2023-08-08T13:34:22-05:00 2022-09-30 941239084 ATHERTON & ASSOCIATES LLP PO BOX 4339 MODESTO CA 953524339 990 2021-10-01 770562224 COMMUNITY HOSPICE FOUNDATION STANISLAUS COUNTY COMM 2095786300 4368 SPYRES WAY MODESTO CA 95356 ALISA BETTIS CEO 2095786300 2023-08-04 1 ALISA BETTIS 999009999 JACQUELYN HOWELL P01327223 2095774800 2023-08-04 X 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z ALISA BETTIS 4368 SPYRES WAY MODESTO CA 95356 1461590 0 X WWW.HOSPICEHEART.ORG X 2002 CA SUPPORT OF COMMUNITY HOSPICE, INC. 17 17 6 70 0 0 1117142 1100178 0 0 214654 162239 20385 19604 1352181 1282021 385031 780048 0 0 314666 321833 0 0 161377 235460 251276 935157 1353157 417024 -71136 9425602 7852730 376125 110959 9049477 7741771 THE FOUNDATION EXISTS TO RAISE FUNDS AND AWARENESS OF THE COMMUNITY HOSPICE MISSION. COMMUNITY HOSPICE PROVIDES COMPASSIONATE END-OF-LIFE CARE AND BEREAVEMENT SUPPORT TO PATIENTS AND THEIR FAMILIES REGARDLESS OF ABILITY TO PAY. 0 0 1145178 780048 0 TO RAISE FUNDS TO SUPPORT THE OPERATIONS OF COMMUNITY HOSPICE, INC., A RELATED NOT-FOR-PROFIT CORPORATION. COMMUNITY HOSPICE, INC. USES THESE FUNDS TO PROVIDE SERVICES AND SUPPORT TO THE TERMINALLY ILL AND THEIR FAMILIES. 1145178 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 0 0 1 1 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 1 0 6 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 17 17 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X MARK MALTUN 2095786300 4368 SPYRES WAY MODESTO CA 95356 CHUCK MITTEN CHAIRMAN 1.00 1.00 X X 0 0 0 MELVIN BRADLEY VICE CHAIR 1.00 X X 0 0 0 JOY MASTACHE SECRETARY 1.00 X X 0 0 0 TRACEY KERR TREASURER 1.00 X X 0 0 0 TERESA SCOTT PAST CHAIR 1.00 X X 0 0 0 MITCHELL KUDLER DIRECTOR 1.00 X 0 0 0 PAM DIFRANCIA DIRECTOR 1.00 X 0 0 0 DON GAEKLE DIRECTOR 1.00 X 0 0 0 CLAUDIA KRAUSNICK DIRECTOR 1.00 X 0 0 0 NANCY HOUGHTON DIRECTOR 1.00 X 0 0 0 CATHY MENDOZA DIRECTOR 1.00 X 0 0 0 ERIKA MENDOZA DIRECTOR 1.00 X 0 0 0 MERYL SNIDER DIRECTOR 1.00 X 0 0 0 TRINDA NELSON DIRECTOR 1.00 X 0 0 0 MELISSA WILLIAMS DIRECTOR 1.00 X 0 0 0 JEFF PETERSON DIRECTOR 1.00 X 0 0 0 STEVEN PINEDO DIRECTOR 1.00 X 0 0 0 JOHN RENNER INTERIM CEO 1.00 41.00 X 0 143539 13597 MARK MALTUN CHIEF FINANCIAL OFFICER 1.00 41.00 X 0 152500 8877 FRANCINE FOLEY CHF EXECUTIVE DIRECTOR 40.00 2.00 X 38946 0 2600 ALISA BETTIS CHIEF EXECUTIVE OFFICER 1.00 41.00 X 0 0 0 MANINDERDEEP KAHLON NURSE PRACTITIONER 1.00 41.00 X 0 191295 9311 HEIDI YEE NURSE PRACTITIONER 1.00 41.00 X 0 142940 6647 CHERYL KIRK RN CASE MANAGER 1.00 41.00 X 0 147393 13337 RAJVINDER KAUR NURSE PRACTITIONER 1.00 41.00 X 0 190584 14046 JUDITH COLCLEASURE TRIAGE RN 1.00 41.00 X 0 143405 7170 CHARLOTTE D MCLEOD FORMER CHIEF EXECUTIVE OFFICER 1.00 41.00 X 0 295784 14637 38946 1407440 90222 0 1 1 0 0 248366 851812 56761 1100178 162239 162239 118329 248366 179569 -61240 -61240 80844 0 80844 80844 1282021 0 0 181843 780048 780048 136615 68308 68307 160628 80314 80314 3652 1826 1826 20938 10469 10469 46602 46602 24719 24719 15315 15315 18000 18000 595 595 2232 2232 10531 10070 461 BANK, CREDIT CARD & PAY 73523 73523 COMPUTER MAINTENANCE 28367 28367 OTHER PROGRAM EXPENSES 24854 24854 STAFF RECRUITMENT, TRAI 6333 6333 205 205 1353157 1145178 46602 161377 599857 377631 173717 167892 0 3264 14466 16806 31331 23943 45570 45570 0 0 7237236 6154885 1368995 1108309 9425602 7852730 59360 65811 28119 18919 288646 26229 376125 110959 X 7895168 6566056 1154309 1175715 9049477 7741771 9425602 7852730 -71136 -1236570 0 X X 0 1 X 1 0 X X 1 COMMUNITY HOSPICE INC 942638213 10 1 780048 0 1 780048 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1409600 1339 -201492 1133925 1204287 1767 225932 1409600 1142324 1640 60323 1204287 1058448 114384 -30508 1142324 1037202 1638 19608 1058448 0.15300 0.84700 0.00000 0 0 17989 17989 0 27581 27581 0 0 INVESTMENT PROPERTY 4000 ENDOWMENT INVESTMENTS 1104309 1108309 RELATED PARTY PAYABLE 26229 26229 X 47731 -1236570 2280 -1234290 1282021 0 1282021 575389 2280 2280 573109 780048 780048 1353157 PART V, LINE 4: THE INTENDED USE OF THE ENDOWMENT FUNDS ARE TO FUND FUTURE OPERATING EXPENSES OF COMMUNITY HOSPICE, INC. PART X, LINE 2: MANAGEMENT HAS EVALUATED THE FOUNDATION'S TAX POSITIONS AND CONCLUDED THAT THE FOUNDATION 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. THE FOUNDATION IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE, OR LOCAL TAX AUTHORITIES FOR TAX YEARS ENDING SEPTEMBER 30, 2018 AND PRIOR. PART XI, LINE 2D - OTHER ADJUSTMENTS: EVENT EXPENSES INCLUDED IN PART VIII LINE 8B PART XII, LINE 2D - OTHER ADJUSTMENTS: EVENT EXPENSES INCLUDED IN PART VIII LINE 8B PART XII, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTION TO COMMUNITY HOSPICE NOT INCLUDED AS FINANCIAL STATEMENT EXP. SPRING EVENT 148074 107438 40636 6592 4087 40245 GOLF FORE HOSPICE 68035 47175 20860 9360 14522 15364 3 150586 93753 56833 1278 4661 83460 366695 248366 118329 17230 23270 139069 179569 -61240 80844 1 0.95000 80844 80844 CA 1 0 0 0 1.00000 MARK MALTUN 4368 SPYRES WAY MODESTO CA 95356 0 FRANCINE FOLEY 1231 REGISTRATION AND OPERATION OF RAFFLES. X 0 1 COMMUNITY HOSPICE INC 4368 SPYRES WAY MODESTO CA 95356 942638213 501(C)(3) 780048 0 FUNDS RAISED AND REIMBURSED EXPENSES FOR COMMUNITY HOSPICE INC 1 PART I, LINE 2: ALL FUNDS ARE DISTRIBUTED TO COMMUNITY HOSPICE, INC. WHICH IS A RELATED ENTITY. X X X X X 0 0 0 0 0 0 0 0 0 CHARLOTTE D MCLEOD FORMER CHIEF EXECUTIVE OFFICER 0 295784 0 0 0 0 0 11864 0 2773 0 310421 0 0 RAJVINDER KAUR NURSE PRACTITIONER 0 190584 0 0 0 0 0 7626 0 6420 0 204630 0 0 MANINDERDEEP KAHLON NURSE PRACTITIONER 0 191295 0 0 0 0 0 9311 0 0 0 200606 0 0 MARK MALTUN CHIEF FINANCIAL OFFICER 0 152500 0 0 0 0 0 2726 0 6151 0 161377 0 0 CHERYL KIRK RN CASE MANAGER 0 147393 0 0 0 0 0 7186 0 6151 0 160730 0 0 JOHN RENNER INTERIM CEO 0 143539 0 0 0 0 0 7177 0 6420 0 157136 0 0 JUDITH COLCLEASURE TRIAGE RN 0 143405 0 0 0 0 0 7170 0 0 0 150575 0 0 X PRIZES 92 39236 DONOR REPRESENTATION X CONSUMABLE GOODS 13 17525 DONOR REPRESENTATION 0 0 1 0 FORM 990, PART VI, SECTION A, LINE 3 MANAGEMENT DUTIES ARE PERFORMED BY CHI MANAGEMENT, INC. WHICH IS A RELATED PARTY EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6 COMMUNITY HOSPICE INC. IS THE MEMBER OF COMMUNITY HOSPICE FOUNDATION AND IS A RELATED ENTITY. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION HAS ONE MEMBER WITH THE POWER TO ELECT OR APPOINT ONE OR MORE MEMBERS OF THE GOVERNING BODY. THE MEMBER IS COMMUNITY HOSPICE, INC., A RELATED ENTITY. FORM 990, PART VI, SECTION A, LINE 7B GOVERNANCE DECISIONS BY THE ORGANIZATION MAY BE SUBJECT TO APPROVAL BY COMMUNITY HOSPICE, INC. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS REVIEWS THE FORM 990 AND IS PROVIDED WITH AN OPPORTUNITY TO COMMENT ON THE TAX RETURN PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C ALL EMPLOYEES, VOLUNTEERS, AND MEMBERS OF THE BOARD OF DIRECTORS AND ADVISORY COMMITTEES WILL SIGN A CONFLICT OF INTEREST DOCUMENT UPON EMPLOYMENT, APPOINTMENT, OR REAPPOINTMENT AT LEAST ANNUALLY AND MONITORED BY THE CORPORATE COMPLIANCE OFFICER, INDICATING THAT THEY HAVE READ AND UNDERSTOOD THE RELEVANT POLICIES AND THAT THEY WILL OBSERVE THEM. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS APPROVED BY THE INDEPENDENT BOARD OF DIRECTORS WHERE THE VOTE OF EACH MEMBER IS COUNTED. COMPENSATION ANALYSIS OF SIMILARLY SITUATED ORGANIZATIONS (TAXABLE AND TAX-EXEMPT) WITH RESPECT TO SIZE AND RESPONSIBILITIES OF EACH POSITION ARE COMPARED. THIS ANALYSIS IS PREPARED ANNUALLY. THE PROCESS OF ARRIVING AT EACH INDIVIDUAL'S COMPENSATION ARRANGEMENT IS DOCUMENTED IN BOARD MINUTES, PERSONAL ACTION FORMS, AND THE EMPLOYEE'S PERSONNEL FILE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES AVAILABLE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND ANNUAL REPORT TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C MEMBERS OF THE BOARD OF DIRECTORS FROM COMMUNITY HOSPICE, INC., CHI MANAGEMENT, INC. AND COMMUNITY HOSPICE FOUNDATION MAKE UP THE AUDIT COMMITTEE CHARGED WITH THE RESPONSIBILITY OF OVERSIGHT IN CONNECTION TO THE AUDITED FINANCIAL STATEMENTS AND SELECTION OF INDEPENDENT AUDITORS. COMMUNITY HOSPICE INC 4368 SPYRES WAY MODESTO CA 95356 942638213 HOSPICE CARE FOR THE TERMINALLY ILL CA 501(C)(3) 509(A)(2) N/A 0 CHI MANAGEMENT INC 4368 SPYRES WAY MODESTO CA 95356 200178425 PROVIDE PROFESSIONAL SERVICES FOR CHI INC., CHI FOUNDATION AND HOPE CHEST CA 501(C)(3) 509(A)(2) N/A 0 0 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0