total Revenue$477,759PYTotalRevenueAmt
CY Total Revenue$633,737CYTotalRevenueAmt
PY Grants And Similar Paid$108,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$90,000CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$175,276PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$184,056CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$214,110PYOtherExpensesAmt
CY Other Expenses$221,611CYOtherExpensesAmt
PY Total Expenses$497,386PYTotalExpensesAmt
CY Total Expenses$495,667CYTotalExpensesAmt
PY Revenues Less Expenses-$19,627PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$138,070CYRevenuesLessExpensesAmt
Total Assets BOY$676,141TotalAssetsBOYAmt
Total Assets EOY$1,848,482TotalAssetsEOYAmt
Total Liabilities BOY$5,774TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,040,045TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$670,367NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$808,437NetAssetsOrFundBalancesEOYAmt
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 FOUR PART- TIME EMPLOYEE. THE BOARD OF DIRECTORS IS COMPRISED OF FOUR NON-COMPENSATED MEMBERS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$482,487ExpenseAmt
Grant$90,000GrantAmt
Revenue$521,658RevenueAmt
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 2019 PROFITS OF 90,000 WERE GIVEN.Desc
Total Program Service Expenses$482,487TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee7EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnfalseAnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcfalseRegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldOHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMARLENE BARKHEIMERPersonNm
Phone3302622012PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
DAWN SCHIRM
EXECUTIVE DI40.00Yes (X)$58,500$0$0
JACKIE FRY
BOARD MEMBER1.00Yes (X)$0$0$0
MARLENE BARKHEIMER
TREASURER1.00$0$0$0Yes (X)
LOUSIE KEATING
SECRETARY1.00$0$0$0Yes (X)
RON LEATHERMAN
PRESIDENT1.00$0$0$0Yes (X)
PAMELA TAYLOR
VICE PRESIDE1.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$58,500TotalReportableCompFromOrgAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$100,642AllOtherContributionsAmt
Total Contributions$100,642TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescDONATED GOODS/RETAILDesc
Business448000BusinessCd
Total Revenue Column$521,658TotalRevenueColumnAmt
Related Or Exempt Func Income$521,658RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$521,658TotalProgramServiceRevenueAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$22,500RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$11,063RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$11,437RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,437TotalRevenueColumnAmt
Unrelated Business Revenue$11,437UnrelatedBusinessRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$633,737TotalRevenueColumnAmt
Related Or Exempt Func Income$521,658RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$11,437UnrelatedBusinessRevenueAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$90,000TotalAmt
Program Services$90,000ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$58,500TotalAmt
Program Services$58,500ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$112,264TotalAmt
Program Services$112,264ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$13,292TotalAmt
Program Services$13,292ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$2,166TotalAmt
Management And General$2,166ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$10,319TotalAmt
Program Services$10,319ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$7,764TotalAmt
Program Services$7,764ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$122,301TotalAmt
Program Services$122,301ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$10,694TotalAmt
Management And General$10,694ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$23,915TotalAmt
Program Services$23,915ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$7,405TotalAmt
Program Services$7,405ProgramServicesAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
AUCTION PURCHASES-RESALE$27,204$27,204
AUTO$9,523$9,523
BANK CHARGES$320$320

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$495,667TotalAmt
Program Services$482,487ProgramServicesAmt
Management And General$13,180ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$116,787BOYAmt
EOY$254,590EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,671BOYAmt
EOY$2,671EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,764,296LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$173,075LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$556,683BOYAmt
EOY$1,591,221EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$676,141BOYAmt
EOY$1,848,482EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
EOY$1,021,939EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,774BOYAmt
EOY$18,106EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,774BOYAmt
EOY$1,040,045EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$670,367BOYAmt
EOY$808,437EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$670,367BOYAmt
EOY$808,437EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$676,141BOYAmt
EOY$1,848,482EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$138,070ReconcilationRevenueExpnssAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

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$205CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$21CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,010CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$305CurrentTaxYearMinus1YearAmt
Current Tax Year$642CurrentTaxYearAmt
Total$2,183TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$336,342CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$396,099CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$429,735CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$486,298CurrentTaxYearMinus1YearAmt
Current Tax Year$521,658CurrentTaxYearAmt
Total$2,170,132TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$336,547CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$396,120CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$430,745CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$486,603CurrentTaxYearMinus1YearAmt
Current Tax Year$522,300CurrentTaxYearAmt
Total$2,172,315TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$2,172,315PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1CurrentTaxYearMinus2YearsAmt
Total$10TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Current Tax Year$7,475CurrentTaxYearAmt
Total$7,475TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1CurrentTaxYearMinus2YearsAmt
Current Tax Year$7,475CurrentTaxYearAmt
Total$7,485TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$336,553CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$396,123CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$430,746CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$486,603CurrentTaxYearMinus1YearAmt
Current Tax Year$529,775CurrentTaxYearAmt
Total$2,179,800TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99660PublicSupportCY509Pct
Public Support PY5090.99490PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Investment Income PY0.00000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (true)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt OrgfalseOperateBenefitNonSuprtOrgInd

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$1,385,770OtherCostOrOtherBasisAmt
Depreciation$152,628DepreciationAmt
Book Value$1,233,142BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,272OtherCostOrOtherBasisAmt
Depreciation$9,341DepreciationAmt
Book Value$5,931BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,396OtherCostOrOtherBasisAmt
Depreciation$11,106DepreciationAmt
Book Value$4,290BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,591,221TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
REAL ESTATE TAXES PAYABLE$11,883
PAYROLL LIABILITIES$6,223
FieldValueIRS element (for citing)
Total Liability$18,106TotalLiabilityAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)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$90,000CashGrantAmt
Purpose Of GrantPATIENT CAREPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990 - ORGANIZATION'S 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 FOUR PART- TIME EMPLOYEE. THE BOARD OF DIRECTORS IS COMPRISED OF FOUR NON-COMPENSATED MEMBERS.
FORM 990, PART VIMARLENE 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.
FORM 990, PAGE 6, PART VI, LINE 11BREVIEWED BY THE TREASURER AND EXECUTIVE DIRECTOR PRIOR TO FILING. REVIEWED BY THE BOARD OF DIRECTORS AFTER FILING.
FORM 990, PAGE 6, PART VI, LINE 15ATHE BOARD REVIEWS THE SALARIES AND COMPARES THEM TO SIMILAR NON-PROFITS WITH COMPARABLE INCOME TYPES AND SALES FIGURES.
FORM 990, PAGE 6, PART VI, LINE 19DOCUMENTS ARE MADE AVAILABLE UPON REQUEST.