STRATEGY STUDIO / PUBLIC DATA EXPLORER

HOSPICE OF THE WESTERN RESERVE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
HOSPICE OF THE WESTERN RESERVE INC (EIN 34-1256377)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-08-12
IRS object ID
201312249349301051
Schema version
2012v2.1
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)
Timestamp2013-08-12T09:36:41-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Howard Wershbale & CoBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line123240 Chagrin Blvd Suite 700AddressLine1
CityClevelandCity
StateOHState
ZIP Code441225450ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN341256377EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Hospice of The Western Reserve IncBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% JOHN E HARVAN JRInCareOfName
Name ControlHOSPNameControl
Phone2163832222Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line117876 St Clair AvenueAddressLine1
Address Line2SuiteAddressLine2
CityClevelandCity
StateOHState
ZIP Code44110ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJohn HarvanName
TitleCFOTitle
Phone2163832222Phone
Date Signed2013-08-09DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJoseph C Sbrocco CPAName
Phone2168311200Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonWILLIAM E FINNNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line117876 ST CLAIRAddressLine1
CityCLEVELANDCity
StateOHState
ZIP Code44110ZIPCode
FieldValueIRS element (for citing)
Gross Receipts98537946GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.HOSPICEWR.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1978YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionHOSPICE OF THE WESTERN RESERVE PROVIDES PALLIATIVE END-OF-LIFE CARE, CAREGIVER SUPPORT, AND BEREAVEMENT SERVICES THROUGHOUT NORTHERN OHIO. We strive to relieve suffering & enhance comfort in end of life care.ActivityOrMissionDescription
Nbr Voting Members Governing Body25NbrVotingMembersGoverningBody
Nbr Independent Voting Members23NbrIndependentVotingMembers
Total Nbr Employees1074TotalNbrEmployees
Total Nbr Volunteers2500TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year3336021ContributionsGrantsPriorYear
Contributions Grants Current Year3910402ContributionsGrantsCurrentYear
Program Service Revenue Prior Year86180366ProgramServiceRevenuePriorYear
Program Service Revenue CY90576989ProgramServiceRevenueCY
Investment Income Prior Year759642InvestmentIncomePriorYear
Investment Income Current Year693930InvestmentIncomeCurrentYear
Other Revenue Prior Year392944OtherRevenuePriorYear
Other Revenue Current Year1323436OtherRevenueCurrentYear
Total Revenue Prior Year90668973TotalRevenuePriorYear
Total Revenue Current Year96504757TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year54513206SalariesEtcPriorYear
Salaries Etc Current Year58348701SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year1313261TotalFundrsngExpCurrentYear
Other Expense Prior Year36412212OtherExpensePriorYear
Other Expenses Current Year36595249OtherExpensesCurrentYear
Total Expenses Prior Year90925418TotalExpensesPriorYear
Total Expenses Current Year94943950TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-256445RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1560807RevenuesLessExpensesCY
Total Assets BOY75254029TotalAssetsBOY
Total Assets EOY87551848TotalAssetsEOY
Total Liabilities BOY25690999TotalLiabilitiesBOY
Total Liabilities EOY34316578TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY49563030NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY53235270NetAssetsOrFundBalancesEOY
Mission DescriptionHOSPICE OF THE WESTERN RESERVE PROVIDES PALLIATIVE END-OF-LIFE CARE, CAREGIVER SUPPORT, AND BEREAVEMENT SERVICES THROUGHOUT NORTHERN OHIO. IN CELEBRATION OF THE INDIVIDUAL WORTH OF EACH LIFE, WE STRIVE TO RELIEVE SUFFERING, ENHANCE COMFORT, PROMOTE QUALITY LIFE, FOSTER CHOICE IN END-OF-LIFE CARE AND SUPPORT EFFECTIVE GRIEVING.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense78614731Expense
Revenue91808840Revenue
DescriptionHOSPICE CARE SERVICES ARE ABOUT PROVIDING PEOPLE (ADULTS AND CHILDREN) WITH A LIFE-LIMITING ILLNESS, AND THEIR FAMILIES WITH CHOICES AND DIGNITY. CARE IS PROVIDED WHEREVER THE PATIENTS LIVE; IN THEIR HOME, IN A HOSPITAL, ASSISTED LIVING/LONG-TERM CARE FACILITY OR at two HOSPICE HOUSE residential facilities. IN 2012, HOSPICE OF WESTERN RESERVE PROVIDED 459,612 PATIENT DAYS. CARE IS PROVIDED BY A TEAM OF PAID AND NON-PAID STAFF WHO ARE AVAILABLE 24-HOURS A-DAY, SEVEN DAYS A WEEK. ADDITIONALLY, BEREAVEMENT SERVICES ARE PROVIDED FOR FAMILIES FOR MORE THAN A YEAR FOLLOWING THE LOSS OF A LOVED ONE.Description
Total Program Service Expense78614731TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096121NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1074NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members25NbrVotingGoverningBodyMembers
Number Independent Voting Members23NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledOHStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJOHN E HARVAN JRNamePerson
Telephone Number2163832222TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line117876 ST CLAIRAddressLine1
CityCLEVELANDCity
StateOHState
ZIP Code44110ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (40 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
PEG MILBOURN
VICE CHAIR3.0XX000
JOSEPH CARSON
TREASURER3.0XX000
MARGIT DALEY
DIRECTOR1.0X000
CYNTHIA HUNDORFEAN
DIRECTOR1.0X000
MARY ANN KOCURKO
Board Chair3.0XX000
CAROL G MANNING
Director1.0X000
WENDY MIANO
DIRECTOR1.0X000
VIRGINIA A MOONEY
DIRECTOR1.0X000
DAVID MORDARSKI
DIRECTOR1.0X000
JANICE MURPHY
Vice Chair3.0XX000
LAURA NAVIN
Director1.0X000
MARY L OGRINC
DIRECTOR1.0X000
SARAH ROBERTSON
DIRECTOR1.0X000
RICHARD T SPOTZ JR
DIRECTOR1.0X000
WILLIAM SPRINGER
DIRECTOR1.0X000
ELIZABETH PITORAK
DIRECTOR1.0X206737024392
RICHARD A BARONE
DIRECTOR1.0X000
JAMES W ROGERSON
Director1.0X000
Stephen P Kresnye
Director1.0X000
H Clark Harvey Jr
Director1.0X000
Paula Ames Redman
Director1.0X000
Rev Neroy Carter
Director1.0X000
Alfred F Connors Jr MD
Director1.0X000
Amelia V Llerena MD
Director1.0X000
Hilary Mason King
Secretary3.0XX000
DAVID SIMPSON
CEO, EMERITUS40.0X38922502601
William Finn
ceo40.0X335613033436
John E Harvan Jr
Chief Financial Officer40.0X194184025872
CHARLES V WELLMAN
CHIEF MEDICAL OFFICER40.0246088026428X
Dann Ganzhorn
Medical Director40.0201617024526X
Jeffrey Spiess
Medical Director40.0184483025156X
John Walters
Medical Director40.0177211025423X
John Lim
Medical Director40.0157039023876X
Julia A Bartel
Chief Clinical Officer40.0150409013017X
Shareefah T Sabur
chief quality & educational40.0285528023415X
Wayne Grant
PHARMacist40.0106134022781X
Patricia A Kilfoyle
director-home care40.0110900023023X
Janice M Scheufler
PHARMacist40.011982603584X
Robert Phillips-Plona
director-residential services40.0122158011767X
Clement Heary
director-human resources40.0120462022207X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3107614TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation331504TotalOtherCompensation
Number Individuals GT100 K21NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
VOCON PARTNERS OF OHIO LLC
3142 PROSPECT AVENUECLEVELANDOH44115ARCHITECTURAL149899
DONLEY'S INC
5430 WARNER ROADCLEVELANDOH44125BUILDING CONTRACTOR5809232
LONDON ROAD ELECTRIC CO
16109 SAINT CLAIR AVECLEVELANDOH44110CONTRACTOR185302
DR CARLA BASTER
16920 CHARDON-WINDSOR ROADHUNSTBURGOH44046CONTRACTOR-PHYSICIAN179201
COMFORT SYSTEMS USA
7401 FIRST PLACEOAKWOOD VILLAGEOH44146CONTRACTOR-HVAC150102
FieldValueIRS element (for citing)
Number Of Contractors GT100 K8NumberOfContractorsGT100K
Federated Campaigns394595FederatedCampaigns
All Other Contributions3515807AllOtherContributions
Noncash Contributions127636NoncashContributions
Total Contributions3910402TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
HOSPICE CARE SERVICES6230009053916490539164
GRIEF COUNSELING6241003782537825
FieldValueIRS element (for citing)
Total Program Service Revenue90576989TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column851175TotalRevenueColumn
Exclusion$851,175ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1814423Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1947635Securities
Other24033Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-133212Securities
Other-24033Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-157245TotalRevenueColumn
Related Or Exempt Function Income-24033RelatedOrExemptFunctionIncome
Exclusion-$133,212ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events129073GrossIncomeFundraisingEvents
Fundraising Direct Expenses61521FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column67552TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
RESALE SHOP900099284980284980
MISCELLANEOUS REVENUE900099539804539804
REBATES AND REFUNDS900099431100431100
FieldValueIRS element (for citing)
Total Other Revenue1255884TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column96504757TotalRevenueColumn
Related Or Exempt Function Income91808840RelatedOrExemptFunctionIncome
Exclusion$717,963ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2302283Total
Management And General2302283ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total40768607Total
Program Services33524458ProgramServices
Management And General6584664ManagementAndGeneral
Fundraising659485Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2247958Total
Program Services1869871ProgramServices
Management And General343667ManagementAndGeneral
Fundraising34420Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total8858173Total
Program Services7358447ProgramServices
Management And General1363436ManagementAndGeneral
Fundraising136290Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4171680Total
Program Services3470040ProgramServices
Management And General637765ManagementAndGeneral
Fundraising63875Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total390463Total
Management And General390463ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2241434Total
Program Services1289143ProgramServices
Management And General878150ManagementAndGeneral
Fundraising74141Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total240798Total
Program Services60168ProgramServices
Management And General167505ManagementAndGeneral
Fundraising13125Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2749800Total
Program Services1429882ProgramServices
Management And General1207268ManagementAndGeneral
Fundraising112650Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1615107Total
Program Services1234851ProgramServices
Management And General330500ManagementAndGeneral
Fundraising49756Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total93508Total
Program Services77781ProgramServices
Management And General14295ManagementAndGeneral
Fundraising1432Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total183589Total
Program Services83986ProgramServices
Management And General92163ManagementAndGeneral
Fundraising7440Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total273887Total
Program Services209403ProgramServices
Management And General56046ManagementAndGeneral
Fundraising8438Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1512753Total
Program Services1280482ProgramServices
Management And General213694ManagementAndGeneral
Fundraising18577Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total309325Total
Program Services236499ProgramServices
Management And General63297ManagementAndGeneral
Fundraising9529Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesFundraisingFundraisingManagement And GeneralManagementAndGeneral
BAD DEBT36916934235026819
MEDICAL SUPPLIES475540947305651229712547
PATIENT SERVICES2059910204914853275435
NURSING FACILITIES17708578176160604579446724

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2091519Total
Program Services1751597ProgramServices
Management And General306056ManagementAndGeneral
Fundraising33866Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total94943950Total
Program Services78614731ProgramServices
Management And General15015958ManagementAndGeneral
Fundraising1313261Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4421020BOY
EOY4478649EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3740000BOY
EOY5555000EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY3049220BOY
EOY2743700EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY9193753BOY
EOY9459091EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY465320BOY
EOY628948EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis42759120LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec6303766LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY30609144BOY
EOY36455354EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY22163774BOY
EOY26278248EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY1199903BOY
EOY1562122EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY383789BOY
EOY370555EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY28106BOY
EOY20181EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY75254029BOY
EOY87551848EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY10714795BOY
EOY10504785EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY12659754BOY
EOY21440000EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2316450BOY
EOY2371793EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY25690999BOY
EOY34316578EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY42312875BOY
EOY49168920EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY6785253BOY
EOY3601448EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY464902BOY
EOY464902EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY49563030BOY
EOY53235270EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY75254029BOY
EOY87551848EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1560807ReconcilationRevenueExpenses
Reconciliation Unrealized Invest2463013ReconciliationUnrealizedInvest
Reconcilation Other Changes-351580ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years8829804CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8526768CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5927849CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3336021CurrentTaxYearMinus1Year
Current Tax Year3910402CurrentTaxYear
Total30530844Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years73369832CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years82077261CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years87368989CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year86180366CurrentTaxYearMinus1Year
Current Tax Year90576989CurrentTaxYear
Total419573437Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years82199636CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years90604029CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years93296838CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year89516387CurrentTaxYearMinus1Year
Current Tax Year94487391CurrentTaxYear
Total450104281Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total509450104281PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years801992CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years760658CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years578480CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year578773CurrentTaxYearMinus1Year
Current Tax Year851175CurrentTaxYear
Total3571078Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years801992CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years760658CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years578480CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year578773CurrentTaxYearMinus1Year
Current Tax Year851175CurrentTaxYear
Total3571078Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years326388CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years357582CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years344887CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year392944CurrentTaxYearMinus1Year
Current Tax Year1231851CurrentTaxYear
Total2653652Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years83328016CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years91722269CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years94220205CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year90488104CurrentTaxYearMinus1Year
Current Tax Year96570417CurrentTaxYear
Total456329011Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98636PublicSupportPercentage509
Prior Year Support Percentage0.98804PriorYearSupportPercentage
Investment Income Percentage0.00783InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00815PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance829943BeginningOfYearBalance
Investment Earnings Or Losses131205InvestmentEarningsOrLosses
End Of Year Balance961148EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance852162BeginningOfYearBalance
Investment Earnings Or Losses-22219InvestmentEarningsOrLosses
End Of Year Balance829943EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance774691BeginningOfYearBalance
Investment Earnings Or Losses77471InvestmentEarningsOrLosses
End Of Year Balance852162EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance790588BeginningOfYearBalance
Investment Earnings Or Losses-15897InvestmentEarningsOrLosses
End Of Year Balance774691EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance464902BeginningOfYearBalance
Investment Earnings Or Losses37729InvestmentEarningsOrLosses
Other Expenditures37729OtherExpenditures
End Of Year Balance464902EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.48369PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.51631TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis8045374OtherCostOrOtherBasis
Book Value8045374BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis26469883OtherCostOrOtherBasis
Depreciation3623636Depreciation
Book Value22846247BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis71945OtherCostOrOtherBasis
Depreciation47608Depreciation
Book Value24337BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3171811OtherCostOrOtherBasis
Depreciation1335474Depreciation
Book Value1836337BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5000107OtherCostOrOtherBasis
Depreciation1297048Depreciation
Book Value3703059BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings36455354TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
ANNUITY OBLIGATIONS$78,562
DEFERRED COMPENSATION OBLIGATION$832,609
INTEREST RATE SWAP$1,460,622
FieldValueIRS element (for citing)
Total Of Amounts2371793TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt100490562TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments2463013NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities1522792DonatedSrvcAndUseOfFacilities
Revenue Not Rptd F9903985805RevenueNotRptdF990
Revenue Subtotal96504757RevenueSubtotal
Total Revenue Per Form99096504757TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt96818322TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities1522792DonatedServicesUseOfFacilities
Other Expenses Included351580OtherExpensesIncluded
Expenses Not Rptd F9901874372ExpensesNotRptdF990
Expenses Subtotal94943950ExpensesSubtotal
Total Expenses Per Form99094943950TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
OTHER EXPENSESSCHEDULE D, PART XIII, #2DChange in Split Value Interest Agreements - $9,930 Change in Value of Interest Rate Swap - $ 341,650 Total Other Expenses = $ 351,580
INTENDED USES OF ENDOWMENT FUNDSSCHEDULE D, PART V, #4DONOR-IMPOSED STIPULATIONS INDICATING THAT THE FUNDS BE MAINTAINED PERMANENTLY BY THE ORGANIZATION AND THAT ALLOW THE INCOME EARNED ON ANY RELATED INVESTMENT TO BE USED FOR GENERAL PURPOSES.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Walk to RemembeNameOfEvent1
Gross Receipts Event1112332GrossReceiptsEvent1
Gross Revenue Event1112332GrossRevenueEvent1
Non Cash Prizes Event14720NonCashPrizesEvent1
Rent Facility Costs Event15523RentFacilityCostsEvent1
Food And Beverage Event19848FoodAndBeverageEvent1
Entertainment Event13199EntertainmentEvent1
Other Direct Expenses Event129063OtherDirectExpensesEvent1
Name Of Event2Jaguar RaffleNameOfEvent2
Gross Receipts Event216741GrossReceiptsEvent2
Gross Revenue Event216741GrossRevenueEvent2
Non Cash Prizes Event27225NonCashPrizesEvent2
Other Direct Expenses Event21943OtherDirectExpensesEvent2
Total Number Of Other Events0TotalNumberOfOtherEvents
Gross Receipts Other Events0GrossReceiptsOtherEvents
Charitable Contrib Other Events0CharitableContribOtherEvents
Gross Revenue Other Events0GrossRevenueOtherEvents
Cash Prizes Other Events0CashPrizesOtherEvents
Non Cash Prizes Other Events0NonCashPrizesOtherEvents
Rent Facility Costs Other Events0RentFacilityCostsOtherEvents
Food And Beverage Other Events0FoodAndBeverageOtherEvents
Entertainment Other Events0EntertainmentOtherEvents
Other Direct Expenses Other Events0OtherDirectExpensesOtherEvents
Gross Receipts Total129073GrossReceiptsTotal
Charitable Contributions Total0CharitableContributionsTotal
Gross Revenue Total Events129073GrossRevenueTotalEvents
Cash Prizes Total Events0CashPrizesTotalEvents
Non Cash Prizes Total Events11945NonCashPrizesTotalEvents
Rent Facility Costs Total Events5523RentFacilityCostsTotalEvents
Food And Beverage Total Events9848FoodAndBeverageTotalEvents
Entertainment Total Events3199EntertainmentTotalEvents
Other Direct Expenses Total Events31006OtherDirectExpensesTotalEvents
Direct Expense Summary Events61521DirectExpenseSummaryEvents
Net Income Summary67552NetIncomeSummary

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ELIZABETH PITORAK
DIRECTOR1456780250060809059430184490231129000
DAVID SIMPSON
CEO, EMERITUS89135030000009001065015360391826000
CHARLES V WELLMAN
CHIEF MEDICAL OFFICER245438065000079790184490272516000
William Finn
ceo258978075250013850149870184490369049000
John E Harvan Jr
Chief Financial Officer193934025000076100182620220056000
Dann Ganzhorn
Medical Director201367025000060770184490226143000
Jeffrey Spiess
Medical Director183833065000068940182620209639000
John Walters
Medical Director176561065000069740184490202634000
John Lim
Medical Director156789025000054670184090180915000
Julia A Bartel
Chief Clinical Officer14975906500005592074250163426000
Shareefah T Sabur
chief quality & educational12171102500163567049660184490308943000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierParticipate in, receive payment from, supplemental nonqualified retirementIdentifier
Return Referenceschedule J, part I, #4BReturnReference
ExplanationDavid Simpson, CEO, Emeritus - 98,432 Shareefah T. Sabur, Chief Quality & Education Officer - $163,567 Elizabeth Pitorak, Director of Hospice Institute - $60,809 Clem Hearey, Director of Human Resources - $9,563Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1CLEVELAND-CUYAHOGA COUNTY PORT AUTHORITYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN341029691IssuerEIN
Date Issued2010-12-30DateIssued
Issue Price21565000IssuePrice
Description Of PurposeRETIRE 1999 BONDS AND CONSTRUCT FADescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired125000AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds21565000TotalProceeds
Amount In Reserve Fund0AmountInReserveFund
Capitalized Interest120302CapitalizedInterest
Refunding Escrow0RefundingEscrow
Issuance Costs From Proceeds397023IssuanceCostsFromProceeds
Credit Enhancement0CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures17480849CapitalExpenditures
Other Spent Proceeds3566826OtherSpentProceeds
Amount Unspent0AmountUnspent
Year Of Subst Completion2012YearOfSubstCompletion
Current RefundingtrueCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Prcntge Prvt Business Use By Others0PrcntgePrvtBusinessUseByOthers
Bond Iss Meet Prvt Security Pay TestfalseBondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed PropfalseChangeInUseBondFinancedProp
Remedial Action TakenfalseRemedialActionTaken
Non Qualified Bond Remed ProcdrstrueNonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiled
Exception To RebatetrueExceptionToRebate
Variable Rate IssuetrueVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1

Name Of GIC Provider NameOfGICProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
RICHARD SPOTZ JR
DIRECTOR66239PROVIDED LEGAL SERVICESfalse
WILLIAM F FINN
CEO21641ANNUAL ORGANIZATION DUESfalse

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierBUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONSIdentifier
Return ReferenceSCHEDULE L, PART IVReturnReference
ExplanationMR. RICHARD T. SPOTZ, JR. IS AN ATTORNEY AND LONG STANDING MEMBER OF THE BOARD OF DIRECTORS. MR. SPOTZ IS A PARTNER AT THE LAW FIRM, ZIEGLER, METZER, MILLER, LLP, IN CLEVELAND, OHIO. IN 2012, THAT FIRM PROVIDED LEGAL ADVICE AND SERVICES TO HOSPICE OF THE WESTERN RESERVE AND WAS PAID $66,239. William Finn serves as the chair of the National Hospice Work Group board of directors. This role is voluntary and receives no compensation. The National Hospice Work Group is a Not for Profit, 501(c)(3) organization. The organization's mission is to stimulate new ideas, share best practices and emerging models, stay informed of key issues and to build a strong network among hospice leaders who aspire to excellence. Hospice of the Western Reserve is a member of the National Hospice Work Group, and paid dues of $21,641 in 2012.Explanation

Schedule M IRS990ScheduleM

Works Of Art WorksOfArt

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions3NumberOfContributions
Noncash Contribs Rptd F99018000NoncashContribsRptdF990
Method Of Determining RevenuesfmvMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Art Historical TreasuresArtHistoricalTreasures
Art Fractional InterestArtFractionalInterest
Books And PublicationsBooksAndPublications

Clothing And Household Goods ClothingAndHouseholdGoods

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Noncash Contribs Rptd F9905000NoncashContribsRptdF990
Method Of Determining RevenuesfmvMethodOfDeterminingRevenues

Cars And Other Vehicles CarsAndOtherVehicles

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F9906750NoncashContribsRptdF990
Method Of Determining RevenuesfmvMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Boats And PlanesBoatsAndPlanes
Intellectual PropertyIntellectualProperty

Securities Publicly Traded SecuritiesPubliclyTraded

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions10NumberOfContributions
Noncash Contribs Rptd F99097886NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Securities Closely Held StockSecuritiesCloselyHeldStock
Securities Prtnrshp Trust IntrstsSecuritiesPrtnrshpTrustIntrsts
Securities MiscellaneousSecuritiesMiscellaneous
Qualified Contrib Hist StructQualifiedContribHistStruct
Qualified Contrib OtherQualifiedContribOther
Real Estate ResidentialRealEstateResidential
Real Estate CommercialRealEstateCommercial
Real Estate OtherRealEstateOther
CollectiblesCollectibles
Food InventoryFoodInventory
Drugs And Medical SuppliesDrugsAndMedicalSupplies
TaxidermyTaxidermy
Historical ArtifactsHistoricalArtifacts
Scientific SpecimensScientificSpecimens
Archaeological ArtifactsArchaeologicalArtifacts
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftstrueReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DOCUMENTS AVAILABLE TO PUBLICPAGE 6, PART VI, SECTION C, #19HOSPICE OF THE WESTERN RESERVE DOES MAKE ITS FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC BY PROVIDING COPIES UPON REQUEST, INSPECTION AT THE HEADQUARTERS OFFICE AND BY PROVIDING FINANCIAL DATA IN ANNUAL REPORTS WHICH ARE AVAILABLE ON HOSPICE OF THE WESTERN RESERVE'S WEBSITE. HOSPICE OF THE WESTERN RESERVE DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE GENERAL PUBLIC AT THIS TIME.
PROCESS FOR DETERMINING COMPENSATIONPAGE 6, PART VI, SECTION B, #15ATHE COMPENSATION OF THE CEO IS BASED ON ANNUAL LABOR MARKET DATA FROM BOTH LOCAL AND NATIONAL SOURCES. WITH THE HELP OF THE HUMAN RESOURCES TEAM, THE ORGANIZATION PARTICIPATES IN ANNUAL AND SPECIAL COMPENSATION SURVEYS AND THE RESULTING DATA IS SHARED WITH THE BOARD OF DIRECTORS. COMPENSATION INFORMATION IS ALSO OBTAINED FROM FORM 990'S FROM OTHER COMPARABLE NOT-FOR-PROFIT HOSPICES. IN ADDITION, EACH BOARD DIRECTOR IS ASKED TO RESPOND TO A QUESTIONNAIRE EVALUATING THE CEO'S PERFORMANCE COMPARED TO GOALS ESTABLISHED DURING THE PREVIOUS YEAR'S EVALUATION. THE RESULTS OF THE QUESTIONNAIRES ARE TABULATED AND SHARED WITH THE BOARD'S EXECUTIVE COMMITTEE. BASED ON THE THE LABOR MARKET DATA AND ANNUAL PERFORMANCE EVALUATION PROCESS, THE EXECUTIVE COMMITTEE THEN ESTABLISHES THE CEO'S COMPENSATION LEVEL AS WELL AS ANY PERFORMANCE BONUS THAT MAY BE PROVIDED. FOR OTHER KEY OFFICERS, THE PROCESS IS SIMILAR TO THE PROCESS NOTED ABOVE. THE ORGANIZATION OBTAINS ANNUAL LABOR MARKET DATA FROM BOTH LOCAL AND NATIONAL SOURCES. THE ORGANIZATION PARTICIPATES IN ANNUAL AND SPECIAL COMPENSATION SURVEYS AND THE RESULTING DATA IS SHARED WITH THE CEO. IN ADDITION, THE INTERNAL ALIGNMENT OF OUR POSITIONS IS PERIODICALLY REVIEWED. RATES OF PAY ARE REVIEWED AND ESTABLISHED FOR INTERNAL POSITIONS BASED ON EQUITABLE RELATIONSHIPS AND THE DIFFICULTY AND RESPONSIBILITY OF WORK PERFORMED. RECOMMENDATIONS FOR REQUISITE CHANGES ARE DISCUSSED WITH THE CEO. THE OFFICER'S PERFORMANCE IS REVIEWED ON AN ANNUAL BASIS BY THE CEO. BASED ON THE INDIVIDUAL'S ANNUAL PERFORMANCE AND GOALS ACHIEVED, AND THE INTERNAL AND EXTERNAL DATA, THE CEO WILL ESTABLISH THE COMPENSATION LEVEL FOR HIS OFFICERS. THIS PROCESS HELPS US MAINTAIN THE ORGANIZATION'S INTERNAL ALIGNMENT AND EXTERNAL COMPETITIVENESS. THE ABOVE PROCESSES ARE DOCUMENTED AT THE TIME THE DECISIONS ARE MADE.
FAMILY OR BUSINESS RELATIONSHIPSPAGE 6, PART VI, SECTION A, #2MRS. MARGARET MENDENHALL SIMPSON, THE WIFE OF HOSPICE OF THE WESTERN RESERVE'S emeritus CEO, MR. DAVID A. SIMPSON, IS AN EMPLOYEE OF ZIEGLER, METZER, MILLER, LLP. (THE LAW FIRM PROVIDED LEGAL ADVICE AND SERVICES TO THE ORGANIZATION DURING 2012.) MR. RICHARD T. SPOTZ, JR. IS A BOARD MEMBER OF HOSPICE OF THE WESTERN RESERVE AND THE MANAGING PARTNER AT ZIEGLER, METZER & MILLER, LLP.
FORM 990 REVIEW PROCESSPAGE 6, PART VI, SECTION A, #11BInitially the Form 990 is sent to the Finance Committee of the Board for their review and approval before it is finalized. Then, it is made available to the full Board for their review, prior to filing the form with the IRS.
MONITOR AND ENFORCE CONFLICT OF INTEREST POLICYPAGE 6, PART VI, SECTION B, #12CAll Board members and employees are required to submit a disclosure statement at the beginning of employment and annually thereafter. If a matter arises which a Board member or employee has a conflict of interest, it shall be promptly disclosed to the Board or Chief Executive Officer as appropriate. Staff may initiate disclosure through their supervisor. However, the Board member or employee shall not participate in the discussion or vote to determine whether a conflict exists unless requested to do so. The Human Resources Committee shall be available to the Chief Executive Officer for review of conflict situations.
RECONCILIATION OF NET ASSETSPAGE 12, PART XI, #5CHANGE IN FAIR VALUE OF INTEREST RATE SWAP - $ (341,650) CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS - $ (9,930) ------------- $ (351,580)