HOSPICE OF SANTA CRUZ COUNTY: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- HOSPICE OF SANTA CRUZ COUNTY (EIN 94-2497618)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-15
- IRS object ID
- 202331359349311013
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-15T13:49:11-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 941239084 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ATHERTON & ASSOCIATES LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 4339 | AddressLine1Txt |
| City | MODESTO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 953524339 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 942497618 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE OF SANTA CRUZ COUNTY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HOSP | BusinessNameControlTxt |
| Phone | 8314303000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 940 DISC DRIVE | AddressLine1Txt |
| City | SCOTTS VALLEY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95066 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ADAM SHORE | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 8314303000 | PhoneNum |
| Signature | 2023-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ADAM | PersonFirstNm |
| Person Last | SHORE | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JACQUELYN HOWELL | PreparerPersonNm |
| PTIN | P01327223 | PTIN |
| Phone | 2095774800 | PhoneNum |
| Self Employed | Yes (X) | SelfEmployedInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ADAM SHORE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 940 DISC DRIVE | AddressLine1Txt |
| City | SCOTTS VALLEY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95066 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $19,290,539 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HOSPICESANTACRUZ.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1978 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | HOSPICE SERVICE AND SUPPORT FOR TERMINAL PATIENTS AND THEIR FAMILIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 167 | TotalEmployeeCnt |
| Total Volunteers | 80 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,825,299 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,268,698 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $17,943,603 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $17,950,638 | CYProgramServiceRevenueAmt |
| PY Investment Income | $245,920 | PYInvestmentIncomeAmt |
| CY Investment Income | $10,621 | CYInvestmentIncomeAmt |
| PY Other Revenue | $52,666 | PYOtherRevenueAmt |
| CY Other Revenue | $60,582 | CYOtherRevenueAmt |
| PY Total Revenue | $21,067,488 | PYTotalRevenueAmt |
| CY Total Revenue | $19,290,539 | 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 | $14,446,300 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $14,699,094 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $482,662 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,758,196 | PYOtherExpensesAmt |
| CY Other Expenses | $7,664,671 | CYOtherExpensesAmt |
| PY Total Expenses | $20,204,496 | PYTotalExpensesAmt |
| CY Total Expenses | $22,363,765 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $862,992 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$3,073,226 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,612,272 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,203,092 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,395,377 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,311,272 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,216,895 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $7,891,820 | NetAssetsOrFundBalancesEOYAmt |
| Mission | HOSPICE SERVICE AND SUPPORT FOR TERMINAL PATIENTS AND THEIR FAMILIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $13,784,098 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $17,950,638 | RevenueAmt |
| Desc | 992 PATIENTS AND FAMILIES RECEIVED 57,913 DAYS OF EXPERT END-OF-LIFE CARE FROM HOSPICE TEAMS OF MEDICAL DIRECTORS, NURSES, SOCIAL WORKERS, CHAPLAINS, HOSPICE AIDES, AND VOLUNTEERS. ADDITIONALLY, 2,210 INDIVIDUAL GRIEF SUPPORT SESSIONS AND 94 GROUP GRIEF SUPPORT SESSIONS WERE PROVIDED TO HOSPICE FAMILIES AND GRIEVING COMMUNITY MEMBERS OF ALL AGES. | Desc |
| Total Program Service Expenses | $13,784,098 | 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 | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | 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 | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | 0 | 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 | 86 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 167 | 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 | 0 | QuidProQuoContributionsInd |
| 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | 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 | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ADAM SHORE | PersonNm |
| Phone | 8314303000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 940 DISC DRIVE | AddressLine1Txt |
| City | SCOTTS VALLEY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95066 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| RICHARD CLARK | |||||||
| PRESIDENT | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JULIA COWELL RN PHD | |||||||
| VICE PRESIDENT | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| CARA DESIMONE | |||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| TIMOTHY ULEN | |||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BETH HANSMAN | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DALE BISHOP MD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID KLUGER | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SHARON TAPPER MD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL ALLARD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAISY NUNEZ | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KATHERINE GABRIEL-COX MD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SIGOLENE A ORTEGA | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CATHY CONWAY | |||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $271,419 | $0 | $9,941 | ||
| ADAM SHORE | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $230,103 | $0 | $9,641 | ||
| KARL SEGNITZ | |||||||
| CHIEF MEDICAL OFFICER | 40.00 | $285,836 | $0 | $10,292 | Yes (X) | ||
| JUDITH HUMBLE | |||||||
| CHIEF COMPLIANCE OFFICER | 40.00 | $211,929 | $0 | $10,062 | Yes (X) | ||
| GLORIA REED | |||||||
| CHIEF CLINICAL OFFICER | 40.00 | $203,236 | $0 | $12,409 | Yes (X) | ||
| DIANE SYRCLE | |||||||
| CHIEF MISSION OFFICER | 40.00 | $175,956 | $0 | $11,983 | Yes (X) | ||
| ANGELA BROUSE | |||||||
| ADMISSIONS NURSE | 40.00 | $172,082 | $0 | $7,344 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,550,561 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $71,672 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 39 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ALLEN BUENO DEL BOSQUE | |||||
| 311 33RD AVE | SANTA CRUZ | CA | 95062 | PHYSICIAN | $294,194 |
| BONNY MASTERS | |||||
| 634 SAN JUAN AVENUE | SANTA CRUZ | CA | 95065 | PHYSICIAN | $115,390 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $52,925 | FundraisingAmt |
| All Other Contributions | $1,215,773 | AllOtherContributionsAmt |
| Noncash Contributions | $7,130 | NoncashContributionsAmt |
| Total Contributions | $1,268,698 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | HOSPICE SERVICES | Desc |
| Business | 621610 | BusinessCd |
| Total Revenue Column | $17,950,638 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,950,638 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $17,950,638 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,576 | TotalRevenueColumnAmt |
| Exclusion | $6,576 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,045 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,045 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,045 | TotalRevenueColumnAmt |
| Exclusion | $4,045 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $52,925 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $60,582 | TotalRevenueColumnAmt |
| Exclusion | $60,582 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $60,582 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,290,539 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,950,638 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $71,203 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $567,668 | TotalAmt |
| Management And General | $567,668 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,782,537 | TotalAmt |
| Program Services | $8,058,085 | ProgramServicesAmt |
| Management And General | $3,428,126 | ManagementAndGeneralAmt |
| Fundraising | $296,326 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,205,532 | TotalAmt |
| Program Services | $784,659 | ProgramServicesAmt |
| Management And General | $381,851 | ManagementAndGeneralAmt |
| Fundraising | $39,022 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,143,357 | TotalAmt |
| Program Services | $750,461 | ProgramServicesAmt |
| Management And General | $363,662 | ManagementAndGeneralAmt |
| Fundraising | $29,234 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,920 | TotalAmt |
| Management And General | $31,920 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $184,912 | TotalAmt |
| Management And General | $184,912 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,370 | TotalAmt |
| Management And General | $28,370 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,942,520 | TotalAmt |
| Program Services | $1,227,355 | ProgramServicesAmt |
| Management And General | $698,757 | ManagementAndGeneralAmt |
| Fundraising | $16,408 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,501 | TotalAmt |
| Program Services | $2,231 | ProgramServicesAmt |
| Management And General | $94,649 | ManagementAndGeneralAmt |
| Fundraising | $621 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $181,728 | TotalAmt |
| Program Services | $3,178 | ProgramServicesAmt |
| Management And General | $158,125 | ManagementAndGeneralAmt |
| Fundraising | $20,425 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $249,582 | TotalAmt |
| Management And General | $249,582 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $212,277 | TotalAmt |
| Program Services | $191,732 | ProgramServicesAmt |
| Management And General | $20,427 | ManagementAndGeneralAmt |
| Fundraising | $118 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,875 | TotalAmt |
| Program Services | $12,970 | ProgramServicesAmt |
| Management And General | $27,302 | ManagementAndGeneralAmt |
| Fundraising | $26,603 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,018 | TotalAmt |
| Management And General | $12,577 | ManagementAndGeneralAmt |
| Fundraising | $26,441 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $310,558 | TotalAmt |
| Management And General | $310,558 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $128,665 | TotalAmt |
| Management And General | $128,665 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|---|
| PATIENT RELATED | $1,501,111 | $1,500,521 | $590 | |
| OTHER EXPENSE | $1,123,483 | $1,123,483 | ||
| COMPUTER & SUPPORT EXPE | $620,172 | $6,973 | $25,616 | $587,583 |
| BAD DEBT EXPENSE | $358,506 | $358,506 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $587,473 | TotalAmt |
| Program Services | $122,450 | ProgramServicesAmt |
| Management And General | $463,765 | ManagementAndGeneralAmt |
| Fundraising | $1,258 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,363,765 | TotalAmt |
| Program Services | $13,784,098 | ProgramServicesAmt |
| Management And General | $8,097,005 | ManagementAndGeneralAmt |
| Fundraising | $482,662 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,261,887 | BOYAmt |
| EOY | $462,169 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,742,989 | BOYAmt |
| EOY | $3,037,138 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,000 | BOYAmt |
| EOY | $113,764 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,269,174 | BOYAmt |
| EOY | $1,984,266 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,056 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $274,248 | BOYAmt |
| EOY | $303,749 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,698,197 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,328,540 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,815,874 | BOYAmt |
| EOY | $2,369,657 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,724,930 | BOYAmt |
| EOY | $3,287,197 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $159,990 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,432,114 | BOYAmt |
| EOY | $485,162 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,612,272 | BOYAmt |
| EOY | $12,203,092 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,962,972 | BOYAmt |
| EOY | $1,181,499 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $223,569 | BOYAmt |
| EOY | $194,503 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,208,836 | BOYAmt |
| EOY | $2,935,270 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,395,377 | BOYAmt |
| EOY | $4,311,272 | 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 | $10,495,872 | BOYAmt |
| EOY | $7,170,797 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $721,023 | BOYAmt |
| EOY | $721,023 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,216,895 | BOYAmt |
| EOY | $7,891,820 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,612,272 | BOYAmt |
| EOY | $12,203,092 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$3,073,226 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$172,324 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | -$79,525 | PriorPeriodAdjustmentsAmt |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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 | $1,405,711 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,808,791 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,106,587 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,825,299 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,268,698 | CurrentTaxYearAmt |
| Total | $8,415,086 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,405,711 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,808,791 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,106,587 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,825,299 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,268,698 | CurrentTaxYearAmt |
| Total | $8,415,086 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $950,203 | SubstantialContributorsTotAmt |
| Public Support Total170 | $7,464,883 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $62,977 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $97,561 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $52,065 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $45,248 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,576 | CurrentTaxYearAmt |
| Total | $264,427 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $31,122 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $47,477 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $26,862 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,771 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $60,582 | CurrentTaxYearAmt |
| Total | $174,814 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $8,854,327 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $99,347,639 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.84310 | PublicSupportCY170Pct |
| Public Support PY170 | 0.83450 | 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
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $635,181 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $62,889 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $698,070 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $511,407 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $133,480 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $9,706 | AdministrativeExpensesAmt |
| End Year Balance | $635,181 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $535,980 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$17,237 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $7,336 | AdministrativeExpensesAmt |
| End Year Balance | $511,407 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $530,022 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $15,146 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $9,188 | AdministrativeExpensesAmt |
| End Year Balance | $535,980 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $517,009 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $13,013 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $530,022 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $565,980 | OtherCostOrOtherBasisAmt |
| Book Value | $565,980 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,658,159 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,233,728 | DepreciationAmt |
| Book Value | $1,424,431 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $541,874 | OtherCostOrOtherBasisAmt |
| Depreciation | $321,715 | DepreciationAmt |
| Book Value | $220,159 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $370,584 | OtherCostOrOtherBasisAmt |
| Depreciation | $299,904 | DepreciationAmt |
| Book Value | $70,680 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $561,600 | OtherCostOrOtherBasisAmt |
| Depreciation | $473,193 | DepreciationAmt |
| Book Value | $88,407 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,369,657 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| ENDOWED AGENCY FUND HELD AT COMMUNITY FOUNDATION OF SCC | $698,070 | F |
| NON ENDOWED AGENCY FUND HELD AT COMMUNITY FOUNDATION OF SCC | $2,589,127 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $3,287,197 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| SELF-INSURANCE LIABILITY | $258,090 |
| PPP LOAN | $2,677,180 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,935,270 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $19,118,215 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$172,324 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$172,324 | RevenueNotReportedAmt |
| Revenue Subtotal | $19,290,539 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $19,290,539 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $22,363,765 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $22,363,765 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $22,363,765 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE ORGANIZATION'S ENDOWMENT FUNDS CONSIST OF FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES TO SUPPORT THE ORGANIZATION'S PROGRAMS. THE ORGANIZATION HAS A POLICY OF CLASSIFYING INVESTMENT INCOME ON THE ENDOWMENT FUNDS AS TEMPORARILY RESTRICTED UNTIL SUCH TIME AS SPECIFICALLY BUDGETED FOR SPENDING AND APPROVED BY THE BOARD. |
| PART X, LINE 2: | MANAGEMENT HAS EVALUATED HOSPICE'S TAX POSITIONS AND CONCLUDED THAT HOSPICE HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS. HOSPICE IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE, OR LOCAL TAX AUTHORITIES FOR TAX YEARS ENDING JUNE 30, 2018 AND PRIOR. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | FAIRWAYS FOR KIDS GOLF TOURNAMENT | Event1Nm |
| Gross Receipts Event1 | $52,925 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $52,925 | CharitableContriEvent1Amt |
| Other Direct Expenses Event1 | $0 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $52,925 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $52,925 | CharitableContributionsTotAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 | 0 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KARL SEGNITZ | ||||||||||||||
| CHIEF MEDICAL OFFICER | $285,836 | $0 | $0 | $0 | $0 | $0 | $3,350 | $0 | $6,942 | $0 | $296,128 | $0 | $0 | $0 |
| CATHY CONWAY | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $271,419 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $9,941 | $0 | $281,360 | $0 | $0 | $0 |
| ADAM SHORE | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $230,103 | $0 | $0 | $0 | $0 | $0 | $2,699 | $0 | $6,942 | $0 | $239,744 | $0 | $0 | $0 |
| JUDITH HUMBLE | ||||||||||||||
| CHIEF COMPLIANCE OFFICER | $211,929 | $0 | $0 | $0 | $0 | $0 | $3,120 | $0 | $6,942 | $0 | $221,991 | $0 | $0 | $0 |
| GLORIA REED | ||||||||||||||
| CHIEF CLINICAL OFFICER | $203,236 | $0 | $0 | $0 | $0 | $0 | $2,325 | $0 | $10,084 | $0 | $215,645 | $0 | $0 | $0 |
| DIANE SYRCLE | ||||||||||||||
| CHIEF MISSION OFFICER | $175,956 | $0 | $0 | $0 | $0 | $0 | $3,742 | $0 | $8,241 | $0 | $187,939 | $0 | $0 | $0 |
| ANGELA BROUSE | ||||||||||||||
| ADMISSIONS NURSE | $172,082 | $0 | $0 | $0 | $0 | $0 | $1,008 | $0 | $6,336 | $0 | $179,426 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER IS CALIFORNIA HOSPICE NETWORK, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE ORGANIZATION'S SOLE MEMBER IS CALIFORNIA HOSPICE NETWORK. THE ORGANIZATION ELECTS DIRECTORS, WHO ARE APPROVED BY THE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE ORGANIZATION'S BYLAWS INCLUDE CERTAIN POWERS RESERVED BY MEMBER, WHICH INCLUDE APPOINTMENT OF THE ORGANIZATION'S DIRECTORS AND CEO, APPROVAL OF THE ANNUAL OPERATING BUDGET, AND ANY ACTION TO MERGE, DISSOLVE OR SELL SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE CFO AND CEO REVIEW THE FORM 990 WHEN COMPLETED BY THE CPA FIRM. A COPY OF THE FORM 990 IS FURNISHED TO THE FINANCE COMMITTEE AND TO THE BOARD OF DIRECTORS BEFORE IT IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE PURPOSE OF THE CONFLICT OF INTEREST POLICY IS TO PROTECT HSCC'S INTEREST WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN OFFICER OR DIRECTOR OF THE ORGANIZATION. OFFICERS AND DIRECTORS REVIEW AND SIGN AN ANNUAL STATEMENT INDICATING UNDERSTANDING AND ADHERENCE TO THE POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | MARKET DATA ON SALARIES FOR CEO AND CFO POSITIONS IN THE HEALTHCARE AND HOSPICE FIELD IS COMPILED AND REVIEWED ANNUALLY BY THE HR DIRECTOR. A REPORT CONSIDERING MARKET AND GEOGRAPHIC FACTORS WAS PRESENTED TO THE ORGANIZATION'S COMPENSATION COMMITTEE, WHICH REVIEWS AND RECOMMENDS ANY SALARY ADJUSTMENT TO THE FULL BOARD OF DIRECTORS. THE BOARD OF DIRECTORS REVIEW AND VOTE ON PROPOSED SALARY CHANGES. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL GOVERNING DOCUMENTS, POLICIES, AND ANNUAL FORM 990 ARE AVAILABLE TO THE PUBLIC UPON REQUEST. ANNUAL FINANCIAL RESULTS ARE PUBLISHED IN THE ORGANIZATION'S ANNUAL REPORT. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CALIFORNIA HOSPICE NETWORK | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 66 BOVET RD SUITE 100 | AddressLine1Txt |
| City | SAN MATEO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 834716484 | EIN |
| Primary Activities | TO PROVIDE HOSPICE SUPPORT, ADMIN, PROGRAMMATIC AND OTHER SUPPORT | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 509(A)(3) | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| 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 | 0 | 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 | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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