2022-05-09T10:29:45-05:00 2021-06-30 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 200 STOCKTON CA 952192367 990 2020-07-01 942823240 PATHWAYS HOME HEALTH AND HOSPICE PATH 5135760262 585 N MARY AVENUE SUNNYVALE CA 94085 JACK HAWKINS INTERIM CFO 5135760262 2022-05-05 1 JACK HAWKINS 999009999 TRACY S PAGLIA P00366884 2099556100 2022-05-05 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z DAN DIETZ 1700 EDISON DR MILFORD OH 45150 48295327 0 X HTTP://WWW.PATHWAYSHEALTH.ORG X 1982 CA PROVIDES HIGH-QUALITY PATIENT AND FAMILY-CENTERED CARE IN THE HOME WITH KINDNESS AND DIGNITY. 7 7 263 161 0 0 2742359 1876755 32000057 30365601 -74086 1332147 150715 98731 34819045 33673234 6000 0 0 0 24313520 19181137 0 48999 614618 13560633 12408921 37880153 31639057 -3061108 2034177 62771044 72582123 11164269 10670124 51606775 61911999 X PATHWAYS PROVIDES HIGH-QUALITY PATIENT AND FAMILY-CENTERED CARE IN THE HOME, WITH KINDNESS AND RESPECT, PROMOTING COMFORT, INDEPENDENCE AND DIGNITY. 0 0 26272911 30365601 SEE SCHEDULE O PATHWAYS HOME HEALTH & HOSPICE IS A NOT-FOR-PROFIT COMMUNITY-BASED ORGANIZATION THAT PROVIDES HOME HEALTH AND HOSPICE SERVICES. FOUNDED IN 1977, PATHWAYS SERVES FAMILIES IN FIVE BAY AREA COUNTIES. WE CARE FOR PATIENTS IN THEIR PLACE OF RESIDENCE - IN HOSPICE THAT MAY ALSO BE A HOSPITAL OR NURSING HOME. PATHWAYS IS MEDICARE CERTIFIED, LICENSED BY THE STATE OF CALIFORNIA AND ACCREDITED BY THE JOINT COMMISSION. THE ORGANIZATIONAL FOCUS OF HOME HEALTH IS TO PROVIDE EXCELLENT CARE TO HOMEBOUND PATIENTS, AND IN HOSPICE TO SUPPORT AND CARE FOR TERMINALLY ILL PATIENTS AND THEIR FAMILIES. HOSPICE SERVICES ARE INTERDISCIPLINARY AND INCLUDE NURSES, SOCIAL WORKERS, PERSONAL CARE AIDES, PHYSICIANS, CHAPLAINS, VOLUNTEERS. PATHWAYS HOME HEALTH PROVIDES SUPPORT TO HOMEBOUND PATIENTS INCLUDING THOSE RECOVERING FROM SURGERY, ILLNESS OR INJURY THROUGH THE SUPPORT OF NURSES; PHYSICAL, OCCUPATIONAL, RESPIRATORY AND SPEECH THERAPISTS; SOCIAL WORKERS; DIETITIANS; AND PERSONAL CARE AIDES. PATHWAYS HAS SPECIALTY PROGRAMS THAT INCLUDE: PALLIATIVE CARE, HEART FAILURE, TELE-MONITORING, INFUSION THERAPY, CHRONIC OBSTRUCTIVE PULMONARY DISEASE MANAGEMENT, AND WOUND MANAGEMENT AMONG OTHERS. PATHWAYS HOSPICE IS HOLISTIC CARE THAT PROVIDES SYMPTOM MANAGEMENT, AS WELL AS SPIRITUAL AND EMOTIONAL SUPPORT FROM NURSES, PHYSICIANS, SOCIAL WORKERS, VOLUNTEERS, CHAPLAINS, AND PERSONAL CARE AIDES TO PEOPLE WITH SIX MONTHS OR LESS TO LIVE. PATHWAYS HOSPICE CARE ALSO PROVIDES ROUND-THE-CLOCK NURSING AND MEDICAL SUPPORT. WE PROVIDE EXTENSIVE BEREAVEMENT SUPPORT TO FAMILY AND FRIENDS OF PATIENTS. 26272911 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 48 0 1 263 1 0 0 0 0 0 1 1 1 0 0 0 0 0 0 X 7 7 0 1 0 0 1 1 1 1 1 1 0 1 1 1 1 1 1 0 0 0 CA X JACK HAWKINS 5135768478 585 N MARY AVE SUNNYVALE CA 94085 X CHERYL REINKING PRESIDENT 1.00 X X 0 0 0 DIETER BRUNO TREASURER 1.00 X X 0 0 0 KIM OSBORNE TREASURER (THRU 4/21) 1.00 X X 0 0 0 TOM HARSHMAN SECRETARY/VICE PRESIDENT 1.00 X X 0 0 0 DEB MURO DIRECTOR 1.00 X 0 0 0 CINDY MURPHY DIRECTOR (THRU 4/21) 1.00 X 0 0 0 KIM COSTELLO DIRECTOR 1.00 X 0 0 0 CARLOS BOHORQUEZ DIRECTOR 1.00 X 0 0 0 ELEANOR EBERHARD DIRECTOR 1.00 X 0 0 0 W SCOTT HERDTNER CFO 10.00 X 0 0 0 DANIEL S DIETZ CEO 10.00 X 0 0 0 BARBARA BURGESS FORMER CEO (THRU 11/19) 40.00 X 384612 0 0 SCOTT ROBINSON FORMER COO/CCO (THRU 11/19) 40.00 X 354617 0 0 SATWANT JOHAL FORMER CFO/CAO (THRU 11/19) 40.00 X 313163 0 0 JAGMOHAN KHAIRA MEDICAL DIRECTOR 40.00 X 183446 0 23251 YAN QIN RN HOME CARE-SCHLD 40.00 X 180748 0 11907 1416586 0 35158 58 0 1 0 AMERICAN NURSING CARE (CONSOLIDATED HEAL 1700 EDISON DR MILFORD OH 45150 MANAGEMENT FEES 3168794 MEDEFIS CONSOLIDATED PO BOX 5068 NEW YORK NY 10087 FIELD STAFF CONTRACTOR 975945 JEWISH HOME OF SAN FRANCISCO 302 SILVER AVE SAN FRANCISCO CA 94112 MEDICAL PROVIDER 488593 RAKHI YADAV 203 MONTCLAIR RD LOS GATOS CA 95032 MEDICAL DIRECTOR 323600 CHAPARRAL HOUSE 1309 ALLSTON WAY BERKELEY CA 94702 MEDICAL PROVIDER 310963 10 272666 753818 850271 5109 1876755 PATIENT SERVICE 621610 30365601 30365601 30365601 1071037 1071037 21951 4143 17808 17808 17808 14858614 14438132 159372 420482 -159372 261110 261110 0 272666 20446 -20446 -20446 OTHER REVENUE 900099 101369 101369 101369 33673234 30365601 0 1430878 X 121856 121856 15361171 12783033 2271914 306224 2493057 1651009 786966 55082 1205053 792793 390991 21269 18432 18432 100844 100844 48999 48999 21105 21105 7175249 7137572 37677 69101 8964 57278 2859 1771144 1359545 281056 130543 350055 108668 241387 321400 317773 3627 24288 24288 443196 443196 152296 149596 2700 MEDICAL SUPPLIES 1655882 1655882 REPAIRS AND MAINTENANCE 132485 132485 DUES AND SUBSCRIPTIONS 20373 14650 5723 SALES TAX 11283 11283 141788 14476 123770 3542 31639057 26272911 4751528 614618 1934197 2546237 5597370 6362030 4676 3458 4237971 3466235 473919 264562 7293708 3618492 4160124 3675216 43537237 53497446 2825550 2766939 62771044 72582123 4590097 6385807 1041965 324094 4160000 3960000 1372207 223 11164269 10670124 X 50275475 60178599 1331300 1733400 51606775 61911999 62771044 72582123 2034177 8271047 0 X 0 1 X 1 0 X 1859575 5293599 1985781 2742359 1876755 13758069 41595302 38551738 35523317 32000057 30365601 178036015 63630 59430 50320 43319 0 216699 43518507 43904767 37559418 34785735 32242356 192010783 345900 3943050 284000 302000 285000 5159950 0 345900 3943050 284000 302000 285000 5159950 186850833 789122 977078 1062416 1470655 1092988 5392259 789122 977078 1062416 1470655 1092988 5392259 204292 63221 17859 113506 101369 500247 44511921 44945066 38639693 36369896 33436713 197903289 0.94420 0.95030 0.02720 0.02320 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER REVENUE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1314406 417846 16035 1716217 1303520 17023 6137 1314406 1298965 18337 13782 1303520 1205839 110370 17244 1298965 883889 199783 134964 12797 1205839 0.00000 1.00000 0.00000 0 0 1524100 1524100 1750900 953267 797633 2242491 1204766 1037725 1040547 882382 158165 735670 578077 157593 3675216 MEDICARE REIMB RECON -226680 457B PLAN 226903 223 X 42128300 8271047 179818 8450865 33677435 -4201 -4201 33673234 31823000 179818 179818 31643182 -4125 -4125 31639057 PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUND ARE TO BE REINVESTED AND USED FOR OPERATIONAL SUPPORT. PART X, LINE 2: THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND SECTION 2370(D) OF THE CALIFORNIA REVENUE AND TAXATION CODE. AS OF JUNE 30, 2021 AND 2020, THE ORGANIZATION HAD NO UNRECOGNIZED TAX POSITIONS OR UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: LOSS ON SALE FIXED ASSETS 159,372. RECLASSIFIED SPECIAL EVENT EXPENSES TO REVENUE 20,446. PART XI, LINE 4B - OTHER ADJUSTMENTS: RECLASSIFIED RENTAL INCOME FROM EXPENSES -4,201. PART XII, LINE 2D - OTHER ADJUSTMENTS: RECLASSIFIED SPECIAL EVENT EXPENSES TO REVENUE 20,446. LOSS ON SALE FIXED ASSETS 159,372. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECLASSIFIED RENTAL INCOME FROM EXPENSES -4,125. X X X X X X X 1 KERRY BEUTHIN CFRE 1303 LEIMERT BLVD OAKLAND CA 94602 GRANT WRITER & GRANTS MANAGER 0 412800 48999 363801 412800 48999 363801 CA ANNUAL BREAKFAST 272666 272666 20446 272666 272666 20446 20446 -20446 1 0 0 0 0 0 0 0 0 BARBARA BURGESS FORMER CEO (THRU 11/19) 0 0 0 0 384612 0 0 0 0 0 384612 0 0 0 SCOTT ROBINSON FORMER COO/CCO (THRU 11/19) 0 0 0 0 354617 0 0 0 0 0 354617 0 0 0 SATWANT JOHAL FORMER CFO/CAO (THRU 11/19) 0 0 0 0 313163 0 0 0 0 0 313163 0 0 0 JAGMOHAN KHAIRA MEDICAL DIRECTOR 183271 0 0 0 175 0 0 0 23251 0 206697 0 0 0 YAN QIN RN HOME CARE-SCHLD 180515 0 0 0 233 0 0 0 11907 0 192655 0 0 0 PART I, LINE 4A BARBARA BURGESS, SCOTT ROBINSON AND SATWANT JOHAL RECEIVED SEVERANCE PAYMENTS DURING THE YEAR. AMOUNTS ARE REPORTED IN SCHEDULE J, PART II COLUMN (B)(III). A ABAG FINANCE AUTHORITY FOR NONPROFIT ORGANIZATIONS 943130123 00037CGL8 2004-10-19 6070000 FINANCE COSTS OF THE ACQUISITION, RENOVATION AND EQUIPPING OF A FACILITY 0 0 0 A 2310000 6090757 55034 6035723 2005 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 1 0 0 0 1 A 1 SCHEDULE K, PART III, LINE 7: AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR RELATED TRADE OR BUSINESS REPORTED IN PART III, LINE 6, IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. SCHEDULE K, PART IV, LINE 2(C): THE REBATE COMPUTATION WAS PERFORMED AS OF JUNE 1, 2006. NO REBATE CALCULATION WAS PERFORMED AS OF JUNE 1, 2016 AS ALL BOND PROCEEDS WERE EXPENDED PRIOR TO THE JUNE 1, 2006 CALCULATION. FORM 990, PART VI, SECTION A, LINE 3 EFFECTIVE NOVEMBER 1, 2019, CONSOLIDATED HEALTH SERVICES, INC, D/B/A CHI HEALTH AT HOME (CHAH) WAS GIVEN THE AUTHORITY AND RESPONSIBILITY TO CONDUCT, SUPERVISE, AND MANAGE THE DAY-TO-DAY OPERATIONS OF PATHWAYS HOME HEALTH AND HOSPICE (PHHH), INCLUDING BUT NOT LIMITED TO SUPERVISION, DIRECTION AND MANAGEMENT OF PHHS' EMPLOYEES OR CONTRACTORS, AND TO PERFORM ALL OF THE MANAGEMENT SERVICES NECESSARY FOR THE BUSINESS OPERATIONS OF PHHH, INCLUDING, BUT NOT LIMITED TO, BILLING, SCHEDULING OF VISITS, COLLECTION OF REVENUES, ACCOUNTS PAYABLE, DISBURSEMENT OF FUNDS, COORDINATION WITH THIRD-PARTY PAYERS, OBTAINING SUPPLIES, EQUIPMENT, AND SERVICES, NEGOTIATING MANAGED CARE AGREEMENTS, STRATEGIC PLANNING, OVERSIGHT OF RELEASE OF INFORMATION AND HEALTH INFORMATION MANAGEMENT SERVICES, PROVIDING ADMINISTRATIVE SUPPORT TO PHHH, OPERATING AND MAINTAINING INFORMATION SYSTEMS, AND PROVIDING SUCH OTHER SERVICES AS ARE REQUIRED FOR THE EFFICIENT OPERATION OF PHHH. THROUGH THIS MANAGEMENT AGREEMENT, DANIEL S. DIETZ-CEO, AND WILLIAM S. HERDTNER-CFO, OFFICERS OF CHAH, WHOM SERVE IN THEIR RESPECTIVE ROLES FOR PHHH, ARE COMPENSATED BY CHAH. THE PORTION OF THEIR COMPENSATION RELATED TO THEIR SERVICES PROVIDED TO PHHH FOR THE FISCAL YEAR ENDED JUNE 30, 2021 WERE AS FOLLOWS: DANIEL S. DIETZ-$127,386, WILLIAM S. HERDTNER $60,931. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS TWO MEMBERS; EL CAMINO HOSPITAL AND DIGNITY HEALTH, DBA SEQUOIA HOSPITAL; BOTH ARE CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATIONS AND EXEMPT UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE. FORM 990, PART VI, SECTION A, LINE 7A EACH OF THE MEMBER HOSPITALS HAS THE RIGHT TO VOTE FOR ONE HALF OF THE CORPORATION'S DIRECTORS. AN ADDITIONAL MEMBER SHALL BE APPOINTED BY A MAJORITY VOTE OF THE CORPORATIONS ELECTED AND SERVING DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER HOSPITALS HAVE RESERVED POWERS, INCLUDING THE POWER TO APPROVE CHANGES IN THE ORGANIZATIONAL DOCUMENTS AND PURPOSES, THE DISPOSITION OF ALL OR SUBSTANTIALLY ALL ASSETS, MERGER OR OTHER REORGANIZATION, EXTRAORDINARY EXPENDITURES, AND DEBT INCURRENCE. FORM 990, PART VI, SECTION B, LINE 11B OUR PROCESS IS, UPON COMPLETION OF THE DRAFT COPY, THE 990 IS REVIEWED IN DETAIL BY A COMMITTEE OF THE BOARD ALONG WITH THE ORGANIZATION'S CEO, CFO, AND TAX AUDIT FIRM. THE DRAFT COPY IS PROVIDED TO THE COMMITTEE IN PAPER FORM. THE 990 IS REVIEWED PRIOR TO FILING. THE 990 IS MADE AVAILABLE TO BOARD MEMBERS FOR FINAL REVIEW. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY APPLIES TO BOARD MEMBERS AND EXECUTIVE STAFF. THE POLICY IS REVIEWED ANNUALLY. IN THE CASE OF A POTENTIAL OR ACTUAL CONFLICT, THE MEMBER WOULD RECUSE HIMSELF/HERSELF FROM MANAGEMENT DECISIONS RELATED TO THAT CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 NO OFFICERS, DIRECTORS OR TRUSTEES RECEIVED COMPENSATION FROM THE ORGANIZATION. ANY EXECUTIVE COMPENSATION PAID TO OFFICERS, DIRECTORS OR TRUSTEES BY MANAGEMENT COMPANY WAS SET BY THE MANAGEMENT COMPANY'S COMPENSATION COMMITTEE UTILIZING BOTH AN INDEPENDENT CONSULTANT AND COMPARABILITY STUDIES TO DETERMINE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE AUDITED FINANCIAL STATEMENTS AND WRITTEN CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST; THE PUBLIC CAN COME IN AND REVIEW A COPY OF THE DOCUMENTS; HOWEVER IN SOME CASES WE WILL PROVIDE A BOUND COPY OR EMAIL THEM A PDF COPY. UPON REQUEST, AND IN PERSON, THE PUBLIC CAN COME IN AND REVIEW A COPY OF THE ORGANIZATION'S 990 AND GOVERNING DOCUMENTS. FORM 990, PART VII CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC W. SCOTT HERDTNER - 1700 EDISON DR., MILFORD, OH 45150. DANIEL S. DIETZ - 1700 EDISON DR., MILFORD, OH 45150. FORM 990, PART IX, LINE 11G OTHER DIRECTOR FEES FOR SERVICE (NON EMPLOYEES): PROGRAM SERVICE EXPENSES 3,037,856. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,037,856. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,617,980. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 37,677. TOTAL EXPENSES 2,655,657. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 991,640. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 991,640. MEDICAL PROFESSIONALS: PROGRAM SERVICE EXPENSES 490,096. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 490,096.