2024-08-08T19:46:10-05:00 2023-09-30 440160260 FORVIS LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2022-10-01 591940256 COMMUNITY HOSPICE OF NORTHEAST FLORIDA COMM 9042685200 4266 SUNBEAM RD JACKSONVILLE FL 32257 ANDREA FRITZ SR. VP OF FINANCE 9042685200 2024-08-08 1 1 AMY BIBBY P00445891 8282542254 2024-08-08 2022 2024-08-08 14:25:15Z SEE SCH O DISCLOSURE SUSAN PONDER-STANSEL 4266 SUNBEAM RD JACKSONVILLE FL 32257 123796658 0 X WWW.COMMUNITYHOSPICE.COM X 1984 FL ADVANCING PHILANTHROPY TO ENABLE COMMUNITY HOSPICE OF NORTHEAST FLORIDA TO FULFILL ITS MISSION AND VISION OF CARE, RESEARCH AND EDUCATION. 23 23 1010 257 0 0 1186800 2339773 111923024 117954432 1550354 3050936 649401 451517 115309579 123796658 132 1866 0 0 65723605 70952076 0 0 0 49909352 53288673 115633089 124242615 -323510 -445957 97103089 104844542 11163710 20238844 85939379 84605698 X ADVANCING PHILANTHROPY TO ENABLE COMMUNITY HOSPICE OF NORTHEAST FLORIDA TO FULFILL ITS MISSION AND VISION OF CARE, RESEARCH AND EDUCATION. 0 0 82612108 98417638 HOSPICE HOMECARE ESTABLISHED IN 1979, COMMUNITY HOSPICE & PALLIATIVE CARE IS AN INNOVATIVE NATIONAL LEADER IN PALLIATIVE AND HOSPICE CARE, PROVIDING PROGRAMS AND SERVICES TO MEET THE DIVERSE NEEDS OF THE COMMUNITIES IT SERVES. DURING ITS 45-YEAR HISTORY, THE JACKSONVILLE, FLORIDA-BASED NONPROFIT ORGANIZATION HAS SERVED APPROXIMATELY 153,468 ADULTS AND CHILDREN IN BAKER, CLAY, DUVAL, NASSAU, AND ST. JOHNS COUNTIES, AS WELL AS 11 COUNTIES IN NORTH CENTRAL FLORIDA. DURING FISCAL YEAR 2023, THE ORGANIZATION HELPED 9,746 PATIENTS AND THEIR FAMILIES LIVE BETTER WITH ADVANCED ILLNESS THROUGH HOSPICE CARE AND SUPPORT PROGRAMS. MOST OF THIS CARE IS PROVIDED IN THE HOME SETTING, INCLUDING PRIVATE RESIDENCES, NURSING HOMES, AND ASSISTED LIVING COMMUNITIES. COMMUNITY HOSPICE & PALLIATIVE CARE ENSURES PATIENTS' COMFORT BY ADDRESSING THEIR PHYSICAL, EMOTIONAL, AND SPIRITUAL NEEDS THROUGH INTERDISCIPLINARY CLINICAL CARE TEAMS, WHOSE MEMBERS MAKE UP MORE THAN HALF OF THE ORGANIZATION'S 821 EMPLOYEES, ALONG WITH THE SERVICES OF APPROXIMATELY 754 VOLUNTEERS. THE ORGANIZATION ALSO ASSISTS FAMILY CAREGIVERS THROUGH EDUCATION, ACCESS TO COMMUNITY RESOURCES, AND BEREAVEMENT SUPPORT FOR UP TO 13 MONTHS AFTER A LOSS. A DEDICATED, INTERDISCIPLINARY TEAM OF PROFESSIONALS WORKS WITH PATIENTS TO HELP MANAGE THE PAIN AND SYMPTOMS ASSOCIATED WITH A LIFE-LIMITING ILLNESS AND PROVIDES PERSONAL, RESPECTFUL CARE AND ASSISTANCE. THE ORGANIZATION HELPS EDUCATE PATIENTS AND THEIR CAREGIVERS ABOUT THE ILLNESS THEY HAVE, WHAT TO EXPECT AS THE ILLNESS PROGRESSES, AND ABOUT MEDICINES AND THERAPIES TO HELP MANAGE PATIENT COMFORT. ON-CALL SERVICES ARE AVAILABLE 24 HOURS A DAY, SEVEN DAYS A WEEK. IN FISCAL YEAR 2023, OUR HOMECARE TEAMS PROVIDED 452,087 ROUTINE DAYS OF CARE. 18250707 19755327 HOSPICE INPATIENT CARE INPATIENT CARE, IF NEEDED, IS AVAILABLE IN ONE OF OUR TEN INPATIENT CENTERS, CALLED CENTERS FOR CARING. THESE FACILITIES ARE AVAILABLE FOR PATIENTS WHO NEED PAIN AND SYMPTOM MANAGEMENT AT AN ACUTE LEVEL UNAVAILABLE IN A HOMECARE SETTING. THE PATIENT STAYS UNTIL HIS/HER CONDITION AND SYMPTOMS ARE STABILIZED, TYPICALLY THREE TO FIVE DAYS OR LESS. OUR FACILITIES OFFER HOMELIKE SURROUNDINGS WITH GARDENS AND SERENE SETTINGS. IN FISCAL YEAR 2023, OUR STAFF PROVIDED 21,229 DAYS OF GENERAL INPATIENT CARE (GIP). 3757498 1866 PALLIATIVE CARE ESTABLISHED IN 2010, COMMUNITY PALLIATIVE CONSULTANTS PROVIDES PALLIATIVE CONSULTATIVE SERVICES THROUGH FIFTEEN LOCAL HOSPITALS. AT THE REQUEST OF THE PATIENT'S ATTENDING PHYSICIAN, SPECIALLY TRAINED PHYSICIANS, AND ADVANCED PRACTICE REGISTERED NURSES (APRNS) TAKE THE TIME TO UNDERSTAND EACH INDIVIDUAL SITUATION AND THEN RECOMMEND OPTIONS TO MEET THE PATIENT'S PERSONAL GOALS OF CARE. COMMUNITY PALLIATIVE CONSULTANTS ALSO PROVIDES EDUCATION AND TRAINING OF HOSPITAL/FACILITY STAFF. PALLIATIVE CARE PROVIDES AN EXTRA LAYER OF SUPPORT FOR PATIENTS AND THEIR FAMILIES THROUGH A MULTIDISCIPLINARY TEAM FOCUSED ON PROVIDING RELIEF FROM THE SYMPTOMS, PAIN, AND STRESS ASSOCIATED WITH A SERIOUS ILLNESS OR COMPLEX CHRONIC CONDITION. IN FISCAL YEAR 2023, OUR PALLIATIVE CARE TEAM SAW 6,100 PATIENTS. 536786 SPECIALIZED CARE FOR CHILDREN SINCE 2000, COMMUNITY HOSPICE & PALLIATIVE CARE HAS PROVIDED PALLIATIVE AND HOSPICE CARE AND SUPPORT FOR CHILDREN LIVING WITH LIFE-LIMITING AND LIFE-THREATENING CONDITIONS THROUGH COMMUNITY PEDSCARE, AN AWARD-WINNING PEDIATRIC CARE PROGRAM IN COLLABORATION WITH WOLFSON CHILDREN'S HOSPITAL, NEMOURS CHILDREN'S SPECIALTY CARE AND THE UNIVERSITY OF FLORIDA-JACKSONVILLE. THE PROGRAM, ONE OF ONLY A FEW COMMUNITIES' PEDIATRIC PROGRAMS IN THE UNITED STATES OFFERING BOTH PALLIATIVE AND HOSPICE CARE, PROVIDES CLINICAL, SOCIAL SERVICE, SPIRITUAL, CHILD LIFE, MEDICAL AND VOLUNTEER SUPPORT TO IMPROVE QUALITY OF LIFE FOR CHILDREN FROM PRENATAL TO AGE 21. TO DATE, THE PROGRAM HAS SERVED NEARLY 2,400 PATIENTS, WHILE SERVING 353 PATIENTS, AND THEIR FAMILIES IN FISCAL YEAR 2023. ADVANCE CARE PLANNING HONORING CHOICES FLORIDA IS A COMMUNITY COLLABORATIVE ADVANCE CARE PLANNING INITIATIVE OF COMMUNITY HOSPICE & PALLIATIVE CARE. THE PROGRAM LAUNCHED IN 2014 AND IS BASED ON A MODEL FROM RESPECTING CHOICES, A PIONEERING ACP PROGRAM IMPLEMENTING THROUGHOUT THE UNITED STATES, CANADA AND MANY COUNTRIES IN EUROPE AND ASIA. HONORING CHOICES FLORIDA IS DESIGNED TO SUSTAIN AN INTEGRATED, COMMUNITY-WIDE SYSTEM TO ENSURE PATIENTS' FUTURE HEALTH CARE PREFERENCES ARE DISCUSSED, DOCUMENTED, AND HONORED. THE PROGRAM ENGAGES INDIVIDUALS THROUGH HEALTH CARE FACILITIES AND COMMUNITY-BASED VENUES THROUGH A SPECIALIZED ADVANCE CARE PLANNING DOCUMENT AND OFFERS TRAINED FACILITATORS TO GUIDE INDIVIDUALS AND FAMILIES THROUGH THE PROCESS OF DISCUSSING AND DOCUMENTING THEIR HEALTH CARE WISHES. BEREAVEMENT SERVICES AND COMMUNITY GRIEF SUPPORT COMMUNITY HOSPICE & PALLIATIVE CARE OFFERS A VARIETY OF GRIEF AND LOSS SUPPORT SERVICES FOR THOSE WHO HAVE EXPERIENCED THE DEATH OF A LOVED ONE. THESE SERVICES PROVIDE SUPPORT OR GUIDANCE FOR DEALING WITH LOSS AND SORROW. SERVICES ARE AVAILABLE NOT ONLY TO SURVIVORS OF PATIENTS IN OUR HOSPICE CARE PROGRAM BUT TO ANYONE IN THE COMMUNITY WHO REQUESTS THEM. SERVICES INCLUDE BEREAVEMENT SUPPORT GROUPS HELD AT MANY LOCATIONS, UNDERSTANDING GRIEF (A PROGRAM FOR THE NEWLY BEREAVED), AN ANNUAL CANDLELIGHT SERVICE OF REMEMBRANCE, GRIEF CAMP FOR KIDS (CAMP HEALING POWERS) AND A PROGRAM TO COPE WITH GRIEF DURING THE HOLIDAY SEASON (NOVEMBER AND DECEMBER). HOSPICE PATIENTS' FAMILY MEMBERS MAY ALSO RECEIVE INDIVIDUAL AND FAMILY COUNSELING (INCLUDING CHILDREN AND TEENS). WE SEND LETTERS TO THE BEREAVED DURING THE YEAR AFTER THE DEATH, THESE INCLUDE HELPFUL HINTS AND INVITATIONS TO OUR SUPPORT ACTIVITIES. IN FISCAL YEAR 2023, 9,545 WERE PROVIDED GRIEF SERVICES THROUGH PROGRAMS, SUPPORT GROUPS, COUNSELING, EDUCATIONAL LETTERS AND OTHER INFORMATIONAL SERVICES. OUTREACH TO FAMILY CAREGIVERS AND MILITARY/VETERAN COMMUNITIES THE COMMUNITY HOSPICE VETERANS PARTNERSHIP (CHVP) RAISES AWARENESS AS WELL AS FUNDS FOR PINS AND FLAGS TO HONOR VETERANS IN THE CARE OF COMMUNITY HOSPICE & PALLIATIVE CARE, A WE HONOR VETERANS LEVEL III PROVIDER. IN FISCAL YEAR 2023, COMMUNITY HOSPICE & PALLIATIVE CARE PROVIDED HOSPICE SERVICES TO 1,606 VETERANS FROM ALL BRANCHES OF SERVICES THROUGHOUT THE ORGANIZATION'S 16-COUNTY REGION.VOLUNTEERSTHE NEARLY 754 COMMUNITY HOSPICE & PALLIATIVE CARE VOLUNTEERS ARE VITAL MEMBERS OF OUR TEAM. WHETHER OFFERING COMPANIONSHIP AND A LISTENING EAR TO PATIENTS AND FAMILY MEMBERS, HELPING WITH CLERICAL WORK AT ONE OF OUR OFFICE LOCATIONS, ASSISTING AT FUNDRAISING EVENTS OR GREETING GUESTS AT ONE OF OUR FRONT DESK LOCATIONS, THERE'S A VOLUNTEER OPPORTUNITY FOR EVERYONE. FOUNDATION THE COMMUNITY HOSPICE & PALLIATIVE CARE FOUNDATION IS DEDICATED TO ENABLING COMMUNITY HOSPICE & PALLIATIVE CARE TO FULFILL ITS MISSION AND VISION. FUNDS RAISED THROUGH THE FOUNDATION ENHANCE THE QUALITY OF LIFE FOR PATIENTS AND FAMILIES AND SUPPORT UNFUNDED AND UNDER-FUNDED PATIENT CARE, OUTREACH PROGRAMS, AND SERVICES FOR THOSE FACING ADVANCED ILLNESS AND GRIEF. DONOR SUPPORT PROVIDES COMMUNITY PROGRAMS AND COMPASSIONATE CARE TO ALL WHO NEED IT, REGARDLESS OF ABILITY TO PAY. 536786 105157099 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 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 1 193 0 1 1010 1 0 0 0 0 0 0 0 0 0 0 0 0 X 23 23 0 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 FL X X ANDREA FRITZ 9042685200 4266 SUNBEAM ROAD JACKSONVILLE FL 32257 SUSAN PONDER-STANSEL PRES. & CEO ALIVIA CARE, I 37.00 3.00 X X 0 541122 45853 KEVIN ROBBINS CHAIR 2.00 X X 0 0 0 TRACY ARTHUR SECRETARY 2.00 X X 0 0 0 CHRISTOPHER EMANS TREASURER 2.00 X X 0 0 0 JASON W OSBORNE EX-OFFICIO 2.00 X 0 0 0 ALISON BARTFIELD MD BOARD MEMBER 1.00 X 0 0 0 KATHERINE BATENHORST BOARD MEMBER 1.00 X 0 0 0 JANE BOLES BOARD MEMBER 1.00 X 0 0 0 GERARDO COLON-OTERO MD BOARD MEMBER 1.00 X 0 0 0 NANCY L DAWSON MD BOARD MEMBER 1.00 X 0 0 0 CARLTON DEVOOGHT BOARD MEMBER 1.00 X 0 0 0 LT COLONEL BILL DUDLEY RET BOARD MEMBER 1.00 X 0 0 0 SENATOR AUDREY GIBSON BOARD MEMBER 1.00 X 0 0 0 MARIE GNAGE PHD BOARD MEMBER 1.00 X 0 0 0 RICHARD W RICK HAWTHORNE BOARD MEMBER 1.00 X 0 0 0 T FITCH KING III BOARD MEMBER 1.00 X 0 0 0 SUE LEGER-KRALL ARNP PHD BOARD MEMBER 1.00 X 0 0 0 JOHN D LOGUE CFP BOARD MEMBER 1.00 X 0 0 0 MICHAEL A MAYO DHA BOARD MEMBER 1.00 X 0 0 0 GREG MILLER MBA BOARD MEMBER 1.00 X 0 0 0 DR JUDY SAYRE BOARD MEMBER 1.00 X 0 0 0 KENNETH MCCOSH CFO ALIVIA CARE (THROUGH 4 40.00 X 0 0 0 PHILLIP WARD PRES. & CEO COMMUNITY HOSP 38.00 2.00 X 0 420018 37179 MARY MCELROY SR. VP OF HOSPICE SERVICES 40.00 X 246427 0 22948 ANA SANCHEZ CHIEF MEDICAL DIRECTOR 40.00 X 427298 0 41803 JENNIFER CONTIN DIRECTOR OF MEDICAL OPERATIONS - PALLIATIVE CARE 40.00 X 270580 0 31560 JAMES BOMHARD SR MEDICAL DIRECTOR 40.00 X 258731 0 18382 MARIA TIOMICO ASSOCIATE MEDICAL DIRECTOR 40.00 X 264287 0 25319 REUBEN SMITH DIRECTOR OF MEDICAL OPERATIONS - NORTHEAST FL 40.00 X 286570 0 31070 GREGORY DIXON FORMER CFO ALIVIA CARE 0.00 X 0 329722 18213 1753893 1290862 272327 54 1 1 0 LIFE CARE CTR -ORANGE PARK 2145 KINGSLEY AVENUE ORANGE PARK FL 32073 NURSING HOME 899601 MOULTRIE CREEK NURSING 200 MARINER HEALTH WAY ST AUGUSTINE FL 32086 NURSING HOME 866928 TAYLOR CARE CENTER 6535 CHESTER AVENUE JACKSONVILLE FL 33217 NURSING HOME 709841 AT&T MOBILITY POBOX 6463 CAROL STREAM IL 601976463 CELLULAR 638765 ORANGE PARK MEDICAL CENTER P O BOX 402369 ATLANTA GA 303842369 HOSPITAL 602510 53 2337536 2237 2339773 PATIENT SERVICE REV 623000 98199105 98199105 NURSING HOME SUPPORT 623000 19755327 19755327 117954432 1604807 1604807 218533 0 218533 218533 218533 1331627 114502 0 0 1331627 114502 1446129 1446129 MISCELLANOUS REVENUE 623000 194432 194432 CAFE REVENUE 722514 38552 38552 232984 123796658 118172965 0 3283920 1866 1866 245700 122850 122850 58950069 43678976 15271093 1338438 1174770 163668 6729204 5995616 733588 3688665 3269650 419015 193196 193196 51561 51561 76501 76501 33576 33576 2170323 1777406 392917 441609 175833 265776 4895734 4046829 848905 1619305 1619305 3742743 3742743 1956617 1877769 78848 170628 105287 65341 28 28 3010429 3010429 368681 368681 ROOM AND BOARD 21436323 21436323 MEDICAL SUPPLIES EXPENS 8633250 8633250 BAD DEBT EXPENSE 2159681 2159681 CHARITY CARE EXPENSES 1630265 1630265 698223 698223 124242615 105157099 19085516 0 1650 1650 20640037 15693307 9546869 8797304 567285 411371 3469130 1537574 69540830 36545828 35461199 32995002 26664689 28793166 577374 577374 174856 16037794 97103089 104844542 6355867 7029135 26168 37610 4781675 13172099 11163710 20238844 X 85939379 84605698 85939379 84605698 97103089 104844542 X -445957 1312276 -2200000 X X 0 1 X 1 0 X 1808647 1456171 1938853 1186799 2339773 8730243 110302269 117107727 113711376 112110151 118172965 571404488 112110916 118563898 115650229 113296950 120512738 580134731 0 0 0 580134731 791899 1121937 1360365 1007399 1823340 6104940 791899 1121937 1360365 1007399 1823340 6104940 1411888 1003514 655800 462275 232984 3766461 114314703 120689349 117666394 114766624 122569062 590006132 0.98330 0.98200 0.01030 0.00920 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3007 3007 0 PART II-B, LINE 1: THE ORGANIZATION'S INCURRED LOBBYING EXPENSES ARE RELATED TO THAT PORTION OF THE ANNUAL DUES PAID TO THE FLORIDA HOSPICE AND PALLIATIVE CARE ASSOCIATION TO SUPPORT MEMBER ADVOCACY EFFORTS. 1967544 1967544 37770380 18503439 19266941 12171420 4830112 7341308 17305460 13212277 4093183 326026 326026 32995002 DUE FROM FOUNDATION 361950 DUE FROM ALIVIA CARE SOLUTIONS 1311542 DUE FROM SUBSIDY ALIVIA CARE INC 3586260 DUE FROM SUBSIDY ALIVIA CARE SOLUTIONS 325000 ROU OPERATING LEASE 10453042 16037794 DEFERRED COMPENSATION 3183104 DUE TO AFFILIATES 965750 OPERATING LEASE LIABILITY 9023245 13172099 X 121125792 1312276 1312276 119813516 193196 3789946 3983142 123796658 122459473 2200000 2200000 120259473 193196 3789946 3983142 124242615 PART X, LINE 2: COMMUNITY HOSPICE OF NORTHEAST FLORIDA AND ITS AFFILIATES ARE NOT-FOR-PROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPICE FOLLOWS THE FINANCIAL ACCOUNTING STANDARDS BOARD'S AUTHORITATIVE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR THE RECOGNITION AND MEASUREMENT OF THE BENEFITS OF INDIVIDUAL TAX POSITIONS IN THE CONSOLIDATED FINANCIAL STATEMENTS. TAX POSITIONS MUST MEET A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT IN ORDER FOR THE BENEFIT OF THOSE TAX POSITIONS TO BE RECOGNIZED IN THE HOSPICE'S CONSOLIDATED FINANCIAL STATEMENTS. THE HOSPICE HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2023. PART XI, LINE 4B - OTHER ADJUSTMENTS: CHARITY CARE INCLUDED IN REVENUES 1,630,265. BAD DEBT EXPENSES 2,159,681. PART XII, LINE 2D - OTHER ADJUSTMENTS: PACE PURCHASE 2,200,000. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHARITY CARE INCLUDED IN REVENUES 1,630,265. BAD DEBT EXPENSES 2,159,681. 1 1 0 0 0 0 0 0 0 SUSAN PONDER-STANSEL PRES. & CEO ALIVIA CARE, I 0 500000 0 28030 0 13092 0 16470 0 29383 0 586975 0 0 ANA SANCHEZ CHIEF MEDICAL DIRECTOR 416997 0 9000 0 1301 0 18814 0 22989 0 469101 0 0 0 PHILLIP WARD PRES. & CEO COMMUNITY HOSP 0 385445 0 13138 0 21435 0 16470 0 20709 0 457197 0 0 GREGORY DIXON FORMER CFO ALIVIA CARE 0 198568 0 0 0 131154 0 4062 0 14151 0 347935 0 0 REUBEN SMITH DIRECTOR OF MEDICAL OPERATIONS - NOR 286495 0 75 0 0 0 16914 0 14156 0 317640 0 0 0 JENNIFER CONTIN DIRECTOR OF MEDICAL OPERATIONS - PAL 269830 0 750 0 0 0 16485 0 15075 0 302140 0 0 0 MARIA TIOMICO ASSOCIATE MEDICAL DIRECTOR 261283 0 150 0 2854 0 15428 0 9891 0 289606 0 0 0 JAMES BOMHARD SR MEDICAL DIRECTOR 255897 0 150 0 2684 0 13751 0 4631 0 277113 0 0 0 MARY MCELROY SR. VP OF HOSPICE SERVICES 220889 0 9075 0 16463 0 12418 0 10530 0 269375 0 0 0 PART I, LINE 3 THE PROCESS USED TO ESTABLISH COMPENSATION FOR THE PRESIDENT/CEO WAS UNDERTAKEN BY A RELATED ORGANIZATION. THIS PROCESS INCLUDED THE USE OF A COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, FORM 990S OF OTHER ORGANIZATIONS, COMPENSATION STUDIES/SURVEY, AND THE APPROVAL BY THE BOARD/COMMITTEE. PART I, LINES 4A-B GREGORY DIXON RECEIVED A SEVERANCE PAYMENT DURING THE FISCAL YEAR OF $131,154. NONQUALIFIED DEFERRED COMPENSATION - CERTAIN EMPLOYEES PARTICIPATE IN A 457(F) NON-QUALIFIED DEFERRED COMPENSATION PLAN SPONSORED BY THE ORGANIZATION. THE FOLLOWING AMOUNTS REPRESENT THE INCREASE IN VALUE RECEIVED UNDER THE TERMS OF THE PLAN. JAMES BOMHARD - $6,314 ANA SANCHEZ - $9,664 REUBEN SMITH - $8,074 JENNIFER CONTIN - $8,346 MARIA TIOMICO - $7,585 FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE OFFICERS AND THE IMMEDIATE PAST CHAIR, IF HE OR SHE CONTINUES TO SERVE ON THE BOARD, AND THE CHAIRS OF THE STRATEGIC PLANNING COMMITTEE, THE COMPLIANCE/QUALITY OVERSIGHT COMMITTEE AND THE NOMINATING AND BOARD DEVELOPMENT COMMITTEE. THE CHAIR OF THE COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION FOR CARING, INC. SHALL BE AN EX-OFFICIO MEMBER OF THE EXECUTIVE COMMITTEE WITHOUT VOTE. THE EXECUTIVE COMMITTEE SHALL MEET AT THE CALL OF THE CHAIR, OR, IN THE ABSENCE OF THE CHAIR, AT THE CALL OF THE FIRST VICE-CHAIR. THE EXECUTIVE COMMITTEE SHALL HAVE SUCH POWERS AS MAY BE DELEGATED BY THE BOARD OF DIRECTORS FROM TIME TO TIME. THE EXECUTIVE COMMITTEE SHALL ACT UPON INTERIM BUSINESS ARISING BETWEEN REGULAR MEETINGS OF THE BOARD OF DIRECTORS AND SHALL REPORT ITS ACTION AT THE NEXT MEETING OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL PERIODICALLY REVIEW THE PERFORMANCE OF THE PRESIDENT/CEO, AND SHALL REVIEW, FROM TIME TO TIME, PERSONNEL POLICIES, INCLUDING CONDITIONS OF EMPLOYMENT, AND SHALL MEET PERIODICALLY WITH THE PRESIDENT/CEO TO ASSESS PERSONNEL POLICIES AND WORKING CONDITIONS. THE COMMITTEE WILL REVIEW THE SALARY PLAN AND RECOMMEND CHANGES WHEN INDICATED. THE COMMITTEE SHALL OVERSEE THE ADMINISTRATION OF ANY AFFIRMATIVE ACTION PLAN. ACTIONS OF THE EXECUTIVE COMMITTEE PURSUANT TO THIS PARAGRAPH SHALL HAVE THE SAME EFFECT AS ACTIONS OF THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 ALIVIA CARE, INC A FLORIDA NOT-FOR-PROFIT TAX EXEMPT ENTITY AS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION'S BYLAWS WERE AMENDED TO STATE THAT ALICARE CARE, INC A FLORIDA NOT-FOR-PROFIT TAX EXEMPT ENTITY AS THE SOLE MEMBER. AS THE SOLE MEMBER ALIVIA CARE, INC HAS THE RIGHT TO: (A) EMPLOY THE PRESIDENT OF THE CORPORATION (THE "HOSPICE PRESIDENT"); (B) APPROVE THE AMENDMENT, MODIFICATION, OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION, IN WHOLE OR IN PART; (C) APPROVE THE ANNUAL CAPITAL AND OPERATING BUDGET OF THE CORPORATION; (D) APPROVE THE ANNUAL AND LONG-TERM STRATEGIC PLANS OF THE CORPORATION; (E) INCUR ANY LONG-TERM DEBT OR FINANCING TO BE USED IN FURTHERANCE OF THE CORPORATION'S PURPOSES; (F) APPROVE AND AUTHORIZE THE EXPANSION OF THE CORPORATION INTO ANY NEW SERVICE LINES WHICH ARE NOT SET FORTH IN ARTICLE I OF THESE BYLAWS; (G) APPROVE AND AUTHORIZE THE GEOGRAPHIC EXPANSION OF THE CORPORATION INTO ANY SERVICE AREA BEYOND THE CORPORATION'S LICENSED HOSPICE SERVICE AREA; (H) APPROVE AND AUTHORIZE THE ESTABLISHMENT OR DISSOLUTION OF ORGANIZATIONAL RELATIONSHIPS BY THE CORPORATION INCLUDING SUBSIDIARIES, CONSOLIDATION, PARTNERSHIPS, JOINT VENTURES, MERGERS, OR ANY OTHER FUNDAMENTAL REORGANIZATION OF THE CORPORATION; FORM 990, PART VI, SECTION B, LINE 11B THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTANT WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. UPON COMPLETION, THE RETURN WAS REVIEWED IN ITS ENTIRETY BY THE BUDGET FINANCE COMMITTEE OF THE BOARD, FOLLOWED BY A PRESENTATION TO THE FULL BOARD FOR APPROVAL. FOLLOWING APPROVAL, THE RETURN WAS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS OF THE BOARD OF DIRECTORS ARE REQUIRED ANNUALLY TO COMPLETE AND SIGN A CONFLICT OF INTEREST POLICY IDENTIFYING RELATIONSHIPS THAT MAY GIVE RISE TO CONFLICT. OFFICERS AND KEY MANAGEMENT PERSONNEL ALSO COMPLETE A SURVEY REGARDING POTENTIAL BUSINESS RELATIONSHIPS WITH OTHER OFFICERS, DIRECTORS, AND KEY PERSONNEL.ANY PERSON DETERMINED TO HAVE A CONFLICT OF INTEREST IS REQUIRED TO RECUSE THEMSELVES FROM ANY VOTE RELATED TO THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMMITTEE OF THE BOARD REVIEWS AND MAKES DECISIONS ANNUALLY REGARDING COMPENSATION FOR EXECUTIVE STAFF. THE EXECUTIVE COMMITTEE RETAINED AN INDEPENDENT CONSULTANT TO CONDUCT A COMPREHENSIVE REVIEW OF THE COMPETITIVENESS AND REASONABLENESS OF THE COMPENSATION AND BENEFITS PROVIDED TO THE FOLLOWING POSITIONS: CEO, COO, CFO, SVP OF PALLIATIVE CARE, SVP HOSPICE SERVICES, VP DEPUTY CHIEF FINANCIAL OFFICER, VP COMPLIANCE AND QUALITY, AND VICE PRESIDENT EDUCATION & COMMUNITY ENGAGEMENT. A REVIEW OF COMPETITIVENESS AND REASONABLENESS FOR LIKE ORGANIZATIONS TO INCLUDE NOT-FOR-PROFIT POST ACUTE CARE PROVIDERS AND HOSPITALS OF COMPARABLE SIZE, REGARDLESS OF GEOGRAPHY WAS CONDUCTED. TARGET MARKET AT MEDIAN. FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION WILL PROVIDE ANY GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS UPON REQUEST. THIS CAN BE DONE IN PERSON, BY PHONE, VIA OUR WEBSITE OR ON WWW.GUIDESTAR.COM. FORM 990, PART XI, LINE 9: PACE PURCHASE -2,200,000. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION FOR CARING 4266 SUNBEAM RD JACKSONVILLE FL 32257 593583920 FUNDRAISING FOR COMMUNITY HOSPICE OF NORTHEAST FLORIDA FL 501(C)(3) LINE 12A, I COMMUNITY HOSPICE OF NORTHEAST FLORIDA 1 HOSPICE OF GOLDEN ISLES INC 1692 GLYNCO PKWY BRUNSWICK GA 31525 581428562 HOSPICE & PALLIATIVE CARE GA 501(C)(3) LINE 7 ALIVIA CARE OF GEORGIA INC 0 HOSPICE SATILLA 808 EVERGREEN WAY WAYCROSS GA 31501 581741612 HOSPICE & PALLIATIVE CARE GA 501(C)(3) LINE 3 ALIVIA CARE OF GEORGIA INC 0 ALIVIA CARE INC 4266 SUNBEAM RD JACKSONVILLE FL 32257 844695341 LEADERSHIP SUPPORT FOR HOSPICE & PALLIATIVE CARE FL 501(C)(3) LINE 10 N/A 0 ALIVIA CARE OF GEORGIA INC 4266 SUNBEAM RD JACKSONVILLE FL 32257 850842222 LEADERSHIP SUPPORT FOR HOSPICE & PALLIATIVE CARE FL 501(C)(3) LINE 10 ALIVIA CARE INC 0 ALIVIA CARE SOLUTIONS INC 4266 SUNBEAM RD JACKSONVILLE FL 32257 852777461 HOSPICE & PALLIATIVE CARE FL 501(C)(3) LINE 10 ALIVIA CARE INC 0 PACE PARTNERS FOR NORTHEAST FLORIDA INC 4266 SUNBEAM RD JACKSONVILLE FL 32257 364861283 PROGRAM FOR NURSING HOME PATIENTS FL 501(C)(3) LINE 12A, I COMMUNITY HOSPICE OF NORTHEAST FLORIDA 1 0 0 1 1 0 0 0 0 1 0 1 1 0 1 1 1 0 0 0 COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION A 129865 FMV COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION C 2337541 FMV COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION O 767857 FMV COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION M 6933219 FMV SCHEDULE R, PART VII THE COMMUNITY MANAGEMENT COMPANY OF NORTHEAST FLORIDA, INC. WAS ESTABLISHED IN DECEMBER 2012 AND IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE AND EDUCATIONAL PURPOSES, INCLUDING THE PROVISION OF PALLIATIVE CARE SERVICES AND OTHER HEALTH SERVICES TO IMPROVE THE HEALTH SERVICES OF THE PEOPLE IN THE COMMUNITY IT SERVES. AS OF SEPTEMBER 30, 2020, COMMUNITY MANAGEMENT COMPANY OF NORTHEAST FLORIDA, INC. HAD NOT ENGAGED IN ANY FINANCIAL TRANSACTIONS AND THEIR APPLICATION FOR EXEMPTION WAS STILL IN THE PROCESS.