NORTH CENTRAL FLORIDA HOSPICE INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- NORTH CENTRAL FLORIDA HOSPICE INC (EIN 59-2490893)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-10-31
- IRS object ID
- 202233049349302133
- Schema version
- 2021v4.2
- 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 I
- Schedule J
- Schedule K
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-10-31T15:02:10-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 134008324 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRICEWATERHOUSECOOPERS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 76 S LAURA STREET SUITE 2100 | AddressLine1Txt |
| City | JACKSONVILLE | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 592490893 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH CENTRAL FLORIDA HOSPICE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 3523728400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | SANTAFE HEALTHCARE INC PO BOX 749 | AddressLine1Txt |
| City | GAINESVILLE | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 326270749 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PHILIP G BOWLING | PersonNm |
| Person Title | ASSISTANT TREASURER | PersonTitleTxt |
| Phone | 3523728400 | PhoneNum |
| Signature | 2022-10-31 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | PHILIP | PersonFirstNm |
| Person Last | BOWLING | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | NADER FARHAT | PreparerPersonNm |
| PTIN | P01004599 | PTIN |
| Phone | 9043540671 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAVEN HOSPICE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LAWRENCE G SCHREIBER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | SANTAFE HEALTHCARE INC PO BOX 749 | AddressLine1Txt |
| City | GAINESVILLE | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 326270749 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $49,927,180 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BEYOURHAVEN.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1982 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | HONORING LIFE BY PROVIDING COMFORT, CARE AND COMPASSION TO THOSE WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 595 | TotalEmployeeCnt |
| Total Volunteers | 620 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,524,298 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,841,982 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $40,616,247 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $36,746,501 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,868,022 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,735,227 | CYInvestmentIncomeAmt |
| PY Other Revenue | $168,317 | PYOtherRevenueAmt |
| CY Other Revenue | $534,608 | CYOtherRevenueAmt |
| PY Total Revenue | $48,176,884 | PYTotalRevenueAmt |
| CY Total Revenue | $43,858,318 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $79,376 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $28,595,669 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $28,229,268 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $746,308 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $17,404,785 | PYOtherExpensesAmt |
| CY Other Expenses | $16,460,922 | CYOtherExpensesAmt |
| PY Total Expenses | $46,000,454 | PYTotalExpensesAmt |
| CY Total Expenses | $44,769,566 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,176,430 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$911,248 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $59,160,364 | TotalAssetsBOYAmt |
| Total Assets EOY | $59,524,924 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $13,888,415 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $15,276,002 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $45,271,949 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $44,248,922 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF NORTH CENTRAL FLORIDA HOSPICE, INC. (HAVEN HOSPICE) IS TO HONOR LIFE BY PROVIDING COMFORT, CARE AND COMPASSION TO THOSE WE SERVE.NORTH CENTRAL FLORIDA HOSPICE, INC. (HAVEN HOSPICE) HELPS PATIENTS BE AS COMFORTABLE AS POSSIBLE AND PROVIDES THEIR CAREGIVERS WITH NEEDED RESOURCES AND ASSISTANCE. HAVEN HOSPICE PROVIDES THE MOST CURRENT THERAPIES AND METHODS TO MAXIMIZE COMFORT AND CARE TO PATIENTS INCLUDING ACCESS TO PROFESSIONAL STAFF AROUND THE CLOCK. HAVEN HOSPICE PROVIDES CLINICAL EDUCATION ABOUT END-OF-LIFE AND PALLIATIVE CARE, GRIEF SUPPORT TO CHILDREN AND FAMILIES AND BEREAVEMENT PROGRAMS FOR BOTH GROUPS AND INDIVIDUALS IN ITS SERVICE AREA. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $16,836,928 | ExpenseAmt |
| Grant | $79,376 | GrantAmt |
| Revenue | $23,954,107 | RevenueAmt |
| Desc | HAVEN HOSPICE OFFERS COMPASSIONATE HOSPICE CARE AND SUPPORT TO INDIVIDUALS WITH LIFE-LIMITING ILLNESS AND THEIR FAMILIES, WHICH ADDRESS THE PHYSICAL, PSYCHOSOCIAL, EMOTIONAL AND SPIRITUAL NEEDS ASSOCIATED WITH ADVANCED ILLNESS WHILE RESPECTING EACH INDIVIDUAL'S GOALS, BELIEFS AND WISHES. HAVEN HOSPICE'S TEAM OF MEDICAL PROVIDERS AND STAFF EXPERTLY MANAGE PAIN AND SYMPTOMS AT HOME OR IN A VARIETY OF SETTINGS INCLUDING HOSPITALS, NURSING HOMES OR ASSISTED LIVING FACILITIES. HAVEN HOSPICE PROVIDED SERVICES TO 3,624 HOSPICE PATIENTS INCLUDING 176,018 DAYS OF SERVICE. EXPENSES INCLUDE $229,468 OF UNREIMBURSED CARE. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $9,665,317 | ExpenseAmt |
| Revenue | $11,513,094 | RevenueAmt |
| Desc | HAVEN HOSPICE OFFERS HOSPICE CARE CENTERS IN GAINESVILLE, PALATKA, LAKE CITY AND ORANGE PARK WHEN THERE IS A NEED FOR SHORT-TERM INPATIENT CARE. IN THESE WELCOMING AND HOME-LIKE SETTINGS, HAVEN HOSPICE PHYSICIANS, ADVANCED REGISTERED NURSE PRACTITIONERS AND OTHER CLINICIANS PROVIDE AROUND-THE-CLOCK CARE TO PATIENTS NEEDING INTENSE PAIN AND SYMPTOM MANAGEMENT AS WELL AS PROVIDE EDUCATION AND SUPPORT TO FAMILY AND LOVED ONES. FAMILY MEMBERS ARE WELCOME 24 HOURS A DAY AND ARE ENCOURAGED TO STAY. HAVEN HOSPICE ALSO WELCOMES VISITS FROM CHILDREN AND FAMILY PETS. THE CARE CENTERS OFFER OVERNIGHT RESPITE CARE TO PROVIDE A BREAK TO PRIMARY CAREGIVERS FOR UP TO FIVE DAYS. EACH CARE CENTER OFFERS THE LOCAL COMMUNITY A PLACE TO HOLD MEETINGS AND EDUCATIONAL EVENTS.HAVEN HOSPICE PROVIDED SERVICES TO 2,259 PATIENTS IN INPATIENT CARE CENTERS, FOR A TOTAL OF 14,618 DAYS OF SERVICE. EXPENSES INCLUDE $344,476 OF UNREIMBURSED CARE. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,464,024 | ExpenseAmt |
| Revenue | $0 | RevenueAmt |
| Desc | HAVEN HOSPICE PROVIDES BEREAVEMENT SERVICES TO FAMILY MEMBERS OF PATIENTS WHO HAVE DIED IN OUR CARE AND TO THE COMMUNITIES IN WHICH WE SERVE. WORKPLACE COUNSELING AND SUPPORT: HAVEN HOSPICE PROVIDES COUNSELING AND SUPPORT TO AREA BUSINESSES WHOSE STAFF ARE DEALING WITH GRIEF, LOSS, LIFE-LIMITING ILLNESS, OR SERVING AS CAREGIVERS. HAVEN HOSPICE IS A RESOURCE FOR COUNSELING SERVICES AND EDUCATIONAL PROGRAMS. HELPING EMPLOYEES WITH FAMILY CONCERNS HAS PROVEN TO LOWER UNSCHEDULED ABSENCES, REDUCE THE NUMBER OF BENEFIT CLAIMS AND INCREASE PRODUCTIVITY. (CONTINUED AT SCHEDULE O)HAVEN HOSPICE OFFERS SEVERAL COUNSELING AND SUPPORT PROGRAMS AND SERVICES AT COMMUNITY WORKSITES AS FOLLOWS: COPING WITH GRIEF AND LOSS IN THE WORKPLACE; WORKING CAREGIVERS: BALANCING TWO FULL-TIME JOBS; LIFE PLANNING: DOCUMENTS YOU SHOULDN'T LIVE WITHOUT; AND PREVENTING COMPASSION FATIGUE IN THE CAREGIVING PROFESSION.CAMP SAFE HAVEN: CAMP SAFE HAVEN PROVIDES CHILDREN, TEENS AND FAMILIES WITH FUN AND THERAPEUTIC ACTIVITIES TO HELP THEM WORK THROUGH THEIR FEELINGS OF GRIEF. THE CAMP IS SUPPORTED BY HAVEN HOSPICE'S STAFF OF PROFESSIONALS AND VOLUNTEERS.HEALING HEARTS GRIEF SUPPORT: HAVEN HOSPICE'S HEALING HEARTS GRIEF SUPPORT PROGRAM OFFERS INDIVIDUAL, FAMILY AND GROUP COUNSELING TO ANYONE COPING WITH LOSS, REGARDLESS OF HOW THE LOSS OCCURRED.COUNSELING AND EDUCATION: HAVEN HOSPICE OFFERS SHORT-TERM INDIVIDUAL, FAMILY AND GROUP BEREAVEMENT COUNSELING WITH SPECIALLY TRAINED HAVEN HOSPICE PROFESSIONALS FOR ANYONE IN THE COMMUNITY WHO HAS EXPERIENCED A LOSS.MEMORIAL SERVICES: HAVEN HOSPICE HOSTS LOVE AND REMEMBRANCE (MEMORIAL) SERVICES IN SPRING AND FALL TO HONOR THE LIVES OF FAMILY, FRIENDS AND LOVED ONES.THE BEREAVEMENT DEPARTMENT CONDUCTED 32 COMMUNITY EDUCATION EVENTS. IN ADDITION, 11,527 SUPPORT MAILERS WERE DISTRIBUTED, 12,483 BEREAVEMENT SUPPORT PHONE CALLS WERE PLACED AND 178 COUNSELING SESSIONS WERE PROVIDED FOR EITHER GROUP, INDIVIDUAL, OR FAMILY GRIEF SUPPORT. NO MEMORIAL SERVICES AND TEEN/KID GRIEF CAMPS WERE HELD IN 2021. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,105,661 | ExpenseAmt |
| Revenue | $1,279,300 | RevenueAmt |
| Desc | PALLIATIVE CARE CONSULTATIONS: HAVEN HOSPICE'S PALLIATIVE CARE CONSULTATIONS ARE PROVIDED BY A TEAM OF PHYSICIANS AND NURSE PRACTITIONERS. THE PROGRAM INCLUDES A PALLIATIVE CARE MEDICAL EXAMINATION TO ADDRESS PAIN AND SYMPTOMS AS WELL AS DISCUSSIONS WITH INDIVIDUALS AND THEIR HEALTHCARE PROVIDERS ABOUT TREATMENT GOALS, OPTIONS AND RECOMMENDATIONS.TRANSITIONS: HAVEN HOSPICE'S TRANSITIONS PROGRAM OFFERS EMOTIONALLY SUPPORTIVE PHONE CALLS, VOLUNTEER COMPANIONS AND REFERRALS TO COMMUNITY SERVICES FOR INDIVIDUALS AND FAMILIES WHO ARE DEALING WITH ADVANCED ILLNESS AND WHO ARE NEEDING ADDITIONAL SUPPORT.ADVANCE CARE PLANNING: THE MISSION OF ADVANCE CARE PLANNING IS TO HAVE AS MANY PEOPLE OVER THE AGE OF 18 AND ESPECIALLY THOSE WITH ADVANCED ILLNESS EXPERIENCE AN ADVANCE CARE PLANNING SESSION. THE GOAL IS TO HAVE THE CONVERSATION WITH LOVED ONES AND/OR A HEALTH CARE SURROGATE SO THAT THE INDIVIDUAL'S CURRENT AND FUTURE HEALTHCARE GOALS, WISHES AND VALUES ARE DOCUMENTED AND SHARED. IN ORDER TO HONOR WISHES, OTHERS HAVE TO BE INFORMED. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $3,105,661 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $1,279,300 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $31,071,930 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (1) | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 | 0 | 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 | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (1) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 200 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 595 | 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 | 0 | QuidProQuoContributionsInd |
| 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHILIP G BOWLING ASST TREASURER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3523728400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4300 NW 89TH BLVD | AddressLine1Txt |
| City | GAINESVILLE | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 326065688 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| LAWRENCE G SCHREIBER | |||||||||
| CHIEF EXECUTIVE OFFICER/DIRECTOR | 3.00 | 57.00 | Yes (X) | Yes (X) | $0 | $2,065,713 | $368,929 | ||
| STEVEN M ZIEGLER | |||||||||
| ASSISTANT SECRETARY | 3.00 | 57.00 | Yes (X) | $0 | $1,382,460 | $41,751 | |||
| RANDALL L STUART | |||||||||
| ASSISTANT TREASURER | 3.00 | 57.00 | Yes (X) | $0 | $951,678 | $141,554 | |||
| PAULINE E TAYLOR | |||||||||
| PRESIDENT | 50.00 | 10.00 | Yes (X) | $0 | $400,944 | $81,330 | |||
| TIFFANY T MASSEY MD | |||||||||
| ASSOCIATE MEDICAL DIRECTOR | 40.00 | 0.00 | $309,147 | $0 | $10,742 | Yes (X) | |||
| GERALDINE S BICHIER MD | |||||||||
| ASSOCIATE MEDICAL DIRECTOR | 40.00 | 0.00 | $250,208 | $0 | $40,898 | Yes (X) | |||
| ELLEN L TALOS MD | |||||||||
| ASSOCIATE MEDICAL DIRECTOR | 40.00 | 0.00 | $259,092 | $0 | $12,316 | Yes (X) | |||
| CHRISTOPHER RUSSELL | |||||||||
| VP OF OPERATIONS | 40.00 | 0.00 | $0 | $224,705 | $31,679 | Yes (X) | |||
| KAREN L LAAUWE MD | |||||||||
| ASSOCIATE MEDICAL DIRECTOR | 40.00 | 0.00 | $210,390 | $0 | $19,053 | Yes (X) | |||
| MERRY ROBERTSON | |||||||||
| RN - FIELD | 40.00 | 0.00 | $145,329 | $0 | $0 | Yes (X) | |||
| GLENDA E HOOD | |||||||||
| CHAIR/DIRECTOR | 0.10 | 2.90 | Yes (X) | Yes (X) | $0 | $71,800 | $0 | ||
| JACKSON N SASSER PHD | |||||||||
| VICE CHAIR/DIRECTOR | 0.10 | 1.40 | Yes (X) | Yes (X) | $0 | $59,050 | $0 | ||
| BENJAMIN I DOERR JR | |||||||||
| DIRECTOR | 0.10 | 1.40 | Yes (X) | $0 | $59,050 | $0 | |||
| ROBERT L EPLING | |||||||||
| TREASURER/DIRECTOR | 0.10 | 1.40 | Yes (X) | Yes (X) | $0 | $56,650 | $0 | ||
| KATHERINE L FERNANDEZ | |||||||||
| DIRECTOR | 0.10 | 1.40 | Yes (X) | $0 | $56,650 | $0 | |||
| JAMES D LEE | |||||||||
| DIRECTOR | 0.10 | 1.40 | Yes (X) | $0 | $56,650 | $0 | |||
| PAMELA J MOONEY PHD | |||||||||
| DIRECTOR | 0.10 | 1.40 | Yes (X) | $0 | $56,650 | $0 | |||
| JOSEPH W DAVIS | |||||||||
| DIRECTOR | 0.10 | 1.40 | Yes (X) | $0 | $54,250 | $0 | |||
| GEORGE E FLETCHER | |||||||||
| DIRECTOR | 0.10 | 1.40 | Yes (X) | $0 | $54,250 | $0 | |||
| ALBERT E DOTSON PHD | |||||||||
| SECRETARY/DIRECTOR (THRU 5/29/21) | 0.10 | 1.40 | Yes (X) | Yes (X) | $0 | $27,125 | $0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,174,166 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $5,577,625 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $748,252 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 19 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | 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 |
|---|---|---|---|---|---|
| SANTAFE MANAGEMENT SERVICES LLC | |||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | MANAGEMENT SERVICES | $3,009,958 |
| NF WINDSOR LLC | |||||
| 602 E LAURA ST | STARKE | FL | 32091 | NURSING HOME SERVICES | $486,734 |
| SIMIONE HEALTHCARE CONSULTANTS LLC | |||||
| 4130 WHITNEY AVE | HAMDEN | CT | 06518 | MEDICAL CONSULTING SERVICES | $480,830 |
| HEALTH FACILITIES INC | |||||
| 7280 SW SR 26 | TRENTON | FL | 32693 | NURSING HOME SERVICES | $436,696 |
| PALM GARDEN OF GAINESVILLE LLC | |||||
| 227 SW 62ND BLVD | GAINESVILLE | FL | 32607 | NURSING HOME SERVICES | $435,447 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 25 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $34,207 | FederatedCampaignsAmt |
| Related Organizations | $25,000 | RelatedOrganizationsAmt |
| Government Grants | $959,019 | GovernmentGrantsAmt |
| All Other Contributions | $3,823,756 | AllOtherContributionsAmt |
| Noncash Contributions | $3,130,822 | NoncashContributionsAmt |
| Total Contributions | $4,841,982 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAID REVENUE | 623990 | $34,049,062 | $34,049,062 |
| MEDICARE REVENUE | 623990 | $2,062,606 | $2,062,606 |
| NET PATIENT SERVICE REVENUE | 623990 | $634,833 | $634,833 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $36,746,501 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $268,478 | TotalRevenueColumnAmt |
| Exclusion | $268,478 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,527,070 | SecuritiesAmt |
| Other | $8,541 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $6,018,687 | SecuritiesAmt |
| Other | $50,175 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,508,383 | SecuritiesAmt |
| Other | -$41,634 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,466,749 | TotalRevenueColumnAmt |
| Exclusion | $1,466,749 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CHANGE IN INTEREST IN FOUNDATION | 900003 | $349,220 | $349,220 |
| ADMINISTRATIVE INCOME | 900099 | $185,388 | $185,388 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $534,608 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $43,858,318 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $36,746,501 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,269,835 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,376 | TotalAmt |
| Program Services | $79,376 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,357,602 | TotalAmt |
| Program Services | $19,107,167 | ProgramServicesAmt |
| Management And General | $3,658,766 | ManagementAndGeneralAmt |
| Fundraising | $591,669 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $535,079 | TotalAmt |
| Program Services | $418,921 | ProgramServicesAmt |
| Management And General | $114,481 | ManagementAndGeneralAmt |
| Fundraising | $1,677 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,652,263 | TotalAmt |
| Program Services | $1,978,255 | ProgramServicesAmt |
| Management And General | $662,578 | ManagementAndGeneralAmt |
| Fundraising | $11,430 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,684,324 | TotalAmt |
| Program Services | $1,288,852 | ProgramServicesAmt |
| Management And General | $391,252 | ManagementAndGeneralAmt |
| Fundraising | $4,220 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,281,995 | TotalAmt |
| Program Services | $980,772 | ProgramServicesAmt |
| Management And General | $2,296,174 | ManagementAndGeneralAmt |
| Fundraising | $5,049 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,834 | TotalAmt |
| Management And General | $168,834 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,211 | TotalAmt |
| Management And General | $86,211 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,611,083 | TotalAmt |
| Program Services | $1,517,269 | ProgramServicesAmt |
| Management And General | $1,014,316 | ManagementAndGeneralAmt |
| Fundraising | $79,498 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,887 | TotalAmt |
| Program Services | $74,887 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,166,746 | TotalAmt |
| Program Services | $362,019 | ProgramServicesAmt |
| Management And General | $786,366 | ManagementAndGeneralAmt |
| Fundraising | $18,361 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,008,976 | TotalAmt |
| Program Services | $140,855 | ProgramServicesAmt |
| Management And General | $868,121 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,828,489 | TotalAmt |
| Program Services | $955,796 | ProgramServicesAmt |
| Management And General | $872,693 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,116,593 | TotalAmt |
| Program Services | $957,668 | ProgramServicesAmt |
| Management And General | $158,580 | ManagementAndGeneralAmt |
| Fundraising | $345 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,791 | TotalAmt |
| Program Services | $3,752 | ProgramServicesAmt |
| Management And General | $74,039 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $195,052 | TotalAmt |
| Program Services | $94,029 | ProgramServicesAmt |
| Management And General | $101,023 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,874,761 | TotalAmt |
| Program Services | $1,156,185 | ProgramServicesAmt |
| Management And General | $718,576 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $599,038 | TotalAmt |
| Program Services | $138,873 | ProgramServicesAmt |
| Management And General | $460,165 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PHARMACY SUPPLIES | $1,107,638 | $1,107,638 | |
| MEDICAL SUPPLIES | $462,918 | $451,330 | $11,588 |
| DUES AND SUBSCRIPTIONS | $407,114 | $149,762 | $257,352 |
| FOOD COSTS | $80,017 | $80,017 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $312,779 | TotalAmt |
| Program Services | $28,507 | ProgramServicesAmt |
| Management And General | $250,213 | ManagementAndGeneralAmt |
| Fundraising | $34,059 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,769,566 | TotalAmt |
| Program Services | $31,071,930 | ProgramServicesAmt |
| Management And General | $12,951,328 | ManagementAndGeneralAmt |
| Fundraising | $746,308 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,497,828 | BOYAmt |
| EOY | $737,149 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $351,741 | BOYAmt |
| EOY | $239,929 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,491 | BOYAmt |
| EOY | $52,132 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,660,702 | BOYAmt |
| EOY | $9,297,676 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $436,644 | BOYAmt |
| EOY | $1,184,518 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $56,019,451 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $21,215,927 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,856,636 | BOYAmt |
| EOY | $34,803,524 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,192,728 | BOYAmt |
| EOY | $6,041,945 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,646,089 | BOYAmt |
| EOY | $4,043,491 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,462,505 | BOYAmt |
| EOY | $3,124,560 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,160,364 | BOYAmt |
| EOY | $59,524,924 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,391,736 | BOYAmt |
| EOY | $6,857,967 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,213,653 | BOYAmt |
| EOY | $5,897,764 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,283,026 | BOYAmt |
| EOY | $2,520,271 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,888,415 | BOYAmt |
| EOY | $15,276,002 | 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 | $44,783,721 | BOYAmt |
| EOY | $43,318,803 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $488,228 | BOYAmt |
| EOY | $930,119 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,271,949 | BOYAmt |
| EOY | $44,248,922 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,160,364 | BOYAmt |
| EOY | $59,524,924 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$911,248 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$852,937 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $741,158 | 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 | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,845,699 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,582,393 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,172,614 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,524,298 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,841,982 | CurrentTaxYearAmt |
| Total | $21,966,986 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $53,737,892 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $50,754,030 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $37,312,819 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $40,616,247 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $36,746,501 | CurrentTaxYearAmt |
| Total | $219,167,489 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $57,583,591 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $54,336,423 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $41,485,433 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $46,140,545 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $41,588,483 | CurrentTaxYearAmt |
| Total | $241,134,475 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $241,134,475 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $571,466 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $354,098 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $331,675 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $374,497 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $268,478 | CurrentTaxYearAmt |
| Total | $1,900,214 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $571,466 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $354,098 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $331,675 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $374,497 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $268,478 | CurrentTaxYearAmt |
| Total | $1,900,214 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $191,268 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $590,878 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,206,815 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $168,317 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $534,608 | CurrentTaxYearAmt |
| Total | $2,691,886 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $58,346,325 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $55,281,399 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $43,023,923 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $46,683,359 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $42,391,569 | CurrentTaxYearAmt |
| Total | $245,726,575 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.98130 | PublicSupportCY509Pct |
| Public Support PY509 | 0.98330 | PublicSupportPY509Pct |
| Investment Income CY | 0.00770 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00820 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | ADMINISTRATIVE INCOME - 2017 AMOUNT: $ 366,745. 2018 AMOUNT: $ 739,613. 2019 AMOUNT: $ 1,237,126. 2020 AMOUNT: $ 190,724. 2021 AMOUNT: $ 185,388. SPECIAL EVENT INCOME NET - 2017 AMOUNT: $ -175,477. 2018 AMOUNT: $ -148,735. 2019 AMOUNT: $ -30,311. 2020 AMOUNT: $ -24,273. 2021 AMOUNT: $ 0. RENTAL INCOME - 2020 AMOUNT: $ 1,866. 2021 AMOUNT: $ 0. CHANGE IN INTEREST IN FOUNDATION - 2021 AMOUNT: $ 349,220. | 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) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $162 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $162 | 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 | HAVEN HOSPICE IS A MEMBER OF THE FLORIDA HOSPICE AND PALLIATIVE CARE, INC., ALLIANCE FOR CARE, AND THE NATIONAL HOSPICE AND PALLIATIVE CARE ORGANIZATION. MEMBERSHIP DUES TO THE ASSOCIATIONS INCLUDE A SMALL PERCENTAGE FOR LOBBYING EFFORTS. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,609,768 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $399,145 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $4,008,913 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,175,778 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $433,990 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $3,609,768 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,519,832 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $655,946 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $3,175,778 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,769,117 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$249,285 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $2,519,832 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,429,663 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $339,454 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $2,769,117 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 1.00000 | BoardDesignatedBalanceEOYPct |
| 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 | $5,595,019 | OtherCostOrOtherBasisAmt |
| Book Value | $5,595,019 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $41,054,631 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,801,792 | DepreciationAmt |
| Book Value | $28,252,839 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,048,524 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,021,233 | DepreciationAmt |
| Book Value | $27,291 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,321,277 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,392,902 | DepreciationAmt |
| Book Value | $928,375 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $34,803,524 | TotalBookValueLandBuildingsAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| BOARD DESIGNATED ENDOWMENT | $4,008,913 | F |
| GIFT ANNUITIES | $34,578 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $4,043,491 | TotalBookValueProgramRltdAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| CHARITABLE REMAINDER UNITRUST | $1,617,104 |
| OTHER ASSETS | $1,507,456 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,124,560 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES | $1,349,856 |
| CHARITABLE REMAINDER UNITRUST | $813,000 |
| INTEREST RATE SWAP | $210,644 |
| GIFT ANNUITIES | $89,467 |
| CAPITAL LEASE OBLIGATION | $57,304 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,520,271 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE HAVEN HOSPICE ENDOWMENT IS A SEPARATE ACCOUNT OF FUNDS THAT ARE HELD TO PROVIDE CURRENT AND FUTURE INCOME TO HAVEN HOSPICE IN ORDER TO OFFSET THE BURDEN OF UNCOMPENSATED CARE PROVIDED BY HAVEN HOSPICE. THE OBJECTIVE OF THE ENDOWMENT IS TO PROVIDE TIMELY FINANCIAL ASSISTANCE WHEN NEEDED AND LONG-TERM STABILITY TO HAVEN HOSPICE. |
| PART X, LINE 2: | ASC 740 FOOTNOTE: HAVEN IS EXEMPT FROM INCOME TAXES ON INCOME FROM RELATED ACTIVITIES UNDER SECTION 501(C)(3) OF THE U.S. INTERNAL REVENUE CODE AND CORRESPONDING STATE TAX LAW. ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR FEDERAL OR STATE INCOME TAXES. U.S. GAAP REQUIRES THAT A TAX POSITION IS RECOGNIZED AS A BENEFIT ONLY IF IT IS "MORE LIKELY THAN NOT" THAT THE TAX POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION, WITH A TAX EXAMINATION BEING PRESUMED TO OCCUR. THE AMOUNT RECOGNIZED IS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY TO BE REALIZED ON EXAMINATION. FOR TAX POSITIONS NOT MEETING THE "MORE LIKELY THAN NOT" TEST, NO TAX BENEFIT IS RECORDED. HAVEN'S FORM 990 HAS NOT BEEN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE OR THE STATE OF FLORIDA FOR THE LAST THREE YEARS. HAVEN DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS. HAVEN RECOGNIZES INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE. HAVEN DID NOT HAVE ANY AMOUNTS ACCRUED FOR INTEREST AND PENALTIES AT DECEMBER 31, 2021 AND 2020. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAVEN FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4200 NW 90TH BLVD | AddressLine1Txt |
| City | GAINESVILLE | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 326069945 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 850863879 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $79,376 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Purpose Of Grant | NORTH CENTRAL FLORIDA HOSPICE, INC. PROVIDED FINANCIAL ASSISTANCE IN THE AMOUNT OF $79,376 TO SUPPORT AND FURTHER THE MISSION AND TAX EXEMPT PURPOSES OF HAVEN FOUNDATION, INC. | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | NORTH CENTRAL FLORIDA HOSPICE, INC. AND HAVEN FOUNDATION, INC. SHARE COMMON MANAGEMENT. AS A RESULT, MANAGEMENT ENSURES THE USE OF GRANT FUNDS BY HAVEN FOUNDATION, INC. IS CONSISTENT WITH THEIR INTENDED PURPOSE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 | 0 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LAWRENCE G SCHREIBER | ||||||||||||||
| CHIEF EXECUTIVE OFFICER/DIRECTOR | $0 | $1,031,801 | $0 | $983,856 | $0 | $50,056 | $0 | $341,826 | $0 | $27,103 | $0 | $2,434,642 | $0 | $0 |
| STEVEN M ZIEGLER | ||||||||||||||
| ASSISTANT SECRETARY | $0 | $409,764 | $0 | $210,927 | $0 | $761,769 | $0 | $11,641 | $0 | $30,110 | $0 | $1,424,211 | $0 | $443,834 |
| RANDALL L STUART | ||||||||||||||
| ASSISTANT TREASURER | $0 | $514,448 | $0 | $262,007 | $0 | $175,223 | $0 | $116,730 | $0 | $24,824 | $0 | $1,093,232 | $0 | $88,421 |
| PAULINE E TAYLOR | ||||||||||||||
| PRESIDENT | $0 | $344,328 | $0 | $41,426 | $0 | $15,190 | $0 | $50,526 | $0 | $30,804 | $0 | $482,274 | $0 | $0 |
| TIFFANY T MASSEY MD | ||||||||||||||
| ASSOCIATE MEDICAL DIRECTOR | $270,805 | $0 | $9,748 | $0 | $28,594 | $0 | $7,966 | $0 | $2,776 | $0 | $319,889 | $0 | $0 | $0 |
| GERALDINE S BICHIER MD | ||||||||||||||
| ASSOCIATE MEDICAL DIRECTOR | $233,294 | $0 | $9,748 | $0 | $7,166 | $0 | $10,206 | $0 | $30,692 | $0 | $291,106 | $0 | $0 | $0 |
| ELLEN L TALOS MD | ||||||||||||||
| ASSOCIATE MEDICAL DIRECTOR | $240,084 | $0 | $9,998 | $0 | $9,010 | $0 | $10,994 | $0 | $1,322 | $0 | $271,408 | $0 | $0 | $0 |
| CHRISTOPHER RUSSELL | ||||||||||||||
| VP OF OPERATIONS | $0 | $177,906 | $0 | $32,535 | $0 | $14,264 | $0 | $14,189 | $0 | $17,490 | $0 | $256,384 | $0 | $0 |
| KAREN L LAAUWE MD | ||||||||||||||
| ASSOCIATE MEDICAL DIRECTOR | $201,796 | $0 | $3,332 | $0 | $5,262 | $0 | $0 | $0 | $19,053 | $0 | $229,443 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | LAWRENCE G SCHREIBER IS THE CHIEF EXECUTIVE OFFICER (CEO) OF NORTH CENTRAL FLORIDA HOSPICE, INC. (HAVEN HOSPICE). MR. SCHREIBER IS COMPENSATED BY SANTAFE HEALTHCARE, INC., A RELATED SUPPORTING ORGANIZATION. SANTAFE HEALTHCARE, INC. UTILIZES THE FOLLOWING PROCESS TO ESTABLISH THE CEO'S COMPENSATION AND BENEFITS: THE SANTAFE HEALTHCARE, INC. BOARD OF DIRECTORS ANNUALLY RETAINS AN INDEPENDENT THIRD PARTY COMPENSATION AND BENEFITS CONSULTING FIRM (FIRM) TO CONDUCT A MARKET COMPETITIVENESS REVIEW OF THE CEO'S TOTAL DIRECT COMPENSATION (BASE SALARY, ANNUAL INCENTIVES, AND LONG TERM INCENTIVES) AND BENEFITS. THE COMPETITIVE ANALYSIS INCLUDES COMPARISON TO SIMILAR POSITIONS IN COMPANIES OF SIMILAR SIZE WITHIN THE SAME OR SIMILAR INDUSTRY. THE FIRM MAKES RECOMMENDATIONS, IF ANY, DIRECTLY TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS ESTABLISHES THE FINAL COMPENSATION AND BENEFIT PACKAGE FOR THE CEO TAKING INTO CONSIDERATION THE MARKET COMPETITIVENESS REVIEW AND FINAL RECOMMENDATION OF THE FIRM. THE FIRM PROVIDES AN OPINION LETTER REGARDING THE REASONABLENESS OF THE CEO'S FINAL COMPENSATION AND BENEFITS PACKAGE. THE ACTIONS OF THE BOARD ARE DOCUMENTED IN THE MINUTES OF THE BOARD MEETING. |
| PART I, LINE 4B | (RELATES TO PART I, LINE 4A): LISTED PERSONS WHO ARE EMPLOYEES OF HAVEN HOSPICE ARE NOT COVERED BY A SEVERANCE POLICY; SEVERANCE IS HANDLED ON A CASE BY CASE BASIS. EMPLOYEES OF RELATED ORGANIZATIONS ARE COVERED UNDER A SEVERANCE POLICY WHICH INCLUDES MONTHLY PAYMENTS UP TO A MAXIMUM OF 12 - 36 MONTHS UNDER QUALIFYING CIRCUMSTANCES AND DEPENDING ON POSITION. NO ONE LISTED RECEIVED SEVERANCE OR CHANGE OF CONTROL PAYMENTS DURING 2021. PART I, LINE 4B: LISTED PERSONS PARTICIPATING IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN IN THE YEAR: LAWRENCE G SCHREIBER, RANDALL L STUART, STEVEN M ZIEGLER AND PAULINE E TAYLOR ARE EMPLOYEES OF SANTAFE HEALTHCARE, INC., A RELATED SUPPORTING ORGANIZATION. THEY PARTICIPATE IN TWO NONQUALIFIED DEFERRED COMPENSATION RETIREMENT PLANS SPONSORED BY SANTAFE HEALTHCARE, INC. FOR A CERTAIN GROUP OF EXECUTIVES. ONE PLAN RESTORES RETIREMENT BENEFITS EQUIVALENT TO QUALIFIED 401(K) BENEFITS ON INCOME EARNED IN EXCESS OF THE INTERNAL REVENUE SERVICE CODE SECTION 401(A)(17) RECOGNIZABLE PAY LIMITS (A DEFINED CONTRIBUTION RESTORATION PLAN). VESTING FOR THIS PLAN IS ACHIEVED AT AGE 55 AND 10 YEARS OF SERVICE OR AT AGE 65 AND 5 YEARS OF SERVICE. THE SECOND SUPPLEMENTAL DEFINED CONTRIBUTION PLAN PROVIDES ADDITIONAL RETIREMENT INCOME BASED ON A PERCENTAGE OF BASE SALARY AND VESTS AT THREE AND FIVE YEARS OF SERVICE. MR. ZIEGLER VESTED AND RECEIVED $741,092 FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS IN 2021. MR. STUART VESTED AND RECEIVED $165,974 FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS IN 2021. |
| SCHEDULE J, PART II: | CERTAIN SENIOR EXECUTIVES ARE ACCOUNTABLE FOR AND PERFORM SERVICES FOR SANTAFE HEALTHCARE, INC. AND EACH OF ITS AFFILIATES. SANTAFE HEALTHCARE, INC. AND AFFILIATES REPRESENT A DIVERSIFIED FAMILY OF NOT-FOR-PROFIT ORGANIZATIONS WITH APPROXIMATELY $2 BILLION IN GROSS RECEIPTS AND MORE THAN 1,500 EMPLOYEES. THESE SENIOR EXECUTIVES ARE PAID DIRECTLY BY SANTAFE HEALTHCARE, INC. AND THEIR COMPENSATION AND BENEFITS ARE APPORTIONED AND CHARGED TO THE RESPECTIVE AFFILIATES BASED ON THE ESTIMATED AMOUNT OF TIME SPENT ON EACH AFFILIATE'S ACTIVITIES. FOR 2021, EXECUTIVE COMPENSATION AND BENEFITS WERE APPORTIONED AND CHARGED TO HAVEN HOSPICE AS FOLLOWS: 5% - LAWRENCE G SCHREIBER, CHIEF EXECUTIVE OFFICER 5% - RANDALL L STUART, ASSISTANT TREASURER 5% - STEVEN M ZIEGLER, ASSISTANT SECRETARY 100% - PAULINE E TAYLOR, PRESIDENT 100% - CHRISTOPHER RUSSELL, VP OF OPERATIONS |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALACHUA COUNTY HEALTH FACILITIES AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 592442398 | BondIssuerEIN |
| Bond Issued | 2015-12-15 | BondIssuedDt |
| Issue Price | $8,600,000 | IssuePriceAmt |
| Purpose | HOSPICE CARE FACILITY EXPANSION | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $2,433,237 | RetiredAmt |
| Total Proceeds | $8,600,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $62,130 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $8,268,871 | CapitalExpendituresAmt |
| Unspent | $268,999 | UnspentAmt |
| Substantial Completion | 2016 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | 0 | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | Yes (1) | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | Yes (1) | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BBVA COMPASS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 11.500000000000 | TermOfHedgePct |
| Superintegrated Hedge | 0 | SuperintegratedHedgeInd |
| Hedge Terminated | 0 | HedgeTerminatedInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K, PARTS I AND II | FormAndLineReferenceDesc |
| Explanation | ADDITIONAL INFORMATION REGARDING THE BONDS ISSUE: THE ALACHUA COUNTY HEALTH FACILITIES AUTHORITY BONDS WERE ISSUED AS A DRAW-DOWN LOAN FOR EXPANSION OF THE E.T. YORK CARE CENTER. THE ISSUE PRICE AND PROCEEDS AMOUNTS SHOWN ON PARTS I AND II ARE THE MAXIMUM AMOUNT OF THE LOAN. AS OF THE END OF THE REPORTING YEAR, LESS THAN THE ENTIRE BALANCE OF THE LOAN HAD BEEN DRAWN DOWN. | ExplanationTxt |
Schedule M IRS990ScheduleM
Clothing And Household Goods ClothingAndHouseholdGoodsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $3,130,822 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | RESALE VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | HAVEN HOSPICE'S ARTICLES OF INCORPORATION AND BYLAWS STATE THAT THE SANTAFE HEALTHCARE, INC. BOARD OF DIRECTORS SHALL CONSTITUTE THE ORGANIZATION'S BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE SANTAFE HEALTHCARE, INC. BOARD OF DIRECTORS CONSTITUTES THE ORGANIZATION'S BOARD OF DIRECTORS, WHICH MAKES ALL GOVERNANCE DECISIONS OF THE ORGANIZATION. THE SANTAFE HEALTHCARE, INC. BOARD OF DIRECTORS HAS THE POWER AND AUTHORITY TO ESTABLISH COMMITTEES, TO ELECT AND REMOVE OFFICERS, TO APPROVE AMENDMENTS OF THE ORGANIZATION'S GOVERNING DOCUMENTS, AND TO MODIFY, AMEND, RESCIND, OR REPEAL ANY ACTION TAKEN BY THE ORGANIZATION'S BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION'S PROCESS FOR ENSURING THE ACCURATE PREPARATION, REVIEW AND APPROVAL OF THE 2021 FORM 990 BEGAN WITH PROFESSIONAL DEVELOPMENT OF STAFF (SEVERAL OF WHICH ARE CPAS) WHICH WERE INVOLVED IN THE PREPARATION OF THE 2021 FORM 990. IN ADDITION TO STAFF DEVELOPMENT, WHICH INCLUDED ATTENDING TAX SEMINARS AND CLASSES, MANAGEMENT ALSO CONSULTED WITH INDEPENDENT ACCOUNTING FIRMS AND TAX LEGAL COUNSEL REGARDING THE IRS FORM 990 CODE AND FILING REQUIREMENTS. THE ORGANIZATION ALSO PREVIOUSLY EDUCATED ITS MANAGEMENT TEAM, OFFICERS AND DIRECTORS, WITH THE ASSISTANCE OF PRICEWATERHOUSECOOPERS LLP, REGARDING THE FORM 990 AND THEIR INVOLVEMENT IN REVIEWING THE RETURN. FOLLOWING MANAGEMENT'S PREPARATION OF THE 2021 FORM 990, PRICEWATERHOUSECOOPERS LLP REVIEWED THE 2021 FORM 990. A COPY OF THE 2021 FORM 990 AND ATTACHMENTS WERE PROVIDED TO THE ORGANIZATION'S CURRENT BOARD OF DIRECTORS FOR THEIR REVIEW AND COMMENT. EXECUTIVE MANAGEMENT ADDRESSED ANY QUESTIONS RAISED BY THE BOARD MEMBERS PRIOR TO FILING THE 2021 FORM 990 AND ATTACHMENTS WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | HAVEN HOSPICE HAS A PROCEDURE FOR MONITORING AND ENFORCING COMPLIANCE WITH ITS CORPORATE CONFLICT OF INTEREST POLICY (POLICY). EACH COVERED PERSON SHALL RECEIVE A COPY OF THE POLICY FOR REVIEW AND SUBMIT AN AFFIRMATION WHICH IS ATTACHED TO THE CODE OF ETHICAL BUSINESS CONDUCT. ADDITIONALLY, EACH COVERED PERSON ENGAGED IN MAKING OR INFLUENCING DECISIONS ON BEHALF OF SANTAFE HEALTHCARE, INC. OR ITS AFFILIATES SHALL COMPLETE A QUESTIONNAIRE CONCERNING CONFLICTS OF INTEREST ANNUALLY. THE PROCEDURE DETAILS THAT THE CORPORATE SECRETARY HAS RESPONSIBILITY FOR DELIVERY OF THE POLICY TO DIRECTORS AND OFFICERS AND RECEIPT OF THEIR AFFIRMATIONS AND QUESTIONNAIRES. THE HUMAN RESOURCES DEPARTMENT SHALL OBTAIN THE AFFIRMATION AND QUESTIONNAIRE FROM EVERY NEW EMPLOYEE AT ORIENTATION. THE HUMAN RESOURCES DEPARTMENT SHALL ALSO OBTAIN THE AFFIRMATION FROM ALL EMPLOYEES AND THE CONFLICT OF INTEREST QUESTIONNAIRE FROM APPLICABLE EMPLOYEES ANNUALLY. MEMBERS OF CORPORATE ADVISORY BOARDS SUBMIT THE AFFIRMATION AND QUESTIONNAIRE TO THE CHIEF COMPLIANCE OFFICER. ANNUAL CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY INTERNAL STAFF TO ENSURE RECORDS ARE COMPLETE. AS PART OF THE CORPORATE CONTRACT REVIEW PROCESS, CONSIDERATION IS GIVEN TO ANY POTENTIAL CONFLICTS OF INTEREST INVOLVING OPERATIONAL OR FINANCIAL TRANSACTIONS. ALL EMPLOYEES ARE EXPECTED TO DISCLOSE ANY POTENTIAL OR ACTUAL CONFLICTS. INITIAL REVIEW OF EMPLOYEE QUESTIONNAIRES WILL BE PERFORMED BY THE HUMAN RESOURCES DEPARTMENT AND AFFILIATE COMPLIANCE OFFICER, WITH REVIEW OF ANY DISCLOSURES BY THE CHIEF COMPLIANCE OFFICER WHO WILL EVALUATE, MAKE NECESSARY INQUIRIES, AND INVESTIGATE ALTERNATIVES. BOARD MEMBERS SHALL DISCLOSE ANY POTENTIAL OR ACTUAL CONFLICTS TO THE CHAIRPERSON OF THE SANTAFE HEALTHCARE, INC. BOARD, AND THE CHAIRPERSON OR CHIEF COMPLIANCE OFFICER SHALL EVALUATE CONFLICT DISCLOSURES AND, IF APPROPRIATE, INVESTIGATE ALTERNATIVES AND REPORT TO DISINTERESTED BOARD MEMBERS FOR RESOLUTION. THE MINUTES OF THE BOARD OR ANY COMMITTEE MEETING AT WHICH A POTENTIAL OR ACTUAL CONFLICT OF INTEREST IS DISCLOSED OR DISCUSSED SHALL REFLECT THE NAME OF THE INTERESTED PARTY, THE NATURE OF THE CONFLICT, THE DELIBERATIONS AND THE RESOLUTION OF THE CONFLICT. IF IT IS DETERMINED THAT A COVERED PERSON HAS FAILED TO COMPLY WITH THE POLICY, THE CHIEF COMPLIANCE OFFICER OR THE CHAIRPERSON SHALL TAKE APPROPRIATE ACTION, WHICH MAY INCLUDE REMOVAL FROM OFFICE OR TERMINATION OF EMPLOYMENT. |
| FORM 990, PART VI, SECTION B, LINE 15 | LAWRENCE G SCHREIBER IS THE CHIEF EXECUTIVE OFFICER (CEO) OF HAVEN HOSPICE. MR. SCHREIBER IS COMPENSATED BY SANTAFE HEALTHCARE, INC., A RELATED SUPPORTING ORGANIZATION. SANTAFE HEALTHCARE, INC. UTILIZES THE FOLLOWING PROCESS TO ESTABLISH THE CEO'S COMPENSATION AND BENEFITS: THE SANTAFE HEALTHCARE, INC. BOARD OF DIRECTORS ANNUALLY RETAINS AN INDEPENDENT THIRD PARTY COMPENSATION AND BENEFITS CONSULTING FIRM (FIRM) TO CONDUCT A MARKET COMPETITIVENESS REVIEW OF THE CEO'S TOTAL DIRECT COMPENSATION (BASE SALARY, ANNUAL INCENTIVES, AND LONG TERM INCENTIVES) AND BENEFITS. THE COMPETITIVE ANALYSIS INCLUDES COMPARISON TO SIMILAR POSITIONS IN COMPANIES OF SIMILAR SIZE WITHIN THE SAME OR SIMILAR INDUSTRY. THE FIRM MAKES RECOMMENDATIONS, IF ANY, DIRECTLY TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS ESTABLISHES THE FINAL COMPENSATION AND BENEFIT PACKAGE FOR THE CEO TAKING INTO CONSIDERATION THE MARKET COMPETITIVENESS REVIEW AND FINAL RECOMMENDATION OF THE FIRM. THE FIRM PROVIDES AN OPINION LETTER REGARDING THE REASONABLENESS OF THE FINAL COMPENSATION AND BENEFITS PACKAGE. THE ACTIONS OF THE BOARD ARE DOCUMENTED IN THE MINUTES OF THE BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 15B: PROCESS FOR DETERMINING COMPENSATION FOR THE NON-DIRECTOR OFFICERS, PRESIDENT, CHIEF MEDICAL OFFICER, AND DIRECTORS OF HAVEN HOSPICE IS AS FOLLOWS: THE SANTAFE HEALTHCARE, INC. BOARD OF DIRECTORS ANNUALLY RETAINS AN INDEPENDENT THIRD PARTY COMPENSATION AND BENEFITS FIRM (FIRM) TO CONDUCT A MARKET COMPETITIVENESS REVIEW OF THE AFOREMENTIONED OFFICERS' TOTAL DIRECT COMPENSATION (BASE SALARY, ANNUAL INCENTIVES, AND LONG-TERM INCENTIVES) AND BENEFITS. THE COMPETITIVE ANALYSIS INCLUDES COMPARISONS TO SIMILAR POSITIONS IN COMPANIES OF SIMILAR SIZE WITHIN THE SAME OR SIMILAR INDUSTRY. AFTER COMPLETION OF ITS REVIEW, THE FIRM MAKES RECOMMENDATIONS, IF ANY, DIRECTLY TO THE BOARD OF DIRECTORS. THE FIRM PROVIDES AN OPINION LETTER REGARDING THE REASONABLENESS OF TOTAL DIRECT COMPENSATION AND EXECUTIVE BENEFITS. THE ACTIONS OF THE BOARD ARE DOCUMENTED IN THE MINUTES OF THE BOARD MEETINGS. THE SANTAFE HEALTHCARE, INC. BOARD OF DIRECTORS REGULARLY RETAINS AN INDEPENDENT THIRD PARTY CONSULTANT TO CONDUCT A MARKET COMPETITIVENESS REVIEW OF THE BOARD OF DIRECTORS' (INCLUDING OFFICER POSITIONS) COMPENSATION. THE COMPETITIVENESS ANALYSIS INCLUDES COMPARISONS TO BOTH NOT-FOR-PROFIT AND PUBLIC COMPANY (EXCLUDING EQUITY COMPONENT) DATA FOR COMPANIES WITHIN THE SAME OR SIMILAR INDUSTRY. ANY COMPENSATION CHANGES ARE APPROVED BY THE SANTAFE HEALTHCARE, INC. BOARD OF DIRECTORS BASED ON THE MARKET COMPETITIVENESS STUDY. NO DIRECTOR FEES WERE ALLOCATED TO HAVEN HOSPICE DURING 2021. |
| FORM 990, PART VI, SECTION C, LINE 19 | HAVEN HOSPICE'S PROCEDURE FOR MAKING VARIOUS DOCUMENTS AVAILABLE TO THE PUBLIC IS AS FOLLOWS: THE ARTICLES OF INCORPORATION CAN BE ACCESSED DIRECTLY THROUGH THE FLORIDA DEPARTMENT OF STATE, DIVISION OF CORPORATIONS WEBSITE AT WWW.SUNBIZ.ORG. THE CONFLICT OF INTEREST POLICY CAN BE OBTAINED DIRECTLY FROM THE ORGANIZATION UPON WRITTEN REQUEST. HAVEN HOSPICE DID NOT OTHERWISE MAKE ITS GOVERNING DOCUMENTS, INCLUDING BYLAWS, AVAILABLE TO THE PUBLIC. IN ADDITION, DURING THE TAX YEAR, HAVEN HOSPICE DID NOT MAKE ITS AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART VII, SECTION A, LINE 1A: | CERTAIN SENIOR EXECUTIVES ARE ACCOUNTABLE FOR AND PERFORM SERVICES FOR SANTAFE HEALTHCARE, INC. AND EACH OF ITS AFFILIATES. SANTAFE HEALTHCARE, INC. AND AFFILIATES REPRESENT A DIVERSIFIED FAMILY OF NOT-FOR-PROFIT ORGANIZATIONS WITH APPROXIMATELY $2 BILLION IN GROSS RECEIPTS AND MORE THAN 1,500 EMPLOYEES. THESE SENIOR EXECUTIVES ARE PAID DIRECTLY BY SANTAFE HEALTHCARE, INC. AND THEIR COMPENSATION AND BENEFITS ARE APPORTIONED AND CHARGED TO THE RESPECTIVE AFFILIATES BASED ON THE ESTIMATED AMOUNT OF TIME SPENT ON EACH AFFILIATE'S ACTIVITIES. FOR 2021, EXECUTIVE COMPENSATION AND BENEFITS WERE APPORTIONED AND CHARGED TO HAVEN HOSPICE AS FOLLOWS: 5% - LAWRENCE G SCHREIBER, CHIEF EXECUTIVE OFFICER 5% - RANDALL L STUART, ASSISTANT TREASURER 5% - STEVEN M ZIEGLER, ASSISTANT SECRETARY 100% - PAULINE E TAYLOR, PRESIDENT 100% - CHRISTOPHER RUSSELL, VP OF OPERATIONS |
| FORM 990, PART XI, LINE 9: | CHANGE IN FAIR VALUE OF CHARITABLE REMAINDER UNITRUST (CRUT) -79,140. CHANGE IN NET UNREALIZED GAINS/LOSSES ON CRUT 95,445. NET ASSETS RELEASED FOR OPERATIONS (RECOGNIZED FOR TAX IN PRIOR YEARS) -25,800. CHANGE IN NET UNREALIZED GAINS/LOSSES ON INTEREST RATE SWAP 212,693. CHANGE IN INTEREST IN HAVEN FOUNDATION, INC. 458,584. CONTRIBUTION TO HAVEN FOUNDATION, INC. 79,376. |
| FORM 990, PART XII, LINE 2C: | AUDIT OVERSIGHT PROCESS: THE COMPANY'S AUDIT COMMITTEE HAS NOT CHANGED ITS PROCESS FOR SELECTION OF THE INDEPENDENT ACCOUNTANT OR ITS PROCESS FOR MANAGING THE AUDIT. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| HAVEN MEDICAL GROUP LLC | |||||||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | 452557237 | MEDICAL PRACTICE SPECIALIZING IN PALLIATIVE CARE | FL | $411,481 | $358,258 | NORTH CENTRAL FLORIDA HOSPICE INC |
| HAVEN HOSPICE PROPERTIES LLC | |||||||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | 850917632 | REAL ESTATE HOLDING COMPANY | FL | $0 | $0 | NORTH CENTRAL FLORIDA HOSPICE INC |
| HAVEN PALLIATIVE CARE LLC | |||||||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | 851116047 | PALLIATIVE CARE | FL | $0 | $39,307 | NORTH CENTRAL FLORIDA HOSPICE INC |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| SANTAFE HEALTHCARE INC | |||||||||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | 592317607 | MANAGEMENT AND FINANCIAL SUPPORT FOR NOT-FOR-PROFIT AFFILIATES | FL | 501(C)(3) | 12B TYPE II | N/A | 0 | |
| AVMED INC | |||||||||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | 592742907 | HEALTH CARE | FL | 501(C)(4) | N/A | 0 | SANTAFE HEALTHCARE INC | |
| NORTH FLORIDA RETIREMENT VILLAGE INC | |||||||||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | 591912330 | RETIREMENT COMMUNITY | FL | 501(C)(3) | 10 | 0 | SANTAFE HEALTHCARE INC | |
| SANTAFE SENIOR LIVING INC | |||||||||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | 203700526 | MANAGEMENT AND FINANCIAL SUPPORT FOR NOT-FOR-PROFIT AFFILIATES | FL | 501(C)(3) | 12B TYPE II | 0 | SANTAFE HEALTHCARE INC | |
| BVG ACQUISITION INC | |||||||||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | 203701186 | RETIREMENT COMMUNITY | FL | 501(C)(3) | 10 | 0 | SANTAFE HEALTHCARE INC | |
| EAST RIDGE RETIREMENT VILLAGE INC | |||||||||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | 590903331 | RETIREMENT COMMUNITY | FL | 501(C)(3) | 10 | 0 | SANTAFE HEALTHCARE INC | |
| BONITA SPRINGS RETIREMENT VILLAGE INC | |||||||||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | 262386152 | RETIREMENT COMMUNITY | FL | 501(C)(3) | 10 | 0 | SANTAFE HEALTHCARE INC | |
| SANTAFE SENIOR LIVING FOUNDATION INC | |||||||||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | 264464727 | CHARITABLE & EDUCATIONAL PURPOSES | FL | 501(C)(3) | 7 | 0 | SANTAFE HEALTHCARE INC | |
| HFK CARE CORPORATION | |||||||||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | 592386289 | HOSPICE CARE & HOME HEALTH CARE | FL | 501(C)(3) | 7 | 0 | SANTAFE HEALTHCARE INC | |
| HAVEN FOUNDATION INC | |||||||||||
| 4200 NW 90TH BLVD | GAINESVILLE | FL | 326069945 | 850863879 | CHARITABLE & EDUCATIONAL PURPOSES | FL | 501(C)(3) | 12A TYPE I | Yes (1) | NORTH CENTRAL FLORIDA HOSPICE INC | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| SF HOLDING CORP INC | |||||||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | 592903901 | HOLDING COMPANY | FL | N/A | C | 0 |
| AVMED ADMINISTRATORS INC | |||||||||
| PO BOX 749 | GAINESVILLE | FL | 326270749 | 842931956 | THIRD PARTY ADMINISTRATIVE SERVICES | FL | N/A | C | 0 |
| CHARITABLE REMAINDER UNITRUST | |||||||||
| CHARITABLE REMAINDER UNITRUST | FL | N/A | 0 | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | 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 | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| HAVEN FOUNDATION INC | ||
| B | $79,376 | ACTUAL CASH CONTRIBUTED |
| AVMED INC | ||
| M | $2,523,059 | FAIR MARKET VALUE OF SERVICES |