STRATEGY STUDIO / PUBLIC DATA EXPLORER

FRIENDS OF HOSPICE WAYNE COUNTY OHIO: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
FRIENDS OF HOSPICE WAYNE COUNTY OHIO (EIN 20-1370925)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-15
IRS object ID
201803199349310275
Schema version
2017v2.3
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)
Return2018-11-15T14:02:32-05:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

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 Begin2017-01-01TaxPeriodBeginDt

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
Signature2018-11-13SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJENNIFER M HALVORSENPreparerPersonNm
PTINP00014257PTIN
Phone3302627111PhoneNum
Preparation2018-11-13PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address199.26.246.24IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-11-15IPDt
IP Tm13:02:32IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdB81A556EA46BEE54B1871E00B25A1CE6B0A91057AtSubmissionCreationDeviceId
At Submission Filing Device Id451E8AB82705E028D4D41E4A63E12CB08C16782DAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

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$430,746GrossReceiptsAmt
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 Body4VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee6TotalEmployeeCnt
Total Volunteers55TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$21PYContributionsGrantsAmt
CY Contributions Grants$1,010CYContributionsGrantsAmt
PY Program Service Revenue$396,099PYProgramServiceRevenueAmt
CY Program Service Revenue$429,735CYProgramServiceRevenueAmt
PY Investment Income$3PYInvestmentIncomeAmt
CY Investment Income$1CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$396,123PYTotalRevenueAmt
CY Total Revenue$430,746CYTotalRevenueAmt
PY Grants And Similar Paid$125,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$100,000CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$160,933PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$151,579CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$107,226PYOtherExpensesAmt
CY Other Expenses$125,290CYOtherExpensesAmt
PY Total Expenses$393,159PYTotalExpensesAmt
CY Total Expenses$376,869CYTotalExpensesAmt
PY Revenues Less Expenses$2,964PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$53,877CYRevenuesLessExpensesAmt
Total Assets BOY$641,720TotalAssetsBOYAmt
Total Assets EOY$697,288TotalAssetsEOYAmt
Total Liabilities BOY$5,603TotalLiabilitiesBOYAmt
Total Liabilities EOY$7,294TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$636,117NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$689,994NetAssetsOrFundBalancesEOYAmt
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$366,046ExpenseAmt
Grant$100,000GrantAmt
Revenue$429,735RevenueAmt
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 2017 PROFITS OF 100,000 WERE GIVEN.Desc
Total Program Service Expenses$366,046TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
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 With Officer EntfalseBusinessRlnWithOfficerEntInd
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
Employee6EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members4GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
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 (5 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
DAWN SCHIRM
EXECUTIVE DI40.00Yes (X)$57,077$0$0
PAM TAYLOR
BOARD MEMBER1.00Yes (X)$0$0$0
RON LEATHERMAN
BOARD MEMBER1.00Yes (X)$0$0$0
SARAH LITTLE
SECRETARY1.00$0$0$0Yes (X)
MARLENE BARKHEIMER
TREASURER1.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$57,077TotalReportableCompFromOrgAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$1,010AllOtherContributionsAmt
Total Contributions$1,010TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescDONATED GOODS/RETAILDesc
Business448000BusinessCd
Total Revenue Column$429,735TotalRevenueColumnAmt
Related Or Exempt Func Income$429,735RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$429,735TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1TotalRevenueColumnAmt
Exclusion$1ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$430,746TotalRevenueColumnAmt
Related Or Exempt Func Income$429,735RelatedOrExemptFuncIncomeAmt
Exclusion$1ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$100,000TotalAmt
Program Services$100,000ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$57,077TotalAmt
Program Services$57,077ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$82,244TotalAmt
Program Services$82,244ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$12,258TotalAmt
Program Services$12,258ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$1,716TotalAmt
Management And General$1,716ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$7,096TotalAmt
Program Services$7,096ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,452TotalAmt
Program Services$5,452ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$47,871TotalAmt
Program Services$47,871ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$8,737TotalAmt
Management And General$8,737ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$19,217TotalAmt
Program Services$19,217ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$5,504TotalAmt
Program Services$5,504ProgramServicesAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
AUCTION PURCHASES-RESALE$25,570$25,570
AUTO$3,757$3,757
BANK CHARGES$370$370

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$376,869TotalAmt
Program Services$366,046ProgramServicesAmt
Management And General$10,823ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$69,717BOYAmt
EOY$132,006EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$47,573BOYAmt
EOY$35,076EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,486BOYAmt
EOY$1,671EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$666,538LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$138,003LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$522,944BOYAmt
EOY$528,535EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$641,720BOYAmt
EOY$697,288EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,603BOYAmt
EOY$7,294EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,603BOYAmt
EOY$7,294EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$636,117BOYAmt
EOY$689,994EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$636,117BOYAmt
EOY$689,994EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$641,720BOYAmt
EOY$697,288EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$53,877ReconcilationRevenueExpnssAmt
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$1,427CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$17,051CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$205CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$21CurrentTaxYearMinus1YearAmt
Current Tax Year$1,010CurrentTaxYearAmt
Total$19,714TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$297,790CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$301,441CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$336,342CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$396,099CurrentTaxYearMinus1YearAmt
Current Tax Year$429,735CurrentTaxYearAmt
Total$1,761,407TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$299,217CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$318,492CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$336,547CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$396,120CurrentTaxYearMinus1YearAmt
Current Tax Year$430,745CurrentTaxYearAmt
Total$1,781,121TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$10,000CurrentTaxYearMinus3YearsAmt
Total$10,000TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$10,000CurrentTaxYearMinus3YearsAmt
Total$10,000TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$1,771,121PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3CurrentTaxYearMinus1YearAmt
Current Tax Year$1CurrentTaxYearAmt
Total$32TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3CurrentTaxYearMinus1YearAmt
Current Tax Year$1CurrentTaxYearAmt
Total$32TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$299,230CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$318,501CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$336,553CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$396,123CurrentTaxYearMinus1YearAmt
Current Tax Year$430,746CurrentTaxYearAmt
Total$1,781,153TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99440PublicSupportCY509Pct
Public Support PY5090.99070PublicSupportPY509Pct
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 D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$84,980OtherCostOrOtherBasisAmt
Book Value$84,980BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$557,382OtherCostOrOtherBasisAmt
Depreciation$129,743DepreciationAmt
Book Value$427,639BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,780OtherCostOrOtherBasisAmt
Depreciation$4,781DepreciationAmt
Book Value$3,999BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,396OtherCostOrOtherBasisAmt
Depreciation$3,479DepreciationAmt
Book Value$11,917BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$528,535TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescPAYROLL LIABILITIESDesc
Amt$7,294Amt
FieldValueIRS element (for citing)
Total Liability$7,294TotalLiabilityAmt

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$100,000CashGrantAmt
Purpose Of GrantPATIENT CAREPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 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, 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.