SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
Hospice of Kankakee Valley Inc
DBA UpliftedCare
Employer identification number

36-3320227
Return Reference Explanation
Form 990, Part VI, Line 11b: Form 990 Review Process Form 990 is reviewed by the finance committee.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts Annually, Board members sign a conflict of interest form that is retained by Hospice of Kankakee Valley, Inc.(HKV). Board members are expected to abstain from voting on any issues where they have a conflict of interest. However, it is not possible to review the forms to identify conflicts or dual interests for every vote.
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management Officers and the immediate past president meet to review compensation data gathered by HKV personnel for positions with similar responsibilities. This information is evaluated as a basis for compensation decisions. They complete a rebuttable presumption checklist required by regs under IRC 4958. This information is retained.
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees Officers and the immediate past president meet to review compensation data gathered by HKV personnel for positions with similar responsibilities. This information is evaluated as a basis for compensation decisions. They complete a rebuttable presumption checklist required by regs under IRC 4958. This information is retained.
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Hospice of Kankakee Valley makes its documents, conflict of interest statements, and financial statements available to the public upon request.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2020


Additional Data


Software ID: 20011551
Software Version: 2020v4.0