IHC HOSPICE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: IHC HOSPICE INC (EIN 20-0063696)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-11-15
IRS object ID: 201333199349307453
Schema version: 2012v2.3
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule D
Schedule L
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-11-15T13:24:00-06:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	THE CONE COMPANY	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 3855	AddressLine1
City	SAVANNAH	City
State	GA	State
ZIP Code	314143855	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	200063696	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	IHC HOSPICE INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	IHCH	NameControl
Phone	9124416594	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3 W PERRY ST	AddressLine1
City	SAVANNAH	City
State	GA	State
ZIP Code	31401	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	JOE EBBERWEIN	Name
Title	VICE PRESIDENT	Title
Phone	9124416594	Phone
Date Signed	2013-11-11	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	JOHN T CONE	Name
Phone	9124416594	Phone
Date Prepared	2013-11-15	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-03-07 17:11:31Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	ELLEN BOLCH	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	3 W PERRY STREET	AddressLine1
City	SAVANNAH	City
State	GA	State
ZIP Code	31401	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	2272016	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.THAGROUP.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	2003	YearFormation
State Legal Domicile	SC	StateLegalDomicile
Activity Or Mission Description	THE ORGANIZATION PROVIDES HOSPICE CARE ON AN OUTPATIENT AND IN-HOME BASIS FOR TERMINALLY ILL INDIVIDUALS.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	8	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	5	NbrIndependentVotingMembers
Total Nbr Employees	41	TotalNbrEmployees
Total Nbr Volunteers	20	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	10627	ContributionsGrantsPriorYear
Contributions Grants Current Year	48211	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	2501003	ProgramServiceRevenuePriorYear
Program Service Revenue CY	2223805	ProgramServiceRevenueCY
Investment Income Current Year	0	InvestmentIncomeCurrentYear
Other Revenue Current Year	0	OtherRevenueCurrentYear
Total Revenue Prior Year	2511630	TotalRevenuePriorYear
Total Revenue Current Year	2272016	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	1011401	SalariesEtcPriorYear
Salaries Etc Current Year	1088782	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	1293797	OtherExpensePriorYear
Other Expenses Current Year	1086560	OtherExpensesCurrentYear
Total Expenses Prior Year	2305198	TotalExpensesPriorYear
Total Expenses Current Year	2175342	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	206432	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	96674	RevenuesLessExpensesCY
Total Assets BOY	670500	TotalAssetsBOY
Total Assets EOY	863164	TotalAssetsEOY
Total Liabilities BOY	28756	TotalLiabilitiesBOY
Total Liabilities EOY	124746	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	641744	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	738418	NetAssetsOrFundBalancesEOY
Mission Description	THE ORGANIZATION PROVIDES HOSPICE CARE ON AN OUTPATIENT AND IN-HOME BASIS FOR TERMINALLY ILL INDIVIDUALS.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	2052311	Expense
Description	HOSPICE CARE SERVICES	Description
Total Program Service Expense	2052311	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	false	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	false	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	true	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	true	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	false	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	3	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	41	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	8	NbrVotingGoverningBodyMembers
Number Independent Voting Members	5	NumberIndependentVotingMembers
Family Or Business Relationship	true	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	true	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
States Where Copy Of Return Is Filed	SC	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	THE ORGANIZATION	NamePerson
Telephone Number	9124416594	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	3 W PERRY ST	AddressLine1
City	SAVANNAH	City
State	GA	State
ZIP Code	31401	ZIPCode

Field	Value	IRS element (for citing)
No Listed Persons Compensated	X	NoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (8 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation
ELLEN B BOLCH
DIRECTOR/PR	1.00	X	X	0	0	0
JOSEPH EBBERWEIN
DIRECTOR/VP	1.00	X	X	0	0	0
KATHY PIETTE
DIRECTOR/SEC	1.00	X	X	0	0	0
IRA RUBY
DIRECTOR	1.00	X		0	0	0
DAVID SMITH
DIRECTOR	1.00	X		0	0	0
HOWARD MORRISON
DIRECTOR	1.00	X		0	0	0
CORA BETT THOMAS
DIRECTOR	1.00	X		0	0	0
MALIK WATKINS
DIRECTOR	1.00	X		0	0	0

Field	Value	IRS element (for citing)
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources
All Other Contributions	48211	AllOtherContributions
Total Contributions	48211	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	PROGRAM SERVICE REVENUE	Description
Total Revenue Column	2223805	TotalRevenueColumn
Related Or Exempt Function Income	2223805	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	2223805	TotalProgramServiceRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	2272016	TotalRevenueColumn
Related Or Exempt Function Income	2223805	RelatedOrExemptFunctionIncome

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	997121	Total
Program Services	997121	ProgramServices

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	35413	Total
Program Services	35413	ProgramServices

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	56248	Total
Program Services	56248	ProgramServices

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	1888	Total
Management And General	1888	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	5679	Total
Program Services	5679	ProgramServices

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	19884	Total
Management And General	19884	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	81551	Total
Management And General	81551	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	2536	Total
Program Services	2536	ProgramServices

Interest Interest

Field	Value	IRS element (for citing)
Total	199	Total
Management And General	199	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	3069	Total
Management And General	3069	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	25859	Total
Program Services	25859	ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
HOME OFFICE COST ALLOC'N	479399	479399
DRUGS & BIOLOGICALS	102086	102086
HOME MEDICAL EQUIP EXP	91771	91771
MILEAGE REIMBURSEMENT	87622	87622

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	185017	Total
Program Services	168577	ProgramServices
Management And General	16440	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	2175342	Total
Program Services	2052311	ProgramServices
Management And General	123031	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	474113	BOY
EOY	486021	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	50000	BOY
EOY	50000	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	114078	BOY
EOY	302189	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	4286	BOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	46400	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	21446	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	28023	BOY
EOY	24954	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	670500	BOY
EOY	863164	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	99002	BOY
EOY	124746	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	-70246	BOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	28756	BOY
EOY	124746	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	641744	BOY
EOY	738418	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	641744	BOY
EOY	738418	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	670500	BOY
EOY	863164	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	96674	ReconcilationRevenueExpenses
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	false	FSAudited

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	X	PubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	144331	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	6025	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	56655	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	10627	CurrentTaxYearMinus1Year
Current Tax Year	48211	CurrentTaxYear
Total	265849	Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	1470382	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	2565260	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	2030242	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	2501003	CurrentTaxYearMinus1Year
Current Tax Year	2223805	CurrentTaxYear
Total	10790692	Total

Total509 Total509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	1614713	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	2571285	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	2086897	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	2511630	CurrentTaxYearMinus1Year
Current Tax Year	2272016	CurrentTaxYear
Total	11056541	Total

Field	Value	IRS element (for citing)
Public Support Total509	11056541	PublicSupportTotal509

Total Support Total TotalSupportTotal

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	1614713	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	2571285	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	2086897	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	2511630	CurrentTaxYearMinus1Year
Current Tax Year	2272016	CurrentTaxYear
Total	11056541	Total

Field	Value	IRS element (for citing)
Public Support Percentage509	1.00000	PublicSupportPercentage509
Prior Year Support Percentage	1.00000	PriorYearSupportPercentage
Investment Income Percentage	0.00000	InvestmentIncomePercentage
Thirty Three Percnt Tests CY509	X	ThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	46400	OtherCostOrOtherBasis
Depreciation	21446	Depreciation
Book Value	24954	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	24954	TotalOfBookValueLandBuildings

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	THA SERVICES INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Relationship	DIRECTOR OWNED	Relationship
Amount Of Transaction	479399	AmountOfTransaction
Description Of Transaction	HOME OFF COST ALLOCN	DescriptionOfTransaction
Sharing Of Revenues	false	SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
RELATED PARTY INFORMATION AMONG OFFICERS	FORM 990, PAGE 6, PART VI, LINE 2	EMPLOYEES OF INTERESTED PERSON
ELECTION OF MEMBERS AND THEIR RIGHTS	FORM 990, PAGE 6, PART VI, LINE 7A	ORGANIZATION HAS VOTING MEMBERS
DECISIONS SUBJECT TO APPROVAL OF MEMBERS	FORM 990, PAGE 6, PART VI, LINE 7B	DECISIONS ARE SUBJECT TO VOTING MEMBER APPROVAL
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11B	REVIEWED WITH CPA AND OFFICER
ENFORCEMENT OF CONFLICTS POLICY	FORM 990, PAGE 6, PART VI, LINE 12C	REVIEW WITH DIRECTORS
COMPENSATION PROCESS FOR TOP OFFICIAL	FORM 990, PAGE 6, PART VI, LINE 15A	REVIEW WITH DIRECTORS
COMPENSATION PROCESS FOR OFFICERS	FORM 990, PAGE 6, PART VI, LINE 15B	REVIEW WITH DIRECTORS
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION	FORM 990, PAGE 6, PART VI, LINE 19	UPON REQUEST