SCHEDULE O
(Form 990)

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
2021
Open to Public
Inspection
Name of the organization
PRAIRIE HOME HOSPICE INC
 
Employer identification number

41-1494079
Return Reference Explanation
FORM 990, PAGE 6, PART VI, LINE 11B THE COMPLETED FORM 990 IS REVIEWED IN DETAIL BY THE EXECUTIVE DIRECTOR
FORM 990, PAGE 6, PART VI, LINE 12C CONFLICT OF INTEREST POLICY IS ADDRESSED AT EACH MEETING.
FORM 990, PAGE 6, PART VI, LINE 19 GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9 FUNDRAISING COSTS 83,560 FUNDRAISING COSTS -83,560
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


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