COVENANT HOSPICE INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
COVENANT HOSPICE INC (EIN 59-2208300)
Tax period
2021-01-01 to 2021-12-31
Filed
2023-02-14
IRS object ID
202300459349300245
Schema version
2021v4.2
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 ReturnHeader

FieldValueIRS element (for citing)
Return2023-02-14T09:52:24-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN592922169PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1SALTMARSH CLEAVELAND AND GUNDBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1900 NORTH 12TH AVENUEAddressLine1Txt
CityPENSACOLACityNm
State AbbreviationFLStateAbbreviationCd
ZIP32501ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN592208300EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COVENANT HOSPICE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOVEBusinessNameControlTxt
Phone8504332155PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15041 N 12TH AVEAddressLine1Txt
CityPENSACOLACityNm
State AbbreviationFLStateAbbreviationCd
ZIP32504ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonROLAND CLENEAYPersonNm
Person TitleCFOPersonTitleTxt
Phone8504332155PhoneNum
Signature2023-02-10SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstROLANDPersonFirstNm
Person LastCLENEAYPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonALLISON JONES CPAPreparerPersonNm
PTINP02434475PTIN
Phone8504358300PhoneNum
Preparation2023-02-01PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-03-07 01:45:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJEFF MISLEVYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line15041 N 12TH AVEAddressLine1Txt
CityPENSACOLACityNm
State AbbreviationFLStateAbbreviationCd
ZIP32504ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$101,132,237GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CHOOSECOVENANT.ORG/HOSPICEWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1981FormationYr
Legal Domicile StateFLLegalDomicileStateCd
Activity Or MissionCOVENANT HOSPICE IS DEDICATED TO PROVIDING COMPREHENSIVE, COMPASSIONATE SERVICES (SEE SCHEDULE O) (CONTINUATION FROM PART I, LINE 1) TO PATIENTS AND THEIR LOVED ONES DURING TIMES OF LIFE-LIMITING ILLNESSES.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee495TotalEmployeeCnt
Total Volunteers377TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,501,366PYContributionsGrantsAmt
CY Contributions Grants$684,583CYContributionsGrantsAmt
PY Program Service Revenue$54,415,040PYProgramServiceRevenueAmt
CY Program Service Revenue$59,063,943CYProgramServiceRevenueAmt
PY Investment Income$1,464,824PYInvestmentIncomeAmt
CY Investment Income$3,980,151CYInvestmentIncomeAmt
PY Other Revenue$880,186PYOtherRevenueAmt
CY Other Revenue$1,048,495CYOtherRevenueAmt
PY Total Revenue$60,261,416PYTotalRevenueAmt
CY Total Revenue$64,777,172CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$22,673,167PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$22,841,559CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$30,505,862PYOtherExpensesAmt
CY Other Expenses$31,068,345CYOtherExpensesAmt
PY Total Expenses$53,179,029PYTotalExpensesAmt
CY Total Expenses$53,909,904CYTotalExpensesAmt
PY Revenues Less Expenses$7,082,387PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$10,867,268CYRevenuesLessExpensesAmt
Total Assets BOY$76,995,394TotalAssetsBOYAmt
Total Assets EOY$77,009,702TotalAssetsEOYAmt
Total Liabilities BOY$28,526,892TotalLiabilitiesBOYAmt
Total Liabilities EOY$19,364,640TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$48,468,502NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$57,645,062NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionCOVENANT HOSPICE IS DEDICATED TO PROVIDING COMPREHENSIVE, COMPASSIONATE SERVICES TO PATIENTS AND THEIR LOVED ONES DURING TIMES OF LIFE-LIMITING ILLNESSES. SINCE DYING IS A PART OF THE NORMAL PROCESS OF LIFE, THE FOCUS OF COVENANT HOSPICE (SEE SCHEDULE O) (CONTINUATION FROM PART III, LINE 1) IS TO ENABLE OUR PATIENTS TO LIVE AS FULLY AND COMFORTABLY AS POSSIBLE, TO PROVIDE DIGNIFIED PALLIATIVE CARE, TO ASSIST PATIENT'S LOVED ONES IN COPING WITH END-OF-LIFE ISSUES, AND TO IMPROVE CARE FOR ALL PATIENTS AT THE END OF THEIR LIVES BY EXAMPLE AND EDUCATION. FOR 2021, THE ORGANIZATION PROVIDED $976,412 OF CHARITY CARE TO PATIENTS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$33,657,040ExpenseAmt
Revenue$59,063,943RevenueAmt
DescDURING 2021, DIRECT CARE WAS PROVIDED TO 5,643 PATIENTS IN NORTHWEST FLORIDA AND SOUTH ALABAMA. COVENANT HOSPICE, INC. ALSO OFFERS A PREDIATRIC PALLIATIVE CARE PROGRAM. "PARTNERS IN CARE: TOGETHER FOR KIDS", TO CHILDREN FROM BIRTH TO AGE 21 WHO ARE COPING WITH POTENTIALLY LIFE-LIMITING CONDITIONS.Desc
Total Program Service Expenses$33,657,040TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document192IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee495EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ROLAND CLENEAYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8504332155PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15401 N 12TH AVEAddressLine1Txt
CityPENSACOLACityNm
State AbbreviationFLStateAbbreviationCd
ZIP32504ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
TOM OWENS
PAST CHAIR4.0012.00Yes (X)Yes (X)$0$0$0
RODNEY GUTMAN
CHAIRMAN4.0012.00Yes (X)Yes (X)$0$0$0
BRETT PARRA
SECRETARY4.0012.00Yes (X)Yes (X)$0$0$0
JEFFREY M MISLEVY
PRESIDENT/CEO40.0016.00Yes (X)Yes (X)$0$833,778$39,643
JAMES JAMIE CAMPBELL
DIRECTOR4.004.00Yes (X)$0$0$0
KENT SKOLROOD
DIRECTOR4.004.00Yes (X)$0$0$0
MILLER CALDWELL
BOARD MEMBER4.004.00Yes (X)$0$0$0
DON HAFERKAMP
BOARD MEMBER4.004.00Yes (X)$0$0$0
PETER JENNINGS
BOARD MEMBER4.004.00Yes (X)$0$0$0
STEVEN SARROS
BOARD MEMBER4.004.00Yes (X)$0$0$0
ROLAND CLENEAY
TREASURER, CFO40.0012.00Yes (X)Yes (X)$0$144,361$17,738
ODIN BERG
CSO40.0016.00Yes (X)$0$290,860$26,014
TODD FISHER
COO40.0012.00Yes (X)$0$369,369$37,011
JAMES SMITH
PHYSICIAN40.00$146,763$0$18,309Yes (X)
SAUL RODRIGUEZ
PHYSICIAN40.00$248,238$0$70Yes (X)
RICK HARRELSON
PHYSICIAN40.00$215,845$0$4,961Yes (X)
STEPHEN DILL
PHYSICIAN40.00$193,686$0$4,841Yes (X)
JANET DAVIS
PHYSICIAN40.00$177,697$0$70Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$982,229TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,638,368TotReportableCompRltdOrgAmt
Total Other Compensation$148,657TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K20IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ENCLARA PHARMECIA
PO BOX 745791ATLANTAGA30374PATIENT DRUGS$1,570,693
QUALIS MANAGEMENT
PO BOX 7458RIOCKY MOUNTNC27804DME$1,554,234
ASCENSUS TRUST RETIREMENT PLAN
PO BOX 36472NEWARKNJ07188RETIREMENT$1,128,687
APPLEYARD AGENCY
4400 BAYOU BLVDPENSACOLAFL32503ADVERTISING$915,835
MEDLINE INDUSTRIES
DEPT CH 14400PALATINEIL60055PATIENT MEDICAL SUPPLIES$839,804
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K95CntrctRcvdGreaterThan100KCnt
Related Organizations$381,496RelatedOrganizationsAmt
Government Grants$303,087GovernmentGrantsAmt
Total Contributions$684,583TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICESDesc
Business621610BusinessCd
Total Revenue Column$59,063,943TotalRevenueColumnAmt
Related Or Exempt Func Income$59,063,943RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$59,063,943TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$299,966TotalRevenueColumnAmt
Exclusion$299,966ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$723,993RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$95,475RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$628,518RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$628,518TotalRevenueColumnAmt
Exclusion$628,518ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$39,939,775SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$36,259,590SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$3,680,185SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,680,185TotalRevenueColumnAmt
Exclusion$3,680,185ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
PURCHASE CARD REBATE & OTHER900099$431,972$431,972
MISCELLANEOUS INCOME900099-$11,995-$11,995
FieldValueIRS element (for citing)
Other Revenue Total$419,977OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$64,777,172TotalRevenueColumnAmt
Related Or Exempt Func Income$59,063,943RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$5,028,646ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$18,779,448TotalAmt
Program Services$15,500,621ProgramServicesAmt
Management And General$3,278,827ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$71,187TotalAmt
Program Services$54,986ProgramServicesAmt
Management And General$16,201ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,996,413TotalAmt
Program Services$1,562,894ProgramServicesAmt
Management And General$433,519ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,994,511TotalAmt
Program Services$1,677,642ProgramServicesAmt
Management And General$316,869ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$41,211TotalAmt
Management And General$41,211ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$37,970TotalAmt
Management And General$37,970ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$33,825TotalAmt
Management And General$33,825ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$284,196TotalAmt
Management And General$284,196ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$39,019TotalAmt
Management And General$39,019ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,204,975TotalAmt
Management And General$2,204,975ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,685,163TotalAmt
Management And General$1,685,163ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,001,244TotalAmt
Program Services$839,299ProgramServicesAmt
Management And General$161,945ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$61,605TotalAmt
Management And General$61,605ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$222,577TotalAmt
Management And General$222,577ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,428,077TotalAmt
Management And General$1,428,077ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$478,467TotalAmt
Management And General$478,467ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmt
SALARY ALLOCATION$9,368,916$9,368,916
ROOM & BOARD$8,258,646$8,258,646
MEDICATION AND MEDICAL$4,103,889$4,103,889
LAB SERVICES AND TREATM$1,123,732$159,502$964,230

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$694,833TotalAmt
Program Services$694,833ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$53,909,904TotalAmt
Program Services$33,657,040ProgramServicesAmt
Management And General$20,252,864ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$9,932BOYAmt
EOY$10,084EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$7,414,006BOYAmt
EOY$3,171,068EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,535,869BOYAmt
EOY$3,532,162EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$13,245,507BOYAmt
EOY$16,623,136EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$83,687BOYAmt
EOY$70,822EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$718,221BOYAmt
EOY$1,232,663EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$30,425,116LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$16,972,629LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$14,730,967BOYAmt
EOY$13,452,487EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$20,206,607BOYAmt
EOY$11,943,496EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$302,000BOYAmt
EOY$268,708EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$16,748,598BOYAmt
EOY$26,705,076EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$76,995,394BOYAmt
EOY$77,009,702EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$17,620,241BOYAmt
EOY$11,911,149EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$50,643BOYAmt
EOY$50,643EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,439,739BOYAmt
EOY$3,013,046EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$6,444,721BOYAmt
EOY$4,389,802EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$971,548BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$28,526,892BOYAmt
EOY$19,364,640EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$44,922,682BOYAmt
EOY$54,103,014EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,545,820BOYAmt
EOY$3,542,048EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$48,468,502BOYAmt
EOY$57,645,062EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$76,995,394BOYAmt
EOY$77,009,702EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$10,867,268ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$1,697,995NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$7,287OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$1,667CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$283,756CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,501,366CurrentTaxYearMinus1YearAmt
Current Tax Year$684,583CurrentTaxYearAmt
Total$4,471,372TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$52,856,065CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$54,415,040CurrentTaxYearMinus1YearAmt
Current Tax Year$59,063,943CurrentTaxYearAmt
Total$166,335,048TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$1,667CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$53,139,821CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$57,916,406CurrentTaxYearMinus1YearAmt
Current Tax Year$59,748,526CurrentTaxYearAmt
Total$170,806,420TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$170,806,420PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$387,513CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$396,583CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$425,488CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$405,736CurrentTaxYearMinus1YearAmt
Current Tax Year$4,608,669CurrentTaxYearAmt
Total$6,223,989TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$387,513CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$396,583CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$425,488CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$405,736CurrentTaxYearMinus1YearAmt
Current Tax Year$4,608,669CurrentTaxYearAmt
Total$6,223,989TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$760,468CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$51,707CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$69,769CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$45,617CurrentTaxYearMinus1YearAmt
Current Tax Year$419,977CurrentTaxYearAmt
Total$1,347,538TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,147,981CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$449,957CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$53,635,078CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$58,367,759CurrentTaxYearMinus1YearAmt
Current Tax Year$64,777,172CurrentTaxYearAmt
Total$178,377,947TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.95760PublicSupportCY509Pct
Public Support PY5090.96780PublicSupportPY509Pct
Investment Income CY0.03490InvestmentIncomeCYPct
Investment Income PY0.01750InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (1)DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Total Lobbying Expenditures$0TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationLINE 1G DIRECT CONTACT WITH LEGISLATORS, THEIR STAFFS, GOVERNMENT OFFICIALS, OR A LEGISLATIVE BODY: THE ORGANIZATION PAYS CONSULTANTS TO LOBBY FOR LEGISLATION THAT PROMOTES HOSPICES. LINE 1L OTHER ACTIVITIES: THE ORGANIZATION PAYS DUES TO THE NATIONAL HOSPICE AND PALLIATIVE CARE ORGANIZATION ALONG WITH STATE HOSPICE ORGANIZATIONS. A PORTION OF THESE DUES ARE USED FOR LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,936,722OtherCostOrOtherBasisAmt
Book Value$1,936,722BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,888,466OtherCostOrOtherBasisAmt
Depreciation$8,896,513DepreciationAmt
Book Value$5,991,953BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,480,476OtherCostOrOtherBasisAmt
Depreciation$3,274,825DepreciationAmt
Book Value$2,205,651BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,035,042OtherCostOrOtherBasisAmt
Depreciation$4,801,291DepreciationAmt
Book Value$3,233,751BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$84,410OtherCostOrOtherBasisAmt
Book Value$84,410BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$13,452,487TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (6 entries)

DescDescBook ValueBookValueAmt
CASH VALUE OF LIFE INSURANCE$1,689,688
DUE FROM ALZHEIMER'S FAMILY SERVICE$559,527
DUE FROM COVENANT HEALTH AND COMMUNITY SERVICES$24,376,133
DUE FROM COVENANT HOME CARE$251,305
DUE FROM COVENANT HOSPICE FOUNDATIO-$1,404,335
DUE FROM MEMORY CARE CLINIC$1,232,758
FieldValueIRS element (for citing)
Total Book Value Other Assets$26,705,076TotalBookValueOtherAssetsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$89,356,294TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$1,697,995NetUnrealizedGainsInvstAmt
Other Revenue$26,314,649OtherRevenueAmt
Revenue Not Reported$24,616,654RevenueNotReportedAmt
Revenue Subtotal$64,739,640RevenueSubtotalAmt
Investment Expenses Not Incld$33,825InvestmentExpensesNotIncldAmt
Other Revenues Not Included$3,707OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$37,532RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$64,777,172TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$86,378,939TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$32,502,860OtherExpensesIncludedAmt
Expenses Not Reported$32,502,860ExpensesNotReportedAmt
Expenses Subtotal$53,876,079ExpensesSubtotalAmt
Investment Expenses Not Incld2$33,825InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$33,825ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$53,909,904TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:CHCS, HOSPICE, THE FOUNDATION, AFS AND CPCS ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE.
PART XI, LINE 2D - OTHER ADJUSTMENTS:INCREASE CASH SURRENDER VALUE LIFE INSURANCE 10,994. INCOME REPORTED BY COVENANT HOSPICE FOUNDATION EIN 59-3060139 1,803,652. INCOME REPORTED BY ALZHEIMER'S FAMILY SERVICES, INC. EIN 59-3394242 1,801,200. INCOME REPORTED BY COVENANT AT HOME, INC. EIN 35-2543765 INCOME REPORTED BY COVENANT HEALTH AND COMMUNITY SERVICES, INC. EIN 46-51321 18,572,874. ELIMINATION 4,125,929.
PART XI, LINE 4B - OTHER ADJUSTMENTS:INTERCOMPANY CONTRIBUTIONS 3,707.
PART XII, LINE 2D - OTHER ADJUSTMENTS:EXPENSES REPORTED BY COVENANT HOSPICE FOUNDATION EIN 59-3060139 1,252,597. EXPENSES REPORTED BY ALZHEIMER'S FAMILY SERVICES, INC. EIN 59-3394242 2,096,792. EXPENSES REPORTED BY COVENANT AT HOME, INC. EIN 35-2543765 EXPENSES REPORTED BY COVENANT HEALTH AND COMMUNITY SERVICES, EIN 46-51321 29,573,603. ELIMINATION -420,132.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E Expnss0WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JEFFREY M MISLEVY
PRESIDENT/CEO$0$416,242$0$390,889$0$26,647$0$19,500$0$20,143$0$873,421$0$0
TODD FISHER
COO$0$274,942$0$78,851$0$15,576$0$18,702$0$18,309$0$406,380$0$0
ODIN BERG
CSO$0$210,838$0$58,388$0$21,634$0$13,951$0$12,063$0$316,874$0$0
SAUL RODRIGUEZ
PHYSICIAN$248,238$0$0$0$0$0$0$0$70$0$248,308$0$0$0
RICK HARRELSON
PHYSICIAN$215,845$0$0$0$0$0$0$0$4,961$0$220,806$0$0$0
STEPHEN DILL
PHYSICIAN$193,686$0$0$0$0$0$0$0$4,841$0$198,527$0$0$0
JANET DAVIS
PHYSICIAN$177,697$0$0$0$0$0$0$0$70$0$177,767$0$0$0
JAMES SMITH
PHYSICIAN$136,763$0$10,000$0$0$0$0$0$18,309$0$165,072$0$0$0
ROLAND CLENEAY
TREASURER, CFO$0$93,537$0$50,824$0$0$0$14,000$0$3,738$0$162,099$0$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
ESCAMBIA COUNTY HEALTH FACILITIES AUTHORITY
A5213788152005-08-23$900,000RENOVATE INPATIENT FACILITY000
ESCAMBIA COUNTY HEALTH FACILITIES AUTHORITY
B5213788152005-08-23$8,600,000BUILDING ACQUISITION000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$900,000$17,900$882,100200800Yes (1)Yes (1)
B$8,600,000$117,139$8,482,861200700Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0000000
B0000000

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A000Yes (1)00000
B000Yes (1)00000

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
A0
B0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceDATE REBATE COMPUTATION PERFORMEDFormAndLineReferenceDesc
ExplanationISSUER NAME: ESCAMBIA COUNTY HEALTH FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 05/10/2010 ISSUER NAME: ESCAMBIA COUNTY HEALTH FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 05/10/2010ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
CAREY KING
BOARD MEMBER$10,690CAREY KING IS STUDER GROUP'S DIRECTOR OF OPERATIONS AND COVENANT PAYS STUDER GROUP FOR CONSULTING SERVCIES.0
DON HAFERKAMP
BOARD MEMBER$64,668DON HAFERKAMP IS THE CEO CROWN HEALTH CARE LAUNDRY SERVICES. COVENANT HOSPICE PAYS CROWN HEALTH CARE LAUNDRY SERVICES FOR PATIENT RELATED EXPENSES.0
STEVE SARROS
BOARD MEMBER$541STEVE SARROS IS THE CIO OF BAPTIST HEALTH AND COVENANT PAYS BAPTISTS HEALTH FOR PATIENT EXPENSES.0
KENT SKOLROOD
BOARD MEMBER$541KENT SKOLROOD IS THE PRESIDENT OF BAPTIST HEALTH AND COVENANT PAYS BAPTISTS HEALTH FOR PATIENT EXPENSES.0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION'S SOLE MEMBER IS COVENANT HEALTH AND COMMUNITY SERVICES, INC. (CHCS). CHCS ELECTS THE BOARD MEMBERS OF COVENANT HOSPICE, INC.
FORM 990, PART VI, SECTION A, LINE 7ACOVENANT HEALTH AND COMMUNITY SERVICES, INC. ELECTS THE BOARD MEMBERS OF COVENANT HOSPICE, INC.
FORM 990, PART VI, SECTION A, LINE 7BTHE FOLLOWING ACTIONS REQUIRE APPROVAL FROM COVENANT HEALTH AND COMMUNITY SERVICES, INC.: - THE APPOINTMENT OR REMOVAL OF A MEMBER OF THE BOARD OF DIRECTORS; - THE INCURRENCE OF ANY SINGLE INDEBTNESS OR OTHER OBLIGATIONS IN EXCESS OF $500,000 OR IN THE AGGREGATE DURING ANY 12 MONTHS OF INDEBTNESS OR OBLIGATIONS IN EXCESS OF $1,000,000; - THE TRANSFER OF ASSETS OF THE CORPORATION IN ONE OR MORE TRANSACTIONS WITH A VALUE IN EXCESS OF $1,000,000 OR ANY TRANSFER IF THE AGGREGATE TRANSFER IN THE PRECEDING 12 MONTHS EXCEEDS A VALUE IS EXCESS OF $2,000,000; - ANY SINGLE CAPITAL EXPENDITURE IN EXCESS OF $500,000 OR ANY CAPITAL EXPENDITURES IF, IN THE AGGREGATE, THERE WILL BE CAPITAL EXPENDITURES IN EXCESS OF $1,000,000 FOR THE PRIOR 12 MONTHS; - DISSOLUTION OF THE CORPORATION; - A MERGER OF THE CORPORATION INTO ANOTHER ENTITY WHERE THE CORPORATION IS NOT THE SURVIVING ENTITY; AND - AN AMENDMENT TO THE ARTICLES OF INCORPORATION OR THE BYLAWS.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS REVIEWED BY STAFF WITH THE ASSISTANCE OF AND REVIEW BY AN INDEPENDENT ACCOUNTING FIRM BEFORE IT IS SIGNED AND SUBMITTED.
FORM 990, PART VI, SECTION B, LINE 12CCONFLICT OF INTEREST STATEMENTS ARE SENT ANNUALLY TO MEMBERS OF THE BOARD OF DIRECTORS, AND ALL KEY STAFF MEMBERS REPORTABLE ON THE FORM 990. THE FORMS ARE REVIEWED FOR RESPONSES INDICATING A POSSIBLE CONFLICT OF INTEREST. IN ADDITION, THE DIRECTOR OF ACCOUNTING REVIEWS TRANSACTIONS WITH VENDORS WITH WHICH THE BOARD MAY BE AFFILIATED TO DETERMINE THAT ALL TRANSACTIONS ARE MADE AT ARM'S LENGTH. IF A POSSIBLE CONFLICT IS IDENTIFIED, THE PERSON WITH A CONFLICT IS PROHIBITED FROM PARTICIPATING IN THE BOARD OF DIRECTORS DELIBERATIONS AND DECISIONS IN THE TRANSACTION.
FORM 990, PART VI, SECTION B, LINE 15THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE PAID BY COVENANT HEALTH AND COMMUNITY SERVICES, INC. TO DETERMINE THE CEO'S, OTHER OFFICERS', AND OTHER EMPLOYEES' COMPENSATION, COVENANT HEALTH AND COMMUNITY SERVICES, INC. PROCURES SALARY COMPARABILITY DATA AND HIRES AN INDEPENDENT FIRM TO DO A SALARY COMPARISON FOR ALL SENIOR ADMINISTRATIVE STAFF. THE SALARY COMPARISON WITH THE INDEPENDENT FIRM IS UNDERTAKEN ANNUALLY. THE CEO'S COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD WITH INSIGHT GIVEN FROM THE SALARY COMPARISON OF THE INDEPENDENT FIRM. THIS PROCESS IS DONE ANNUALLY AND IS DOCUMENTED. THE PROCESS WAS LAST PERFORMED IN 2019. BECAUSE THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE NOT COMPENSATED BY THE FILING ORGANIZATION, THIS QUESTION WAS MARKED "NO" IN ACCORDANCE WITH FORM 990 INSTRUCTIONS.
FORM 990, PART VI, SECTION C, LINE 18GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ARE AVAILABLE ON WRITTEN REQUEST.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ARE AVAILABLE ON WRITTEN REQUEST.
FORM 990, PART XI, LINE 9:CHANGE IN CASH SURRENDER VALUE 10,994. CHANGE IN VALUE OF TRUST RECEIVABLE -3,707.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
COVENANT HOSPICE FOUNDATION INC
5041 N 12TH AVEPENSACOLAFL32504593060139FUNDRAISINGFL501(C)(3)LINE 12A, ICOVENANT HEALTH AND COMMUNITY SERVICES INC0
ALZHEIMER'S FAMILY SERVICES INC
5041 N 12TH AVEPENSACOLAFL32504593394242SUPPORT TO ALZHEIMERS PATIENTS AND FAMILIESFL501(C)(3)LINE 7COVENANT HEALTH AND COMMUNITY SERVICES INC0
COVENANT AT HOME INC
5041 N 12TH AVEPENSACOLAFL32504352543765HOME HEALTH CAREFL501(C)(3)LINE 10COVENANT HEALTH AND COMMUNITY SERVICES INC0
COVENANT HEALTH AND COMMUNITY SERVICES INC
5041 N 12TH AVEPENSACOLAFL32504465132177SEE SCHEDULE R, PART VIIFL501(C)(3)LINE 100N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1CHARITABLE REMAINDER TRUSTBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line15041 N 12TH AVEAddressLine1Txt
CityPENSACOLACityNm
State AbbreviationFLStateAbbreviationCd
ZIP32504ZIPCd
FieldValueIRS element (for citing)
Primary ActivitiesTRUSTPrimaryActivitiesTxt
Legal Domicile StateFLLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1COVENANT HOSPICE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeTEntityTypeTxt
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (8 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
COVENANT ALZHEIMER'S FAMILY SERVICES
J$270,108FMV
COVENANT ALZHEIMER'S FAMILY SERVICES
D$1,792,285FMV
COVENANT AT HOME
D$251,305FMV
COVENANT HEALTH AND COMMUNITY SERVICES
O$9,368,916FMV
COVENANT HEALTH AND COMMUNITY SERVICES
D$24,376,133FMV
COVENANT HEALTH AND COMMUNITY SERVICES
J$150,024FMV
COVENANT HOSPICE FOUNDATION INC
C$381,496FMV
COVENANT HOSPICE FOUNDATION INC
E$1,404,335FMV

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