2022-11-11T16:22:15-06:00 2021-12-31 450250958 EIDE BAILLY LLP 2950 E HARMONY RD STE 290 FORT COLLINS CO 805283429 990 2021-01-01 841453050 PIKES PEAK HOSPICE FOUNDATION PIKE 7196333400 2550 TENDERFOOT HILL STREET COLORADO SPRINGS CO 80230 JIM HARRIS BOARD CHAIR 7196333400 2022-11-09 1 JIM HARRIS 999009999 KYLE FRITCH CPA P01313374 9702238825 2022-11-09 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z LAURA ROSENDO 2550 TENDERFOOT HILL STREET COLORADO SPRINGS CO 80230 1492341 0 X WWW.PIKESPEAKHOSPICE.ORG X 1998 CO TO GENERATE AND DISTRIBUTE FUNDS IN SUPPORT OF PIKES PEAK HOSPICE AND PALLIATIVE CARE, INC. 10 9 0 10 0 0 952889 628099 0 0 588926 864242 0 0 1541815 1492341 380804 403915 0 0 293003 210901 0 0 364451 240577 218271 914384 833087 627431 659254 20316755 22306845 547679 320483 19769076 21986362 THE MISSION OF PIKES PEAK HOSPICE FOUNDATION IS TO GENERATE AND DISTRIBUTE FUNDS IN SUPPORT OF PIKES PEAK HOSPICE AND PALLIATIVE CARE, INC., SERVE THE CHARITABLE INTERESTS OF OUR DONORS AND PRUDENTLY MANAGE THEIR GIFTS. 0 0 403915 403915 PIKES PEAK HOSPICE FOUNDATION IS A TYPE I SUPPORTING ORGANIZATION FOR PIKES PEAK HOSPICE & PALLIATIVE CARE, INC., WHICH PROVIDED SERVICES TO 1,450 PATIENTS FOR THE PERIOD ENDING DECEMBER 31, 2021. THE AMOUNT TRANSFERRED TO PPHPC WAS $403,915 IN THE SAME TIME PERIOD. 403915 1 1 0 0 0 0 0 1 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 10 9 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 CO X PAUL TOSETTI 3037804600 8289 E LOWRY BLVD DENVER CO 80230 X DAWN K DARVALICS PRESIDENT/CEO/BOARD LIAISON 1.00 49.00 X 0 232925 55091 JOAN SELMAN EXECUTIVE DIRECTOR (THRU 3/21) 40.00 1.00 X 0 47608 3985 LAURA ROSENDO EXECUTIVE DIRECTOR (FROM 8/21) 40.00 1.00 X 0 40943 10638 RAY NUNN CHAIR 1.00 X X 0 0 0 CARLA HARTSELL VICE CHAIR 1.00 X X 0 0 0 SUSAN DAVIS IMMEDIATE PAST CHAIR 1.00 X X 0 0 0 JIM HARRIS TREASURER 1.00 X X 0 0 0 PEGGY CARMACK SECRETARY 1.00 X X 0 0 0 SHARON HARE TRUSTEE 1.00 X 0 0 0 ERIC SCOTT TRUSTEE 1.00 X 0 0 0 MARI SINTON-MARTINEZ TRUSTEE 1.00 X 0 0 0 MICHELLE TALARICO TRUSTEE 1.00 X 0 0 0 0 321476 69714 0 0 1 0 0 6188 621911 10262 628099 324834 324834 539408 0 539408 539408 539408 1492341 0 0 864242 403915 403915 177002 177002 20428 20428 13471 13471 64721 64721 41165 41165 8931 8931 14842 14842 18381 18381 752 752 720 720 1700 1700 DIRECT PATIENT CARE 2403 2403 DUES & SUBSCRIPTIONS 2076 2076 CONTINUING EDUCATION 170 170 62410 62410 833087 403915 64721 364451 1364498 994725 112426 36 214138 40167 174691 173971 17663469 20031592 1001671 1106521 20316755 22306845 4827 4482 542852 316001 547679 320483 X 14331905 15938621 5437171 6047741 19769076 21986362 20316755 22306845 X 659254 1458172 99860 X 0 1 X 1 0 X X X 1 PIKES PEAK HOSPICE AND PALLIATIVE CARE INC 840816047 10 1 403915 0 1 403915 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 173000 X 0 4465605 6431 562611 5034647 3936112 6277 523216 4465605 3379893 9277 676815 129873 3936112 3571156 12512 -75697 128078 3379893 3147820 121560 426941 125165 3571156 0.00000 0.53810 0.46190 0 0 41138 40167 971 173000 173000 173971 DUE TO AFFILIATED ENTITIES 316001 316001 X 2985652 1458172 99860 1558032 1427620 64721 64721 1492341 768366 0 768366 64721 64721 833087 PART III, LINE 4: ARTWORK IS MAINTAINED FOR AN AESTHETIC ENVIRONMENT FOR PATIENTS. PART V, LINE 4: OUR ENDOWMENT CONSISTS OF A SINGLE POOLED FUND ESTABLISHED BY DONORS TO PROVIDE ANNUAL FUNDING FOR FUTURE OPERATIONS. PART X, LINE 2: PIKES PEAK HOSPICE FOUNDATION IS ORGANIZED AS COLORADO NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3), QUALIFY FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTIONS 170(B)(1)(A)(VIII), AND HAS BEEN DETERMINED NOT TO BE PRIVATE FOUNDATION UNDER SECTION 509(A)(3), RESPECTIVELY. THE FOUNDATION IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE FOUNDATION IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSES. WE HAVE DETERMINED THE FOUNDATION IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990-T) WITH THE IRS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN BENEFICIAL INTERESTS IN CHARITABLE AND PERPETUAL TRUSTS 99,860. 1 PIKES PEAK HOSPICE & PALLIATIVE CARE INC 2500 TENDERFOOT HILL STREET COLORADO SPRINGS CO 80906 840816047 501(C)3 403915 0 GENERAL SUPPORT 1 0 PART I, LINE 2: PIKES PEAK HOSPICE AND PALLIATIVE CARE, INC. (PPHPC) IS A SUPPORTED ORGANIZATION OF THE FOUNDATION AND SOLE CORPORATE MEMBER OF THE FOUNDATION. NO SPECIFIC MONITORING OF GRANT FUNDS EXISTS SINCE FUNDS ARE ALL RAISED BY THE FOUNDATION FOR USE BY PPHPC. 0 0 0 0 0 0 0 0 0 DAWN K DARVALICS PRESIDENT/CEO/BOARD LIAISON 0 199798 0 32939 0 188 0 34895 0 22262 0 290082 0 0 PART I, LINE 3 THE ORGANIZATION RELIED ON A RELATED ORGANIZATION THAT USED ONE OR MORE OF THESE METHODS TO ESTABLISH THE COMPENSATION OF OFFICERS. FORM 990, PART VI, SECTION A, LINE 1A THE FOUNDATION'S EXECUTIVE COMMITTEE SHALL BE AUTHORIZED TO ACT IN THE PLACE OF THE FOUNDATION BOARD BETWEEN MEETINGS AND SHALL BE AUTHORIZED TO TAKE ALL ACTION NECESSARY IN THE EVENT THAT SUCH ACTION CANNOT WAIT FOR THE NEXT REGULARLY SCHEDULED FOUNDATION BOARD MEETING. IN THE EVENT THE EXECUTIVE COMMITTEE TAKES ACTION IN THE PLACE OF THE FOUNDATION BOARD BETWEEN REGULARLY SCHEDULED MEETINGS, THE EXECUTIVE COMMITTEE SHALL REPORT ALL SUCH ACTION TO THE FOUNDATION BOARD AT THE NEXT REGULARLY SCHEDULED MEETING. FORM 990, PART VI, SECTION A, LINE 1A THE STANDING PIKES PEAK HOSPICE AND PALLIATIVE CARE PRESIDENT SHALL SERVE AS THE FOUNDATION'S BOARD LIAISON. THE HOSPICE BOARD LIAISON IS A NON-VOTING MEMBER OF THE FOUNDATION BOARD. FORM 990, PART VI, SECTION A, LINE 3 PIKES PEAK HOSPICE AND PALLIATIVE CARE, INC., A RELATED EXEMPT ORGANIZATION, PERFORMED MANAGEMENT SERVICES AND PROVIDED ADMINISTRATIVE RESOURCES TO THE FOUNDATION. FORM 990, PART VI, SECTION A, LINE 6 PIKES PEAK HOSPICE AND PALLIATIVE CARE, INC. IS THE SOLE MEMBER OF THE FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER, PIKES PEAK HOSPICE AND PALLIATIVE CARE, INC. HAS THE POWER TO APPROVE AND REMOVE TRUSTEES OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE HOSPICE CHIEF FINANCIAL OFFICER AND CONTROLLER, EXECUTIVE DIRECTOR AND BOARD OF TRUSTEES PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL EDUCATION IS PROVIDED TO THE BOARD MEMBERS OFFICERS, AND STAFF. ALL CONFLICTS ARE ADDRESSED BY OFFICERS AND CONTRACT LEGAL COUNSEL AS NEEDED. BOARD MEMBERS ARE REQUIRED TO SIGN AN ANNUAL CONFLICT OF INTEREST STATEMENT. BOARD MEMBERS WHO HAVE A CONFLICT WITH RESPECT TO A MATTER BEFORE THE BOARD ARE DIRECTED TO DISCLOSE THE CONFLICT AND ABSTAIN FROM VOTING ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE PRESIDENT/CEO BOARD LIAISON AND EXECUTIVE DIRECTOR POSITIONS OF THE FOUNDATION ARE COMPENSATED BY PIKE PEAK HOSPICE AND PALLIATIVE CARE, INC. (PPHPC), A RELATED TAX-EXEMPT ORGANIZATION. PPHPC USES REGIONAL NONPROFIT COMPENSATION SURVEYS AND MARKET DATA TO DETERMINE COMPENSATION LEVELS. IN ADDITION, THE PIKES PEAK HOSPICE FOUNDATION (PPHF) HAS A SUBCOMMITTEE THAT REVIEWS MARKET DATA FOR THE EXECUTIVE DIRECTOR POSITION. BASED ON THEIR REVIEW, THE SUBCOMMITTEE PROVIDES RECOMMENDATIONS TO THE PPHPC BOARD OF TRUSTEES FOR THE EXECUTIVE DIRECTOR'S ANNUAL SALARY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND FINANCIALS STATEMENTS ARE AT THE ORGANIZATION'S LOCATION AND ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A - EMPLOYEE WAGES PIKES PEAK HOSPICE & PALLIATIVE CARE, INC. (PPHPC) PAYS THE SALARIES FOR THE ORGANIZATION'S EMPLOYEES. THEREFORE, THE ORGANIZATION DOES NOT REPORT ANY COMPENSATION ON W-2S OR 1099-MISCS FOR ITS EMPLOYEES. IN ADDITION, THE SALARY, BENEFITS, AND PAYROLL TAX EXPENSES SHOWN ON LINES 7, 8, 9, AND 10 OF PART IX REPRESENT AMOUNTS PAID BY THE FOUNDATION TO PPHPC FOR THESE EMPLOYEES SERVICES. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN PERPETUAL AND CHARITABLE TRUSTS 99,860. PIKES PEAK HOSPICE AND PALLIATIVE CARE INC 2550 TENDERFOOT HILL STREET COLORADO SPRINGS CO 80906 840816047 CARE OF THE TERMINALLY ILL CO 501(C)(3) LINE 10 N/A 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0