2023-09-26T08:54:41-05:00 2022-12-31 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2022-01-01 311059756 HOSPICE OF CENTRAL OHIO HOSP 9372569507 2269 CHERRY VALLEY ROAD NEWARK OH 43055 ROBERT MORRIS CFO 9372569507 2023-09-26 1 ROBERT MORRIS 999009999 1 AMY CIMINELLO P00796388 6148493000 2023-09-26 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z RENEE SPARKS 2269 CHERRY VALLEY ROAD NEWARK OH 43055 27287404 0 X WWW.HOSPICEOFCENTRALOHIO.ORG X 1982 OH OUR MISSION IS TO PROVIDE COMPASSIONATE END-OF-LIFE CARE THROUGH PHYSICAL, EMOTIONAL, AND SPIRITUAL CARE SUPPORT. 14 14 234 148 0 0 989825 994197 23429199 26164903 2664714 21628 2781 0 27086519 27180728 0 0 0 0 16729636 16159029 0 0 0 9137694 11801054 25867330 27960083 1219189 -779355 16375167 14898925 7821900 8398394 8553267 6500531 X PATIENTS OF HOSPICE OF CENTRAL OHIO RECEIVE COMPASSIONATE, INDIVIDUALIZED END-OF-LIFE CARE. THEIR DESIRES GUIDE THE PHYSICAL, EMOTIONAL, AND SPIRITUAL CARE SUPPORT WE PROVIDE. MEMBERS OF OUR COMMUNITY, PATIENT'S FAMILIES, CHILDREN, AND ANYONE EXPERIENCING LOSS FIND SUPPORT THROUGH BEREAVEMENT SERVICES. 0 0 21364224 0 26164903 HOSPICE OF CENTRAL OHIO IS COMMITTED TO BEING THE PREMIER PROVIDER DEDICATED TO PRESERVING THE QUALITY OF LIFE BY PROVIDING EXPERT PHYSICAL, EMOTIONAL, AND SPIRITUAL CARE TO PATIENTS AND FAMILIES WITH LIFE-LIMITING ILLNESSES. 21364224 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 234 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X ROBERT MORRIS 9372569507 7575 PARAGON ROAD DAYTON OH 45459 KENT ANDERSON CHIEF EXECUTIVE OFFICER 2.00 58.00 X 0 522223 59655 ROBERT MORRIS CHIEF FINANCIAL OFFICER 2.00 38.00 X 0 304009 35339 LISA MAURER VP OF MEDICAL AFFAIRS 40.00 0.00 X 265133 0 27714 COLLEEN PEMA TEAM PHYSICIAN 40.00 0.00 X 250466 0 9331 RENEE SPARKS GENERAL MANAGER/EXECUTIVE VP 40.00 0.00 X 191196 0 9645 ANDREA BAKER EXECUTIVE DIRECTOR HOCO 20.00 20.00 X 149674 0 26556 JUDY MOORE VICE PRESIDENT OF CLINICAL CARE 40.00 0.00 X 140629 0 21166 SHEILA EVERETT PROGRAM DIRECTOR 40.00 0.00 X 118753 0 19802 JOSEPH FINKLE RN HOSPICE HOUSE/INPATIENT CARE 40.00 0.00 X 118649 0 24591 THURASA CURRY RN HOSPICE HOUSE/INPATIENT CARE 40.00 0.00 X 117575 0 25115 DOUG HELMAN CHAIR 3.00 2.00 X X 0 0 0 DAVID GETREU VICE CHAIR 2.00 1.00 X X 0 0 0 KEVIN BLACK TREASURER 2.00 2.00 X X 0 0 0 LESLIE POOLE SECRETARY 2.00 2.00 X X 0 0 0 MISTIE BERSCHET BOARD MEMBER 2.00 0.00 X 0 0 0 BROOKE DATZ BOARD MEMBER 2.00 0.00 X 0 0 0 KEVIN FINLEY BOARD MEMBER 2.00 0.00 X 0 0 0 JACQUIE GOUMAS FOX BOARD MEMBER 2.00 0.00 X 0 0 0 MARY JUSTICE BOARD MEMBER 3.00 0.00 X 0 0 0 JAY KNAPP BOARD MEMBER 2.00 0.00 X 0 0 0 LESA MILLER BOARD MEMBER 3.00 0.00 X 0 0 0 DAVID STANSBURY BOARD MEMBER 2.00 0.00 X 0 0 0 DIANA WOLF BOARD MEMBER 2.00 0.00 X 0 0 0 JEREMY YOUNG BOARD MEMBER 2.00 0.00 X 0 0 0 1352075 826232 258914 11 0 1 0 0 721162 273035 994197 PATIENT SERVICE REVENUE 624100 26164903 26164903 26164903 128304 128304 105542 1134 -105542 -1134 -106676 -106676 27180728 26164903 0 21628 669916 669916 12138312 11784263 354049 465081 441817 23264 1950053 1857792 92261 935667 861168 74499 15773 15773 8400 8400 56910 56910 478380 396800 81580 38719 38719 349412 184737 164675 125335 500 124835 850122 649814 200308 681407 646677 34730 60158 26891 33267 387916 324631 63285 73180 73180 ALLOCATION COSTS 4373639 4373639 MEDICAL SUPPLIES 2566385 2566385 ROOM & BOARD 598536 598536 PATIENT SERVICES 399789 375490 24299 736993 648723 88270 27960083 21364224 6595859 0 786663 34227 23897 0 3444496 4185740 52699 60898 5696897 2826714 3239706 2870183 7939719 6632730 12403 10307 250000 250000 625584 854840 16375167 14898925 1942827 7771608 1234159 0 4644914 626786 7821900 8398394 X 8379138 6326402 174129 174129 8553267 6500531 16375167 14898925 -779355 -1273381 0 X X 0 1 X 1 1 1 X 749400 835707 2062552 989825 994197 5631681 20506204 23087144 23703288 23429199 26164903 116890738 21255604 23922851 25765840 24419024 27159100 122522419 0 0 0 122522419 21903 17840 146280 123704 128304 438031 21903 17840 146280 123704 128304 438031 12950 9870 22820 21277507 23940691 25925070 24552598 27287404 122983270 0.99630 0.99690 0.00360 0.00290 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7775662 -1250140 56850 6468672 6848019 7696107 927643 7696107 7775662 6239083 609297 361 6848019 5599996 1005687 366193 407 6239083 5773933 -173525 412 5599996 0.98008 0.01992 0.00000 0 0 738182 738182 1176794 273403 903391 2462480 1631573 830907 585269 382445 202824 734172 539293 194879 2870183 DEPOSITS 6588 RETIREMENT ASSET 231977 LEASE ASSET 616275 854840 LEASE LIABILITY 626786 626786 PART V, LINE 4: THE ENDOWMENT FUNDS ARE INTENDED TO FURTHER SUPPORT HOSPICE OF CENTRAL OHIO AND ITS ACTIVITIES. 0 0 0 0 0 0 0 1 0 KENT ANDERSON CHIEF EXECUTIVE OFFICER 0 455023 0 67200 0 0 0 35750 0 23905 0 581878 0 0 ROBERT MORRIS CHIEF FINANCIAL OFFICER 0 292759 0 11250 0 0 0 8336 0 27003 0 339348 0 0 LISA MAURER VP OF MEDICAL AFFAIRS 257199 0 7934 0 0 0 1525 0 26189 0 292847 0 0 0 COLLEEN PEMA TEAM PHYSICIAN 250466 0 0 0 0 0 7484 0 1847 0 259797 0 0 0 RENEE SPARKS GENERAL MANAGER/EXECUTIVE VP 184368 0 6828 0 0 0 9529 0 116 0 200841 0 0 0 ANDREA BAKER EXECUTIVE DIRECTOR HOCO 145579 0 4095 0 0 0 7630 0 18926 0 176230 0 0 0 JUDY MOORE VICE PRESIDENT OF CLINICAL CARE 136566 0 4063 0 0 0 6808 0 14358 0 161795 0 0 0 PART I, LINE 3 THE EXECUTIVE COMMITTEE OF THE OHI BOARD OF TRUSTEES UTILIZED LOCAL MARKET KNOWLEDGE, ANNUAL PERFORMANCE EVALUATIONS AND BENCHMARK DATA TO ESTABLISH COMPENSATION FOR THE CEO. THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS ESTABLISHED BY THE CEO UNDER GUIDELINES ESTABLISHED BY OHI AND AFFILIATE BOARDS OF TRUSTEES AS PART OF THE BUDGET PROCESS. PART I, LINE 7 THE BOARD OF DIRECTORS CONDUCTS AN ANNUAL PERFORMANCE REVIEW TO DETERMINE THE COMPENSATION AND BENEFITS OF THE CEO. IN ADDITION TO NORMAL COMPENSATION AND BENEFITS, THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS MAY ALSO AWARD BONUS COMPENSATION TO THE CEO BASED UPON THE ANNUAL PERFORMANCE REVIEW. THE CEO CONDUCTS AN ANNUAL PERFORMANCE REVIEW OF THE OTHER OFFICERS AND EMPLOYEES TO DETERMINE THEIR COMPENSATION AND BENEFITS. IN ADDITION TO NORMAL COMPENSATION AND BENEFITS, THE CEO, WITH THE APPROVAL OF THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS, MAY ALSO AWARD BONUS COMPENSATION TO THE OTHER OFFICERS AND EMPLOYEES BASED UPON THEIR ANNUAL PERFORMANCE REVIEW. FORM 990, PART VI, SECTION A, LINE 6 OHIO'S HOSPICE, INC. BECAME THE SOLE MEMBER OF HOSPICE OF CENTRAL OHIO WITH AN AFFILIATION AGREEMENT SIGNED IN SEPTEMBER 2015. FORM 990, PART VI, SECTION A, LINE 7A OHIO'S HOSPICE INC. HAS THE POWER TO APPOINT THE BOARD OF DIRECTORS. THE BOARD SHALL RECOMMEND INDIVIDUALS TO FILL ANY OPENINGS. OHIO'S HOSPICE HAS THE RIGHT TO ELECT FROM THESE INDIVIDUALS OR OTHER INDIVIDUALS AT ITS DISCRETION. FORM 990, PART VI, SECTION A, LINE 7B OHIO'S HOSPICE INC. RETAINS THE POWER TO AMEND THE ARTICLES OF INCORPORATION, CODE OF REGULATIONS, ETC. OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND REVIEWED BY THE CFO PRIOR TO BEING FILED WITH THE INTERNAL REVENUE SERVICE. THE FORM 990 IS SENT VIA EMAIL TO THE FULL BOARD AND WILL BE REVIEWED IN SESSION BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS AT THEIR NEXT MEETING. FORM 990, PART VI, SECTION B, LINE 12C IN THE EVENT ANY DIRECTOR, OFFICER OR EXECUTIVE OF THE ORGANIZATION SHALL HAVE ANY DIRECT OR INDIRECT INTEREST IN OR RELATIONSHIP WITH ANY INDIVIDUAL OR ORGANIZATION THAT PROPOSES TO ENTER INTO ANY TRANSACTION WITH THE ORGANIZATION FOR THE SALE, PURCHASE, LEASE OR RENTAL OF PROPERTY OR TO RENDER OR EMPLOY SERVICES, PERSONAL OR OTHERWISE, SUCH DIRECTOR, OFFICER OR EXECUTIVE SHALL FORTHWITH GIVE THE BOARD OF DIRECTORS, CHAIR OF THE BOARD OR PRESIDENT OF THE ORGANIZATION NOTICE OF SUCH INTEREST OR RELATIONSHIP AND SHALL THEREAFTER NOT BE COUNTED FOR THE PURPOSE OF DETERMINING A QUORUM AND SHALL REFRAIN FROM VOTING OR OTHERWISE ATTEMPTING TO AFFECT ITS DECISION TO PARTICIPATE IN SUCH TRANSACTION. IN THE EVENT THAT A CHALLENGE OR QUESTION IS RAISED WHETHER CONFLICT OR DUALITY OF INTEREST EXISTS, THE BOARD OR CHAIR OF THE BOARD OF THE ORGANIZATION SHALL DETERMINE THAT A DUALITY OF INTEREST EXISTS (BY A 2/3 VOTE OF THE BODY). MINUTES OF APPROPRIATE MEETINGS SHOULD REFLECT THAT SUCH DISCLOSURE WAS MADE, AND THAT SUCH DIRECTOR REMOVED HIMSELF/HERSELF FROM THE ROOM AND DID NOT PARTICIPATE IN THE FINAL DISCUSSION, AND WAS NOT COUNTED FOR THE PURPOSE OF DETERMINING A QUORUM.THE CONFLICT OF INTEREST STATEMENT SHALL BE REVIEWED ANNUALLY FOR THE INFORMATION AND GUIDANCE OF DIRECTORS, OFFICERS OR EXECUTIVES AND THAT ANY NEW DIRECTORS, OFFICERS OR EXECUTIVES BE ADVISED OF THE POLICY UPON UNDERTAKING THE DUTIES OF SUCH OFFICE. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE OHI BOARD OF TRUSTEES UTILIZED LOCAL MARKET KNOWLEDGE, ANNUAL PERFORMANCE EVALUATIONS AND BENCHMARK DATA TO ESTABLISH COMPENSATION FOR THE CEO. THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS ESTABLISHED BY THE CEO UNDER GUIDELINES ESTABLISHED BY OHI AND AFFILIATE BOARDS OF TRUSTEES AS PART OF THE BUDGET PROCESS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. PART XII, LINE 2C OHI'S FINANCE COMMITTEE HAS RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT THIS PROCESS IS CONSISTENT WITH PRIOR YEAR. OHI HOSPICE INC 7575 PARAGON ROAD DAYTON OH 45459 371495725 TO PROVIDE HOSPICE CARE OH 501(C)(3) LINE 7 OHIO'S HOSPICE INC 1 OHIO'S HOSPICE FOUNDATION 7575 PARAGON ROAD DAYTON OH 45459 311769696 TO PROVIDE FINANCIAL SUPPORT TO ITS PARENT, OHIO'S HOSPICE INC OH 501(C)(3) LINE 7 OHIO'S HOSPICE INC 1 HOSPICE OF DAYTON INC 324 WILMINGTON AVE DAYTON OH 45420 310933339 TO PROVIDE HOSPICE CARE OH 501(C)(3) LINE 7 OHIO'S HOSPICE INC 1 HOSPICE OF MIAMI COUNTY INC 3230 N COUNTY RD 25A TROY OH 45373 311031277 TO PROVIDE HOSPICE CARE OH 501(C)(3) LINE 7 OHIO'S HOSPICE INC 1 LIFECARE HOSPICE 1900 AKRON ROAD WOOSTER OH 44691 341352875 TO PROVIDE HOSPICE CARE OH 501(C)(3) LINE 7 OHIO'S HOSPICE INC 1 OHIO'S HOSPICE INC 7575 PARAGON ROAD DAYTON OH 45459 463215586 TO PROVIDE MANAGEMENT SERVICES AS A SUPPORTING ORGANIZATION OH 501(C)(3) LINE 12A, I N/A 0 LOVING CARE HOSPICE 779 LONDON AVENUE MARYSVILLE OH 43040 311370625 TO PROVIDE HOSPICE CARE OH 501(C)(3) LINE 10 OHIO'S HOSPICE INC 1 HOSPICE OF FAYETTE COUNTY 222 N OAKLAND AVE WASHINGTON COURTHOUSE OH 43160 311243376 TO PROVIDE HOSPICE CARE OH 501(C)(3) LINE 7 OHIO'S HOSPICE INC 1 NATIONAL HOSPICE COOPERATIVE 7575 PARAGON ROAD DAYTON OH 45459 832087147 BUSINESS SUPPORT OH N/A C 1 CENTRAL OHIO GERIATRICS 7575 PARAGON ROAD DAYTON OH 45459 264273198 PHYSICIAN OFFICE OH N/A S 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 1 0