2013-11-14T15:49:26-06:00 2012-12-31 271728945 O'CONNOR DAVIES LLP 555 HUDSON VALLEY AVENUE SUITE 106 NEW WINDSOR NY 12553 990 2012-01-01 141703185 HOSPICE OF ORANGE AND SULLIVAN COUNTIES INC HOSP 8455616111 800 STONY BROOK COURT NEWBURGH NY 12550 DAN GRADY 8455616111 2013-11-13 1 GARRETT M HIGGINS P00543209 8452202400 2013-11-13 2012 2016-02-24 21:20:13Z DAN GRADY 800 STONY BROOK COURT NEWBURGH NY 12550 15285545 0 X HOSPICEOFORANGE.COM X 1988 NY THE PRINCIPAL PURPOSE OF THE ORGANIZATION IS TO PROVIDE HOSPICE SERVICES. 23 23 195 150 0 0 921031 1115846 10803439 11100119 182402 175842 38433 31287 11945305 12423094 0 0 0 0 6110857 6580852 0 0 95765 5432683 5812183 11543540 12393035 401765 30059 13156799 12970892 4142499 3641007 9014300 9329885 X HOSPICE OF ORANGE AND SULLIVAN COUNTIES, INC. PROVIDES PHYSICAL, EMOTIONAL AND SPIRITUAL CARE FOR PATIENTS WITH LIFE LIMITING DISEASES AND THEIR FAMILIES. SERVICES ARE COORDINATED THROUGH A TEAM OF PROFESSIONALS, WHICH INCLUDES NURSES, SOCIAL WORKERS, PHYSICIANS, PASTORAL CARE, VOLUNTEERS AND RELATED THERAPISTS. 0 0 10172402 11100119 HOSPICE OF ORANGE & SULLIVAN COUNTIES, INC. PROVIDES HOSPICE SERVICES TO PATIENTS WITH LIFE LIMITING DISEASES AND THEIR FAMILES. IN 2012, HOSPICE PROVIDED 49,712 DAYS OF CARE TO 1,103 PATIENTS AND THEIR FAMILIES. HOSPICE ALSO SERVED AT THE KAPLAN FAMILY HOSPICE RESIDENCE 195 PATIENTS AND THEIR FAMILIES FOR A TOTAL OF 3,522 DAYS. 10172402 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 77 1 1 195 1 0 0 0 0 0 1 1 0 0 0 0 X 23 23 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X X JEANNE MALTES 8455616111 800 STONY BROOK COURT NEWBURGH NY 12550 A VINCENT MAZZIE 5.00 X 0 0 0 BARBARA NARU 5.00 X X 0 0 0 CHARLES MILICH 1.00 X 0 0 0 THOMAS P SULLIVAN 1.00 X 0 0 0 DR JOSEPH LAUTERSTEIN 1.00 X 0 0 0 FRANK PHILLIPS 1.00 X 0 0 0 GLEN L HELLER 5.00 X X 0 0 0 HON ANTHONY T KANE 4.00 X X 0 0 0 HON JEFFERY G BERRY 1.00 X X 0 0 0 IAN RIEGER 1.00 X 0 0 0 JOAN P KAPLAN 2.00 X X 0 0 0 JOHN D'AMBROSIO 2.00 X X 0 0 0 LEWIS KLUGMAN 1.00 X 0 0 0 MARY BONURA 5.00 X 0 0 0 PRESTON L FELTON 1.00 X 0 0 0 RONALD BARTON 3.00 X X 0 0 0 SUE NAJORK 2.00 X 0 0 0 WILLIAM RICHARDS 2.00 X 0 0 0 JOSEPH V SMITH 3.00 X 0 0 0 SR ANN SAKAC 1.00 X 0 0 0 MYRIAM LOOR 1.00 X 0 0 0 DANIEL BERKOWICZ 2.00 X 0 0 0 DEBRA L JOHNSON 1.00 X 0 0 0 DANIEL GRADY 37.50 X 175541 0 20869 GAIL BURTON 37.50 X 124589 0 10659 300130 0 31528 2 0 1 0 SULLIVAN COUNTY ADULT CARE CENTER PO BOX 671 LIBERTY NY 12754 NURSING HOME SERVICES 227020 ST LUKE'S HOSPITAL 70 DUBOIS STREET NEWBURGH NY 12550 HOSPITAL SERVICES 139336 UNIDINE CORPORATION PO BOX 60479 CHARLOTTE NC 282600479 FOOD SERVICES 129953 HUDSON VALLEY HOSPITAL PHYSICIAN PLLC 707 EAST MAIN STREET MIDDLETOWN NY 10940 PHYSICIAN SERVICES 127250 BONSECOURS COMM HOSPITAL PO BOX 404299 ATLANTA GA 303844299 HOSPITAL SERVICES 125973 6 25982 221338 37751 830775 30119 1115846 HOSPICE SERVICES 900099 11100119 11100119 11100119 199767 199767 2698757 2722682 -23925 -23925 -23925 103020 221338 114769 -11749 -11749 49435 25000 24435 24435 OTHER INCOME 900099 18601 18601 18601 12423094 11100119 0 207129 X 326785 126369 181147 19269 4989550 4163966 769717 55867 85901 72545 12788 568 644458 533795 105699 4964 534158 403610 125206 5342 35141 35141 18000 18000 1000 1000 1766802 1759100 7702 68863 2957 65906 375874 286583 89291 193091 30765 162326 196177 139850 54919 1408 303890 279990 21566 2334 11189 11189 283393 170036 110523 2834 45144 27086 17606 452 PHARMACY 917544 917544 NURSING HOME ROOM & BOA 587979 587979 MEDICAL EQUIPMENT AND S 570521 570521 BAD DEBT 234938 234938 202637 99706 100204 2727 12393035 10172402 2124868 95765 35055 54092 1375845 1263156 232898 158000 1601214 1376749 49768 65820 6892986 1882912 5262236 5010074 4596237 5039455 3546 3546 13156799 12970892 1814369 1706866 47928 50000 1911088 1552786 12948 1065 356166 330290 4142499 3641007 X 5175522 5355694 596406 731819 3242372 3242372 9014300 9329885 13156799 12970892 30059 285526 0 X X 0 1 X 1 0 X 953376 623490 716385 921031 1115846 4330128 8878338 9828761 10251112 10963596 11252574 51174381 9831714 10452251 10967497 11884627 12368420 55504509 50000 25887 111760 187647 0 50000 25887 111760 187647 55316862 247874 228723 225430 200637 199767 1102431 247874 228723 225430 200637 199767 1102431 846 9212 46691 18601 75350 10080434 10690186 11192927 12131955 12586788 56682290 0.97590 0.97670 0.01940 0.02080 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2008 AMOUNT: $ 846. 2009 AMOUNT: $ 9,212. 2011 AMOUNT: $ 8,738. 2012 AMOUNT: $ 18,601. BAD DEBT RECOVERY - 2011 AMOUNT: $ 37,953. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 1698 0 1 1000 2698 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: OTHER LOBBYING ACTIVITIES INCLUDE DUES PAID TO THE NATIONAL AND STATE HOSPICE AND PALLIATIVE CARE ASSOCIATIONS. IN ADDITION, THE CEO SPENT TIME IN WASHINGTON DC LOBBYING THE NATIONAL HOSPICE AND PALLIATIVE CARE ORGANIZATION TO SET THE 2012 PRIORITIES FOR THE PUBLIC POLICY INITIATIVE. 4783418 40000 439297 110015 5152700 4967375 197233 -310190 71000 4783418 4583588 22436 402209 5008233 3891794 106630 585164 4583588 4679272 188503 -975981 3891794 0.26170 0.62930 0.10900 0 0 388933 388933 5282055 1052743 4229312 1221998 830169 391829 5010074 WORKERS' COMPENSATION TRUST OBLIGATION 330290 330290 X 12879479 285526 31090 139769 456385 12423094 0 12423094 12563894 31090 139769 170859 12393035 0 12393035 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: HOSPICE MAINTAINS VARIOUS DONOR-RESTRICTED ENDOWMENT FUNDS AND BOARD DESIGNATED QUASI-ENDOWMENT FUNDS WHOSE PURPOSE IS TO PROVIDE LONG TERM SUPPORT FOR HOSPICE PROGRAMS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: HOSPICE RECOGNIZES THE EFFECTS OF INCOME TAX POSITIONS ONLY IF THEY ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT HOSPICE HAS NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION AND/OR DISCLOSURE. HOSPICE IS NO LONGER SUBJECT TO EXAMINATIONS BY APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO DECEMBER 31, 2009. PART XI, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES REPORTED ON PART VIII, LINE 8B 139,769. PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES REPORTED ON PART VIII, LINE 8B 139,769. GOLF OUTING 83870 54722 29148 16827 4156 ANNUAL GALA 183835 119056 64779 39687 3800 29243 2 56653 47560 9093 2079 100 18877 324358 221338 103020 56514 2079 3900 52276 114769 -11749 49435 25000 0 49435 25000 25000 24435 NY 1 0 1 0 1.00000 JEANNE MALTES 800 STONY BROOK COURT NEWBURGH NY 12550 0 0 X X X X 0 0 0 0 0 0 0 0 0 DANIEL GRADY 175541 0 0 0 0 0 3510 0 17359 0 196410 0 0 0 X AUCTION ITEMS 76 30119 FAIR MARKET VALUE 0 0 0 0 METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: PART I, COLUMN (B): THE NUMBER ITEMS CONTRIBUTED IS REPORTED IN COLUMN (B). FORM 990, PART VI, SECTION B, LINE 11 HOSPICE OF ORANGE AND SULLIVAN COUNTIES, INC. HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. WHEN THE FORM 990 HAS BEEN PREPARED, REVIEWED BY THE OUTSIDE ACCOUNTANTS AND IS READY TO BE FILED WITH THE INTERNAL REVENUE SERVICE, IT IS ELECTRONICALLY SENT TO THE VP OF FINANCE OF THE ORGANIZATION. ANY QUESTIONS OR CHANGES ARE PROVIDED TO THE OUTSIDE ACCOUNTANTS. A REVISED COPY OF THE FORM 990 IS THEN ELECTRONICALLY SENT TO THE TREASURER AND CHAIRMAN OF THE BOARD FOR REVIEW. AFTER THEIR REVIEW IS COMPLETE, A COPY IS PROVIDED TO THE BOARD MEMBERS, AND THE RETURN IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS APPLICABLE TO ALL HOSPICE PERSONNEL, AS WELL AS MEMBERS OF THE GOVERNING BODY AND ADVISORY BOARDS. EACH MEMBER OF THE GOVERNING BODY IS REQUIRED TO SIGN AN ANNUAL DISCLOSURE STATEMENT WHICH STATES IF THEY BELIEVE THAT THEY HAVE ANY ACTUAL OR POTENTIAL CONFLICTS. IF A CONFLICT WERE TO ARISE DURING THE YEAR, THE INDIVIDUAL MUST MAKE THE PRESIDENT/CEO OF THE ORGANIZATION AWARE OF THE CONFLICT IN WRITING. THE PRESIDENT/CEO MAKES A DECISION ON HOW TO PROCEED WITH THE MATTER. THIS PROCESS WAS LAST UNDERTAKEN IN 2012. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION FOR THE ORGANIZATION'S CEO IS APPROVED BY THE BOARD AFTER AN INTERNAL REVIEW IS COMPLETED. THE ORGANIZATION USES THE FOLLOWING ITEMS TO HELP AID IN DETERMINING THE APPROPRIATE COMPENSATION: FORM 990S OF OTHER ORGANIZATION THAT ARE SIMILAR IN SIZE AND OPERATIONS, AND A COMPENSATION SURVEY OR STUDY. AFTER THE BOARD REVIEWS THIS INFORMATION, AN APPROPRIATE SALARY IS DETERMINED BY THE BOARD FOR THAT POSITION AND APPROVED. THE BOARD'S APPROVAL IS DOCUMENTED IN THE MINUTES TO THE MEETING. THIS PROCESS WAS LAST UNDERTAKEN IN 2012. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FORM 990 AND FORM 1023 AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. THE RETURN IS POSTED ON GUIDESTAR.ORG AND OTHER SIMILAR TYPES OF WEBSITES. IN ADDITION, THE FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, ARTICLES OF INCORPORATION AND BY-LAWS ARE ALSO AVAILABLE UPON WRITTEN REQUEST OR BY CALLING THE ORGANIZATION DIRECTLY. OTHER FEES FORM 990, PART IX, LINE 11G CONSULTING: PROGRAM SERVICE EXPENSES 22,081. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,081. TEMPORARY HELP: PROGRAM SERVICE EXPENSES 7,703. MANAGEMENT AND GENERAL EXPENSES 7,702. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,405. INPATIENT SERVICES: PROGRAM SERVICE EXPENSES 1,126,638. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,126,638. HOME HEALTH AIDES: PROGRAM SERVICE EXPENSES 42,975. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,975. MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 559,703. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 559,703. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS DID NOT CHANGE FROM THE PRIOR YEAR.