2023-01-31T17:30:22+00:00 2021-12-31 350921680 CROWE LLP 225 West Wacker Drive Suite 2600 Chicago IL 606061224 990 2021-01-01 843787656 Capital Caring Advanced Illness Services Inc CAPI 7035382065 3180 Fairview Park Drive 500 Falls Church VA 22042 Tom Koutsoumpas President/CEO 7035316201 2023-01-31 true Tom Koutsoumpas 999009999 Jennifer Burke P01342224 3128997000 2021 2023-03-07 01:45:13Z Tom Koutsoumpas 3180 Fairview Park Drive 500 Falls Church VA 22042 685900 false X www.capitalcaring.org X 2019 VA THE MISSION OF CAPITAL CARING ADVANCED ILLNESS SERVICES, INC. IS TO PROVIDE PATIENTS, THEIR FAMILIES AND CAREGIVERS WITH COMPREHENSIVE, HIGH-QUALITY ADVANCED ILLNESS CARE, OVER TIME AND ACROSS DIFFERENT SETTINGS OF CARE. ADVANCED ILLNESS CARE INCLUDES PALLIATIVE AND PRIMARY CARE SERVICES, AS WELL AS MENTAL AND BEHAVIORAL HEALTH AND SOCIAL DETERMINANTS OF HEALTH SERVICES AND SUPPORTS. 8 7 17 7 0 0 153812 32790 239581 653110 0 0 0 0 393393 685900 0 0 1219589 1187613 0 0 155324 144804 1374913 1332417 -981520 -646517 55368 118634 1036888 1746671 -981520 -1628037 THE MISSION OF CAPITAL CARING ADVANCED ILLNESS SERVICES IS TO PROVIDE HOME BASED PRIMARY CARE FOR THOSE FACING SERIOUS ILLNESS OR DISABILITY THROUGH DIRECT SUPPORT OF PATIENTS AND THEIR FAMILIES. false false 813884 0 335683 CAPITAL CARING ADVANCED ILLNESS SERVICES, INC. (CCAIS) PROVIDES PRIMARY CARE AT HOME SERVICES (PCH). UNDER PCH, CCAIS SERVES ELDERS, AGED 65 AND OLDER, WHO ARE HOME-LIMITED OR OTHERWISE BENEFIT FROM RECEIVING MOST OF THEIR CARE IN THE HOME DUE TO AN ADVANCED ILLNESS OR DISABILITY. THESE SERVICES HAVE BEEN IMPORTANT DURING THE COVID-19 PANDEMIC AND PUBLIC HEALTH EMERGENCY. CCAIS PROVIDES SOCIAL WORK SUPPORT TO PATIENTS AND THEIR FAMILIES TO FIND RESOURCES, ASSIST WITH LIFE TRANSITIONS, AND PROVIDE COUNSELING AND CAREGIVER SUPPORT. CCAIS OFFERS 24/7 ON-CALL MEDICAL STAFF BY PHONE WHO PROVIDE AFTER-HOURS ADVICE TO PATIENTS AND FAMILIES. THE GOAL OF CCAIS IS TO PROVIDE PEACE OF MIND FOR PATIENTS AND FAMILIES AND ALLOW PATIENTS TO SAFELY AGE IN PLACE, REGARDLESS OF THE PATIENT'S ABILITY TO PAY. FOR THE YEAR ENDING DECEMBER 31, 2021, CCAIS SERVED 306 PATIENTS AND PERFORMED 3,105 VISITS. 299585 0 317427 CAPITAL CARING ADVANCED ILLNESS SERVICES, INC. (CCAIS) PROVIDES MEDICAL DIRECTOR SUPPORT AT ASSISTED LIVING FACILITIES IN THE AREA TO PROVIDE CARE FOR THEIR RESIDENTS. FOR THE YEAR ENDED DECEMBER 31, 2021, CCAIS PROVIDED 1,605 HOURS OF MEDICAL DIRECTOR SERVICES TO THESE FACILITIES. 1113469 true true false false false false false false false false false false true true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 0 0 17 true false false false false false false false false false false false false X 8 7 false false false false true true true true true false false true true true true true true false false false DC MD VA X THE ORGANIZATION 7035316231 3180 FAIRVIEW PARK DRIVE SUITE 500 FALLS CHURCH VA 220421206 LYNN MENTO BOARD CHAIR 1.0 3.0 X X 0 0 0 Rev Dr TYRONE PITTS BOARD VICE CHAIR 1.0 3.0 X X 0 0 0 TERENCE BURNS TREASURER (through Aug 2021) 1.0 3.0 X X 0 0 0 TOM KOUTSOUMPAS PRESIDENT/CEO 1.0 42.0 X X 0 536983 20567 BILL NOVELLI BOARD MEMBER 1.0 3.0 X 0 0 0 CLIFFORD E BARNES BOARD MEMBER 1.0 3.0 X 0 0 0 DIANE TY BOARD MEMBER 1.0 3.0 X 0 0 0 JOHN ADAMS BOARD MEMBER 1.0 3.0 X 0 0 0 SUE HARGREAVES BOARD MEMBER 1.0 3.0 X 0 0 0 KARL E DE JONGE MD CHIEF OF GERIATRICS 40.0 0 X 185226 0 6487 LINDA BIEDRZYCKI VP, PRACTICE MANAGEMENT 40.0 0 X 150347 0 17840 Pallavi Doddakashi HPM Physician 40.0 0 X 120943 0 4944 456516 536983 49838 3 false true false 0 32790 32790 PATIENT SERVICE REVENUE 621610 653110 653110 0 0 0 0 653110 0 0 0 0 0 0 0 0 0 685900 653110 0 0 0 0 0 0 0 0 0 0 335573 292955 42618 0 663721 559079 104642 0 19333 16879 2454 0 96637 84364 12273 0 72349 63160 9189 0 0 0 0 0 0 0 0 0 32824 0 32824 0 0 0 0 0 0 0 0 0 0 7188 4023 3165 0 0 0 0 0 3987 2446 1541 0 0 0 0 2196 2196 0 7954 4105 3849 0 0 0 0 0 95 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 MEDICAL SUPPLIES 23366 23366 0 0 BAD DEBT 62997 62997 0 0 4197 0 4197 0 1332417 1113469 218948 0 44883 27293 0 0 0 0 10485 78901 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12440 55368 118634 0 949 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1036888 1745722 1036888 1746671 X -981520 -1628037 0 0 -981520 -1628037 55368 118634 -646517 0 X false true X true false X 0 153812 32790 186602 239581 653110 892691 0 0 0 0 0 0 393393 685900 1079293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1079293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 393393 685900 1079293 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RECEIVABLE FROM RELATED PARTIES - CAPITAL PALLIATIVE CARE CONSULTANTS 12440 12440 ACCOUNTS PAYABLE TO RELATED ENTITY - CAPITAL HOSPICE 1745602 ACCOUNTS PAYABLE TO RELATED ENTITIES - CAPITAL CARING STAY AT HOME SERVICES, INC. 120 1745722 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote The Consolidated Group are exempt from income taxes on income from related activities under Section 501(c)(3) of the U.S. Internal Revenue Code and corresponding state tax law. Accordingly, no provision has been made for federal or state income taxes. The Consolidated Group has determined that there are no material uncertain tax positions that require recognition or disclosure in the consolidated financial statements. The Consolidated Group is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. The Consolidated Group believes it is no longer subject to income tax examinations prior to 2018. false true false false false false false true false TOM KOUTSOUMPAS PRESIDENT/CEO 0 536983 0 0 0 0 0 19074 0 1493 0 557550 0 0 KARL E DE JONGE MD CHIEF OF GERIATRICS 174581 0 5250 0 5395 0 6259 0 228 0 191713 0 0 0 LINDA BIEDRZYCKI VP, PRACTICE MANAGEMENT 127095 0 23250 0 2 0 3854 0 13986 0 168187 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation COMPENSATION FOR THE ORGANIZATION'S PRESIDENT AND CEO IS PAID BY Capital Hospice, A RELATED TAX-EXEMPT ORGANIZATION. Capital Hospice USES THE FOLLOWING METHODS TO DETERMINE THE PRESIDENT AND CEO'S COMPENSATION: -Compensation committee -Independent compensation consultant -Form 990 of other organizations -Compensation survey or study -Approval by the board or compensation committee Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan DURING THE 2021 CALENDAR YEAR, Capital Hospice, A RELATED TAX-EXEMPT ORGANIZATION, MAINTAINED A NON QUALIFIED 457(b) DEFERRED COMPENSATION PLAN FOR THE FOLLOWING EMPLOYEE: JOHN T. KOUTSOUMPAS DURING 2021, Capital Hospice, A RELATED TAX-EXEMPT ORGANIZATION, MADE CONTRIBUTIONS TO THE PLAN TOTALLING $10,400. IN 2021, THERE WERE NO DISBURSEMENTS FROM THE PLAN. Schedule J, Part I, Line 7 Non-fixed payments IF THE ORGANIZATION REACHES ITS BUDGETED AMOUNT OF NET INCOME FROM OPERATIONS FOR THE YEAR THEN EMPLOYEES ARE ELIGIBLE FOR A BONUS, WHICH IS BASED UPON CERTAIN KEY METRICS THAT ARE UNRELATED TO NET INCOME. Schedule J, Part II Vacation buy-backs DURING calendar year 2021, the following individuals received a vacation buy-back from Capital Hospice, a related tax-exempt organization, in the following amounts: Karl E De Jonge, $5,395 Pallavi Doddakashi, $5,286 Each of these buy-backs are INCLUDED IN OTHER REPORTABLE COMPENSATION ON SCHEDULE J, PART II, COLUMN B(III), AND are NOT CONSIDERED PART OF each person's NORMAL COMPENSATION. Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL Compensation for the organization's chief executive office is paid by Capital Hospice, a related tax exempt organization. In 2019 THE EXECUTIVE COMMITTEE OF THE BOARD HAS ENGAGED QUATT AND ASSOCIATES, AN INDEPENDENT CONSULTING GROUP, TO PREPARE A REPORT TO ASSIST WITH ESTABLISHING COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL AND OTHER KEY PERSONNEL. THE REPORT WAS REVIEWED AND APPROVED BY THE EXECUTIVE COMMITTEE AFTER THOROUGH DISCUSSION OF THE DATA, ITS SOURCES AND THE FINDINGS. the organization AS SUBJECT TO INTERMEDIATE SANCTIONS UNDER INTERNAL REVENUE CODE (IRC) SECTION 4958, CONSIDERS THAT THE INTERMEDIATE SANCTIONS MARKET BENCHMARKING METHODOLOGY FOR DISQUALIFIED INDIVIDUALS, CONDUCTED BY QUATT AND ASSOCIATES, HAS PROVIDED A VALID AND ROBUST MEANS OF DETERMINING MARKET BASED COMPENSATION COMPETITIVENESS. Form 990, Part VI, Line 1a Delegate broad authority to a committee There shall be an Executive Committee composed of members elected from among the Board of Directors. The Executive Committee shall have powers and duties as delegated by the Board of Directors and consistent with these Bylaws and the Act. Form 990, Part VI, Line 6 Classes of members or stockholders Capital Caring Health, A Virginia NOT FOR PROFIT CORPORATION ("MEMBER"), IS THE SOLE MEMBER OF THE CORPORATION. THE SOLE MEMBER SHALL HAVE AND EXERCISE CERTAIN RIGHTS AND CERTAIN POWERS RELATED TO THE CORPORATION SET FORTH IN THE CORPORATION'S BYLAWS. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE SOLE MEMBER OF THE CORPORATION, Capital Caring Health, SHALL HAVE THE RIGHT TO APPOINT THE DIRECTORS OF THE CORPORATION. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders THE MEMBER, THROUGH ITS CHAIR OR CEO, OR THROUGH ANY OTHER OFFICER OF THE MEMBER WHO IS AUTHORIZED BY THE BOARD OF DIRECTORS OF THE MEMBER (THE "MEMBER BOARD"), SHALL EXERCISE ALL AUTHORITY AT MEETINGS OF THE CORPORATION AS MEMBERS ARE AUTHORIZED TO EXERCISE. Form 990, Part VI, Line 11b Review of form 990 by governing body THE 990 FOR CAPITAL CARING ADVANCED ILLNESS SERVICES IS REVIEWED BY THE CONTROLLER AND CHIEF FINANCIAL OFFICER. NEXT, THE 990 IS SENT TO ALL OF THE MEMBERS OF THE BOARD OF TRUSTEES INCLUDING THE PRESIDENT OF CAPITAL HOSPICE FOR THEIR REVIEW AND TO SOLICIT ANY COMMENTS OR QUESTIONS. THE FINANCE AUDIT INVESTMENT COMMITTEE (FAIC) OF THE BOARD MEETS TO REVIEW AND DISCUSS THE FORM 990 IN DETAIL. THIS MEETING IS OPEN TO ALL BOARD MEMBERS INCLUDING THE COMPENSATION AND OTHER COMMITTEE CHAIRS. AFTER THE FORM 990 HAS BEEN REVIEWED BY THE BOARD AND ANY COMMENTS OR QUESTIONS FROM BOARD MEMBERS HAVE BEEN RESPONDED TO, THE FORM 990 WILL BE FINALIZED, SIGNED BY THE PRESIDENT/CEO AND SUBSEQUENTLY FILED WITH THE INTERNAL REVENUE SERVICE. Form 990, Part VI, Line 12c Conflict of interest policy ALL BOARD MEMBERS, OFFICERS AND KEY MANAGERS ARE REQUIRED TO REPORT ANY REAL OR POTENTIAL OR PERCEIVED CONFLICT OF INTEREST INVOLVING THEM OR ANOTHER PERSON BY PROMPTLY FILING A WRITTEN DISCLOSURE STATEMENT WITH THE PRESIDENT OR CHAIR OF THE BOARD OF TRUSTEES. THE PRESIDENT WILL REVIEW ALL SUCH STATEMENTS AND THE ANNUAL DISCLOSURE STATEMENTS AND DISCUSS WITH THE CHAIR OF THE BOARD ANY POTENTIAL CONFLICTS OF INTEREST. IF THE PRESIDENT AND THE CHAIR OF THE BOARD DETERMINE THAT A POTENTIAL CONFLICT EXISTS, THEN THE BOARD SHALL INFORM THE PERSON OF THE BASIS FOR SUCH BELIEF AND ALLOW THE PERSON TO EXPLAIN AND DISCLOSE. FOR ANY TRANSACTION/ARRANGEMENT DISCUSSED DURING A BOARD MEETING FOR WHICH A CONFLICT OF INTEREST IS DEEMED TO EXIST, THE AFFECTED BOARD MEMBER SHALL NOT BE COUNTED IN DETERMINING THE QUOROM FOR THE MEETING BUT SHALL BE PERMITTED TO BRIEFLY STATE HIS POSITION ON THE MATTER AND ANSWER PERTINENT QUESTIONS OF OTHER BOARD MEMBERS BEFORE VACATING THE GOVERNING BOARD. THE BOARD MEMBER SHALL LEAVE THE GOVERNING BOARD AND A MAJORITY OF THE REMAINING BOARD MEMBERS SHALL DETERMINE WHETHER TO UNDERTAKE SUCH TRANSACTION/ARRANGEMENT. IF THE BOARD DECIDES THAT A PERSON HAS FAILED TO DISCLOSE A CONFLICT OF INTEREST, THE BOARD SHALL TAKE CORRECTIVE ACTION. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CAPITAL HOSPICE 3180 FAIRVIEW PARK DRIVE SUITE 500 FALLS CHURCH VA 220421206 541920770 DIRECT SUPPORT OF PATIENTS AND THEIR FAMILIES, PUBLIC EDUCATION AND ADVOCACY. VA 501(c)(3) 10 CAPITAL CARING HEALTH false CAPITAL CARING HEALTH 3180 FAIRVIEW PARK DRIVE SUITE 500 FALLS CHURCH VA 220421206 843773372 MEDICAL SUPPORT SERVICES VA 501(c)(3) Type III-FI NA false CAPITAL CARING STAY AT HOME SERVICES INC 3180 FAIRVIEW PARK DRIVE SUITE 500 FALLS CHURCH VA 220421206 843797085 AT HOME medical SERVICES VA 501(c)(3) 7 CAPITAL CARING HEALTH false ADVANCED ILLNESS PARTNERS LLC 3180 FAIRVIEW PARK Dr FALLs CHURCH VA 22042 853613085 MEDICARE DIRECT CONTRACT MEDICAL SERVICES DE CAPITAL CARING ADVANCED ILLNESS SERVICES INC Related -50000 71515 false true 0.1429 false false false false false false false false false false false false true true true true false true true