2018-11-13T11:37:37-06:00 2017-12-31 351178661 BLUE & CO LLC 813 WEST SECOND STREET SEYMOUR IN 47274 990 2017-01-01 351479425 OUR HOSPICE OF SOUTH CENTRAL INDIANA INC OURH 8123148000 2626 E 17TH STREET COLUMBUS IN 47201 LAURA LEONARD PRESIDENT 8123148000 2018-11-12 1 KANDY L WISCHMEIER CPA P00118327 8125228416 2018-11-12 38.109.186.2 2018-11-12 12:52:11 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 7C7B47936940A20FE0123DA9B400AB0E4818A817 2017 2019-02-21 02:37:17Z LAURA LEONARD 2626 E 17TH STREET COLUMBUS IN 47201 15411383 0 X WWW.OURHOSPICE.ORG X 1980 IN OUR HOSPICE OF SOUTH CENTRAL INDIANA, INC. (OHSCI) IS AN INDEPENDENT, NOT-FOR-PROFIT ORGANIZATION PROVIDING SERVICES TO THE TERMINALLY ILL IN A 16-COUNTY SERVICE AREA. SINCE ITS INCEPTION 37 YEARS AGO, HOSPICE HAS EXPANDED TO MEET THE NEEDS FOR END-OF-LIFE CARE IN SOUTHERN INDIANA. 13 13 191 110 0 0 934501 850082 12960441 14197740 2177 3439 233099 217554 14130218 15268815 0 0 0 0 9738971 10520965 0 0 315793 3526804 4005421 13265775 14526386 864443 742429 11576123 13178608 1419520 1642955 10156603 11535653 X OUR HOSPICE OF SOUTH CENTRAL INDIANA, INC. (OHSCI) IS AN INDEPENDENT, NOT-FOR-PROFIT ORGANIZATION PROVIDING SERVICES TO THE TERMINALLY ILL IN A 16-COUNTY SERVICE AREA. SINCE ITS INCEPTION 37 YEARS AGO, HOSPICE HAS EXPANDED TO MEET THE NEEDS FOR END-OF-LIFE CARE IN SOUTHERN INDIANA. 0 0 12975100 14205883 HOSPICE EXISTS TO PROVIDE CARE AND SUPPORT TO INDIVIDUALS AND THEIR FAMILIES IN THE LAST PHASES OF AN INCURABLE DISEASE SO THAT THEY MAY LIVE AS FULLY AND COMFORTABLY AS POSSIBLE. BEREAVEMENT SERVICES ARE PROVIDED TO FAMILY MEMBERS AND/OR SIGNIFICANT OTHERS FOR 13 MONTHS FOLLOWING A DEATH. AN INTERDISCIPLINARY TEAM CARES FOR THE PHYSICAL, PSYCHOSOCIAL, SPIRITUAL AND EMOTIONAL NEEDS OF THOSE WHO CHOOSE HSCI, WHETHER IT IS A MATTER OF DAYS, WEEKS, OR MONTHS. SERVICES ARE PROVIDED IN A VARIETY OF SETTINGS, INCLUDING THE PATIENT'S HOME, A LONG-TERM CARE FACILITY, AN ASSISTED LIVING FACILITY OR THE HOSPICE INPATIENT FACILITY. A TEAM OF HIGHLY SKILLED PROFESSIONALS AND VOLUNTEERS ARE AVAILABLE 24-HOURS A DAY, 7 DAYS A WEEK.OHSCI IS LICENSED BY THE STATE OF INDIANA AND CERTIFIED BY THE FEDERAL GOVERNMENT. MEDICARE, MEDICAID AND PRIVATE INSURANCE COVER MOST SERVICES. ADDITIONAL FUNDS ARE RAISED THROUGH MEMORIALS, PRIVATE DONATIONS, FUND-RAISING ACTIVITIES, GRANTS AND THE UNITED WAY. TO ENSURE THAT CARE CAN BE PROVIDED REGARDLESS OF ABILITY TO PAY, OHSCI IS A COMMUNITY RESOURCE FOR END-OF-LIFE CARE. HOSPICE PROFESSIONALS AND VOLUNTEERS ARE AVAILABLE TO PARTICIPATE IN EDUCATIONAL OFFERINGS IN A VARIETY OF SETTINGS, INCLUDING CHURCHES, SCHOOLS, CIVIC ORGANIZATIONS, AND OTHER HEALTH CARE PROVIDERS. IN 2017, APPROXIMATELY 824 PEOPLE WERE REACHED THROUGH 28 PRESENTATIONS IN THE COMMUNITIES WE SERVE.IN 2017, 1,257 PATIENTS AND FAMILIES RECEIVED 84,160 DAYS OF CARE. ADDITIONALLY, BEREAVEMENT SERVICES PROVIDED TO 7,194 PERSONAL CONTACTS TO HOSPICE BEREAVED FAMILIES IN 2017. APPROXIMATELY 8.5% OF OHSCI'S ANNUAL BUDGET IS RAISED EACH YEAR TO PROVIDE THE SPECIALIZED CARE NEEDED BY THE TERMINALLY ILL AND THEIR FAMILIES. YOU ARE WELCOME TO VISIT OUR WEBSITE AT WWW.OURHOSPICE.ORG<HTTP://WWW.OURHOSPICE.ORG> FOR ADDITIONAL INFORMATION AND TO VIEW PHOTOS OF THE INPATIENT FACILITY. 12975100 1 1 0 0 0 0 0 0 0 1 1 0 0 1 0 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 6 0 1 191 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X THE ORGANIZATION 8123148098 2626 E 17TH STREET COLUMBUS IN 47201 TOM DOWD BOARD SECRETARY/TREASURER 1.00 X X 0 0 0 MARLENE WEATHERWAX BOARD PRESIDENT 1.00 X X 0 0 0 SUZANNE WELLS BOARD IMMEDIATE PAST PRESIDENT 1.00 X X 0 0 0 MIKE MCIVER BOARD PRESIDENT-ELECT 1.00 X X 0 0 0 REX MCKINNEY BOARD MEMBER 1.00 X 0 0 0 DOUG THOMAS BOARD MEMBER 1.00 X 0 0 0 CHRIS IORIO MD BOARD MEMBER 1.00 X 0 0 0 LARRY OLSON BOARD MEMBER 1.00 X 0 0 0 JAMES BICKEL BOARD MEMBER 1.00 X 0 0 0 RORY GLICK BOARD MEMBER 1.00 X 0 0 0 FRANK REINDL BOARD MEMBER 1.00 X 0 0 0 DANNY HOUZE BOARD MEMBER 1.00 X 0 0 0 DAVID THOMPSON BOARD MEMBER 1.00 X 0 0 0 LAURA LEONARD PRESIDENT 40.00 X 160904 0 17345 SHOBHA SAHI MD HOSPICE PHYSICIAN 19.20 X 101993 0 20412 ROY GOODE MD FORMER MEDICAL DIRECTOR 24.00 X 170731 0 27129 KATHY ROSE DIRECTOR OF CLINICAL SERVICES 40.00 X 104577 0 10796 PHIL BUSH DIRECTOR OF BUSINESS OPERATIONS 40.00 X 101725 0 22081 JAMES PETERS HOSPICE PHYSICIAN 40.00 X 100539 0 743 740469 0 98506 6 0 1 0 ENCLARA PHARMACIA PO BOX 95000-7255 PHILADELPHIA PA 19195 PATIENT PRESCRIPTIONS/MEDS 898025 LINCARE 14839 W 95TH STREET LENEXA KS 66215 PATIENT DME (DURABLE MEDICAL EQUIPMENT) 554358 WILLIAMS BROS PHARMACY PO BOX 271 WASHINGTON IN 475014535 HOME INFUSION MEDS & FEEDINGS SERVICES 138103 HILL-ROM PO BOX 643592 PITTSBURGH PA 152643592 NEW PATIENT BEDS & RECLINERS FOR CENTER 134895 HOMECARE HOMEBASE PO BOX 678637 DALLAS TX 752678637 ELECTRONIC MEDICAL REORD PROVIDER 122860 5 58946 791136 850082 NET PATIENT SERVICE REVENUE 624100 14069231 14069231 PROGRAM SERVICE REVENUE 624100 128509 128509 14197740 3815 3815 5809 6185 -376 -376 -376 289048 114454 174594 174594 47440 12623 34817 34817 17449 9306 8143 8143 15268815 14205883 0 212850 178249 162207 16042 8244475 7301617 722138 220720 213266 186051 18401 8814 1247716 1107739 109557 30420 637259 564378 55818 17063 129517 33674 95843 20625 19181 1444 129512 113907 15605 177060 161125 15935 163992 127914 36078 335796 335796 343646 260172 77714 5760 82040 74656 7384 PATIENT SERVICE EXPENSE 2191621 2191621 REPAIRS AND MAINTENANCE 271474 219894 51580 BAD DEBT 61566 61566 DUES SUBSCRIPTIONS BOOK 37270 28698 8572 61302 24904 3382 33016 14526386 12975100 1235493 315793 400 400 2057886 2467980 1679130 1575805 6365 6184 523531 108246 8838150 4016099 4863566 4822051 2445245 4197942 11576123 13178608 1419520 1642955 1419520 1642955 X 10145242 11524287 11361 11366 10156603 11535653 11576123 13178608 742429 636621 0 X X 0 1 X 1 0 X 554434 631810 485086 934501 850082 3455913 554434 631810 485086 934501 850082 3455913 647048 2808865 22091 19275 6402 2331 3815 53914 338974 378865 336488 1054327 4564154 61311374 0.61540 0.67740 X 1 2443145 1117633 644978 9914 4195842 2443145 2443145 1.00000 1 0 6678141 2414938 4263203 220901 122557 98344 1939108 1478604 460504 4822051 OTHER ASSETS 2100 ASSETS HELD BY OTHERS 4195842 4197942 X 16101820 636621 60000 136384 833005 15268815 0 15268815 14722770 60000 136384 196384 14526386 0 14526386 PART V, LINE 4: TO HELP FURTHER THE EXEMPT PURPOSE OF THE ORGANIZATION PART X, LINE 2: HOSPICE IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY HOSPICE AND RECOGNIZE A TAX LIABILITY IF HOSPICE HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY HOSPICE, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2017 AND 2016, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. HOSPICE IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. AS SUCH, HOSPICE IS GENERALLY EXEMPT FROM INCOME TAXES. HOWEVER, HOSPICE IS REQUIRED TO FILE FEDERAL FORM 990 RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX WHICH IS AN INFORMATIONAL RETURN ONLY PART XI, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENTS EXPENSE 127,078. COGS EXPENSES 9,306. PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENTS EXPENSES 127,078. COGS EXPENSES 9,306. CONCERT 193520 193520 100 101356 JENNINGS GALA 55283 55283 450 8576 2 40245 40245 3972 289048 289048 550 113904 114454 174594 47440 11225 1398 1 1.00000 47440 11225 1398 12623 34817 IN 1 0 0 0 1.00000 JOCELYN ARVISAIS 2626 E 17TH STREET COLUMBUS IN 47201 0 LAURA LEONARD 0 OVERALL RESPONSIBILITY FOR THE OPERATION AND CONDUCT OF THE GAMING EVENT X 0 X 0 0 0 0 0 0 0 0 0 LAURA LEONARD PRESIDENT 160904 0 0 0 0 0 0 6436 0 10909 160904 17345 0 0 ROY GOODE MD FORMER MEDICAL DIRECTOR 170731 0 0 0 0 0 0 6829 0 20300 170731 27129 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE EXECUTIVE COMMITTEE OF THE BOARD DELEGATED AUTHORITY TO THE FINANCE COMMITTEE OF THE BOARD TO APPROVE THE FORM 990. THE FINANCE COMMITTEE OF THE BOARD WILL REVIEW THE ENTIRE FORM 990. ONCE APPROVED BY THE FINANCE COMMITTEE OF THE BOARD, A FULL COPY OF THE FORM 990 WAS MADE AVAILABLE TO EVERY BOARD MEMBER FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EFFECTIVE 2006, BOARD MEMBERS, KEY EMPLOYEES, DIRECTORS AND OFFICERS SIGNED A CONFLICT OF INTEREST STATEMENT, STATING THAT THEY HAVE READ AND UNDERSTOOD THE STATEMENT. SINCE THAT TIME, ORIENTATION FOR NEW BOARD MEMBERS, KEY EMPLOYEES, OFFICERS AND DIRECTORS, INCLUDES REVIEW AND SIGNATURE OF A CONFLICT OF INTEREST STATEMENT. THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY THE COMPLIANCE OFFICER WITH FOLLOW-UP BY THE COMPLIANCE COMMITTEE IF ANY POTENTIAL CONFLICTS ARE IDENTIFIED. FORM 990, PART VI, SECTION B, LINE 15 EACH POSITION HAS A SALARY RANGE. COMPENSATION AT HIRE IS DETERMINED BY SEVERAL FACTORS, INCLUDING THE APPLICANT'S EXPERIENCE, EDUCATION, APPLICANT'S SALARY AT THEIR MOST RECENT EMPLOYMENT AND WHERE THE PROPOSED SALARY WOULD FALL WITHIN THE SALARY RANGE OF OTHER MEMBERS OF THE HOSPICE TEAM WHO ARE IN SIMILAR POSITIONS. INCREASES IN SALARY DURING THE YEAR WERE MADE DUE TO MARKET WAGE ADJUSTMENTS, OR BASED ON PERFORMANCE. IN 2011, HOSPICE DEVELOPED A PRESIDENT'S COMPENSATION POLICY. THE POLICY STIPULATED THAT INCREASES FOR THE PRESIDENT'S POSITION WOULD NEED TO BE APPROVED BY THE BOARD PRESIDENT. IN 2015 THE COMPENSATION COMMITTEE OF THE BOARD WAS ESTABLISHED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST STATEMENT, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C THE PROCESS OF SELECTING AN INDEPENDENT ACCOUNTANT AND OVERSIGHT OF THE AUDIT HAS NOT CHANGED FROM THE PRIOR YEAR. PALLIATIVE SUPPORT CENTER 2626 E 17TH STREET COLUMBUS IN 47201 320451198 PROVIDE SYMPTOM MANAGEMENT FOR ADVANCED ILLNESS IN 0 OUR HOSPICE OF SOUTH CENTRAL INDIANA INC