2022-01-14T13:21:43-06:00 2021-06-30 821819999 C RANDOLPH CPA PLLC 560 BEAVER CREEK SCHOOL RD WEST JEFFERSON NC 28694 990 2020-07-01 561338470 CALDWELL HOSPICE AND PALLIATIVE CARE INC DBA AMOREM CALD 8287540101 902 KIRKWOOD STREET NW LENOIR NC 28645 CATHY SWANSON CEO 8287540101 2022-01-13 1 CATHY SWANSON 999009999 CYNTHIA D RANDOLPH P00441502 3368463211 2022-01-13 X 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z X CATHY SWANSON 902 KIRKWOOD STREET NW LENOIR NC 28645 17924348 0 X WWW.AMOREMSUPPORT.ORG X 1981 NC PROVIDE END OF LIFE CARE THROUGH THE HOSPICE PHILOSOPHY 15 15 332 272 0 0 225505 391752 14360036 16345776 149357 151681 -75206 1035139 14659692 17924348 0 0 0 0 9300107 11099044 0 0 0 4018410 4784841 13318517 15883885 1341175 2040463 23690712 29200261 3933508 4137655 19757204 25062606 PROVIDE END OF LIFE CARE THROUGH THE HOSPICE PHILOSOPHY 0 0 11198152 17532096 HOSPICE CARE - TO PROVIDE CARE AND SUPPORT TO TERMINALLY ILL PERSONS AND THEIR FAMILIES, BY AN INTERDISCIPLINARY TEAM OF PHYSICIANS, NURSES, SOCIAL WORKERS, AND VOLUNTEERS. 11198152 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 21 0 332 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X TERRY JOHNSON 8287540101 902 KIRKWOOD STREET NW LENOIR NC 28645 GREGORY JONES MD BOARD MEMBER 0.00 X X 0 0 0 PEG BROYHILL BOARD MEMBER 0.00 X X 0 0 0 MARC CARPENTER BOARD MEMBER 0.00 X X 0 0 0 DAVID BURNETTE II DO BOARD MEMBER 0.00 X 0 0 0 DAVID GRAY BOARD MEMBER 0.00 X 0 0 0 RICH DEAUGUSTINIS BOARD MEMBER 0.00 X 0 0 0 ROB HINMAN BOARD MEMBER 0.00 X 0 0 0 MACK JARVIS BOARD MEMBER 0.00 X 0 0 0 JORDAN GREENE BOARD MEMBER 0.00 X X 0 0 0 DAVID LACKEY BOARD MEMBER 0.00 X 0 0 0 JARED HUFFMAN BOARD MEMBER 0.00 X 0 0 0 RHONDA LEE BOARD MEMBER 0.00 X 0 0 0 TAMRA STARNES BOARD MEMBER 0.00 X 0 0 0 WONGALEE THOMAS BOARD MEMBER 0.00 X 0 0 0 JANET WINKLER BOARD MEMBER 0.00 X 0 0 0 CATHY SWANSON CEO 40.00 X 207334 0 10050 THOMAS RAY MEDICAL DOCTOR 40.00 X 204537 0 10748 JULIA SHERRILL CHIEF MEDICAL OFFICER 40.00 X 202250 0 1594 FREDA COWAN LEAD NURSE PRACTITIONER 40.00 X 128878 0 6299 DONNA TATE NURSE PRACTITIONER 40.00 X 113087 0 2595 856086 0 31286 5 0 1 0 0 391752 391752 MEDICARE/MEDICAID PAYMENTS 623990 13854307 13854307 PAYCHECK PROTECTION PROGRAM 623990 1461100 1461100 INSURANCE REIMBURSEMENT 623990 659545 659545 PRIVATE REIMBURSEMENT 623990 364357 364357 CARES ACT FUNDING 623990 6467 6467 16345776 151681 151681 500 0 500 500 MISCELLANEOUS REVENUE 623990 1034639 1034639 1034639 17924348 17532096 0 500 9395727 7051966 2343761 1703317 1703317 158893 158893 596052 596052 109378 109378 23587 8200 15387 17525 17525 380648 325845 54803 2416 2416 360851 360851 123079 123079 MEDICATION EXPENSE 694429 694429 DME 413924 413924 FACILITY RELATED EXPENS 294127 294127 COMPUTER EXPENSE 292843 292843 1317089 1000471 316618 15883885 11198152 4685733 0 6795474 5726729 2302863 5613056 200033 316267 19389080 9509197 7880220 9879883 6512122 7664326 23690712 29200261 337396 1012928 3596112 3124727 3933508 4137655 X 19757204 25062606 19757204 25062606 23690712 29200261 X 2040463 3264939 X 0 1 X 1 0 X 173517 218420 278861 225505 391752 1288055 9968786 10807384 12440859 14937704 16345776 64500509 10142303 11025804 12719720 15163209 16737528 65788564 0 0 0 65788564 42274 48980 120563 149357 151681 512855 42274 48980 120563 149357 151681 512855 147823 76893 135681 -75206 1035137 1320328 10332400 11151677 12975964 15237360 17924346 67621747 0.97290 0.98900 0.00760 0.00620 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 941481 941481 18447599 9509197 8938402 9879883 VARIOUS INVESTMENTS 7664326 F 7664326 DUE TO PHYSICIANS AND NURSING HOMES 817649 ACCRUED PAYROLL AND PAYROLL TAXES 1424119 DEFERRED REVENUE 882959 3124727 X 17924348 0 17924348 0 17924348 15883885 0 15883885 0 15883885 PART X, LINE 2: FASB ASC 740-10, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS. BASED ON AN EVALUATION OF UNCERTAIN TAX POSITIONS, MANAGEMENT IS REQUIRED TO MEASURE POTENTIAL TAX LIABILITIES THAT COULD HAVE A RISK OF GREATER THAN A 50% LIKELIHOOD OF BEING REALIZED UPON SETTLEMENT. AS OF JUNE 30, 2021, MANAGEMENT HAS DETERMINED THAT THE ORGANIZATION HAS NO SUCH RISK AND THEREFORE NO LIABILITIES HAVE BEEN RECORDED FOR UNCERTAIN TAX POSITIONS. X X 0 0 0 0 0 0 0 0 0 CATHY SWANSON CEO 207334 0 0 0 0 0 10050 0 0 0 217384 0 0 0 THOMAS RAY MEDICAL DOCTOR 204537 0 0 0 0 0 10748 0 0 0 215285 0 0 0 JULIA SHERRILL CHIEF MEDICAL OFFICER 202250 0 0 0 0 0 1594 0 0 0 203844 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PROVIDED TO THE ORGANIZATION'S MANAGMEMENT BEFORE IT IS FILED AND IT IS REVIEWED BY THE MANAGEMENT AND IS MADE AVAILABLE TO THE BOARD OF DIRECTORS AT A BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS, EMPLOYEES, AND VOLUNTEERS MUST SIGN AN ACKNOWLEDGEMENT ON OUR POLICY FOR AN INDIVIDUAL STATEMENT OF CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION DETERMINES THE SALARY OF THE EXECUTIVE DIRECTOR BY PERFORMANCE REVIEWS AND SALARY SURVEYS OF SIMILAR POSITIONS. THESE ITEMS ARE REVIEWED BY BOARD PERSONNEL COMMITTEE AND APPROVED BY THE BOARD OF DIRECTORS. THE SALARIES OF OTHER KEY EMPLOYEES ARE DONE BY PERFORMANCE REVIEWS, SALARY SURVEYS OF SIMILAR POSITIONS AND APPROVAL BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVALIABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVALIABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: TRANSFER OF ASSETS FROM BURKE HOSPICE AND PALLIATIVE CARE, INC. 3,264,939. CALDWELL HOSPICE FOUNDATION 1265 MOUNTAIN CIRCLE DR LENOIR NC 28645 566469396 SUPPORT CALDWELL HOSPICE AND PALLIATIVE CARE, INC. NC 501(C)(3) LINE 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0