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Connecticut Hospice 2005 IRS Form 990

Connecticut Hospice 2005 IRS Form 990

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Published by estannard
Connecticut Hospice of Branford's 2005 IRS Form 990 shows five registered nurses as its highest-paid employees, working from 41.75 to 80.50 hours a week on average.
Connecticut Hospice of Branford's 2005 IRS Form 990 shows five registered nurses as its highest-paid employees, working from 41.75 to 80.50 hours a week on average.

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Published by: estannard on Jul 16, 2010
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'I
"
2005
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung
benefit trust or private foundation)
D epartmentofthe Treasury
InternalRev enueS erv Ice
~ Th e organization may h ave to use a copy of th is return to satisfy state reporting req uirements.
Form990
OMBNo 1545· 0047
Open to P ublic
Ins pection
A For the 2005 calendar year or tax year beginning
OCT 1
2005
and ending
SEP 30
2006
,
.
8
CheckIf
P leaseC N ame of organization
DEmployer identification number
applocab leus e IRS
oAddresslab elor
THECONNECTICUT HOSPICE
INC.
06-0878822
ch angeprontor
ON ame
type
N umber and street (or P .O. box If rnaihs not dehvered to street address)
IB oom/s uiteETelephone number
ch ange
See
Olnotlal
S pecIfic100DOUBLE BEACH ROAD
203-315-7500
return
D Flnal
Ins truc-C ity or tow n, state or country, and ZIP + 4
FAccounbng method
0Cash[X]A caual
return
lions
OA mend ed
BRANFORD
CT
06405-4003
Dg~~)~
return
OA ppiocatlon
Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts
Hand Iarenot applIcable to section 5 2 7orgamzatlons
pend Ing
must attach a completed Schedule A (Form 990 or 990-EZ).
H (a) Is this a group return for afflhates?
DVes
[XJ N O
GW ebsite:~W W W .
HOSPICE. COM/CTHOSPICE
H(b) If "Yes,' enter number of affihates~
NLA
JOrganization type(ch eck onlyone)~
[X]501(c) (3
).... Onsertno)0 4947(a)( 1) or0 527H(c) Areall atnhates Included?
N/A
DVes
ON o
KCheck here ~ D
If the ornamzanon's gross receipts are normally not more than $25,000. The
(If 'N o,' attach a hst)
H (d) Is this a separate return filed by an or-D
organization need not file a return W ith the IRS ; but If the orpamzanon chooses to file a return, be
ganlzallon covered by a group ruhng?
V es[X]No
sure to file a complete return. Some states require a complete return.
IG rouo Exernnuon N umber ~
N/A
MCheck ~0 Ifthe organization ISnot requued to attach
LGross receipts: Add hnes 6b, 8b, 9b, and 10b to hne 12 ~
30 031 823.
Sch. B (Form 990, 990-EZ, or 990-PF).
IPart IRevenue, Expenses, and C hanges in N et Assets or Fund Balances
1
C ontnbutrons, giftS, grants, and Similar amounts received:
a Direct pubhc support
1a
2358,083.
bIndirect pubhc support
1b
400 000.
cGovernment contnounons (grants)
1c
dTotal (add hnes 1a through 1c) (cash $
2,758,083.
noncash $
)
1d
2758 083.
2
P rogram service revenue including government fees and contracts (from P art V II, line 93)
2
26.737574.
3
Membership dues and assessments
..
3
4
Interest on savings and temporary cash Investments
4
198 419.
5
DIVidends and Interest from securmes
I6a I
..
5
6 aGross rents
bLess: rental expenses
6b
cNet rental Income or (loss) (subtract hne 6b from hne 6a)
6c
CP
7
Other Investment Income (descnbe ~
1
7
:I
8 aG ross amount from sales of assets other
( A I S ecurities
(8 lOth er
I:
CP
262 412.
>
than Inventory
8a
CP
a:
bLess: cost or other baSIS and sales expenses
8b
cGain or (loss) (attach schedule)
8c
262 412.
dN et gain or (loss) (combine line 8c, columns (A ) and (B ))
STMT2
8d
262.412.
9
Special events and activities (attach schedule).If any amount IS from g~~ing, ~h~ck here ~ D
a Gross revenue (not Including $
of contnbunons
I9a I
reported on hne 1a)
bLess: direct expenses other than fund raising expenses
9b
cNet Income or (loss) from special events (subtract hne 9b from hne 9a)
l10a1
9c
10 a G ross sales of Inventory, less returns and allowances
bLess: cost of goods sold.
10b
c G ross profit or (loss) from sales of Inventory (attach schedule) (subtract hne 10b from hne 10a) .
10c
11
Other revenue (from P art V II, hne 103)
11
75 335.
12
Total revenue (add hnes 1d 2 3 4 5 6c 7 8d 9c 10c and 11l
12
30.031823.
13
P rogram
w e44, ~olumn (B))
.
13
24662 986.
III
CP
~~
~a~~
e 44, column (C))
14
3.299713.
III
I:
239 407.
CP
1
~"n~
I \"
om hne 44, col
(0))
.
.
15
Q.
)(
16 o'paYa~o
a~~:E1~Ch!
~
ule)
16
w
..
..
1 70) ota
n~ s
dd hnes 16J riit.A .column (All
17
28.202 106.
18 tFl~SS
o.!.-~'
:~(SUb
act hne 17 from hne 12)
. .....
18
1.829-,-
717.
III
, re~ Ia
s ~lng
of year (from hne73, column (A))
~t;19
19
7.357 477.
z!:l
...
<20LOthp'
'IIv~In ne~ sets
or fund balances (attach explanation)
SEE..
S'l'ATEMENT3
20
<21 878.
21
N et assets or fund balances at end of year (combine hnes 18, 19, and 20)
21
9165 316.
>
0...
l J ...J
U)
~~~f - 1 BLHA
For Privacy Act and Paperw ork Reduction Act N otice, see the separate instructions.
Form 990 (2005)
1
(;15'
e:
13020810 755449 8481
2005.09001 THE CONNECTICUT
HOSPICE, IN 8481
1 ~
TH E
C ON N EC TIC U T
HOSPICE
INC.
06-0878822
Pae2
A ll organizations must complete column (A ). C olumns(B ), (C ), and (0) are required for section 501(c)(3)
and (4) orparuzations and secnon 4947(a)(1) nonexempt chantable trusts but optional for others.
Do not Include amounts reported on line
(A) Total
(B)P rogram
(e)M anagement
(0) Fundralsmg
6b, Bb, 9b, 10b, or16 of Part I.
s erv ices
and general
22 Grants and allocations (attach schedule)
(cas h$
o .noncas hS
O.
If ttusamountIncludesforeIgngrants,ched<here ~D22
23 Specific assistance to Individuals (attach
s ch ed ule).......
.............
23
24 Benefits paid to orfor members (attach
s ch ed ule)........
.....................
24
25Compensation of officers, directors, etc.
25
L368
353.
644431.
697,494.
26 428.
26 Other salaries and wages
.. ..
26
11 449 991. 10 435 071.
904.849.
110071-
27 Pension plan contributions
....
27
148 704.
136 620.
10.630.
1 454.
28 Other employee benefits
......
28
1196 957.
1099 692.
85564.
11701-
29 Payroll taxes
...... ..
29
1. 060837.
974 633.
75.834.
10 370.
30Professional fund raising fees
.......
30
31 Accounting fees
..
.......
...
'"
....
31
96 730.
96730.
32Legal fees
.......
........
.
. .
32
<18676.>
<18676.>
33 Supplies
........
.....
.....
33
994831.
963 494.
30.143.
1 194.
34 Telephone
..
..
34
243034.
113847.
129187.
35Postage and shipping
....
35
54,403.
5.158.
34831.
14 414.
36 Occupancy.
....
....
36
37Eq uipment rental and maintenance
......
37
1.373036.
1.113.807.
259229.
38Pnnting and publications
....
38
92 540.
51 634.
7389.
33 517.
39Trav el
......... .
39
275 356.
258.540.
16,816.
40 Conferences, conventions, and meetings
40
20 958.
10649.
10309.
41Interes t
....
41
183,686.
183686.
42 Depreciatton, depletion, etc (attach schedule)
42
169 809.
169809.
43 Other expenses not covered above [itemize)'
aCLINICAL
S ERV IC ES
43a
4 829 305.
4 668943.
160362.
b C ON TRA C TED
S ERV IC ES
43b
744,543.
176159.
538126.
30 258.
cN ON
MEDICAL
G EN ERA L
43c
3 917709.
4 010308.
<92 599.I>
d
43d
e
43e
f
43f
g
430
44Total functional
expenses. Add lines 22
through 43. (Organizations completing
columns (B)·(D), carry these totals to lines
13·15)
..
44
28202,106. 24 662986.
3299 713.
239_L_407.
Joint Costs. Check ~DIf you are following SOP 98·2.
A re any iomt costs from a combmed educauonal campaign and fundraismp sohcitatron reported m (B ) P rogram services?
~ D Y es
[XJNo
If " Y es ; enter(i) th e aggregate amount of th es e iomt cos ts$
N fA
;(ii) the amount allocated to P rogram services$__
--" -'N!..<f...!A~
__
(iii)th e amount allocated to M anagement and general$
N fA
; and (iv) th e amount allocated to Fund ralsmg$
N fA
Form990 (2005)
52301'
02- 03- D6
13020810 755449 8481
2
2005.09001
TH E
C ON N EC TIC U T
H OS P IC E,
IN
8481
1
06-0878822
Pae3
Form 990 is available for public inspection and, for some people, serves as the pnmary or sole source of Information about a particular organization.
H ow the public perceives an organization In such cases may be determined by the Information presented on its retum. Therefore, please make sure the
retum IS complete and accurate and fully describes, In Part III, the organization's programs and accomplishments.
W hat is the organization's
primary exempt purpose? ~
P rogramS erv ice
PROVIDECARE TO THE IRREVERSIBLY
ILL
Expens es
All organizations must describe their exempt purpose achievements
Ina clear and concise manner. State the number of
(ReqUired for 501(c)(3)
and (4) orgs., and
clients served, publications Issued, etc. DIscuss achievements that are not measurable. (Section 501 (c)(3) and (4)
4947(a)(1) trusts; but
organizations and 494 7(a)(1) nonexempt chantable trusts must also enter the amount of grants and allocations to others.)
opnonal for oth ers.)
aPHYSICIAN DIRECTED PAIN AND SYMPTOM MANAGEMENT
PROVIDED STATEWIDETO PALLIATIVEHOSPITAL AND HOSPICECARE
ADULT AND PEDIATRIC PATIENTSAND THEIR FAMILIES
l_Grants and allocations
$
) If tlus amount includes foreign orants check here
~D11,428,828.
b PHYSICIAN DIRECTEDHOME MEDICAL AND HOSPICE
CARESERVICES TO ADULTS AND PEDIATRICPATIENTS ON A
STATEWIDEBASIS
(Grants and allocations
$
1 If this amount Includes foreran arants check here
~D13234 158.
C
(Grants and allocations
$
) If trus amount Includes toreion arants check here
~D
d
_1_Grantsand allocations
$
)If trus amount Includes foreign orants check here
~D
eOther program services (attach schedule)
{Grants and allocations
$
)If thrs amount Includes foreiqn orants check here
~D
fTotal of Program Service Expenses (should egual line 44, column (8), Program services)
24,662,986.
Form990 (2005)
523021
02-03-06
13020810 755449 8481
3
2005.09001 THE CONNECTICUT HOSPICE, IN 8481
1

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