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  5. PENNYROYAL HOSPICE, INC.

PENNYROYAL HOSPICE, INC.

Company Details

Name: PENNYROYAL HOSPICE, INC.
Legal type: Kentucky Corporation
Status: Active
Standing: Good
Profit or Non-Profit: Non-profit
File Date: 14 Apr 1982 (43 years ago)
Organization Date: 14 Apr 1982 (43 years ago)
Last Annual Report: 07 Feb 2025 (2 months ago)
Organization Number: 0165993
Industry: Health Services
Number of Employees: Medium (20-99)
ZIP code: 42240
City: Hopkinsville
Primary County: Christian County
Principal Office: 220 BURLEY AVENUE, HOPKINSVILLE, KY 42240
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PENNYROYAL HOSPICE, INC 401(K) PLAN 2023 311076528 2024-05-15 PENNYROYAL HOSPICE, INC. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621610
Sponsor’s telephone number 2708856428
Plan sponsor’s address 220 BURLEY AVENUE, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2024-05-15
Name of individual signing SELINA PYLE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-05-15
Name of individual signing KELLY MARTIN
Valid signature Filed with authorized/valid electronic signature
PENNYROYAL HOSPICE, INC 401(K) PLAN 2022 311076528 2023-05-25 PENNYROYAL HOSPICE, INC. 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621610
Sponsor’s telephone number 2708856428
Plan sponsor’s address 220 BURLEY AVENUE, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2023-05-25
Name of individual signing SELINA PYLE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-05-25
Name of individual signing SELINA PYLE
Valid signature Filed with authorized/valid electronic signature
PENNYROYAL HOSPICE, INC 401(K) PLAN 2021 311076528 2022-04-28 PENNYROYAL HOSPICE, INC. 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621610
Sponsor’s telephone number 2708856428
Plan sponsor’s address 220 BURLEY AVENUE, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2022-04-28
Name of individual signing SELINA PYLE
Valid signature Filed with authorized/valid electronic signature
PENNYROYAL HOSPICE, INC 401(K) PLAN 2020 311076528 2021-05-18 PENNYROYAL HOSPICE, INC. 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621610
Sponsor’s telephone number 2708856428
Plan sponsor’s address 220 BURLEY AVENUE, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2021-05-18
Name of individual signing SELINA PYLE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-05-18
Name of individual signing SELINA PYLE
Valid signature Filed with authorized/valid electronic signature
PENNYROYAL HOSPICE, INC 401(K) PLAN 2019 311076528 2020-05-01 PENNYROYAL HOSPICE, INC. 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621610
Sponsor’s telephone number 2708856428
Plan sponsor’s address 220 BURLEY AVENUE, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2020-05-01
Name of individual signing SELINA PYLE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-05-01
Name of individual signing SELINA PYLE
Valid signature Filed with authorized/valid electronic signature
PENNYROYAL HOSPICE, INC 401(K) PLAN 2018 311076528 2019-05-31 PENNYROYAL HOSPICE, INC. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621610
Sponsor’s telephone number 2708856428
Plan sponsor’s address 220 BURLEY AVENUE, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2019-05-31
Name of individual signing SELINA PYLE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-05-31
Name of individual signing SELINA PYLE
Valid signature Filed with authorized/valid electronic signature
PENNYROYAL HOSPICE, INC 401(K) PLAN 2017 311076528 2018-05-10 PENNYROYAL HOSPICE, INC. 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621610
Sponsor’s telephone number 2708856428
Plan sponsor’s address 220 BURLEY AVENUE, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2018-05-10
Name of individual signing SELINA PYLE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-05-10
Name of individual signing SELINA PYLE
Valid signature Filed with authorized/valid electronic signature
PENNYROYAL HOSPICE, INC 401(K) PLAN 2016 311076528 2017-05-22 PENNYROYAL HOSPICE, INC 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621610
Sponsor’s telephone number 2708856428
Plan sponsor’s address 220 BURLEY AVENUE, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2017-05-22
Name of individual signing SELINA PYLE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-22
Name of individual signing SELINA PYLE
Valid signature Filed with authorized/valid electronic signature
PENNYROYAL HOSPICE, INC 401(K) PLAN 2015 311076528 2016-06-09 PENNYROYAL HOSPICE, INC 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621610
Sponsor’s telephone number 2708856428
Plan sponsor’s address 220 BURLEY AVENUE, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2016-06-09
Name of individual signing SELINA PYLE
Valid signature Filed with authorized/valid electronic signature
PENNYROYAL HOSPICE, INC 401(K) PLAN 2014 311076528 2015-06-10 PENNYROYAL HOSPICE, INC 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621610
Sponsor’s telephone number 2708856428
Plan sponsor’s address 220 BURLEY AVENUE, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2015-06-10
Name of individual signing BARBARA C PTASZEK
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/08/14/20140814142144P040085477143001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621610
Sponsor’s telephone number 2708856428
Plan sponsor’s address 220 BURLEY AVENUE, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2014-08-14
Name of individual signing BARBARA PTASZEK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-08-14
Name of individual signing BARBARA PTASZEK
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/12/20130712132054P030108291237001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621610
Sponsor’s telephone number 2708856428
Plan sponsor’s address 220 BURLEY AVENUE, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2013-07-12
Name of individual signing BARBARA PTASZEK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-12
Name of individual signing BARBARA PTASZEK
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/06/08/20120608150436P040032257970001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621610
Sponsor’s telephone number 2708856428
Plan sponsor’s address 220 BURLEY AVENUE, HOPKINSVILLE, KY, 42240

Plan administrator’s name and address
Administrator’s EIN 311076528
Plan administrator’s name PENNYROYAL HOSPICE
Plan administrator’s address 220 BURLEY AVENUE, HOPKINSVILLE, KY, 42240
Administrator’s telephone number 2708856428

Signature of
Role Plan administrator
Date 2012-06-08
Name of individual signing BARBARA PTASZEK
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/09/20100709101019P030037749555001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621610
Sponsor’s telephone number 2708856428
Plan sponsor’s address 220 BURLEY AVE., HOPKINSVILLE, KY, 42240

Plan administrator’s name and address
Administrator’s EIN 311076528
Plan administrator’s name PENNYROYAL HOSPICE
Plan administrator’s address 220 BURLEY AVE., HOPKINSVILLE, KY, 42240
Administrator’s telephone number 2708856428

Signature of
Role Plan administrator
Date 2010-07-09
Name of individual signing BARBARA PTASZEK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-09
Name of individual signing BARBARA PTASZEK
Valid signature Filed with authorized/valid electronic signature

Incorporator

Name Role
GARY GRAGG Incorporator
LYNN COHN Incorporator
DAVID COTTHOFF Incorporator
CONNIE NILES Incorporator
ROBERT M. FRANZ Incorporator

Director

Name Role
LYNN COHN Director
DAVID COTTHOFF Director
ROBERT M. FRANZ Director
GARY GRAGG Director
CONNIE NILES Director
Tom Sholar Director
Carolyn Self Director
Stephen Underwood Director

Registered Agent

Name Role
KELLY MARTIN Registered Agent

Officer

Name Role
Rebecca Boggess Officer
Selina Pyle Officer
Kelly Martin Officer

Filings

Name File Date
Annual Report 2025-02-07
Annual Report 2024-05-15
Annual Report 2023-03-17
Annual Report 2022-03-07
Annual Report 2021-02-10
Annual Report 2020-03-12
Annual Report 2019-04-24
Annual Report 2018-04-25
Annual Report 2017-04-20
Annual Report 2016-04-15

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
31-1076528 Corporation Unconditional Exemption 220 BURLEY AVE, HOPKINSVILLE, KY, 42240-8725 1984-01
In Care of Name -
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Organization that receives a substantial part of its support from a governmental unit or the general public 170(b)(1)(A)(vi)
Tax Period 2023-12
Asset 1,000,000 to 4,999,999
Income 1,000,000 to 4,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 4812177
Income Amount 2664144
Form 990 Revenue Amount 2629460
National Taxonomy of Exempt Entities -
Sort Name -

Publication 78 Data
Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name PENNYROYAL HOSPICE INC
EIN 31-1076528
Tax Period 202212
Filing Type E
Return Type 990
File View File
Organization Name PENNYROYAL HOSPICE INC
EIN 31-1076528
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name PENNYROYAL HOSPICE INC
EIN 31-1076528
Tax Period 201912
Filing Type E
Return Type 990
File View File
Organization Name PENNYROYAL HOSPICE INC
EIN 31-1076528
Tax Period 201812
Filing Type E
Return Type 990
File View File
Organization Name PENNYROYAL HOSPICE INC
EIN 31-1076528
Tax Period 201712
Filing Type E
Return Type 990
File View File
Organization Name PENNYROYAL HOSPICE INC
EIN 31-1076528
Tax Period 201612
Filing Type E
Return Type 990
File View File
Organization Name PENNYROYAL HOSPICE
EIN 31-1076528
Tax Period 201512
Filing Type E
Return Type 990
File View File

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Related by address

220 BURLEY AVENUE, HOPKINSVILLE, KY 42240

WESTERN KENTUCKY HOSPICE ALLIANCE, LLC

Sources: Kentucky Secretary of State

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