HOSPICE OF SANTA CRUZ COUNTY: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- HOSPICE OF SANTA CRUZ COUNTY (EIN 94-2497618)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-11-16
- IRS object ID
- 202223209349302862
- Schema version
- 2020v4.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule J
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-16T20:03:45-06:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 946214841 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ARMANINO LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 W SAN FERNANDO ST STE 500 | AddressLine1Txt |
| City | SAN JOSE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95113 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | 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 | CATHERINE CONWAY | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 8314303000 | PhoneNum |
| Signature | 2022-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | CATHERINE | PersonFirstNm |
| Person Last | CONWAY | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MATTHEW PETROSKI | PreparerPersonNm |
| PTIN | P00853132 | PTIN |
| Phone | 4082006400 | PhoneNum |
| Preparation | 2022-11-11 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CATHERINE CONWAY | 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 | $21,336,470 | 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 | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 176 | TotalEmployeeCnt |
| Total Volunteers | 80 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,106,587 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,825,299 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $20,945,187 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $17,943,603 | CYProgramServiceRevenueAmt |
| PY Investment Income | $10,565 | PYInvestmentIncomeAmt |
| CY Investment Income | $245,920 | CYInvestmentIncomeAmt |
| PY Other Revenue | $61,954 | PYOtherRevenueAmt |
| CY Other Revenue | $52,666 | CYOtherRevenueAmt |
| PY Total Revenue | $22,124,293 | PYTotalRevenueAmt |
| CY Total Revenue | $21,067,488 | 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 | $16,143,935 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $14,446,300 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $466,578 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,220,241 | PYOtherExpensesAmt |
| CY Other Expenses | $5,758,196 | CYOtherExpensesAmt |
| PY Total Expenses | $23,364,176 | PYTotalExpensesAmt |
| CY Total Expenses | $20,204,496 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,239,883 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $862,992 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $13,958,586 | TotalAssetsBOYAmt |
| Total Assets EOY | $16,612,272 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,099,504 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,395,377 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,859,082 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $11,216,895 | NetAssetsOrFundBalancesEOYAmt |
| Mission | HOSPICE OF SANTA CRUZ COUNTY HONORS THE CHOICES OF INDIVIDUALS AND FAMILIES BY PROVIDING EXEMPLARY END-OF-LIFE CARE AND GRIEF SUPPORT TO OUR COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $14,864,074 | ExpenseAmt |
| Revenue | $17,943,603 | RevenueAmt |
| Desc | 1,049 PATIENTS AND FAMILIES RECEIVED 63,250 DAYS OF EXPERT END-OF-LIFE CARE FROM HOSPICE TEAMS OF MEDICAL DIRECTORS, NURSES, SOCIAL WORKERS, CHAPLAINS, HOSPICE AIDES, AND VOLUNTEERS. ADDITIONALLY, 2,141 INDIVIDUAL GRIEF SUPPORT SESSIONS AND 92 GROUP GRIEF SUPPORT SESSIONS WERE PROVIDED TO HOSPICE FAMILIES AND GRIEVING COMMUNITY MEMBERS OF ALL AGES. | Desc |
| Total Program Service Expenses | $14,864,074 | 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 | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | 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 | 0 | 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 | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | 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 | 74 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 176 | 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 | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| 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 | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | 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
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (30 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| BOB KASWEN | ||||||||
| PRESIDENT (THRU 12/20), DIRECTOR | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DICK CLARK | ||||||||
| PRESIDENT (AS OF 01/21)) | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DAVID KLUGER | ||||||||
| VICE PRESIDENT (THRU 12/20), DIRECTOR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JULIA COWELL | ||||||||
| VICE PRESIDENT (AS OF 01/21) | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| CARA DISIMONE | ||||||||
| SECRETARY (AS OF 01/21) | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MARGARET GORDON | ||||||||
| SECRETARY (THRU 12/20) | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| TIMOTHY TIM ULEN | ||||||||
| TREASURER (AS OF 01/21) | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ALICIA FLORES | ||||||||
| DIRECTOR (THRU 12/20) | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DALE BISHOP MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ED NEWMAN | ||||||||
| DIRECTOR (THRU 02/21) | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ED SACKS MD | ||||||||
| DIRECTOR (THRU 01/21) | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| HOLLY ALEXANDER | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KUNTAL THAKER MD | ||||||||
| DIRECTOR (THRU 01/21) | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SHARON TAPPER MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BETH HANSMAN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL ALLARD | ||||||||
| DIRECTOR (AS OF 01/21) | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| GARRY CRUMMER MD | ||||||||
| DIRECTOR (AS OF 01/21) | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DAISY NUNEZ | ||||||||
| DIRECTOR (AS OF 01/21) | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KATHERINE KATIE GABRIEL-COX MD | ||||||||
| DIRECTOR (AS OF 03/21) | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SIGOLENE A ORTEGA | ||||||||
| DIRECTOR (AS OF 03/21) | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RACHEL WEDEEN | ||||||||
| DIRECTOR (THRU 12/20) | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CATHERINE G CONWAY | ||||||||
| CHIEF EXECUTIVE OFFICER CURRENT | 40.00 | Yes (X) | $229,493 | $0 | $33,294 | |||
| ADAM SIMON SHORE | ||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $236,935 | $0 | $14,102 | |||
| MICHAEL MILWARD | ||||||||
| CEO FORMER | 40.00 | Yes (X) | $189,167 | $0 | $19,821 | |||
| LISA M FLORES | ||||||||
| SENIOR IT DIRECTOR | 40.00 | $152,989 | $0 | $11,378 | Yes (X) | |||
| KARL JOSEPH SEGNITZ | ||||||||
| CHIEF MEDICAL OFFICER | 40.00 | $261,743 | $0 | $15,458 | Yes (X) | |||
| JUDITH HUMBLE | ||||||||
| CHIEF COMPLIANCE OFFICER | 40.00 | $204,488 | $0 | $14,798 | Yes (X) | |||
| GLORIA REED | ||||||||
| CHIEF CLINICAL OFFICER | 40.00 | $189,515 | $0 | $11,096 | Yes (X) | |||
| KAREN TANASESCU | ||||||||
| DIRECTOR OF OPERATIONS | 40.00 | $158,450 | $0 | $12,886 | Yes (X) | |||
| ANGELA MAE BROUSE | ||||||||
| NURSE TEAM LEAD | 40.00 | $150,483 | $0 | $11,929 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,773,263 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $144,762 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 55 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| COVENANT CARE CAPITOLA LLC | |||||
| 1935 WHARF ROAD | CAPITOLA | CA | 950102606 | NURSING HOME R/B | $531,122 |
| ALLEN BUENO DEL BOSQUE | |||||
| 311 33RD AVE | SANTA CRUZ | CA | 95062 | CONTRACT MEDICAL DIRECTOR | $294,194 |
| SANTA CRUZIDENCEOPCO LLC | |||||
| 1115 CAPITOLA RD | SANTA CRUZ | CA | 95062 | NURSING HOME R/B | $208,279 |
| BONNY MASTERS | |||||
| 634 SAN JUAN AVENUE | SANTA CRUZ | CA | 95065 | CONTRACT MEDICAL DIRECTOR | $115,390 |
| DRIFTWOOD S C OPERATING CO LLC | |||||
| 675 24TH AVE | SANTA CRUZ | CA | 95062 | NURSING HOME R/B | $107,660 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $8,924 | FederatedCampaignsAmt |
| Government Grants | $1,227,051 | GovernmentGrantsAmt |
| All Other Contributions | $1,589,324 | AllOtherContributionsAmt |
| Noncash Contributions | $578,587 | NoncashContributionsAmt |
| Total Contributions | $2,825,299 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | HOSPICE SERVICES | Desc |
| Business | 621610 | BusinessCd |
| Total Revenue Column | $17,943,603 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,943,603 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $17,943,603 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,353 | TotalRevenueColumnAmt |
| Exclusion | $1,353 | ExclusionAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $43,895 | TotalRevenueColumnAmt |
| Exclusion | $43,895 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $513,549 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $268,982 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $244,567 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $244,567 | TotalRevenueColumnAmt |
| Exclusion | $244,567 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $8,771 | TotalRevenueColumnAmt |
| Exclusion | $8,771 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $8,771 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,067,488 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,943,603 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $298,586 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $779,958 | TotalAmt |
| Program Services | $43,909 | ProgramServicesAmt |
| Management And General | $736,049 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,216,863 | TotalAmt |
| Program Services | $9,909,875 | ProgramServicesAmt |
| Management And General | $972,884 | ManagementAndGeneralAmt |
| Fundraising | $334,104 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $131,196 | TotalAmt |
| Program Services | $107,968 | ProgramServicesAmt |
| Management And General | $19,578 | ManagementAndGeneralAmt |
| Fundraising | $3,650 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,381,485 | TotalAmt |
| Program Services | $1,089,097 | ProgramServicesAmt |
| Management And General | $256,242 | ManagementAndGeneralAmt |
| Fundraising | $36,146 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $936,798 | TotalAmt |
| Program Services | $785,652 | ProgramServicesAmt |
| Management And General | $125,388 | ManagementAndGeneralAmt |
| Fundraising | $25,758 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,590 | TotalAmt |
| Program Services | $3,283 | ProgramServicesAmt |
| Management And General | $9,307 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,697 | TotalAmt |
| Management And General | $58,697 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96 | TotalAmt |
| Management And General | $96 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,316 | TotalAmt |
| Management And General | $19,316 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,305,744 | TotalAmt |
| Program Services | $958,895 | ProgramServicesAmt |
| Management And General | $341,358 | ManagementAndGeneralAmt |
| Fundraising | $5,491 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,286 | TotalAmt |
| Program Services | $805 | ProgramServicesAmt |
| Management And General | $57,491 | ManagementAndGeneralAmt |
| Fundraising | $3,990 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $493,894 | TotalAmt |
| Program Services | $126,103 | ProgramServicesAmt |
| Management And General | $344,964 | ManagementAndGeneralAmt |
| Fundraising | $22,827 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $724,369 | TotalAmt |
| Program Services | $11,347 | ProgramServicesAmt |
| Management And General | $695,981 | ManagementAndGeneralAmt |
| Fundraising | $17,041 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $285,580 | TotalAmt |
| Management And General | $285,580 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $150,814 | TotalAmt |
| Program Services | $149,108 | ProgramServicesAmt |
| Management And General | $1,687 | ManagementAndGeneralAmt |
| Fundraising | $19 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,241 | TotalAmt |
| Program Services | $14,912 | ProgramServicesAmt |
| Management And General | $24,493 | ManagementAndGeneralAmt |
| Fundraising | $836 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,026 | TotalAmt |
| Management And General | $16,879 | ManagementAndGeneralAmt |
| Fundraising | $12,147 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $341,143 | TotalAmt |
| Management And General | $341,143 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $174,680 | TotalAmt |
| Program Services | $75,592 | ProgramServicesAmt |
| Management And General | $99,088 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|---|
| PATIENT SERVICE, SUPPLY | $1,536,230 | $1,531,813 | $4,417 | |
| MEMBERSHIPS AND SUBSCRI | $342,740 | $43,670 | $150 | $298,920 |
| BAD DEBT | $168,703 | $168,703 | ||
| MEDICAL ROOM & BOARD | $11,825 | $11,823 | $2 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $222 | TotalAmt |
| Program Services | $222 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,204,496 | TotalAmt |
| Program Services | $14,864,074 | ProgramServicesAmt |
| Management And General | $4,873,844 | ManagementAndGeneralAmt |
| Fundraising | $466,578 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,029,477 | BOYAmt |
| EOY | $3,261,887 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,045,918 | BOYAmt |
| EOY | $1,742,989 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $369,689 | BOYAmt |
| EOY | $30,000 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,742,354 | BOYAmt |
| EOY | $2,269,174 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $61,056 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $356,757 | BOYAmt |
| EOY | $274,248 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,221,173 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,405,299 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,965,277 | BOYAmt |
| EOY | $2,815,874 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,788,469 | BOYAmt |
| EOY | $4,724,930 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $660,645 | BOYAmt |
| EOY | $1,432,114 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,958,586 | BOYAmt |
| EOY | $16,612,272 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,997,422 | BOYAmt |
| EOY | $1,962,972 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $248,658 | BOYAmt |
| EOY | $223,569 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,853,424 | BOYAmt |
| EOY | $3,208,836 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,099,504 | BOYAmt |
| EOY | $5,395,377 | 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 | $9,247,624 | BOYAmt |
| EOY | $10,495,872 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $611,458 | BOYAmt |
| EOY | $721,023 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,859,082 | BOYAmt |
| EOY | $11,216,895 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,958,586 | BOYAmt |
| EOY | $16,612,272 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $862,992 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $354,757 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $140,064 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| 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 | $958,027 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,405,711 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,808,791 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,106,587 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,825,299 | CurrentTaxYearAmt |
| Total | $8,104,415 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $958,027 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,405,711 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,808,791 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,106,587 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,825,299 | CurrentTaxYearAmt |
| Total | $8,104,415 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $938,562 | SubstantialContributorsTotAmt |
| Public Support Total170 | $7,165,853 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $54,691 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $62,977 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $97,561 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $52,065 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $45,248 | CurrentTaxYearAmt |
| Total | $312,542 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $55,517 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $31,122 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $47,477 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $26,862 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,771 | CurrentTaxYearAmt |
| Total | $169,749 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $8,586,706 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $101,381,035 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.83450 | PublicSupportCY170Pct |
| Public Support PY170 | 0.87180 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | GROSS INCOME SPECIAL EVENTS GROSS INCOME SPECIAL EVENTS GAMING OTHER INCOME | ExplanationTxt |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $96 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $96 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS A MEMBER OF NATIONAL HOSPICE & PALLIATIVE CARE ORGANIZATION, WHICH PERFORMS LIMITED LOBBYING ACTIVITIES. BASED ON THAT ORGANIZATIONS TAX RETURN THE AMOUNT OF ALLOCATED LOBBYING EXPENSES IS DE MINIMIS ($96) | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| 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 Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| 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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| 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 Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $517,009 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $13,013 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $530,022 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $470,969 | BeginningYearBalanceAmt |
| Contributions | $100 | ContributionsAmt |
| Investment Earnings Or Losses | $45,940 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $517,009 | 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 | $558,850 | OtherCostOrOtherBasisAmt |
| Book Value | $558,850 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,658,158 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,135,152 | DepreciationAmt |
| Book Value | $1,523,006 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $541,874 | OtherCostOrOtherBasisAmt |
| Depreciation | $284,696 | DepreciationAmt |
| Book Value | $257,178 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $932,186 | OtherCostOrOtherBasisAmt |
| Depreciation | $647,774 | DepreciationAmt |
| Book Value | $284,412 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $530,105 | OtherCostOrOtherBasisAmt |
| Depreciation | $337,677 | DepreciationAmt |
| Book Value | $192,428 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,815,874 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| ENDOWED AGENCY FUND HELD AT COMMUNITY FOUNDATION OF SCC | $511,307 | F |
| NON ENDOWED AGENCY FUND HELD AT COMMUNITY FOUNDATION OF SCC | $4,213,623 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $4,724,930 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DEPOSITS | $799,294 |
| DEFERRED COMPENSATION ASSETS | $287,413 |
| SELF-INSURANCE RESERVE | $244,243 |
| DUE FROM CHN | $101,164 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,432,114 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED COMPENSATION LIABILITIES | $287,413 |
| SELF-INSURANCE LIABILITY | $244,243 |
| PPP LOAN | $2,677,180 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,208,836 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, LINE 4: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION'S ENDOWMENT FUNDS CONSISTS OF FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES TO SUPPORT THE ORGANIZATIONS PROGRAMS. THE ORGANIZATION HAS A POLICY OF CLASSIFYING INVESTMENT INCOME ON ENDOWMENT FUNDS AS TEMPORARILY RESTRICTED UNTIL SUCH TIME AS SPECIFICALLY BUDGETED FOR SPENDING AND APPROVED BY THE BOARD. | ExplanationTxt |
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 | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 JOSEPH SEGNITZ | ||||||||||||||
| CHIEF MEDICAL OFFICER | $261,743 | $0 | $0 | $0 | $0 | $0 | $3,900 | $0 | $11,558 | $0 | $277,201 | $0 | $0 | $0 |
| CATHERINE G CONWAY | ||||||||||||||
| CHIEF EXECUTIVE OFFICER CURRENT | $229,493 | $0 | $0 | $0 | $0 | $0 | $23,413 | $0 | $9,881 | $0 | $262,787 | $0 | $0 | $0 |
| ADAM SIMON SHORE | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $236,935 | $0 | $0 | $0 | $0 | $0 | $2,803 | $0 | $11,299 | $0 | $251,037 | $0 | $0 | $0 |
| JUDITH HUMBLE | ||||||||||||||
| CHIEF COMPLIANCE OFFICER | $204,488 | $0 | $0 | $0 | $0 | $0 | $3,240 | $0 | $11,558 | $0 | $219,286 | $0 | $0 | $0 |
| MICHAEL MILWARD | ||||||||||||||
| CEO FORMER | $189,167 | $0 | $0 | $0 | $0 | $0 | $15,150 | $0 | $4,671 | $0 | $208,988 | $0 | $0 | $0 |
| GLORIA REED | ||||||||||||||
| CHIEF CLINICAL OFFICER | $189,515 | $0 | $0 | $0 | $0 | $0 | $1,215 | $0 | $9,881 | $0 | $200,611 | $0 | $0 | $0 |
| KAREN TANASESCU | ||||||||||||||
| DIRECTOR OF OPERATIONS | $155,121 | $0 | $3,329 | $0 | $0 | $0 | $1,543 | $0 | $11,343 | $0 | $171,336 | $0 | $0 | $0 |
| LISA M FLORES | ||||||||||||||
| SENIOR IT DIRECTOR | $147,046 | $0 | $5,943 | $0 | $0 | $0 | $0 | $0 | $11,378 | $0 | $164,367 | $0 | $0 | $0 |
| ANGELA MAE BROUSE | ||||||||||||||
| NURSE TEAM LEAD | $148,138 | $0 | $2,345 | $0 | $0 | $0 | $688 | $0 | $11,241 | $0 | $162,412 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED NONFIXED PAYMENTS IN THE FORM OF A BONUS, AMOUNTS WERE INCLUDED IN COLUMN B(II) AND IN THE EMPLOYEE W-2. BONUS AMOUNTS ARE BASED ON PERFORMANCE MEASURED AGAINST METRICS WHICH ARE REVIEWED AND APPROVED ANNUALLY BY THE COMPENSATION COMMITTEE. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KATHERYNE ROBINSON | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | DAUGHTER OF BOARD MEMBER | RelationshipDescriptionTxt |
| Transaction | $81,312 | TransactionAmt |
| Transaction | EMPLOYMENT | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 3 | ContributionCnt |
| Noncash Contributions Rpt F990 | $578,587 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | MARKET QUOTATIONS | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | Yes (1) | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, COLUMN (B): | THIS NUMBER REFLECTS THE NUMBER OF CONTRIBUTIONS, NOT THE NUMBER OF ITEMS CONTRIBUTED. |
| PART I, LINE 32B: | ALL SECURITIES ARE TO BE SOLD IMMEDIATELY UPON RECEIPT. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | THE CHANGES IN THE AMENDED BYLAWS INCLUDE A REDUCTION IN CHN RESERVED POWERS, A CHN POSITION OF OVERSIGHT VS. CONTROL, CHN'S REMAINING LEGALLY REQUIRED CONTROL HAS LESS INVOLVEMENT IN THE PROCESS, CHN'S CONTROL OF THE AFFILIATES' CEOS HAS BEEN REMOVED, AND THE REQUIREMENT FOR CONSOLIDATED FINANCIAL REPORTS AND A JUNE THROUGH JULY FISCAL YEAR HAVE BEEN REMOVED. |
| 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 | ORGANIZATION'S SOLE MEMBER IS CALIFORNIA HOSPICE NETWORK. ORGANIZATION ELECTS DIRECTORS, WHOM ARE APPROVED BY MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7B | ORGANIZATION'S RESTATED BYLAWS INCLUDE CERTAIN POWERS RESERVED BY MEMBER, WHICH INCLUDE APPOINTMENT OF ORGANIZATION'S DIRECTORS AND CEO, APPROVAL OF ANNUAL OPERATING BUDGET, AND ANY ACTION TO MERGE OR DISSOLVE OR SELL SUBSTANTIALLY ALL THE ASSETS OF ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | CFO AND CEO REVIEW 990 WHEN COMPLETED BY CPA FIRM. A COPY OF THE 990 IS FURNISHED TO THE FINANCE COMMITTEE AND TO THE BOARD MEMBERS BEFORE THE 990 IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | 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 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 FULL BOARD OF DIRECTORS. BOARD OF DIRECTORS REVIEW AND VOTE ON PROPOSED SALARY CHANGES. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL GOVERNING DOCUMENTS, POLICIES, AND ANNUAL 990 INFORMATION RETURNS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. ANNUAL FINANCIAL RESULTS ARE PUBLISHED IN THE ORGANIZATION'S ANNUAL REPORT. |
| FORM 990, PART XI, LINE 2C: | THE OVERSIGHT AND SELECTION PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
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 | HOSPICE SUPPORT. ADMIN, PROGRAMMATIC AND OTHER SUPPORT | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 10 | 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 |
Comments