STRATEGY STUDIO / PUBLIC DATA EXPLORER

HOSPICE OF THE WESTERN RESERVE INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
HOSPICE OF THE WESTERN RESERVE INC (EIN 34-1256377)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-10-29
IRS object ID
201233039349300128
Schema version
2011v1.3
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-10-29T10:53:56-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

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 BLVDAddressLine1
CityCLEVELANDCity
StateOHState
ZIP Code441225450ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

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
CityCLEVELANDCity
StateOHState
ZIP Code44110ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN HARVANName
TitleCFOTitle
Date Signed2012-10-18DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJoseph C Sbrocco CPAName
Phone2168311200Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
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 Receipts92642544GrossReceipts
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 Body28NbrVotingMembersGoverningBody
Nbr Independent Voting Members27NbrIndependentVotingMembers
Total Nbr Employees1021TotalNbrEmployees
Total Nbr Volunteers2000TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year5927849ContributionsGrantsPriorYear
Contributions Grants Current Year3336021ContributionsGrantsCurrentYear
Program Service Revenue Prior Year87328489ProgramServiceRevenuePriorYear
Program Service Revenue CY86180366ProgramServiceRevenueCY
Investment Income Prior Year258808InvestmentIncomePriorYear
Investment Income Current Year759642InvestmentIncomeCurrentYear
Other Revenue Prior Year385388OtherRevenuePriorYear
Other Revenue Current Year392944OtherRevenueCurrentYear
Total Revenue Prior Year93900534TotalRevenuePriorYear
Total Revenue Current Year90668973TotalRevenueCurrentYear
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 Year52602441SalariesEtcPriorYear
Salaries Etc Current Year54513206SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year7500TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year1158954TotalFundrsngExpCurrentYear
Other Expense Prior Year36423576OtherExpensePriorYear
Other Expenses Current Year36412212OtherExpensesCurrentYear
Total Expenses Prior Year89033517TotalExpensesPriorYear
Total Expenses Current Year90925418TotalExpensesCurrentYear
Revenues Less Expenses Prior Year4867017RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-256445RevenuesLessExpensesCY
Total Assets BOY67821107TotalAssetsBOY
Total Assets EOY75254029TotalAssetsEOY
Total Liabilities BOY15501550TotalLiabilitiesBOY
Total Liabilities EOY25690999TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY52319557NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY49563030NetAssetsOrFundBalancesEOY
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
Expense76698968Expense
Revenue86573310Revenue
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 THE 42-BED RESIDENTIAL FACILITY HOSPICE HOUSE. IN 2011, HOSPICE OF WESTERN RESERVE PROVIDED 453,854 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 Expense76698968TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
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 ActivitiesfalseFundraisingActivities
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 ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096136NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees1021NumberOfEmployees
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 Members28NbrVotingGoverningBodyMembers
Number Independent Voting Members27NumberIndependentVotingMembers
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 (38 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
H CLARK HARVEY JR
DIRECTOR1.0X000
PEG MILBOURN
VICE CHAIR3.0X000X
RICHARD B WHITNEY
DIRECTOR1.0X000
CARL BALDASSARRE
Vice Chair3.0X000X
JOSEPH CARSON
TREASURER3.0X000X
REV NEROY CARTER
DIRECTOR1.0X000
DAVID G COLE
DIRECTOR1.0X000
MARGIT DALEY
DIRECTOR1.0X000
CYNTHIA HUNDORFEAN
DIRECTOR1.0X000
JEAN E KILGORE
DIRECTOR1.0X000
HILARY MASON KING
DIRECTOR1.0X000
MARY ANN KOCURKO
BOARD CHAIR3.0X000X
CAROL G MANNING
Secretary3.0X00X
WENDY MIANO
DIRECTOR1.0X
VIRGINIA A MOONEY
DIRECTOR1.0X000
DAVID MORDARSKI
DIRECTOR1.0X000
JANICE MURPHY
DIRECTOR1.0X000
LAURA NAVIN
DIRECTOR1.0X000
MARY L OGRINC
DIRECTOR1.0X000
SARAH ROBERTSON
DIRECTOR1.0X000
RICHARD T SPOTZ JR
DIRECTOR1.0X000
WILLIAM SPRINGER
DIRECTOR1.0X000
BRET WILLIAMS
DIRECTOR1.0X000
ELIZABETH PITORAK
DIRECTOR1.0X145878018922
RICHARD A BARONE
DIRECTOR1.0X000
JAMES W ROGERSON
DIRECTOR1.0X000
TRACY K STRATFORD
DIRECTOR1.0X000
JAMES L HAMBRICK
VICE CHAIR3.0X000X
DAVID SIMPSON
CEO, EMERITUS40.0467699028015X
BRIDGET J MONTANA
CHIEF OPERATING OFFICER40.0171687015333X
JOHN E HARVAN JR
CHIEF FINANCIAL OFFICER40.0194134020934X
WILLIAM FINN
EXECUTIVE DIRECTOR40.0226338018898X
CHARLES V WELLMAN
CHIEF MEDICAL OFFICER40.0312682024643X
STEPHEN RYDER
MEDICAL DIRECTOR40.015300705866X
DANN GANZHORN
MEDICAL DIRECTOR40.0193273018672X
JEFFREY SPIESS
MEDICAL DIRECTOR40.0181263020203X
JOHN WALTERS
MEDICAL DIRECTOR40.015956506126X
SUSAN M FIGULA
CHIEF MARKETING & COMM OFFICER40.0162113020924X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2367639TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation198536TotalOtherCompensation
Number Individuals GT100 K22NumberIndividualsGT100K
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 AVENUECLEVELANDOH44115ARCHITECTURAL196448
DONLEY'S INC
5430 WARNER ROADCLEVELANDOH44125BUILDING CONTRACTOR7985651
SUBURBAN MAINTENANCE CONSTRUCTION
PO BOX 33009NORTH ROYALTONOH44133CONTRACTOR-BLDG269278
ACE DEMO INC
2111 CENTER STREETCLEVELANDOH44113DEMOLITION189380
COMFORT SYSTEMS USA
7401 FIRST PLACEOAKWOOD VILLAGEOH44146CONTRACTOR-HVAC187327
FieldValueIRS element (for citing)
Number Of Contractors GT100 K10NumberOfContractorsGT100K
Federated Campaigns422325FederatedCampaigns
All Other Contributions2913696AllOtherContributions
Noncash Contributions21803NoncashContributions
Total Contributions3336021TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
HOSPICE CARE SERVICES6230008614468886144688
GRIEF COUNSELING6241003567835678
FieldValueIRS element (for citing)
Total Program Service Revenue86180366TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column578773TotalRevenueColumn
Exclusion$578,773ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities2154440Securities
Other0Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1892353Securities
Other81218Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities262087Securities
Other-81218Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column180869TotalRevenueColumn
Exclusion$180,869ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

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 (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
RESALE SHOP900099314156314156
MISCELLANEOUS REVENUE9000997878878788
FieldValueIRS element (for citing)
Total Other Revenue392944TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column90668973TotalRevenueColumn
Related Or Exempt Function Income86573310RelatedOrExemptFunctionIncome
Exclusion$759,642ExclusionAmount

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)
Total2265071Total
Management And General2265071ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total38250756Total
Program Services33600682ProgramServices
Management And General4054850ManagementAndGeneral
Fundraising595224Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1248421Total
Program Services1035343ProgramServices
Management And General194737ManagementAndGeneral
Fundraising18341Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total8252323Total
Program Services6820946ProgramServices
Management And General1308707ManagementAndGeneral
Fundraising122670Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4496635Total
Program Services3729160ProgramServices
Management And General701414ManagementAndGeneral
Fundraising66061Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total172580Total
Management And General172580ManagementAndGeneral

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)
Total2258737Total
Program Services1068116ProgramServices
Management And General1120514ManagementAndGeneral
Fundraising70107Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total632534Total
Program Services179873ProgramServices
Management And General421781ManagementAndGeneral
Fundraising30880Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2820451Total
Program Services1348216ProgramServices
Management And General1361470ManagementAndGeneral
Fundraising110765Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1973214Total
Program Services1340186ProgramServices
Management And General573834ManagementAndGeneral
Fundraising59194Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total93845Total
Program Services77827ProgramServices
Management And General14639ManagementAndGeneral
Fundraising1379Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total178662Total
Program Services80305ProgramServices
Management And General91482ManagementAndGeneral
Fundraising6875Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total71232Total
Program Services48379ProgramServices
Management And General20715ManagementAndGeneral
Fundraising2138Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1071957Total
Program Services781400ProgramServices
Management And General269981ManagementAndGeneral
Fundraising20576Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total286624Total
Program Services194672ProgramServices
Management And General83354ManagementAndGeneral
Fundraising8598Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesFundraisingFundraisingManagement And GeneralManagementAndGeneral
BAD DEBT29455027812916421
MEDICAL SUPPLIES4711559469363051017419
PATIENT SERVICES202920720214842217502
NURSING FACILITIES1793117417862942194066292

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1885886Total
Program Services1537678ProgramServices
Management And General321154ManagementAndGeneral
Fundraising27054Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total90925418Total
Program Services76698968ProgramServices
Management And General13067496ManagementAndGeneral
Fundraising1158954Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1416BOY
EOY4421020EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY8126279BOY
EOY3740000EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY5001959BOY
EOY3049220EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY9719391BOY
EOY9193753EOY

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)
BOY669582BOY
EOY465320EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis36073731LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec5464587LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY19367899BOY
EOY30609144EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY23267535BOY
EOY22163774EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY1234391BOY
EOY1199903EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY396345BOY
EOY383789EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY36310BOY
EOY28106EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY67821107BOY
EOY75254029EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY10006771BOY
EOY10714795EOY

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)
BOY3938170BOY
EOY12659754EOY

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)
BOY1556609BOY
EOY2316450EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY15501550BOY
EOY25690999EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY45114011BOY
EOY42312875EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY6740644BOY
EOY6785253EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY464902BOY
EOY464902EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY52319557BOY
EOY49563030EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY67821107BOY
EOY75254029EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-256445ReconcilationRevenueExpenses
Reconcilation Other Changes-2500082ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
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 Years4254990CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8829804CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8526768CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5927849CurrentTaxYearMinus1Year
Current Tax Year3336021CurrentTaxYear
Total30875432Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years72018845CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years73369832CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years82077261CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year87368989CurrentTaxYearMinus1Year
Current Tax Year86180366CurrentTaxYear
Total401015293Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years76273835CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years82199636CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years90604029CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year93296838CurrentTaxYearMinus1Year
Current Tax Year89516387CurrentTaxYear
Total431890725Total
FieldValueIRS element (for citing)
Public Support Total509431890725PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years842135CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years801992CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years760658CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year578480CurrentTaxYearMinus1Year
Current Tax Year578773CurrentTaxYear
Total3562038Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years842135CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years801992CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years760658CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year578480CurrentTaxYearMinus1Year
Current Tax Year578773CurrentTaxYear
Total3562038Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years241893CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years326388CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years357582CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year344887CurrentTaxYearMinus1Year
Current Tax Year392944CurrentTaxYear
Total1663694Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years77357863CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years83328016CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years91722269CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year94220205CurrentTaxYearMinus1Year
Current Tax Year90488104CurrentTaxYear
Total437116457Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98804PublicSupportPercentage509
Prior Year Support Percentage0.98668PriorYearSupportPercentage
Investment Income Percentage0.00815InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00956PriorYrInvestIncomePercentage
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 Balance852162BeginningOfYearBalance
Investment Earnings Or Losses-22219InvestmentEarningsOrLosses
End Of Year Balance829943EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

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

Current Year Minus2 Years CurrentYearMinus2Years

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

Current Year Minus3 Years CurrentYearMinus3Years

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 Balance0.56016PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.43984TermEndowmentEOYBalance
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 Basis9015944OtherCostOrOtherBasis
Depreciation3047534Depreciation
Book Value5968410BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis73090OtherCostOrOtherBasis
Depreciation36772Depreciation
Book Value36318BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2889940OtherCostOrOtherBasis
Depreciation1161156Depreciation
Book Value1728784BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis16049383OtherCostOrOtherBasis
Depreciation1219124Depreciation
Book Value14830258BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings30609144TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
ANNUITY OBLIGATIONS$81,382
DEFERRED COMPENSATION OBLIGATION$1,116,096
INTEREST RATE SWAP$1,118,972
FieldValueIRS element (for citing)
Total Of Amounts2316450TotalOfAmounts
Total Revenue90668973TotalRevenue
Total Expenses90925418TotalExpenses
Excess Or Deficit For Year-256445ExcessOrDeficitForYear
Net Unrealized GL On Investments-1371218NetUnrealizedGLOnInvestments
Other-$1,128,864OtherAmount
Total Adjustments-2500082TotalAdjustments
Excess Or Deficit Per FS-2756527ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt92042245TotRevenueEtcAuditedFinclStmt
Donated Srvc And Use Of Facilities1373272DonatedSrvcAndUseOfFacilities
Revenue Not Rptd F9901373272RevenueNotRptdF990
Revenue Subtotal90668973RevenueSubtotal
Total Revenue Per Form99090668973TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt94798772TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities1373272DonatedServicesUseOfFacilities
Losses Reported1371218LossesReported
Other Expenses Included1128864OtherExpensesIncluded
Expenses Not Rptd F9903873354ExpensesNotRptdF990
Expenses Subtotal90925418ExpensesSubtotal
Total Expenses Per Form99090925418TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
CHANGES IN NET ASSETSSCHEDULE D, PART XI, #8Change in Split Value Interest Agreements - $ (9,892) Change in Value of Interest Rate Swap - $ (1,118,972) Total Other Change in Net Assets = $ (1,128,864)
OTHER EXPENSESSCHEDULE D, PART XIII, #2DChange in Split Value Interest Agreements - $9,892 Change in Value of Interest Rate Swap - $ 1,118,972 Total Other Expenses = $ 1,128,864
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 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)

Base 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
145678020000056070133150164800000
CHARLES V WELLMAN
23956406000725180113280133150337325000
STEPHEN RYDER
15280702000005866000158873000
DANN GANZHORN
192673060000053570133150211945000
JEFFREY SPIESS
180663060000067320134710201466000
JOHN WALTERS
15936502000006126000165691000
DAVID SIMPSON
30000001237000439990147000133150495714000
BRIDGET J MONTANA
171687000005338099950187020000
JOHN E HARVAN JR
193934020000074630134710215068000
SUSAN M FIGULA
968530600064660076090133150183037000
WILLIAM FINN
225014020001124078040110940245236000

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 - $43,279 BRIDGET MONTANA, CHIEF OPERATING OFFICER - $79,586 CHARLES WELLMAN, CHIEF MEDICAL OFFICER - $72,518 SUSAN FIGULA, CHIEF MARKETING & COMMUNICATIONS OFFICER - $64,660Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

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
DefeasedtrueDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired0AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds12659574TotalProceeds
Amount In Reserve Fund0AmountInReserveFund
Capitalized Interest41572CapitalizedInterest
Refunding Escrow0RefundingEscrow
Issuance Costs From Proceeds397023IssuanceCostsFromProceeds
Credit Enhancement0CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures8282809CapitalExpenditures
Other Spent Proceeds3938170OtherSpentProceeds
Amount Unspent8905426AmountUnspent
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)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Post Issuance Compliance ProcdrstruePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuetrueVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatetrueExceptionToRebate
FieldValueIRS element (for citing)
Fed Tax Requirements ComplianceXFedTaxRequirementsCompliance

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
Identifierschedule k, part II, line 3Identifier
Return Reference0ReturnReference
Explanationdifference in proceeds and issue price is due to construction period draws on bond financing.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
RICHARD SPOTZ JR
DIRECTOR45029PROVIDED LEGAL SERVICESfalse
JOHN E HARVAN JR
CFO1800ANNUAL ORGANIZATION DUESfalse
WILLIAM F FINN
CEO13600ANNUAL ORGANIZATION DUESfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 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 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 2011.) 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.
BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONSSCHEDULE L, PART IVMR. 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 2011, THAT FIRM PROVIDED LEGAL ADVICE AND SERVICES TO HOSPICE OF THE WESTERN RESERVE AND WAS PAID $45,029. HOSPICE OF THE WESTERN RESERVE IS A MEMBER OF THE HOSPICE ALLIANCE OF OHIO (ANNUAL DUES PAID IN 2011 OF $1,800). HOSPICE ALLIANCE OF OHIO, AN OHIO 501(C)(6) ORGANIZATION, IS A GROUP OF NINETEEN HOSPICES THROUGHOUT THE STATE THAT COLLECTIVELY NEGOTIATE CONTRACTS WITH HEALTHCARE INSURANCES FOR HOSPICE SERVICES AND NETWORKS WITH EACH OTHER. MR. JOHN E. HARVAN, JR., CFO OF HOSPICE OF THE WESTERN RESERVE, IS A BOARD MEMBER OF THE HOSPICE ALLIANCE OF OHIO AND SERVES IN THE ROLE AS ITS TREASURER. 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 $13,600 in 2011.
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 - $ (1,118,972) UNREALIZED LOSS ON INVESTMENTS - $ (1,371,218) CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS - $ (9,892)