2021-05-17T14:01:13-05:00 2020-06-30 946214841 ARMANINO LLP 50 W SAN FERNANDO ST STE 500 SAN JOSE CA 95113 990 2019-07-01 942497618 HOSPICE OF SANTA CRUZ COUNTY HOSP 8314303000 940 DISC DRIVE SCOTTS VALLEY CA 95066 CATHERINE CONWAY CHIEF EXECUTIVE OFFICER 8314303000 2021-05-14 1 MATTHEW PETROSKI P00853132 4082006400 2021-05-14 2019 2022-09-23 18:48:47Z CATHERINE CONWAY 940 DISC DRIVE SCOTTS VALLEY CA 95066 22175178 0 X HOSPICESANTACRUZ.ORG X 1978 CA HOSPICE SERVICE AND SUPPORT FOR TERMINAL PATIENTS AND THEIR FAMILIES. 15 15 197 225 0 0 1808791 1106587 21640922 20945187 49840 10565 57437 61954 23556990 22124293 18434 0 0 0 16263089 16143935 0 0 494357 7274886 7220241 23556409 23364176 581 -1239883 13857637 13958586 2654964 4099504 11202673 9859082 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. 0 0 19106910 20945187 1,036 PATIENTS AND FAMILIES RECEIVED 73,459 DAYS OF EXPERT END-OF-LIFE CARE FROM HOSPICE TEAMS OF MEDICAL DIRECTORS, NURSES, SOCIAL WORKERS, CHAPLAINS, HOSPICE AIDES, AND VOLUNTEERS. ADDITIONALLY, 2,592 INDIVIDIAL GRIEF SUPPORT SESSIONS AND 124 GROUP GRIEF SUPPORT SESSIONS WERE PROVIDED TO HOSPICE FAMILIES AND GRIEVING COMMUNITY MEMBERS OF ALL AGES. 19106910 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 1 0 0 0 1 92 0 1 197 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 15 15 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X THE ORGANIZATION 8314303000 940 DISC DRIVE SCOTTS VALLEY CA 95066 BOB KASWEN PRESIDENT 6.00 X X 0 0 0 DAVID KLUGER VICE PRESIDENT 6.00 X X 0 0 0 CARA DISIMONE TREASURER 4.00 X X 0 0 0 MARGARET GORDON SECRETARY 4.00 X X 0 0 0 ALICIA FLORES DIRECTOR 3.00 X 0 0 0 DALE BISHOP MD DIRECTOR 4.00 X 0 0 0 ED NEWMAN DIRECTOR 1.00 X 0 0 0 ED SACKS MD DIRECTOR 1.00 X 0 0 0 HOLLY ALEXANDER DIRECTOR 1.00 X 0 0 0 JULIA COWELL DIRECTOR 1.00 X 0 0 0 KUNTAL THAKER MD DIRECTOR 1.00 X 0 0 0 RACHEL WEDEEN DIRECTOR TO 2/2020 1.00 X 0 0 0 RUTH MEHR DIRECTOR TO 12/2019 1.00 X 0 0 0 SHARON TAPPER MD DIRECTOR 1.00 X 0 0 0 TIMOTHY TIM ULEN DIRECTOR 1.00 X 0 0 0 BETH HANSMAN DIRECTOR 1.00 X 0 0 0 DICK CLARK DIRECTOR 1.00 X 0 0 0 MICHAEL MILWARD CEO TO 6/1/20 40.00 X 341246 0 14714 ADAM SHORE CFO 40.00 X 228066 0 14599 CHARLEA TARMAS MASSION CHIEF MEDICAL & PALLIATIVE 40.00 X 235248 0 13405 KIERAN SHAH CHIEF STRATEGY OFFICER 40.00 X 238338 0 13781 JUDITH HUMBLE CHIEF COMPLIANCE OFFICER 40.00 X 198395 0 15141 CATHERINE CONWAY CEO FROM 6/1/20 - CMO TO 6/1/20 40.00 X 183092 0 14681 GLORIA REED DIRECTOR OF PATIENT SERVIC 40.00 X 174464 0 12083 HEATHER SVERSON-TANEZ CLINICAL NURSE MANAGER 40.00 X 153783 0 13712 LISA M FLORES SR. DIRECTOR OF IT 40.00 X 144136 0 11687 AMY HARTE NURSE, VARIABLE STAFFING N 32.00 X 136513 0 12229 EMILIA SCHAMBECK PATIENT CARE MANAGER 40.00 X 151561 0 17449 DIANE RENAE SYRCLE DEVELOPMENT DIRECTOR 40.00 X 136117 0 13727 2320959 0 167208 41 0 1 0 NETWORK MANAGEMENT SOLUTIONS INC 1574-F SOQUEL DRIVE SANTA CRUZ CA 95065 INFORMATION TECHNOLOGY SERVICE 285661 PALO ALTO MEDICAL FOUNDATION PO BOX 3757 SUNNYVALE CA 94086 CONTRACTED PHYSICIANS 180834 JANIE KEESLING VESTAL GLEGHORN 417 LINDEN STREET SANTA CRUZ CA 95062 PHYSICIAN 148338 DAN J RIORDAN PO BOX 1026 SUTTER CREEK CA 95685 PROJECT CONSULTANT 109546 HANSON BRIDGETT LLP 425 MARKET STREET 26TH FLOOR SAN FRANCISCO CA 94105 LEGAL 106465 5 43250 1063337 44889 1106587 HOSPICE SERVICES 621610 20945187 20945187 20945187 844 844 51221 51221 44477 34756 9721 9721 9721 17067 43250 14254 2813 2813 9795 1875 7920 7920 22124293 20945187 0 72519 1641724 421140 1220584 12066709 10407729 1327717 331263 106879 98217 5610 3052 1308558 1100376 174826 33356 1020065 808014 187291 24760 45662 45662 20528 20528 28868 28868 356340 232527 111718 12095 6831 6831 364202 267821 69909 26472 578742 479362 84348 15032 337857 279840 49240 8777 193150 185763 6478 909 131429 97249 29098 5082 285193 236220 41565 7408 425050 352062 61948 11040 MEDICAL ROOM & BOARD 1810821 1810821 PATIENT SERVICE, SUPPLY 1056707 1045596 11111 MEDICATIONS 706724 706724 MEMBERSHIPS AND SUBSCRI 387845 103357 281247 3241 484292 474092 9441 759 23364176 19106910 3762909 494357 3230425 4029477 1044719 1045918 546481 369689 2274630 1742354 223264 356757 5029433 2064156 3080059 2965277 2911323 2788469 546736 660645 13857637 13958586 1856557 1997422 276845 248658 521562 1853424 2654964 4099504 X 10331847 9247624 870826 611458 11202673 9859082 13857637 13958586 -1239883 -103708 0 X X 0 0 0 X 2767070 958027 1405711 1808791 1106587 8046186 2767070 958027 1405711 1808791 1106587 8046186 533426 7512760 94242 54691 62977 97561 52065 361536 48824 55517 31122 47477 26862 209802 8617524 101291176 0.87180 0.85060 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: GROSS INCOME SPECIAL EVENTS GROSS INCOME SPECIAL EVENTS GAMING RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 306 306 0 PART II-B, LINE 1: 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 ($306) 535980 -17237 7336 511407 530022 15146 9188 535980 517009 13013 530022 470969 100 45940 517009 482392 75 -11423 75 470969 0.00000 0.85480 0.14520 0 0 558850 558850 1441150 604333 836817 1758881 666249 1092632 1264207 789484 474723 6345 4090 2255 2965277 ENDOWED AGENCY FUND HELD AT COMMUNITY FOUNDATION OF SCC 511307 F NON ENDOWED AGENCY FUND HELD AT COMMUNITY FOUNDATION OF SCC 2277162 F 2788469 DEFERRED COMPENSATION LIABILITIES 385498 SELF-INSURANCE LIABILITY 240875 REFUNDABLE ADVANCE - COVID 1227051 1853424 22007846 -103708 16129 -87579 22095425 28868 28868 22124293 23351437 16129 16129 23335308 28868 28868 23364176 PART V, LINE 4: 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. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING DIRECT EXPENSES 14,254. GAMING DIRECT EXPENSES 1,875. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING DIRECT EXPENSES 14,254. GAMING DIRECT EXPENSES 1,875. AN EVENING WITH FRIENDS 58225 43250 14975 0 0 2923 7415 3916 58225 43250 14975 2923 7415 3916 14254 721 X X X 0 0 0 0 0 0 0 1 0 MICHAEL MILWARD CEO TO 6/1/20 300070 0 41176 0 0 0 3750 0 10964 0 355960 0 0 0 ADAM SHORE CFO 208176 0 19890 0 0 0 2698 0 11901 0 242665 0 0 0 CHARLEA TARMAS MASSION CHIEF MEDICAL & PALLIATIVE 235248 0 0 0 0 0 3619 0 9786 0 248653 0 0 0 KIERAN SHAH CHIEF STRATEGY OFFICER 228887 0 9451 0 0 0 2850 0 10931 0 252119 0 0 0 JUDITH HUMBLE CHIEF COMPLIANCE OFFICER 189936 0 8459 0 0 0 3240 0 11901 0 213536 0 0 0 CATHERINE CONWAY CEO FROM 6/1/20 - CMO TO 6/1/20 174821 0 8271 0 0 0 3750 0 10931 0 197773 0 0 0 GLORIA REED DIRECTOR OF PATIENT SERVIC 166391 0 8073 0 0 0 1170 0 10913 0 186547 0 0 0 HEATHER SVERSON-TANEZ CLINICAL NURSE MANAGER 149855 0 3928 0 0 0 2025 0 11687 0 167495 0 0 0 LISA M FLORES SR. DIRECTOR OF IT 138071 0 6065 0 0 0 0 0 11687 0 155823 0 0 0 EMILIA SCHAMBECK PATIENT CARE MANAGER 147972 0 3589 0 0 0 3750 0 13699 0 169010 0 0 0 PART I, LINE 7 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. KATHERYNE ROBINSON DAUGHTER OF BOARD MEMBER 111065 EMPLOYMENT (NURSE) AMOUNT OF TRANSACTION INCLUDES WAGES OF $103,920, EMPLOYER CONTRIBUTION TO 403(B) PLAN OF $779, AND HEALTH CARE BENEFITS $6,366. 0 X 5 44889 MARKET QUOTATIONS 0 0 0 FORM 990, PART VI, SECTION A, LINE 4 ARTICLES OF INCORPORATION AND BYLAWS WERE RESTATED AS OF AUGUST 1, 2019. RESTATEMENT TO ADD ONE MEMBER AS DEFINED IN SECTION 5056 OF THE CALIFORNIA CORPORATIONS CODE. THE MEMBER, CALIFORNIA HOSPICE NETWORK, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION, SHALL HAVE ALL RIGHTS OF A MEMBER OF A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION AS PROVIDED IN THE PUBLIC BENEFIT CORPORATION LAW AND THE BYLAWS. THE MEMBER SHALL NOT BY ITS VIRTUE OF ITS MEMBERSHIP HAVE ANY RIGHT OR TITLE TO ANY OF THE PROPERTIES, MONIES, OR ASSETS OF THE CORPORATION. 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. CALIFORNIA HOSPICE NETWORK 940 DISC DRIVE SCOTTS VALLEY CA 95066 834716484 HOSPICE SUPPORT. ADMIN, PROGRAMMATIC AND OTHER SUPPORT CA 501(C)(3) LINE 10 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0