HOSPICE OF CLEVELAND COUNTY INC: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- HOSPICE OF CLEVELAND COUNTY INC (EIN 56-1452373)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-11-08
- IRS object ID
- 202433139349301993
- Schema version
- 2023v5.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-11-08T10:55:23-06:00 | ReturnTs |
| Tax Period End | 2023-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 882730877 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHERRY BEKAERT ADVISORY LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 METROPOLITAN AVE STE 900 | AddressLine1Txt |
| City | CHARLOTTE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561452373 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE OF CLEVELAND COUNTY INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HOSP | BusinessNameControlTxt |
| Phone | 7044874677 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 951 WENDOVER HEIGHTS DRIVE | AddressLine1Txt |
| City | SHELBY | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 281503565 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PETER A BRUNNICK | PersonNm |
| Person Title | PRESIDENT/CEO | PersonTitleTxt |
| Phone | 7043750100 | PhoneNum |
| Signature | 2024-11-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MELANIE MCPEAK | PreparerPersonNm |
| PTIN | P01346034 | PTIN |
| Phone | 7043771678 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2024-10-15 13:58:12Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE CLEVELAND COUNTY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PETER A BRUNNICK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 470408 | AddressLine1Txt |
| City | CHARLOTTE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28247 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $18,320,665 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HOSPICECARES.CC | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF HOSPICE CLEVELAND COUNTY IS TO RELIEVE SUFFERING AND IMPROVE THE QUALITY AND DIGNITY OF LIFE THROUGH COMPASSIONATE HOSPICE CARE FOR THOSE AT THE END OF LIFE, PALLIATIVE CARE FOR THOSE WITH ADVANCED ILLNESS, AND THROUGH COMMUNITY EDUCATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 20 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 20 | VotingMembersIndependentCnt |
| Total Employee | 187 | TotalEmployeeCnt |
| Total Volunteers | 78 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,449,958 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,142,836 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $13,455,189 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $16,610,629 | CYProgramServiceRevenueAmt |
| PY Investment Income | $7,560 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,935 | CYInvestmentIncomeAmt |
| PY Other Revenue | $44,603 | PYOtherRevenueAmt |
| CY Other Revenue | $192,619 | CYOtherRevenueAmt |
| PY Total Revenue | $14,957,310 | PYTotalRevenueAmt |
| CY Total Revenue | $17,948,019 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,896,927 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,140,420 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $440,068 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,742,311 | PYOtherExpensesAmt |
| CY Other Expenses | $7,550,697 | CYOtherExpensesAmt |
| PY Total Expenses | $15,639,238 | PYTotalExpensesAmt |
| CY Total Expenses | $18,691,117 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$681,928 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$743,098 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $12,781,106 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,119,547 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,385,514 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,467,053 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $10,395,592 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,652,494 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF HOSPICE CLEVELAND COUNTY IS TO RELIEVE SUFFERING AND IMPROVE THE QUALITY AND DIGNITY OF LIFE THROUGH COMPASSIONATE HOSPICE CARE FOR THOSE AT THE END OF LIFE, PALLIATIVE CARE FOR THOSE WITH ADVANCED ILLNESS, AND THROUGH COMMUNITY EDUCATION. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $12,907,063 | ExpenseAmt |
| Revenue | $13,812,164 | RevenueAmt |
| Desc | HOSPICE CLEVELAND COUNTY PROVIDES HOSPICE CARE IN A HOMECARE SETTING THAT CONSISTS OF COMPREHENSIVE END OF LIFE CARE FOR TERMINALLY ILL PATIENTS AND THEIR FAMILIES DURING THE FINAL STAGES OF ILLNESS. HOME HOSPICE CARE IS PROVIDED IN A PATIENT'S PRIVATE RESIDENCE, NURSING FACILITY, OR HOSPITAL. AS A NOT-FOR-PROFIT ORGANIZATION, HOME HOSPICE CARE IS PROVIDED REGARDLESS OF A PATIENT'S INSURANCE STATUS OR ABILITY TO PAY. THESE HOME HOSPICE CARE SERVICES INCLUDE AN INTERDISPLINARY TEAM THAT IS MADE UP OF NURSING CARE, PHYSICIAN VISITS, SOCIAL WORK AND CHAPLAIN SERVICES. IN ADDITION, ANCILLARY SERVICES AND BEREAVEMENT SUPPORT ARE PROVIDED TO THE PATIENT'S FAMILY AFTER THE PATIENT'S DEATH. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,470,708 | ExpenseAmt |
| Revenue | $2,566,941 | RevenueAmt |
| Desc | HOSPICE CLEVELAND COUNTY OPERATES TWO HOSPICE HOUSES THAT PROVIDE HOSPICE INPATIENT AND RESIDENTIAL CARE FOR TERMINALLY ILL PATIENTS DURING THE FINAL STAGES OF ILLNESS. THE WENDOVER HOSPICE HOUSE HAS 16 BEDS AND THE TESTA FAMILY HOSPICE HOUSE HAS 8 BEDS. THESE HOSPICE HOUSE CARE SERVICES INCLUDE AN INTERDISCIPLINARY TEAM THAT IS MADE UP OF NURSING CARE, PHYSICIAN VISITS, SOCIAL WORK, AND CHAPLAIN SERVICES. IN ADDITION, ANCILLARY SERVICES AND BEREAVEMENT SUPPORT ARE PROVIDED TO THE PATIENT'S FAMILIES AFTER THE PATIENT'S DEATH. AS A NOT-FOR-PROFIT ORGANIZATION, HOSPICE CARE IS PROVIDED IN THE ORGANIZATION'S HOSPICE HOUSES REGARDLESS OF A PATIENT'S INSURANCE SOURCE OR ABILITY TO PAY. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $708,178 | ExpenseAmt |
| Revenue | $231,524 | RevenueAmt |
| Desc | PALLIATIVE CARE CLEVELAND COUNTY PROVIDES A PROGRAM OF PAIN CONTROL, SYMPTOM MANAGEMENT, AND ASSISTANCE WITH DIFFICULT DECISION MAKING FOR PATIENTS WHO MAY NOT YET BE ELIGIBLE FOR COMPREHENSIVE HOSPICE CARE SERVICES. PALLIATIVE CARE SERVICES ARE OFFERED IN A PATIENT'S PRIVATE RESIDENCE, NURSING FACILITY, OR HOSPITAL. AS A NOT-FOR-PROFIT ORGANIZATION, THESE SERVICES ARE PROVIDED TO PATIENTS REGARDLESS OF THEIR INSURANCE SOURCE OR ABILITY TO PAY. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $17,085,949 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 65 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 187 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 20 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 20 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NC | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PETER A BRUNNICK | PersonNm |
| Phone | 7043750100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 470408 | AddressLine1Txt |
| City | CHARLOTTE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28247 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (32 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JOHN A MORRICE | ||||||||
| BOARD CHAIR | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LAURA ENGEL | ||||||||
| VICE CHAIR AT LARGE | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JANE B NEESE | ||||||||
| VICE CHAIR AT LARGE | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JEFFREY G GORE | ||||||||
| VICE CHAIR | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ALAN R THALINGER | ||||||||
| VICE CHAIR | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GREGORY R KILPATRICK | ||||||||
| SECRETARY | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MICHAEL A MCNAMARA | ||||||||
| TREASURER | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RICHARD BATTLE | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| HEATHER G CARSON | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| SHERYL CHAPMAN | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| PATRICK FLETCHER | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| GREGORY GRIER | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID H JONES | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| COLLIE LEHN | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| BRYAN R MIDURA | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MEREDITH PINSON | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL I ROSE | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ASHLEY LOVE SUMRALL | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JOSEPH TYSINGER | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JONATHAN WEATHERS | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MYRA MCGINNIS | ||||||||
| HCC PRESIDENT | 40.00 | 0.00 | Yes (X) | $194,303 | $0 | $10,438 | ||
| PETER BRUNNICK | ||||||||
| PRESIDENT & CEO | 1.00 | 41.00 | Yes (X) | $0 | $723,112 | $14,965 | ||
| MICHAEL BOLEWITZ | ||||||||
| CHIEF OPERATING OFFICER | 1.00 | 41.00 | Yes (X) | $0 | $455,796 | $0 | ||
| PETE DAVIES | ||||||||
| CHIEF INFORMATION OFFICER | 1.00 | 41.00 | Yes (X) | $0 | $253,536 | $26,542 | ||
| TODD FONTENOT | ||||||||
| CHIEF FINANCIAL OFFICER | 1.00 | 41.00 | Yes (X) | $0 | $441,376 | $27,244 | ||
| DEAN FORMAN | ||||||||
| CHIEF STRATEGY OFFICER | 1.00 | 41.00 | Yes (X) | $0 | $132,821 | $3,968 | ||
| BRIDGET HILLER | ||||||||
| CHIEF MEDICAL OFFICER | 1.00 | 41.00 | Yes (X) | $0 | $394,706 | $27,957 | ||
| DONNIELLE L GREEN | ||||||||
| MEDICAL DIRECTOR | 40.00 | 0.00 | $194,034 | $0 | $11,708 | Yes (X) | ||
| KRISTY SUTTLE | ||||||||
| NURSE PRACTITIONER | 40.00 | 0.00 | $113,475 | $0 | $17,027 | Yes (X) | ||
| ELIZABETH WEAVER NEWTON | ||||||||
| NURSE PRACTITIONER | 40.00 | 0.00 | $119,530 | $0 | $2,314 | Yes (X) | ||
| ERIC WAYNE PARKER | ||||||||
| NURSE PRACTITIONER | 40.00 | 0.00 | $124,658 | $0 | $18,439 | Yes (X) | ||
| BETH SCISM | ||||||||
| NURSE PRACTITIONER | 40.00 | 0.00 | $122,961 | $0 | $9,067 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $868,961 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,401,347 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $169,669 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $19,145 | FundraisingAmt |
| All Other Contributions | $1,123,691 | AllOtherContributionsAmt |
| Noncash Contributions | $367,827 | NoncashContributionsAmt |
| Total Contributions | $1,142,836 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 621610 | BusinessCd |
| Total Revenue Column | $16,610,629 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,610,629 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $16,610,629 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,935 | TotalRevenueColumnAmt |
| Exclusion | $1,935 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $20,590 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $19,145 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $8,461 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,129 | TotalRevenueColumnAmt |
| Exclusion | $12,129 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $371,109 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $364,185 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,924 | TotalRevenueColumnAmt |
| Exclusion | $6,924 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $173,566 | TotalRevenueColumnAmt |
| Exclusion | $173,566 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $173,566 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,948,019 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,610,629 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $194,554 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $204,742 | TotalAmt |
| Management And General | $204,742 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,919,944 | TotalAmt |
| Program Services | $8,372,944 | ProgramServicesAmt |
| Management And General | $288,931 | ManagementAndGeneralAmt |
| Fundraising | $258,069 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $128,174 | TotalAmt |
| Program Services | $114,888 | ProgramServicesAmt |
| Management And General | $9,025 | ManagementAndGeneralAmt |
| Fundraising | $4,261 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,232,517 | TotalAmt |
| Program Services | $1,131,925 | ProgramServicesAmt |
| Management And General | $48,469 | ManagementAndGeneralAmt |
| Fundraising | $52,123 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $655,043 | TotalAmt |
| Program Services | $600,355 | ProgramServicesAmt |
| Management And General | $36,161 | ManagementAndGeneralAmt |
| Fundraising | $18,527 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $115,129 | TotalAmt |
| Management And General | $115,129 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,114 | TotalAmt |
| Management And General | $88,114 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $206,271 | TotalAmt |
| Program Services | $125,539 | ProgramServicesAmt |
| Management And General | $64,731 | ManagementAndGeneralAmt |
| Fundraising | $16,001 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,117 | TotalAmt |
| Program Services | $41,117 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $791,535 | TotalAmt |
| Program Services | $598,729 | ProgramServicesAmt |
| Management And General | $108,856 | ManagementAndGeneralAmt |
| Fundraising | $83,950 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $291,455 | TotalAmt |
| Program Services | $264,142 | ProgramServicesAmt |
| Management And General | $26,577 | ManagementAndGeneralAmt |
| Fundraising | $736 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $329,507 | TotalAmt |
| Program Services | $208,619 | ProgramServicesAmt |
| Management And General | $117,661 | ManagementAndGeneralAmt |
| Fundraising | $3,227 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,588 | TotalAmt |
| Program Services | $19,009 | ProgramServicesAmt |
| Management And General | $34,197 | ManagementAndGeneralAmt |
| Fundraising | $2,382 | FundraisingAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PATIENT ANCILLARY EXPEN | $5,329,236 | $5,329,236 | |
| BAD DEBT | $130,667 | $130,667 | |
| DEVELOPMENT EXPENSES | $3,582 | $526 | $3,056 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,496 | TotalAmt |
| Program Services | $148,253 | ProgramServicesAmt |
| Management And General | $19,451 | ManagementAndGeneralAmt |
| Fundraising | $792 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,691,117 | TotalAmt |
| Program Services | $17,085,949 | ProgramServicesAmt |
| Management And General | $1,165,100 | ManagementAndGeneralAmt |
| Fundraising | $440,068 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,686 | BOYAmt |
| EOY | $5,347 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,133,058 | BOYAmt |
| EOY | $3,277,829 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $238,813 | BOYAmt |
| EOY | $325,365 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,736,173 | BOYAmt |
| EOY | $2,283,012 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,992 | BOYAmt |
| EOY | $65,750 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,605 | BOYAmt |
| EOY | $7,730 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,800,094 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,113,985 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,772,440 | BOYAmt |
| EOY | $5,686,109 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $846,339 | BOYAmt |
| EOY | $468,405 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,781,106 | BOYAmt |
| EOY | $12,119,547 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,168,114 | BOYAmt |
| EOY | $1,475,115 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,217,400 | BOYAmt |
| EOY | $991,938 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,385,514 | BOYAmt |
| EOY | $2,467,053 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,167,038 | BOYAmt |
| EOY | $8,855,455 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,228,554 | BOYAmt |
| EOY | $797,039 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,395,592 | BOYAmt |
| EOY | $9,652,494 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,781,106 | BOYAmt |
| EOY | $12,119,547 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$743,098 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $689,043 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $963,951 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $944,260 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,449,958 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,142,036 | CurrentTaxYearAmt |
| Total | $5,189,248 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $689,043 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $963,951 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $944,260 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,449,958 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,142,036 | CurrentTaxYearAmt |
| Total | $5,189,248 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $5,189,248 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $665,906 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $360,400 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,030 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,560 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,935 | CurrentTaxYearAmt |
| Total | $1,050,831 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,601 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year | $12,929 | CurrentTaxYearAmt |
| Total | $23,530 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,831 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $493 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus1 Year | $49,213 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $173,566 | CurrentTaxYearAmt |
| Total | $225,103 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $6,488,712 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $68,523,264 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.79970 | PublicSupportCY170Pct |
| Public Support PY170 | 0.73380 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $317,000 | OtherCostOrOtherBasisAmt |
| Book Value | $317,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,159,652 | OtherCostOrOtherBasisAmt |
| Depreciation | $517,461 | DepreciationAmt |
| Book Value | $4,642,191 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,010,288 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,494,246 | DepreciationAmt |
| Book Value | $516,042 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $313,154 | OtherCostOrOtherBasisAmt |
| Depreciation | $102,278 | DepreciationAmt |
| Book Value | $210,876 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,686,109 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATE | $869,996 |
| OPERATING LEASE OBLIGATION | $121,942 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $991,938 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | MANAGEMENT HAS EVALUATED THE EFFECT OF FASB GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES IN AN ENTITY'S CONSOLIDATED FINANCIAL STATEMENTS BY PRESCRIBING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE ORGANIZATION'S POLICY IS TO RECORD A LIABILITY FOR ANY TAX POSITION TAKEN THAT IS BENEFICIAL TO THE ORGANIZATION, INCLUDING ANY RELATED INTEREST AND PENALTIES, WHEN IT IS MORE LIKELY THAN NOT THE POSITION TAKEN BY MANAGEMENT WITH RESPECT TO A TRANSACTION OR CLASS OF TRANSACTIONS WILL BE OVERTURNED BY A TAXING AUTHORITY UPON EXAMINATION. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | CHICKEN DINNER | Event1Nm |
| Gross Receipts Event1 | $27,682 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $12,975 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $14,707 | GrossRevenueEvent1Amt |
| Food And Beverage Event1 | $5,883 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $2,256 | OtherDirectExpensesEvent1Amt |
| Event2 | LIGHT THE WAY | Event2Nm |
| Gross Receipts Event2 | $6,170 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $6,170 | CharitableContriEvent2Amt |
| Other Direct Expenses Event2 | $322 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $33,852 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $19,145 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $14,707 | GrossRevenueTotalEventsAmt |
| Food And Beverage Total Events | $5,883 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $2,578 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $8,461 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $6,246 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PETER BRUNNICK | ||||||||||||||
| PRESIDENT & CEO | $0 | $548,017 | $0 | $173,487 | $0 | $1,608 | $0 | $0 | $0 | $14,965 | $0 | $738,077 | $0 | $0 |
| TODD FONTENOT | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $0 | $337,486 | $0 | $102,282 | $0 | $1,608 | $0 | $0 | $0 | $27,244 | $0 | $468,620 | $0 | $0 |
| MICHAEL BOLEWITZ | ||||||||||||||
| CHIEF OPERATING OFFICER | $0 | $350,962 | $0 | $103,226 | $0 | $1,608 | $0 | $0 | $0 | $0 | $0 | $455,796 | $0 | $0 |
| BRIDGET HILLER | ||||||||||||||
| CHIEF MEDICAL OFFICER | $0 | $338,298 | $0 | $54,750 | $0 | $1,658 | $0 | $5,513 | $0 | $22,444 | $0 | $422,663 | $0 | $0 |
| PETE DAVIES | ||||||||||||||
| CHIEF INFORMATION OFFICER | $0 | $199,741 | $0 | $52,647 | $0 | $1,148 | $0 | $0 | $0 | $26,542 | $0 | $280,078 | $0 | $0 |
| DONNIELLE L GREEN | ||||||||||||||
| MEDICAL DIRECTOR | $193,434 | $0 | $600 | $0 | $0 | $0 | $0 | $0 | $11,708 | $0 | $205,742 | $0 | $0 | $0 |
| MYRA MCGINNIS | ||||||||||||||
| HCC PRESIDENT | $190,808 | $0 | $506 | $0 | $2,989 | $0 | $0 | $0 | $10,438 | $0 | $204,741 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | BONUS PAYMENTS ARE BASED ON THE EVALUATION OF THE YEAR'S ACCOMPLISHMENTS AND DEGREE OF COMPLETION OF A COMMONLY AGREED UPON SET OF GOALS. THE EVALUATION OF EXECUTIVES' PERFORMANCE AND DETERMINATION OF BONUS PAYMENT IS MADE BY THE PRESIDENT/CEO AND VP OF HUMAN RESOURCES. | ExplanationTxt |
Schedule M IRS990ScheduleM
Books And Publications BooksAndPublicationsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $13,219 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | SALES PROCEEDS | MethodOfDeterminingRevenuesTxt |
Clothing And Household Goods ClothingAndHouseholdGoodsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $350,966 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | SALES PROCEEDS | MethodOfDeterminingRevenuesTxt |
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $205 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | PROGRAM SUPPLIES | Desc |
| Contribution | 24 | ContributionCnt |
| Noncash Contributions Rpt F990 | $3,437 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION'S SOLE MEMBER IS HOSPICE & PALLIATIVE CARE CHARLOTTE REGION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF DIRECTORS OF THE ORGANIZATION SHALL AT ALL TIMES BE COMPRISED ONLY OF THE INDIVIDUALS THEN SERVING AS MEMBERS OF THE BOARD OF DIRECTORS OF THE SOLE MEMBER, HOSPICE & PALLIATIVE CARE CHARLOTTE REGION. |
| FORM 990, PART VI, SECTION A, LINE 7B | AMENDMENTS TO THE BYLAWS MAY ONLY BE MADE BY A MAJORITY VOTE OF THE BOARD OF DIRECTORS OF THE SOLE MEMBER, HOSPICE & PALLIATIVE CARE CHARLOTTE REGION. NO LOANS SHALL BE CONTRACTED ON BEHALF OF THE ORGANIZATION AND NO INDEBTEDNESS SHALL BE ISSUED IN ITS NAME UNLESS AUTHORIZED BY A RESOLUTION OF THE BOARD OF DIRECTORS OF THE SOLE MEMBER, HOSPICE & PALLIATIVE CARE CHARLOTTE REGION. |
| FORM 990, PART VI, SECTION B, LINE 11B | BEFORE SUBMITTING THE FORM 990 TO THE IRS, THE ORGANIZATION EMAILS THE FINAL COPY OF THE FORM 990, INCLUDING ALL REQUIRED SCHEDULES, TO ALL VOTING MEMBERS OF THE GOVERNING BODY. THE FINANCE COMMITTEE MAKES A FULL REVIEW OF THE PREPARED RETURN. ANY COMMENTS OR QUESTIONS REGARDING THE RETURN ARE DISCUSSED AT THE NEXT SCHEDULED MEETING OF THE FULL BOARD. THE BOARD CHAIR, OR DESIGNEE, IS RESPONSIBLE FOR FACILITATING THE REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 12C | WHEN A POTENTIAL CONFLICT OF INTEREST IS IDENTIFIED, THE CONFLICT WILL BE RESOLVED BY EITHER THE BOARD OF DIRECTOR'S EXECUTIVE COMMITTEE, WHEN A BOARD MEMBER IS INVOLVED, OR BY THE CEO AND THE VICE PRESIDENT OF HUMAN RESOURCES WHEN THE CONFLICT INVOLVES AN EMPLOYEE. IN EACH CASE, A MEETING WILL BE CALLED WITH THE INDIVIDUAL WITH THE POTENTIAL CONFLICT AND THE PARTIES WILL REACH A MUTUALLY AGREED UPON RESOLUTION. IF A CONFLICT OF INTEREST CANNOT BE RESOLVED TO THE SATISFACTION OF BOTH PARTIES, OR IF THERE IS A FAILURE TO COMPLY WITH THE CONFLICT OF INTEREST POLICY, THEN ACTIONS NECESSARY TO ELIMINATE THE CONFLICT OF INTEREST WILL BE TAKEN, UP TO AND INCLUDING THE RESIGNATION OF EITHER THE BOARD MEMBER OR EMPLOYEE. NO BOARD MEMBER OR COMMITTEE MEMBER WILL BE PERMITTED TO BE PRESENT FOR DISCUSSION OF, OR BE PERMITTED TO VOTE ON, ANY SPECIFIC ISSUE IN WHICH HE OR SHE HAS A CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | KEY PERSONNEL IN SUPPORT OF THE ORGANIZATION ARE EMPLOYEES OF A RELATED ORGANIZATION, HOSPICE & PALLIATIVE CARE CHARLOTTE REGION, AND ARE SUBJECT TO COMPENSATION, CLASSIFICATION AND ALL OTHER PERSONNEL POLICIES OF THAT ORGANIZATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC ON A REQUEST BASIS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| HOSPICE & PALLIATIVE CARE CHARLOTTE REGION | |||||||||||
| PO BOX 470408 | CHARLOTTE | NC | 28247 | 561219017 | HOSPICE CARE | NC | 501(C)(3) | LINE 7 | N/A | 0 | |
| HOSPICE OF LAURENS COUNTY | |||||||||||
| PO BOX 470408 | CHARLOTTE | NC | 28247 | 570843527 | HOSPICE CARE | SC | 501(C)(3) | LINE 7 | 0 | HOSPICE & PALLIATIVE CARE CHARLOTTE REGION | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
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