2024-11-13T08:51:22+00:00 2023-12-31 350921680 CROWE LLP 401 East Las Olas Blvd Suite 1100 Fort Lauderdale FL 333014230 990 2023-01-01 541920770 Capital Hospice CAPI 8138718111 12470 Telecom Drive Suite 301 Temple Terrace FL 33637 Andrew Molosky President/CEO 7035382065 2024-11-13 true true Brittney Kocaj P01320603 9542028600 2024-11-13 2023 2024-10-15 13:58:12Z X Capital Caring Andrew Molosky 12470 Telecom Drive Suite 301 Temple Terrace FL 33637 92922873 false X chaptershealth.org X 1998 VA Provides hospice and palliative care services that relieve the suffering of persons residing in its communities affected by life-limiting illnesses and end-of-life issues so all may live as fully as possible. 13 9 777 828 3196698 107068 5971305 4861517 84039648 86478047 847754 191663 293431 402721 91152138 91933948 0 7675 0 0 51592674 54605454 0 0 968717 37093658 40444499 88686332 95057628 2465806 -3123680 69346718 78721422 48698443 41219972 20648275 37501450 THE MISSION OF CAPITAL HOSPICE IS TO IMPROVE CARE FOR THOSE FACING LIFE-LIMITING ILLNESSES THROUGH DIRECT SUPPORT OF PATIENTS AND THEIR FAMILIES, PUBLIC EDUCATION AND ADVOCACY. false false 63959084 7675 79735335 CAPITAL HOSPICE PROVIDES EXPERT MEDICAL, EMOTIONAL, SPIRITUAL AND PRACTICAL CARE AND SUPPORT TO PATIENTS WITH SERIOUS, PROGRESSIVE ILLNESS AND THEIR FAMILIES 24 HOURS A DAY, SEVEN DAYS A WEEK TO PATIENTS WHEREVER THEY LIVE BY QUALIFIED PHYSICIANS, NURSES, NURSES' AIDES, SOCIAL WORKERS, NON-DENOMINATIONAL CHAPLAINS AND OTHER PROFESSIONALS. IT IS THE OBJECTIVE OF CAPITAL HOSPICE TO PROVIDE CARE TO ANYONE MEDICALLY ELIGIBLE, REGARDLESS OF THE PATIENT'S ABILITY TO PAY. CAPITAL HOSPICE PROVIDED SERVICES TO 30,303 PATIENTS DURING 2023 AND PROVIDED 370,245 PATIENT DAYS OF CARE. CAPITAL HOSPICE HAD COSTS RELATED TO SERVICES AND SUPPLIES UNDER ITS CHARITY CARE POLICY OF APPROXIMATELY $1,741,000 IN 2023. 8265189 1721604 THE ADLER CENTER FOR CARING INPATIENT UNIT AND THE WASHINGTON HOME CAPITAL CARING HEALTH INPATIENT CENTER AT SIBLEY MEMORIAL HOSPITAL, PROVIDE CARE FOR THOSE PATIENTS THAT REQUIRE CONSTANT MONITORING AND WHOSE PAIN AND SYMPTOMS CAN'T BE ADEQUATELY MANAGED AT HOME. IT IS THE GOAL OF THE ADLER CENTER FOR CARING AND THE WASHINGTON HOME CAPITAL CARING HEALTH AT SIBLEY MEMORIAL HOSPITAL INPATIENT UNITS TO MAKE OUR PATIENTS AS SYMPTOM FREE AND AS COMFORTABLE AS POSSIBLE. THE ADLER CENTER FOR CARING INPATIENT CENTER PROVIDED CARE TO 1,805 PATIENTS AND HAD 2,984 PATIENT DAYS OF CARE IN 2023. THE WASHINGTON HOME CAPITAL CARING HEALTH INPATIENT UNIT AT SIBLEY MEMORIAL HOSPITAL PROVED CARE TO 1,504 PATIENTS AND HAD 2,650 PATIENT DAYS OF CARE IN 2023. 4534404 2092277 CAPITAL PALLIATIVE CARE CONSULTANTS PROVIDES PHYSICIAN SERVICES TO OUR HOSPICE PATIENTS, AND TO NON-HOSPICE ELIGIBLE PATIENTS WHO ARE IN NEED OF SYMPTOM MANAGEMENT. IT IS THE OBJECTIVE OF CAPITAL PALLIATIVE CARE CONSULTANTS TO PROVIDE PHYSICIAN SERVICES TO ALL PATIENTS IN NEED OF SYMPTOM MANAGEMENT, REGARDLESS OF THE PATIENT'S ABILITY TO PAY. CAPITAL PALLIATIVE CARE CONSULTANTS PROVIDED 78,973 PATIENT VISITS DURING 2023. 76758677 true true false false false false false false true true false false true true true false true false false false false false false true false false false false true false false false false false false false false true false false false true true false false false true 166 0 true 777 true true true false false false false true true false false false false true false X 13 9 true false true false true true true true true false false true true true true true true false false false CA CO DC FL GA IL MD MA MO NJ NY NC OH PA SC TN VA WV X Todd Webb 8138718111 12470 Telecom Drive Suite 301 Temple Terrace FL 33637 Andrew Molosky PRESIDENT/CEO (starting 5/2023) 2.0 48.0 X X 0 1576179 969172 ANGELA WEBB Treasurer 2.0 6.0 X X 0 0 0 LYNN MENTO Secretary 2.0 6.0 X X 0 0 0 REV DR TYRONE PITTS Vice Chair 2.0 6.0 X X 0 0 0 RHONDA G WHITE Chief Operating Officer (starting 5/2023) 2.0 48.0 X X 0 469677 191283 TODD A WEBB CHIEF FINANCIAL OFFICER (starting 5/2023) 2.0 48.0 X X 0 399506 184162 Tom Koutsoumpas PRESIDENT & CEO (through 5/2023) / CHAIR 30.0 10.0 X X 715765 0 8220 BILL NOVELLI BOARD MEMBER 2.0 8.0 X 0 0 0 CLIFFORD BARNES BOARD MEMBER 2.0 6.0 X 0 0 0 DIANE TY BOARD MEMBER 2.0 6.0 X 0 0 0 JEANNINE ENGLISH BOARD MEMBER 2.0 6.0 X 0 0 0 JOHN ADAMS BOARD MEMBER 2.0 6.0 X 0 0 0 TOM NELSON BOARD MEMBER 2.0 6.0 X 0 0 0 CHARLES O LEE Chief Administrative Officer (through 6/2023) 2.0 48.0 X 0 576964 49262 Joseph Murray Chief Financial Officer 40.0 0 X 280383 0 4305 MICHAEL SHAPIRO Chief Medical Officer - Hospice (starting 5/2023) 2.0 48.0 X 0 355760 99926 Nicole Romence Chief People Officer (starting 5/2023) 2.0 48.0 X 0 439073 163885 Paola Delp Chief Business Development Officer (starting 5/2023) 2.0 48.0 X 0 680764 239538 Sheri Anne Strobel Amateau Chief Information Officer (starting 5/2023) 2.0 48.0 X 0 407547 143212 Tara Friedman Chief Medical Officer (starting 5/2023) 2.0 48.0 X 0 521450 212195 Valerie Zolman Chief Compliance Officer (starting 5/2023) 2.0 48.0 X 0 285280 120968 Kimberly Grove Vice President, Operations - Capital Caring, CHS 40.0 0 X 267194 0 34842 Linda Maurano Chief of Clinical Operations 40.0 0 X 232956 0 2463 Matthew Kestenbaum Chief Medical Officer 40.0 0 X 261903 0 34812 Melissa Ring Chief Performance and Compliance Officer (Through 12/2023) 40.0 0 X 166145 0 12939 Steve Cone Chief of Communications, Marketing & Philanthropy 40.0 0 X 200881 0 12173 Elizabeth Phan HPM Physician 40.0 0 X 328088 0 14608 Emily Albelda HPM Physician 40.0 0 X 265514 0 5130 Jason Sobel Senior Medical Director 40.0 0 X 296668 0 33638 Ray Garcia HPM Physician 40.0 0 X 286802 0 6677 3302299 5712200 2543410 108 false true false HOSPICE OF MICHIGAN INC DBA NORTHSTAR 2366 OAK VALLEY DR ANN ARBOR MI 48103 CALL CENTER SERVICES 3904933 Inova Fairfax Hospital 3300 GALLOWS ROAD FALLS CHURCH VA 22042 GENERAL INPATIENT SERVICES 1186823 CAPITOL CITY SNF LLC DBA CAPITOL CITY REHAB & HEALTHCARE CENTER 2425 25TH STREET SE WASHINGTON DC 20020 NURSING HOME SERVICES 989947 AYA HEALTHCARE INC 5930 CORNERSTONE COURT WEST SAN DIEGO CA 92121 CONTRACT NURSING 801892 UNIQUE REHABILITATION AND HEALTH CENTER LLC 901 FIRST STREET NW WASHINGTON DC 20001 NURSING HOME SERVICES 750645 23 0 0 143000 88924 25000 4604593 118062 4861517 NET PATIENT SERVICE REVENUE 621620 86478047 83549216 2928831 0 0 0 0 86478047 299308 299308 0 0 584140 20500 526413 185871 57727 -165371 -107645 -107645 170300 143000 276641 -106341 -106341 234491 234491 234491 CONTRACT STAFF REVENUE 541000 267867 267867 ADMINISTRATIVE FEES 900099 6704 6704 0 0 0 0 274571 91933948 83549216 3196698 326517 X 7675 7675 0 0 0 0 0 0 2843968 205238 2469644 169086 0 0 0 0 41423757 36728358 4450550 244849 227376 186368 38919 2089 6786084 5665126 1057466 63492 3324269 2773515 519670 31084 0 0 0 0 269196 0 269196 0 81479 0 81479 0 0 0 0 0 0 0 235 0 235 0 19499637 18649185 718745 131707 1011497 14634 993531 3332 1984720 532783 1386395 65542 2394877 522628 1782437 89812 0 0 0 0 4008150 1892841 2003448 111861 1026559 886448 140095 16 0 0 0 0 25307 19227 6080 0 894433 3860 872512 18061 0 0 0 0 1033266 979475 35839 17952 585152 544505 31880 8767 MEDICAL SUPPLIES 7125140 7115849 9291 0 UNCOLLECTIBLE INTEREST 180376 0 180376 0 AIP EXPENSE 133843 0 133843 0 RECRUITMENT ADVERTISING 92440 10568 81732 140 98192 20394 66871 10927 95057628 76758677 17330234 968717 0 0 0 0 6566 0 4416212 7181928 843865 2164543 12348618 10616982 0 0 0 0 0 0 0 0 1330358 971671 39611551 20682425 19437479 18929126 3176898 3336654 20212 16373 0 7200000 27766510 28304145 69346718 78721422 15768137 14842462 0 0 5000000 0 429554 384522 27500752 25992988 48698443 41219972 X 13701842 30666314 6946433 6835136 20648275 37501450 69346718 78721422 X -3123680 30215 0 0 0 19946640 X false true X true false X 4493942 10258650 7828621 5971305 4861517 33414035 89863153 97018241 97888206 87043486 86478047 458291133 63125 0 0 0 0 63125 0 0 0 0 0 0 0 0 0 0 0 0 94420220 107276891 105716827 93014791 91339564 491768293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 491768293 1125379 595637 545799 268269 299308 2834392 0 0 0 0 0 0 1125379 595637 545799 268269 299308 2834392 0 0 0 0 0 0 485262 196375 226052 302320 679362 1889371 96030861 108068903 106488678 93585380 92318234 496492056 0.9905 0.9897 0.01 0.01 X Schedule A, Part III, Line 12 Other Income DESCRIPTION - OTHER REVENUE, COLUMN A - 485262.0, COLUMN B - 196375.0, COLUMN C - 226052.0, COLUMN D - 302320.0, COLUMN E - 679362.0, COLUMN F - 1889371.0; RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3176310 89018 2 3265326 5257354 -518042 1563002 3176310 5207434 741914 691994 5257354 5780402 233796 806764 5207434 5661714 1218688 1100000 5780402 0.24 0.76 0.0 false false 3920000 3920000 19965136 7466399 12498737 1359029 1043791 315238 14313083 12133932 2179151 54303 38303 16000 18929126 CHARITABLE REMAINDER TRUSTS 105941 DEFERRED COMPENSATION ASSETS 11841 OPERATING LEASE RIGHT-OF-USE ASSETS 22105827 FINANCE LEASE RIGHT-OF-USE ASSETS 569605 AIP MANAGEMENT FEE RECEIVABLE INTERCOMPANY ACCOUNTS RECEIVABLE 5510931 28304145 CHARITABLE GIFT ANNUITIES 75170 OPERATING LEASE LIABILITIES 22344800 FINANCE LEASE LIABILITIES 573018 NOTES & LOANS FROM RELATED PARTIES 3000000 25992988 X Schedule D, Part V, Line 4 Intended uses of endowment funds ENDOWMENT FUNDS ARE HELD UNTIL THEY REACH FIVE MILLION DOLLARS AT WHICH TIME, WITH THE BOARD OF TRUSTEES APPROVAL, EIGHTY PERCENT OF ANY EARNINGS CAN BE USED TO FUND OPERATIONS AND THE REMAINING 20 PERCENT WOULD BE ADDED TO THE FUND. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote Chapters and the affiliate organizations, except for the CareNu entities, are exempt from income taxes on income from related activities under Section 501(c)(3) of the U.S. Internal Revenue Code and corresponding state tax law. Accordingly, no provision has been made for federal or state income taxes. A tax position is recognized as a benefit only if it is "more likely than not" that the tax position would be sustained in a tax examination, with a tax examination being presumed to occur. The amount recognized is the largest amount of tax benefit that is greater than 50% likely to be realized on examination. For tax positions not meeting the "more likely than not" test, no tax benefit is recorded. The applicable Forms 990 have not been subject to examination by the Internal Revenue Service or the state of Florida for the last three years. CHS does not expect the total amount of unrecognized tax benefits to significantly change in the next 12 months. CHS recognizes interest and/or penalties related to income tax matters in income tax expense. CHS did not have any amounts accrued for interest and penalties at December 31, 2023 and 2022. GALA 306000 140500 165500 16500 107406 1200 135194 EVENING AT RDV VINEYARDS 7300 2500 4800 5000 11241 100 0 313300 143000 170300 21500 118647 1200 135294 276641 -106341 true true false false false false false false false Tom Koutsoumpas PRESIDENT & CEO (through 5/2023) / CHAIR 322533 0 0 0 393232 0 6486 0 1734 0 723985 0 33232 0 Andrew Molosky PRESIDENT/CEO (starting 5/2023) 0 840771 0 562200 0 173208 0 915327 0 53845 0 2545351 0 523416 TODD A WEBB CHIEF FINANCIAL OFFICER (starting 5/2023) 0 330189 0 60719 0 8598 0 137439 0 46722 0 583667 0 60719 RHONDA G WHITE Chief Operating Officer (starting 5/2023) 0 368600 0 92400 0 8677 0 170170 0 21113 0 660961 0 92400 Paola Delp Chief Business Development Officer (starting 5/2023) 0 498181 0 130553 0 52030 0 226028 0 13510 0 920302 0 173083 Tara Friedman Chief Medical Officer (starting 5/2023) 0 511328 0 0 0 10122 0 193269 0 18926 0 733645 0 0 CHARLES O LEE Chief Administrative Officer (through 6/2023) 0 217999 0 62001 0 296964 0 6594 0 42667 0 626226 0 62001 Joseph Murray Chief Financial Officer 280383 0 0 0 0 0 2389 0 1916 0 284688 0 0 0 Nicole Romence Chief People Officer (starting 5/2023) 0 312966 0 115718 0 10390 0 142792 0 21093 0 602959 0 93025 MICHAEL SHAPIRO Chief Medical Officer - Hospice (starting 5/2023) 0 354226 0 327 0 1208 0 51084 0 48842 0 455686 0 0 Sheri Anne Strobel Amateau Chief Information Officer (starting 5/2023) 0 321514 0 77245 0 8788 0 138289 0 4923 0 550759 0 77245 Valerie Zolman Chief Compliance Officer (starting 5/2023) 0 231306 0 51717 0 2258 0 90709 0 30259 0 406248 0 37502 Steve Cone Chief of Communications, Marketing & Philanthropy 200881 0 0 0 0 0 0 0 12173 0 213054 0 0 0 Kimberly Grove Vice President, Operations - Capital Caring, CHS 267194 0 0 0 0 0 2035 0 32808 0 302036 0 0 0 Matthew Kestenbaum Chief Medical Officer 261903 0 0 0 0 0 2801 0 32011 0 296715 0 0 0 Linda Maurano Chief of Clinical Operations 232956 0 0 0 0 0 0 0 2463 0 235419 0 0 0 Melissa Ring Chief Performance and Compliance Officer (Through 12/2023) 141530 0 0 0 24615 0 765 0 12174 0 179084 0 0 0 Emily Albelda HPM Physician 265514 0 0 0 0 0 4881 0 249 0 270644 0 0 0 Ray Garcia HPM Physician 276299 0 10000 0 503 0 2938 0 3738 0 293478 0 0 0 Elizabeth Phan HPM Physician 328088 0 0 0 0 0 3568 0 11040 0 342696 0 0 0 Jason Sobel Senior Medical Director 296668 0 0 0 0 0 2175 0 31463 0 330306 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Prior to the affiliation with Chapters Health System, Inc., compensation for the organization's President & CEO was paid by Capital Hospice (a related organization). Capital Hospice used the following methods to determine the President and CEO's compensation: a compensation committee, independent compensation consultant, form 990 of other organizations, compensation survey or study, and approval by the board or compensation committee. After the affiliation with Chapters Health System, Inc., the President & CEO is paid by Chapters Health System, Inc. (a related organization). Chapters Health System used the following to determine his compensation: a compensation committee, independent compensation consultant, compensation survey or study, forms 990 of other organizations, and approval by the board or compensation committee to determine his compensation. Schedule J, Part I, Line 4a Severance or change-of-control payment During the Year, the company paid severance to: J.Koutsoumpas $360,000 M.Ring $24,615 During the Year, Chapters Health System, Inc. paid severance to: C.Lee $291,429 D.Forman $331,937 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Chapters Health System, Inc. (a related organization) has a supplemental executive retirement plan (SERP) in which some of the interested persons participate. During the year, the following payments were made by Chapters Health System, Inc. into the SERP plans of the participants: A.Molosky $354,797 P.Delp $94,737 T.Friedman $77,250 D.O'Neil $57,628 R.White $70,067 N.Romence $67,867 S.Strobel $60,036 T. Webb $60,512 V.Zolman $43,270 X 241465 Selling cost X 5 63117 Market value X 6 2729 Market value X HOTEL/MEAL/TRAVEL 4 35281 Market value X OTHER 4 9961 Market value 0 false false false Form 990, Part VI, Line 15a PROCESS FOR DETERMINING COMPENSATION OF TOP MANAGEMENT OFFICIAL Prior to the affiliation with Chapters Health System, Inc., the Executive Committee of the Board engaged an independent consulting group to prepare a report to assist in establishing compensation for the top management official. After the affiliation with Chapters Health System, Inc., the President/CEO of the organization is paid by Chapters Health System, Inc. The organization engaged an independent compensation consultant to assist in establishing a Compensation Charter that details the organization's procedures for setting compensation of the President/CEO and all other officers and key employees of the organization. The Compensation Charter established the Compensation Committee, the independent body responsible for establishing the compensation of the President/CEO. The Compensation Committee relies on a recent compensation study performed by an independent compensation consultant, which is done on an annual basis, that provides compensation data for similarly qualified persons in comparable organizations to support its decision-making process and reports its activities to the Board of Directors at the next regularly scheduled meeting. The Compensation Committee adequately documents its compensation determinations in the meeting minutes on a timely basis. This process took place during the year. The president/CEO of the organization is paid by Chapters Health System, Inc. The form 990 instructions indicate when the CEO is not paid by the filing organization, the question should be answered "no". Form 990, Part VI, Line 15b PROCESS FOR DETERMINING COMPENSATION OF OTHER OFFICERS Prior to the affiliation with Chapters Health System, Inc., the Executive Committee of the Board engaged an independent consulting group to prepare a report to assist in establishing compensation for other officers and key employees. After the affiliation with Chapters Health System, Inc., the other Officers and key employees of the organization are paid by Chapters Health System, Inc. The compensation of all other officers and key employees is determined by the president/ceo. The president/ceo uses comparability data and an independent compensation consultant to determine the compensation. The decisions are documented in each employee's file. This process took place during the year. Form 990, Part VI, Line 1a Delegate broad authority to a committee The Executive Committee, made up of the President and CEO, CFO, the Chairperson of the Board , the Vice Chairperson of the Board and the Secretary, shall carry out the work of the Board of Directors between meetings and make recommendations to the Board of Directors for its action. The Executive Committee shall have all the authority of the Board of Directors except as may be limited by law and subject to the approval of the the member of the sole member. Form 990, Part VI, Line 2 Family/business relationships amongst interested persons David J. O'Neil, Andrew Molosky and Paola Delp - Business relationship Form 990, Part VI, Line 4 Significant changes to organizational documents Effective May 1, 2023, the articles of incorporation were amended to reflect the affiliation agreement between organization and Chapters Health System, Inc. The amended articles of incorporation name Chapters Health System, Inc. as the member of the organization's sole member,Capital Caring Health (CCH). The member shall have and exercise such reserved rights and powers related to the organization as set forth in the bylaws. In addition, the amended articles state that the bylaws may be amended, altered, added to or rescinded only with the approval of the sole member. Likewise, the bylaws were amended as of May 1, 2023, naming Chapters Health System, Inc. the member of the organization's sole member. In addition, the amended bylaws lay out the following: - The number, composition, qualifications, authority, and duties of the governing body's voting members; - The number, qualifications, powers, and duties of the organization's officers; - The role of the sole member in governance; - The provisions to amend the bylaws; and - The policies or procedures contained within the bylaws regarding compensation, conflicts of interest, and document retention. Form 990, Part VI, Line 6 Classes of members or stockholders The organization's members are Capital Caring Health (CCH) and Chapters Health System, Inc. (CHS). CCH is the sole member of the organization. Certain rights and powers of the sole member shall be exercised only by the member of the sole member, CHS. CHS both elects the members of the governing body of the organization and also approves certain significant decisions made by the governing body of the organization. Specifically, CHS has the following powers: (1) the ability to remove board members (2) the ability to set the schedule for board meetings, special meetings and annual meeting, (3) the officers who are in the following roles as the officer of CHS, COO, CFO, CAO, CMO, CBDO, CPO, CIO, CCO, VP-F, Assistant Secretary (4) approval to amend bylaws. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body The member of the organization's sole member, Chapters Health System, Inc., elects the members of the organization's Board of Directors and may appoint replacement directors at any time when a vacancy occurs. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders Without the written approval of the member of the organization's sole member, Chapters Health System, Inc., the organization's governing body is not permitted to: (A) Sell, lease, or dispose of assets, merge, combine or otherwise or reorganize with any other entity, convert its corporate structure to another form or enter into any management services agreement; (B) Enter into any loan facility, borrow any funds or pledge or hypothecate any or all of its assets as security for any borrowing; (C) Change the character or nature of the organization's business to something other than the operation of a hospice and home health agency; (D) Remove or appoint the President and CEO; (E) Execute any deed, mortgage, note or bond; (F) Adopt or amend the annual operating and/or capital budgets proposed by the President and CEO and the management of the organization; (G) Make any contribution or distribution of assets or property to any person; (H) Amend the Articles of Incorporation of the Corporation; (I) Dissolve, liquidate or otherwise cease to exist as a Not-for-Profit Corporation which is exempt from taxation under Section 501(c)(3) of the Internal Revenue Code; (J) Form, DISSOLVE, LIQUIDATE, SELL, MERGE OR OTHERWISE TRANSFER OWNERSHIP OR CONTROL OF any subsidiary corporation; or (K) Acquire or dispose of patents, copyrights, and trademarks and any licenses and other rights or interests thereunder or therein. Form 990, Part VI, Line 11b Review of form 990 by governing body The organization retains an independent tax advisor to assist management in the preparation and review of its IRS Form 990. Prior to filing the return, management and the independent tax advisor review the return and all required schedules with the Compensation Committee of the Board of Directors. The Compensation Committee is composed of independent directors of the Company. Upon completion of its review, the Compensation Committee recommends to the Executive Committee of the Board of Directors that management be authorized to sign and file the return. Under the Company's by laws the Executive Committee has the authority to take this action on behalf of the Board of Directors. A COMPLETE copy of the Form 990 is provided to the full board prior to filing with the IRS and the Executive Committee reports its activities to the Board of Directors on a quarterly basis. Form 990, Part VI, Line 12c Conflict of interest policy Annually, each officer, director and key employee signs an acknowledgement and disclosure form attesting that they have read the Conflict of Interest Policy and agreeing to comply fully with its terms and conditions during their services with Chapters Health System, Inc. (CHS) and Affiliates. They further agree that if, at any time subsequent to the submission of the disclosure form, they become aware of any actual or potential conflict of interest or the information previously submitted becomes inaccurate or incomplete, they will promptly notify the CHS Board of Directors, the President and CEO of Chapters Health System, Inc., and the Affiliate Board of Directors. DETERMINATION OF AND REMEDIES FOR CONFLICTS OF INTEREST 1. Disclosure. In connection with any actual or possible conflict of interest, an interested person must disclose the existence of his or her financial interest and must be given the opportunity to disclose all material facts to the Directors (and members of committees) considering the proposed transaction or arrangement. The disclosure shall be made as soon as practicable following the realization by the interested person that an actual or possible conflict of interest exists. Ordinarily, disclosures by interested persons should be to the Chairperson of the Board. When an actual or possible conflict of interest becomes apparent in the course of a Board meeting (or committee meeting), the interested person shall immediately disclose his or her financial interest and related material facts to the presiding Director or officer at such meeting. 2. Determining Whether a Conflict of Interest Exists. After disclosure of the financial interest and all material facts, and after any discussion with the interested person, the interested person shall leave the Board (or committee) meeting while the determination of a conflict of interest is discussed and voted upon. The remaining Board (or committee) members shall decide if a conflict of interest exists. 3. Procedures for Addressing the Conflict of Interest. (a) An interested person who has a conflict of interest may make a presentation at the Board (or committee) meeting, but after such presentation, he or she shall leave the meeting during the discussion of, and the vote on, the transaction or arrangement that result in the conflict of interest. The interested person who has a conflict of interest will not be counted as present for determining a majority with respect to the vote on the transaction or arrangement that results in the conflict of interest. (b) The Chairperson of the Board (or committee) shall, if appropriate, appoint a disinterested person or committee to investigate alternatives to the proposed transaction or arrangement. (c) After exercising due diligence, the Board (or Committee) shall determine whether CHS and Affiliates can obtain a more advantageous transaction or arrangement with reasonable efforts from a person or business entity that would not give rise to a conflict of interest. (d)If a more advantageous transaction or arrangement is not reasonably attainable under circumstances that would not give rise to a conflict of interest, the Board (or committee) shall determine by a majority vote of the disinterested Directors (or committee members) whether the transaction or arrangement is in the best interest of CHS and Affiliates and for its own benefit and whether the transaction is fair and reasonable to CHS and Affiliates and shall make its decision as to whether to enter into the transaction or arrangement in conformity with such determination. Violations of the Conflicts of Interest Policy (a) If the Board (or committee) has reasonable cause to believe that an interested person has failed to disclose actual or possible conflicts of interest, it shall inform the interested person of the basis for such belief and afford the interested person an opportunity to explain the alleged failure to disclose. (b) If, after hearing the response of the interested person and making such further investigation as may be warranted under the circumstances, the Board (or committee) determines that the interested person has in fact failed to disclose an actual or possible conflict of interest, it shall take such action as it determines to be appropriate, including corrective and disciplinary action. RECORD OF PROCEEDINGS The minutes of the Board (and each committee) shall contain: 1. The name of each person who disclosed or otherwise was found to have a financial interest in connection with an actual or possible conflict of interest, the nature of the financial interest, any action taken to determine whether a conflict of interest was present, and the Board's (or committee's) decision as to whether a conflict of interest in fact existed. 2. The names of the persons who were present for discussions and votes relating to the transaction or arrangement, the content of the discussion, including any alternatives to the proposed transaction or arrangement, and a record of any votes taken in connection therewith. PERIODIC REVIEWS To ensure that CHS and Affiliates operate in a manner consistent with their charitable purposes and that it does not engage in activities that could jeopardize their status as organizations exempt from federal income tax, periodic reviews shall be conducted. CHS and Affiliates may, but need not, use an outside advisor to conduct a periodic review. The periodic review shall include, at a minimum, the following subjects: 1. Whether compensation arrangements and benefits are reasonable and are the results of arm's-length bargaining. 2. Whether agreements to provide health care and agreements with other health care providers, employees and third party payers further the charitable purposes of CHS and Affiliates and do not result in private inurement or impermissible private benefit. Form 990, Part VI, Line 19 Required documents available to the public The Organization's Articles of Incorporation are filed with and viewable by the public at the official website of the Department of State, division of corporations. The organization's bylaws and conflict of interest policy are not made available to the public. Unaudited financial statements of the organization are filed and viewable by the public at the official website of the State, division of consumer services. In addition, the organization reports its financial performance each year in its annual report, copies of which are available to the public upon request. Form 990, Part IX, Line 11g Other Fees Contract Physician Services - Total Expense: 475849, Program Service Expense: 475849, Management and General Expenses: 0, Fundraising Expenses: 0; Contract Services - Nursing Home - Total Expense: 8684023, Program Service Expense: 8684023, Management and General Expenses: 0, Fundraising Expenses: 0; Contract Services - Labor - Total Expense: 3465846, Program Service Expense: 3443562, Management and General Expenses: 22284, Fundraising Expenses: 0; Contract Services - Consultant - Total Expense: 749570, Program Service Expense: 136715, Management and General Expenses: 483648, Fundraising Expenses: 129207; Contract Services - General Inpatient - Total Expense: 1655156, Program Service Expense: 1655156, Management and General Expenses: 0, Fundraising Expenses: 0; Contract Services - Other Patient Related - Total Expense: 602686, Program Service Expense: 588630, Management and General Expenses: 14056, Fundraising Expenses: 0; Contract Services - Other - Total Expense: 357535, Program Service Expense: 156278, Management and General Expenses: 198757, Fundraising Expenses: 2500; Contract Services - Care Navigation - Total Expense: 3508972, Program Service Expense: 3508972, Management and General Expenses: 0, Fundraising Expenses: 0; Form 990, Part XI, Line 9 Other changes in net assets or fund balances INHERENT CONTRIBUTION DUE TO AFFILIATION - 12946640; Note payable converted to consideration at affliation date - 7000000; CAPITAL PALLIATIVE CARE CONSULTANTS 12470 Telecom Drive Suite 301 Temple Terrace FL 33637 522361003 PALLIATIVE CARE VA 699271 5259713 CAPITAL HOSPICE Chapters Health System Inc 12470 Telecom Drive Suite 301 Temple Terrace FL 33637 592264957 Parent FL 501(c)(3) Type II NA false Chapters Health Foundation Inc 12470 Telecom Drive Suite 301 Temple Terrace FL 33637 593467282 Foundation FL 501(c)(3) 7 Chapters Health System Inc false Chapters Health Home Connect Inc 12470 Telecom Drive Suite 301 Temple Terrace FL 33637 275158323 Long term Care FL 501(c)(3) 10 Chapters Health System Inc false Cornerstone Hospice and Palliative Care Inc 12470 Telecom Drive Suite 301 Temple Terrace FL 33637 592330114 Hospice Care FL 501(c)(3) 10 Chapters Health System Inc false Cornerstone Health Services Inc 12470 Telecom Drive Suite 301 Temple Terrace FL 33637 611798762 Palliative Care FL 501(c)(3) 10 Chapters Health System Inc false Good Shepherd Hospice Inc 12470 Telecom Drive Suite 301 Temple Terrace FL 33637 205276923 Hospice Care FL 501(c)(3) 10 Chapters Health System Inc false Hernando Pasco Hospice Inc 12470 Telecom Drive Suite 301 Temple Terrace FL 33637 592217929 Hospice Care FL 501(c)(3) 10 Chapters Health System Inc false Hospice of Okeechobee Inc 12470 Telecom Drive Suite 301 Temple Terrace FL 33637 592831397 Hospice Care FL 501(c)(3) 7 Chapters Health System Inc false Lifepath Hospice Inc 12470 Telecom Drive Suite 301 Temple Terrace FL 33637 205276870 Hospice Care FL 501(c)(3) 10 Chapters Health System Inc false Capital Caring Health 12470 Telecom Drive Suite 301 Temple Terrace FL 33637 843773372 Medical Support Services VA 501(c)(3) Type III-FI Chapters Health System Inc false Capital Caring Advanced Illness Services Inc 12470 Telecom Drive Suite 301 Temple Terrace FL 33637 843787656 Illness, Palliative and Primary Care Services VA 501(c)(3) 10 Capital Caring Health false Capital Caring Stay at Home Services Inc 12470 Telecom Drive Suite 301 Temple Terrace FL 33637 843797085 At home medical services VA 501(c)(3) 7 Capital Caring Health false Hope Hospice and Community Services Inc 12470 Telecom Drive Suite 301 Temple Terrace FL 33637 592128697 Hospice Care FL 501(c)(3) 7 Chapters Health System Inc false Visiting Nurses Association of SW Florida Inc 12470 Telecom Drive Suite 301 Temple Terrace FL 33637 596175593 Medical Support Services FL 501(c)(3) 10 Hope Hospice & Community Services Inc false ADVANCED ILLNESS PARTNERS LLC 3180 FAIRVIEW PARK DRIVE SUITE 500 FALLS CHURCH VA 22042 853613085 MEDICARE DIRECT CONTRACTED MEDICAL SERVICES DE NA N/A false false Assurity DCE LLC 3535 Little Road Trinity FL 34655 850951162 Medical Services FL NA N/A false false Chapters CareNu Inc 12470 Telecom Drive Suite 301 Temple Terrace FL 33637 850850926 Population Health FL NA C Corporation false SECUR Inc 4200 West Cypress Street Suite 690 Tampa FL 33607 881837830 Licensed Health Plan FL NA C Corporation false false false true false true false false false false false false true true true true false false true true