STRATEGY STUDIO / PUBLIC DATA EXPLORER

HOSPICE ALLIANCE FOUNDATION INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
HOSPICE ALLIANCE FOUNDATION INC (EIN 39-1822945)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-09-28
IRS object ID
201642729349300839
Schema version
2015v2.1
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)
Return2016-09-28T13:52:00-05:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN391648207PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ANDREA & ORENDORFF LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line16300 76TH ST STE 200AddressLine1Txt
CityKENOSHACityNm
State AbbreviationWIStateAbbreviationCd
ZIP531424018ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391822945EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HOSPICE ALLIANCE FOUNDATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHOSPBusinessNameControlTxt
Phone2626524400PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line110220 PRAIRIE RIDGE BLVDAddressLine1Txt
CityPLEASANT PRAIRIECityNm
State AbbreviationWIStateAbbreviationCd
ZIP53158ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN PLOUSPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone2626524482PhoneNum
Signature2016-08-12SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTERRI A SCHMIDTPreparerPersonNm
PTINP00037140PTIN
Phone2626577716PhoneNum
Preparation2016-09-23PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJOHN PLOUSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line110220 PRAIRE RIDGE BLVDAddressLine1Txt
CityPLEASANT PRAIRIECityNm
State AbbreviationWIStateAbbreviationCd
ZIP53158ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$841,123GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.HOSPICEALLIANCE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1996FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionTHE FOUNDATION SUPPORTS HOSPICE ALLIANCE IN PROVIDING PHYSICAL, EMOTIONAL AND SPIRITUAL CARE, AND EDUCATION FOR PATIENTS FACING LIFE-LIMITING ILLNESSES, THOSE WHO SUPPORT THEM AND THE COMMUNITY.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$277,661PYContributionsGrantsAmt
CY Contributions Grants$445,139CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$303,558PYInvestmentIncomeAmt
CY Investment Income$232,373CYInvestmentIncomeAmt
PY Other Revenue-$77,710PYOtherRevenueAmt
CY Other Revenue-$82,374CYOtherRevenueAmt
PY Total Revenue$503,509PYTotalRevenueAmt
CY Total Revenue$595,138CYTotalRevenueAmt
PY Grants And Similar Paid$110,272PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$45,288CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$196,518PYOtherExpensesAmt
CY Other Expenses$432,943CYOtherExpensesAmt
PY Total Expenses$306,790PYTotalExpensesAmt
CY Total Expenses$478,231CYTotalExpensesAmt
PY Revenues Less Expenses$196,719PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$116,907CYRevenuesLessExpensesAmt
Total Assets BOY$12,989,032TotalAssetsBOYAmt
Total Assets EOY$13,019,857TotalAssetsEOYAmt
Total Liabilities BOY$705,365TotalLiabilitiesBOYAmt
Total Liabilities EOY$619,283TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$12,283,667NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$12,400,574NetAssetsOrFundBalancesEOYAmt
MissionTHE FOUNDATION SUPPORTS HOSPICE ALLIANCE IN PROVIDING PHYSICAL, EMOTIONAL AND SPIRITUAL CARE, AND EDUCATION FOR PATIENTS FACING LIFE-LIMITING ILLNESSES, THOSE WHO SUPPORT THEM AND THE COMMUNITY.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$439,734ExpenseAmt
Grant$45,288GrantAmt
DescALL REVENUES AND EXPENSES ARE RELATED TO THE PURPOSE OF RAISING MONEY FOR HOSPICE ALLIANCE, INC. THE FOUNDATION WILL BE ABLE TO GRANT MONEY TO HOSPICE ALLIANCE, INC. AS NEEDED DUE TO CHANGES IN ITS BUSINESS ENVIRONMENT.Desc
Total Program Service Expenses$439,734TotalProgramServiceExpensesAmt
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
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
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 EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document1IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
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 Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
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 BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMARILYN MASIPersonNm
Phone2626524482PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line110220 PRAIRIE RIDGE BLVDAddressLine1Txt
CityPLEASANT PRAIRIECityNm
State AbbreviationWIStateAbbreviationCd
ZIP53158ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)

TitleTitleTxtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
MICHAEL MULLANE MD
MEMBERYes (X)$0$0$0
DENNIS MATTIOLI
MEMBERYes (X)$0$0$0
MARY KARNES
MEMBERYes (X)$0$0$0
SANDRA RIESE RN
MEMBERYes (X)$0$0$0
DAVID BERMAN
MEMBERYes (X)$0$0$0
LEN IAQUINTA
MEMBERYes (X)$0$0$0
GENE OLSON
MEMBERYes (X)$0$0$0
DANIEL HEYDEN CPA
SEC/TREAS$0$0$0Yes (X)
JOHN PLOUS
PRESIDENT$0$0$0Yes (X)
RICHARD REGNER
VICE PRESIDE$0$0$0Yes (X)
FieldValueIRS element (for citing)
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$445,139AllOtherContributionsAmt
Total Contributions$445,139TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$232,373TotalRevenueColumnAmt
Related Or Exempt Func Income$259,764RelatedOrExemptFuncIncomeAmt
Exclusion-$27,391ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$99,997RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$231,760RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$131,763RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$131,763TotalRevenueColumnAmt
Exclusion-$131,763ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$56,339FundraisingGrossIncomeAmt
Fundraising Direct Expenses$14,225FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$42,114TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
BRICK MEMORIAL$7,000$7,000
MISC$275$275
FieldValueIRS element (for citing)
Other Revenue Total$7,275OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$595,138TotalRevenueColumnAmt
Related Or Exempt Func Income$266,764RelatedOrExemptFuncIncomeAmt
Exclusion-$158,879ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$45,288TotalAmt
Program Services$45,288ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$54,618TotalAmt
Program Services$54,618ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$216TotalAmt
Program Services$216ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$13,995TotalAmt
Program Services$13,995ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,332TotalAmt
Program Services$1,332ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
UNREALIZED LOSSES$302,085$302,085
INVESTMENT EXPENSES$25,627$25,627
COMMUNITY AWARENESS$22,061$22,061
OUTSIDE SERVICES$11,413$11,413

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,596TotalAmt
Program Services$139ProgramServicesAmt
Management And General$1,457ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$478,231TotalAmt
Program Services$439,734ProgramServicesAmt
Management And General$38,497ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$431,069BOYAmt
EOY$681,102EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,193,729BOYAmt
EOY$2,238,331EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,874BOYAmt
EOY$1,085EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,623BOYAmt
EOY$1,553EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$5,975,912LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,221,873LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$4,910,619BOYAmt
EOY$4,754,039EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$4,447,118BOYAmt
EOY$5,343,747EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$12,989,032BOYAmt
EOY$13,019,857EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$74,307BOYAmt
EOY$6,894EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$631,058BOYAmt
EOY$612,389EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$705,365BOYAmt
EOY$619,283EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$12,198,520BOYAmt
EOY$12,334,073EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$85,147BOYAmt
EOY$66,501EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$12,283,667BOYAmt
EOY$12,400,574EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$12,989,032BOYAmt
EOY$13,019,857EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$116,907ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
IRS Written DeterminationYes (X)IRSWrittenDeterminationInd
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1HOSPICE ALLIANCE INCBusinessNameLine1Txt
Business Name Line2HOSPICE ALLIANCE INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
EIN391403883EIN
Organization Type9OrganizationTypeCd
Governing Document ListedYes (true)GoverningDocumentListedInd
Support$96,386SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$96,386SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (true)ListedByNameGoverningDocInd
Suprt Org No IRS DeterminationfalseSuprtOrgNoIRSDeterminationInd
Supported Org Section C456falseSupportedOrgSectionC456Ind
Supported Org Not Organized USfalseSupportedOrgNotOrganizedUSInd
Organization Change Suprt OrgfalseOrganizationChangeSuprtOrgInd
Support Non Supported OrgfalseSupportNonSupportedOrgInd
Payment Substantial ContribtrfalsePaymentSubstantialContribtrInd
Loan Disqualified PersonfalseLoanDisqualifiedPersonInd
Controlled Disqualified PrsnfalseControlledDisqualifiedPrsnInd
Disqualified Prsn Controll IntfalseDisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr IntfalseDisqualifiedPrsnOwnrIntInd
Excess Business Holdings RulesfalseExcessBusinessHoldingsRulesInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd

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$1,135,876OtherCostOrOtherBasisAmt
Book Value$1,135,876BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,082,802OtherCostOrOtherBasisAmt
Depreciation$1,042,660DepreciationAmt
Book Value$3,040,142BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$627,805OtherCostOrOtherBasisAmt
Depreciation$75,483DepreciationAmt
Book Value$552,322BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$129,429OtherCostOrOtherBasisAmt
Depreciation$103,730DepreciationAmt
Book Value$25,699BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$4,754,039TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$595,138TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$595,138RevenueSubtotalAmt
Total Revenue Per Form990$595,138TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$478,231TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$478,231ExpensesSubtotalAmt
Total Expenses Per Form990$478,231TotalExpensesPerForm990Amt

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Licensed StatesWILicensedStatesCd

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GENERAL FUNDRAIEvent1Nm
Gross Receipts Event1$56,339GrossReceiptsEvent1Amt
Gross Revenue Event1$56,339GrossRevenueEvent1Amt
Other Direct Expenses Event1$14,225OtherDirectExpensesEvent1Amt
Gross Receipts Total$56,339GrossReceiptsTotalAmt
Gross Revenue Total Events$56,339GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events$14,225OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$14,225DirectExpenseSummaryEventsAmt
Net Income Summary$42,114NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedfalseGrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1HOSPICE ALLIANCE INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line110220 PRAIRIE RIDGE BLVDAddressLine1Txt
CityPLEASANT PRAIRIECityNm
State AbbreviationWIStateAbbreviationCd
ZIP53158ZIPCd
FieldValueIRS element (for citing)
Recipient EIN391403883RecipientEIN
IRC Section501IRCSectionDesc
Cash Grant$44,288CashGrantAmt
Valuation Method UsedFMVValuationMethodUsedDesc
Purpose Of GrantSPONSORSHIPPurposeOfGrantTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 1, PART I, LINE 6THERE ARE NO VOLUNTEERS FOR FOUNDATION, BUT VOLUNTEERS ARE PART OF HOSPICE ALLIANCE, INC. (OPERATIONS).
FORM 990, PAGE 6, PART VI, LINE 11BTHE 990 WAS REVIEWED IN DETAIL BY THE FINANCE DIRECTOR AND BY THE ORGANIZATIONS FINANCE COMMITTEE AND THEN APPROVED BY THE FINANCE COMMITTEE. ALL FINANCIAL INFORMATION IN THIS RETURN IS BASED OFF OF THE AUDITED FINANCIAL STATEMENTS.
FORM 990, PAGE 6, PART VI, LINE 12CPRIOR TO ELECTION, POTENTIAL BOARD MEMBERS MUST DOCUMENT ANY CONFLICTS OF INTEREST. BOARD MEMBERS MUST REAFFIRM ANNUALLY.
FORM 990, PAGE 6, PART VI, LINE 19THE ORGANIZATION WILL FURNISH AUDITED FINANCIAL STATEMENTS UPON REQUEST.
FORM 990, PART IX, LINE 11GCONTRACTED SERVICES-OPS 7,938 0 0 CONTRACTED OFFICE EXPENSE 44,160 0 0 BRICK MEMORIAL 2,520 0 0

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1HOSPICE ALLIANCE INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line110220 PRAIRIE RIDGE BLVDAddressLine1Txt
CityPLEASANT PRAIRIECityNm
State AbbreviationWIStateAbbreviationCd
ZIP53158ZIPCd
FieldValueIRS element (for citing)
EIN391403883EIN
Primary ActivitiesHOSPICEPrimaryActivitiesTxt
Legal Domicile StateWILegalDomicileStateCd
Exempt Code Section501C3ExemptCodeSectionTxt
Public Charity Status9PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
HOSPICE ALLIANCE INC
J$99,997RENTAL CONTRACT
HOSPICE ALLIANCE INC
B$29,870AMOUNT OF SPONSORSHIPS
HOSPICE ALLIANCE INC
P$52,098FOR OFFICE & PERSONNEL
HOSPICE ALLIANCE INC
B$14,418FOR EMPLOYMENT CDS