MONTGOMERY HOSPICE INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
MONTGOMERY HOSPICE INC (EIN 52-1114719)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-10-14
IRS object ID
202122879349301142
Schema version
2020v4.1
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 ReturnHeader

FieldValueIRS element (for citing)
Return2021-10-14T11:11:25-05:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1901 N GLEBE ROAD SUITE 200AddressLine1Txt
CityARLINGTONCityNm
State AbbreviationVAStateAbbreviationCd
ZIP22203ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN521114719EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MONTGOMERY HOSPICE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMONTBusinessNameControlTxt
Phone3019214400PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11355 PICCARD DRIVE NO 100AddressLine1Txt
CityROCKVILLECityNm
State AbbreviationMDStateAbbreviationCd
ZIP20850ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonANN MITCHELLPersonNm
Person TitlePRESIDENT & CHIEF EXECUTIVE OFFICERPersonTitleTxt
Phone3019214400PhoneNum
Signature2021-10-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstANNPersonFirstNm
Person LastMITCHELLPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJ ANDREW SMITHPreparerPersonNm
PTINP00635175PTIN
Phone5712279500PhoneNum
Preparation2021-10-06PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerANN MITCHELLPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11355 PICCARD DRIVE NO 100AddressLine1Txt
CityROCKVILLECityNm
State AbbreviationMDStateAbbreviationCd
ZIP20850ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$61,793,277GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MONTGOMERYHOSPICE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1979FormationYr
Legal Domicile StateMDLegalDomicileStateCd
Activity Or MissionTO GENTLE THE JOURNEY THROUGH SERIOUS ILLNESS AND LOSS WITH SKILL AND COMPASSION.ActivityOrMissionDesc
Voting Members Governing Body20VotingMembersGoverningBodyCnt
Voting Members Independent19VotingMembersIndependentCnt
Total Employee345TotalEmployeeCnt
Total Volunteers300TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,702,218PYContributionsGrantsAmt
CY Contributions Grants$12,879,860CYContributionsGrantsAmt
PY Program Service Revenue$24,983,462PYProgramServiceRevenueAmt
CY Program Service Revenue$23,777,662CYProgramServiceRevenueAmt
PY Investment Income$912,613PYInvestmentIncomeAmt
CY Investment Income$117,253CYInvestmentIncomeAmt
PY Other Revenue$39,472PYOtherRevenueAmt
CY Other Revenue$112,579CYOtherRevenueAmt
PY Total Revenue$29,637,765PYTotalRevenueAmt
CY Total Revenue$36,887,354CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$23,969,899PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$24,999,916CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$526,901CYTotalFundraisingExpenseAmt
PY Other Expenses$5,730,359PYOtherExpensesAmt
CY Other Expenses$5,740,838CYOtherExpensesAmt
PY Total Expenses$29,700,258PYTotalExpensesAmt
CY Total Expenses$30,740,754CYTotalExpensesAmt
PY Revenues Less Expenses-$62,493PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$6,146,600CYRevenuesLessExpensesAmt
Total Assets BOY$31,633,056TotalAssetsBOYAmt
Total Assets EOY$45,336,363TotalAssetsEOYAmt
Total Liabilities BOY$3,628,243TotalLiabilitiesBOYAmt
Total Liabilities EOY$9,785,963TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$28,004,813NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$35,550,400NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO GENTLE THE JOURNEY THROUGH SERIOUS ILLNESS AND LOSS WITH SKILL AND COMPASSION. TO BRING COMFORT BY PROVIDING COMPASSIONATE, PROFESSIONAL CARE TO COMMUNITY RESIDENTS WHO ARE FACING SERIOUS ILLNESS AND LOSS. TO PROVIDE DIGNITY FOR THE DYING AND UNCONDITIONAL COMPASSION, THROUGH DEDICATION AND COLLABORATION.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$28,129,653ExpenseAmt
Revenue$23,777,662RevenueAmt
DescHOSPICE CARE: THE ORGANIZATION PROVIDES SPECIALIZED MEDICAL AND PSYCHOSOCIAL END-OF-LIFE CARE TO MONTGOMERY AND PRINCE GEORGE'S COUNTY, MARYLAND RESIDENTS WHO ARE LIVING WITH A LIFE LIMITING ILLNESS. PATIENTS (AND THEIR FAMILIES) ARE CARED FOR IN HOMES, EXTENDED CARE FACILITIES AND AT CASEY HOUSE, OUR ACUTE CARE FACILITY. OUR TEAMS OF DOCTORS, NURSE PRACTITIONERS, NURSES, SPIRITUAL COUNSELORS, SOCIAL WORKERS, CERTIFIED NURSING ASSISTANTS, COMPLEMENTARY THERAPISTS, BEREAVEMENT COUNSELORS AND VOLUNTEERS WORK TOGETHER TO PROVIDE COMFORT CARE CUSTOMIZED FOR EACH PATIENT. IN 2020, MONTGOMERY HOSPICE SERVED 2,610 PATIENTS AND THEIR FAMILIES. AMONG THE TOTAL PATIENTS SERVED, 19 WERE CHILDREN AND 87 WERE EITHER UNINSURED OR UNDERINSURED. CASEY HOUSE, IS THE ONLY ALL-HOSPICE ACUTE FACILITY IN MONTGOMERY COUNTY.Desc
Total Program Service Expenses$28,129,653TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document13IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee345EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members20GoverningBodyVotingMembersCnt
Independent Voting Member19IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMDStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonABEBAW WUBIYE CONTROLLERPersonNm
Phone3019214400PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11355 PICCARD DRIVE SUITE 100AddressLine1Txt
CityROCKVILLECityNm
State AbbreviationMDStateAbbreviationCd
ZIP20850ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
ANN MITCHELL
PRESIDENT & CEO40.00Yes (X)Yes (X)$274,780$0$14,254
MONICA ESCALANTE
CFO/CCO40.00Yes (X)$236,095$0$13,256
GEOFFREY COLEMAN MD
CHIEF MEDICAL OFFICER40.00$222,753$0$19,904Yes (X)
MARK GOLDMAN
TEAM PHYSICIAN32.00$201,055$0$3,565Yes (X)
ANN LICHTENSTEIN
ASSOCIATE MEDICAL DIRECTOR40.00$189,519$0$13,273Yes (X)
DOROTHY MBELLASON
NURSE40.00$161,648$0$9,083Yes (X)
JENNIFER PLUDE
SR VP OF NURSING SERVICES40.00$166,301$0$4,062Yes (X)
MARLENE BRADFORD
VP OF PHILANTHROPY40.00$151,804$0$11,217Yes (X)
LYA M KARM MD
IMMEDIATE PAST CHAIRMAN1.00Yes (X)Yes (X)$0$0$0
ELMA M LEVY
CHAIRMAN1.00Yes (X)Yes (X)$0$0$0
MICHAEL ZHUANG
TREASURER1.00Yes (X)Yes (X)$0$0$0
DIANE K KUWAMURA ESQ
VICE CHAIRMAN1.00Yes (X)Yes (X)$0$0$0
REV JAMES E BONEY
SECRETARY1.00Yes (X)Yes (X)$0$0$0
BRADLEY H COLTON
DIRECTOR1.00Yes (X)$0$0$0
DELEGATE BONNIE L CULLISON
DIRECTOR1.00Yes (X)$0$0$0
DAWN E DOEBLER
DIRECTOR1.00Yes (X)$0$0$0
SUSAN L GLOVER
DIRECTOR1.00Yes (X)$0$0$0
SURESH K GUPTA MD
DIRECTOR1.00Yes (X)$0$0$0
MIMI HASSANEIN
DIRECTOR1.00Yes (X)$0$0$0
DEBORAH PARHAM HOPSON PHD
DIRECTOR1.00Yes (X)$0$0$0
CYNTHIA A MESMER
DIRECTOR1.00Yes (X)$0$0$0
CECILIA M OTERO
DIRECTOR1.00Yes (X)$0$0$0
CESAR E PALACIOS
DIRECTOR1.00Yes (X)$0$0$0
CHRISTOPHER N PALMER
DIRECTOR1.00Yes (X)$0$0$0
MICHELLE Q PROFIT ESQ
DIRECTOR1.00Yes (X)$0$0$0
SHOBHANA SHARMA
DIRECTOR1.00Yes (X)$0$0$0
JO ANNE ZUJEWSKI MD
DIRECTOR1.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,603,955TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$88,614TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K11IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
HOSPICE PHARMACY SOLUTIONS
2201 N CENTRAL EXPRESSWAY 250RICHARDSONTX75080PHARMACY$805,230
JOERNS HEALTHCARE
2430 WHITEHALL PARK DR 100CHARLOTTENC28273MEDICAL EQUIPMENTS$793,581
MEDLINE INDUSTRIES
P O BOX 382075PITTSBURGHPA15251MEDICAL SUPPLIES$478,356
ROCK CREEK TREE AND TURF LANDSCAPING
17520 BOWIE MILL RDROCKVILLEMD20855LANDSCAPING/ CAPITAL PROJECTS$157,427
WEATHERBEE RESOURCES
14 EAST CHURCH STHEADLANDAL36345CONSULTING SERVICES$134,588
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt
Federated Campaigns$42,504FederatedCampaignsAmt
All Other Contributions$12,837,356AllOtherContributionsAmt
Noncash Contributions$11,215,492NoncashContributionsAmt
Total Contributions$12,879,860TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE REVENUEDesc
Business624100BusinessCd
Total Revenue Column$23,777,662TotalRevenueColumnAmt
Related Or Exempt Func Income$23,777,662RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$23,777,662TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$713,272TotalRevenueColumnAmt
Exclusion$713,272ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$24,309,904SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$24,905,923SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$596,019SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$596,019TotalRevenueColumnAmt
Exclusion-$596,019ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$112,579TotalRevenueColumnAmt
Exclusion$112,579ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$112,579OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$36,887,354TotalRevenueColumnAmt
Related Or Exempt Func Income$23,777,662RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$229,832ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$781,041TotalAmt
Program Services$697,501ProgramServicesAmt
Management And General$71,257ManagementAndGeneralAmt
Fundraising$12,283FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$20,237,546TotalAmt
Program Services$18,482,467ProgramServicesAmt
Management And General$1,406,181ManagementAndGeneralAmt
Fundraising$348,898FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$336,155TotalAmt
Program Services$292,715ProgramServicesAmt
Management And General$36,188ManagementAndGeneralAmt
Fundraising$7,252FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,174,749TotalAmt
Program Services$1,952,987ProgramServicesAmt
Management And General$197,036ManagementAndGeneralAmt
Fundraising$24,726FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,470,425TotalAmt
Program Services$1,322,103ProgramServicesAmt
Management And General$121,965ManagementAndGeneralAmt
Fundraising$26,357FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$64,117TotalAmt
Program Services$57,064ProgramServicesAmt
Management And General$5,912ManagementAndGeneralAmt
Fundraising$1,141FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$49,199TotalAmt
Program Services$43,787ProgramServicesAmt
Management And General$4,536ManagementAndGeneralAmt
Fundraising$876FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$94,918TotalAmt
Management And General$94,918ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$488,011TotalAmt
Program Services$464,323ProgramServicesAmt
Management And General$19,855ManagementAndGeneralAmt
Fundraising$3,833FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$106,906TotalAmt
Program Services$106,906ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$719,929TotalAmt
Program Services$633,327ProgramServicesAmt
Management And General$37,890ManagementAndGeneralAmt
Fundraising$48,712FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$437,345TotalAmt
Program Services$375,599ProgramServicesAmt
Management And General$38,911ManagementAndGeneralAmt
Fundraising$22,835FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$622,660TotalAmt
Program Services$587,122ProgramServicesAmt
Management And General$29,787ManagementAndGeneralAmt
Fundraising$5,751FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$236,516TotalAmt
Program Services$236,412ProgramServicesAmt
Management And General$77ManagementAndGeneralAmt
Fundraising$27FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$17,366TotalAmt
Fundraising$17,366FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$14,966TotalAmt
Program Services$13,320ProgramServicesAmt
Management And General$1,380ManagementAndGeneralAmt
Fundraising$266FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$219,471TotalAmt
Program Services$213,171ProgramServicesAmt
Management And General$5,281ManagementAndGeneralAmt
Fundraising$1,019FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$92,717TotalAmt
Program Services$85,241ProgramServicesAmt
Management And General$6,266ManagementAndGeneralAmt
Fundraising$1,210FundraisingAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
PHARMACY PURCHASES$1,719,965$1,716,431$2,962$572
MEDICAL SUPPLIES$715,373$715,373
DUES & PUBLICATION$64,712$56,446$4,378$3,888

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$76,667TotalAmt
Program Services$77,358ProgramServicesAmt
Management And General-$580ManagementAndGeneralAmt
Fundraising-$111FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$30,740,754TotalAmt
Program Services$28,129,653ProgramServicesAmt
Management And General$2,084,200ManagementAndGeneralAmt
Fundraising$526,901FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,189,130BOYAmt
EOY$4,365,123EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$10,155,267BOYAmt
EOY$12,997,454EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$24,212BOYAmt
EOY$21,487EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,460,645BOYAmt
EOY$3,039,844EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$422,585BOYAmt
EOY$322,568EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$5,843,091LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,357,366LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,554,857BOYAmt
EOY$3,485,725EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$12,795,203BOYAmt
EOY$20,948,211EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$31,157BOYAmt
EOY$155,951EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$31,633,056BOYAmt
EOY$45,336,363EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,192,651BOYAmt
EOY$4,148,800EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$1,366,309EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
EOY$3,900,300EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$435,592BOYAmt
EOY$370,554EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,628,243BOYAmt
EOY$9,785,963EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$20,984,875BOYAmt
EOY$28,004,650EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$7,019,938BOYAmt
EOY$7,545,750EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$28,004,813BOYAmt
EOY$35,550,400EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$31,633,056BOYAmt
EOY$45,336,363EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$6,146,600ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,398,987NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,354,491CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,994,435CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,814,109CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,702,218CurrentTaxYearMinus1YearAmt
Current Tax Year$12,879,860CurrentTaxYearAmt
Total$24,745,113TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$24,465,613CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$26,680,377CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$27,321,360CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$24,983,462CurrentTaxYearMinus1YearAmt
Current Tax Year$23,777,662CurrentTaxYearAmt
Total$127,228,474TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$25,820,104CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$28,674,812CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$32,135,469CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$28,685,680CurrentTaxYearMinus1YearAmt
Current Tax Year$36,657,522CurrentTaxYearAmt
Total$151,973,587TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year$11,101,498CurrentTaxYearAmt
Total$11,101,498TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year$11,101,498CurrentTaxYearAmt
Total$11,101,498TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$140,872,089PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$503,953CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$497,953CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$588,192CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$635,334CurrentTaxYearMinus1YearAmt
Current Tax Year$713,272CurrentTaxYearAmt
Total$2,938,704TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$503,953CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$497,953CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$588,192CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$635,334CurrentTaxYearMinus1YearAmt
Current Tax Year$713,272CurrentTaxYearAmt
Total$2,938,704TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,683CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,810CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$112,668CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$39,472CurrentTaxYearMinus1YearAmt
Current Tax Year$112,579CurrentTaxYearAmt
Total$279,212TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$26,326,740CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$29,184,575CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$32,836,329CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$29,360,486CurrentTaxYearMinus1YearAmt
Current Tax Year$37,483,373CurrentTaxYearAmt
Total$155,191,503TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.90770PublicSupportCY509Pct
Public Support PY5090.98050PublicSupportPY509Pct
Investment Income CY0.01890InvestmentIncomeCYPct
Investment Income PY0.01820InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$8,805,557BeginningYearBalanceAmt
Contributions$8,100,000ContributionsAmt
Investment Earnings Or Losses$1,647,153InvestmentEarningsOrLossesAmt
Other Expenditures$439,100OtherExpendituresAmt
End Year Balance$18,113,610EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,714,442BeginningYearBalanceAmt
Contributions$100,000ContributionsAmt
Investment Earnings Or Losses$1,195,330InvestmentEarningsOrLossesAmt
Other Expenditures$204,215OtherExpendituresAmt
End Year Balance$8,805,557EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,364,859BeginningYearBalanceAmt
Contributions$1,100,030ContributionsAmt
Investment Earnings Or Losses-$558,627InvestmentEarningsOrLossesAmt
Other Expenditures$191,820OtherExpendituresAmt
End Year Balance$7,714,442EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,733,391BeginningYearBalanceAmt
Contributions$1,810ContributionsAmt
Investment Earnings Or Losses$819,624InvestmentEarningsOrLossesAmt
Other Expenditures$189,966OtherExpendituresAmt
End Year Balance$7,364,859EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,562,932BeginningYearBalanceAmt
Contributions$800ContributionsAmt
Investment Earnings Or Losses$347,615InvestmentEarningsOrLossesAmt
Other Expenditures$177,956OtherExpendituresAmt
End Year Balance$6,733,391EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.64000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.36000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,082,200OtherCostOrOtherBasisAmt
Book Value$1,082,200BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,304,147OtherCostOrOtherBasisAmt
Depreciation$1,423,990DepreciationAmt
Book Value$1,880,157BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$264,187OtherCostOrOtherBasisAmt
Depreciation$136,577DepreciationAmt
Book Value$127,610BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$356,871OtherCostOrOtherBasisAmt
Depreciation$322,134DepreciationAmt
Book Value$34,737BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$835,686OtherCostOrOtherBasisAmt
Depreciation$474,665DepreciationAmt
Book Value$361,021BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$3,485,725TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
CAPITAL LEASE OBLIGATION$76,949
ACCRUED RENT PAYABLE$293,605
FieldValueIRS element (for citing)
Total Liability$370,554TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE ENDOWMENT FUNDS RESULTED FROM DONOR-RESTRICTED FUNDS FOR SUPPORT OF SEVERAL HOSPICE PROGRAM ACTIVITIES. CONTRIBUTIONS FROM MAJOR DONORS WERE RESTRICTED TO THE OPERATIONS, MAINTENANCE AND PATIENT CARE AT THE HOSPICE'S INPATIENT ACUTE CARE FACILITY. DONORS HAVE ALSO CONTRIBUTED TO THE FUNDING OF NURSING SERVICES PROVIDED AT THE INPATIENT HOSPICE. THE HOSPICE IN-HOME SERVICES ARE BEING SUPPORTED TO PROVIDE MEDICAL CARE SERVICES BY PHYSICIANS, NURSES, SOCIAL WORKERS AND HOSPICE AIDES. THE ENDOWMENTS ALSO SUPPORT CHARITY CARE AND THE UNCOMPENSATED SERVICES PROVIDED TO PATIENTS AND THEIR FAMILIES THROUGH BEREAVEMENT AND PASTORAL CARE SUPPORT.
PART X, LINE 2:THE HOSPICE IS A TAX-EXEMPT ENTITY AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). THE IRC PROVIDES FOR TAXATION OF UNRELATED BUSINESS INCOME UNDER CERTAIN CIRCUMSTANCES. THE HOSPICE AND ITS SUBSIDIARY HAVE NO SIGNIFICANT UNRELATED BUSINESS INCOME; HOWEVER, SUCH STATUS IS SUBJECT TO FINAL DETERMINATION UPON EXAMINATION OF THE RELATED INCOME TAX RETURNS BY THE APPROPRIATE TAXING AUTHORITIES.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ANN MITCHELL
PRESIDENT & CEO$257,595$0$17,185$0$0$0$5,765$0$8,489$0$289,034$0$0$0
MONICA ESCALANTE
CFO/CCO$236,095$0$0$0$0$0$4,824$0$8,432$0$249,351$0$0$0
GEOFFREY COLEMAN MD
CHIEF MEDICAL OFFICER$212,470$0$0$0$10,283$0$5,564$0$14,340$0$242,657$0$0$0
MARK GOLDMAN
TEAM PHYSICIAN$201,055$0$0$0$0$0$3,565$0$0$0$204,620$0$0$0
ANN LICHTENSTEIN
ASSOCIATE MEDICAL DIRECTOR$189,519$0$0$0$0$0$4,182$0$9,091$0$202,792$0$0$0
DOROTHY MBELLASON
NURSE$161,648$0$0$0$0$0$0$0$9,083$0$170,731$0$0$0
JENNIFER PLUDE
SR VP OF NURSING SERVICES$166,301$0$0$0$0$0$3,522$0$540$0$170,363$0$0$0
MARLENE BRADFORD
VP OF PHILANTHROPY$151,804$0$0$0$0$0$3,054$0$8,163$0$163,021$0$0$0

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution3ContributionCnt
Noncash Contributions Rpt F990$11,215,492NoncashContributionsRptF990Amt
Method Of Determining RevenuesPUBLISHED MARKET VALUEMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE BOARD CHAIRPERSON, BOARD VICE CHAIRPERSON, BOARD SECRETARY, BOARD TREASURER, IMMEDIATE PAST CHAIRPERSON, AND THE PRESIDENT/CHIEF EXECUTIVE OFFICER (CEO), AND SUCH OTHER BOARD MEMBERS AS THE BOARD MAY DEEM APPROPRIATE. IT SHALL HAVE AUTHORITY TO CONDUCT ESSENTIAL HOSPICE BUSINESS BETWEEN BOARD MEETINGS, WHEN DELAY IN ACTION WOULD BE DETRIMENTAL TO THE HOSPICE, EXCEPT AS TO THE MATTERS LISTED BELOW AS WELL AS ANY OTHERS IMPOSED BY THE BOARD: 1. AMENDING THE ARTICLES OF INCORPORATION OR THE BYLAWS; 2. APPROVING A PLAN OF MERGER OR CONSOLIDATION; 3. FILLING VACANCIES ON THE HOSPICE BOARD OR REMOVING DIRECTORS OR OFFICERS FROM OFFICE; 4. APPOINTING OR REMOVING MEMBERS OF THE EXECUTIVE COMMITTEE; 5. APPOINTING OR REMOVING ANY OFFICER, THE MEDICAL DIRECTOR OR THE PRESIDENT/CEO, WITHOUT THE APPROVAL OF A MAJORITY OF THE BOARD; 6. APPROVING SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, THE PROPERTY OR ASSETS OF THE HOSPICE; OR 7. APPROVING VOLUNTARY DISSOLUTION OF THE HOSPICE OR REVOCATION OF VOLUNTARY DISSOLUTION PROCEEDINGS.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS REVIEWED BY THE PRESIDENT AND MEMBERS OF THE FINANCE COMMITTEE BEFORE FILING. THE CHAIRMAN GIVES A SUMMARY REPORT TO THE BOARD. BOARD MEMBERS CAN REQUEST A COPY OF THE FORM 990 RETURN.
FORM 990, PART VI, SECTION B, LINE 12CALL INDIVIDUALS, UPON APPOINTMENT TO THE BOARD OF DIRECTORS, ANY BOARD DESIGNATED COMMITTEE, OR MONTGOMERY HOSPICE STAFF OR VOLUNTEER POSITION, SHALL BE REQUIRED TO EXAMINE AND SIGN AN INDIVIDUAL STATEMENT REGARDING CONFLICT OF INTEREST. IN THE EVENT A CONFLICT OF INTEREST OR POTENTIAL CONFLICT ARISES, THE CONFLICT OF INTEREST STATEMENT MUST PROMPTLY BE UPDATED AND BROUGHT TO THE ATTENTION OF THE PRESIDENT/CEO AND/OR CHAIRMAN OF THE BOARD. IF THE MATTER CONCERNS A STAFF MEMBER OR VOLUNTEER, THE CHANGE SHOULD BE PRESENTED TO THE INDIVIDUAL'S SUPERVISOR. THE INDIVIDUAL BOARD MEMBERS, WHO HAVE A CONFLICT OF INTEREST WITH THEIR CURRENT BUSINESS RELATIONSHIP AND THE HOSPICE, WILL WITHDRAW THEMSELVES FROM BOARD DISCUSSIONS AND VOTING.
FORM 990, PART VI, SECTION B, LINE 15AREVIEW FOR PRESIDENT/CEO IS CONDUCTED ANNUALLY BY CERTAIN MEMBERS OF THE EXECUTIVE COMMITTEE. MEMBERS MAY INTERVIEW PRESIDENT/CEO'S COLLEAGUES CONCERNING THEIR INTERACTION AND RELATIONSHIP WITH PRESIDENT/CEO. OTHER ANALYSIS INCLUDES A WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE EXECUTIVE COMMITTEE. KEY EMPLOYEES ARE GIVEN ANNUAL PERFORMANCE REVIEWS BY THEIR IMMEDIATE SUPERVISOR INCLUDING THE PRESIDENT/CEO. THE PERFORMANCE SUMMARY IS REVIEWED AND DISCUSSED WITH THE PRESIDENT/CEO. AN ANALYSIS OF COMPARABLE STAFF POSITIONS AND SIMILAR HOSPICE ORGANIZATIONS IS DONE BY HR DEPARTMENT. DATA FROM BENCHMARK REPORTS PROVIDED BY NHPCO ARE ALSO USED IN THIS ANALYSIS. THE MOST RECENT YEAR IN WHICH THE COMPENSATION PROCESS WAS REVIEWED WAS 2019.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ALSO SUMMARIZED ON THE ORGANIZATION'S WEBSITE.
FORM 990, PART XII, LINE 2C:THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILTY OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE ORGANIZATION'S PROCESS WAS UNCHANGED IN CURRENT YEAR.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1PALLIATIVE MEDICINE CONSULTANTS OF GREATER WASHINGTON LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11355 PICCARD DR SUITE 100OAddressLine1Txt
CityROCKVILLECityNm
State AbbreviationMDStateAbbreviationCd
ZIP20850ZIPCd
FieldValueIRS element (for citing)
EIN522343635EIN
Primary ActivitiesTO OFFER A CONTINUUM OF CARE FOR PATIENTS WITH ADVANCED ILLNESSPrimaryActivitiesTxt
Legal Domicile StateMDLegalDomicileStateCd
Total Income$14,709TotalIncomeAmt
End Of Year Assets$39,427EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1MONTGOMERY HOSPICE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1PALLIATIVE MEDICINE CONSULTANTS OF GREATER WASHINGTON LLCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeETransactionTypeTxt
Involved$84,145InvolvedAmt
Method Of Amount DeterminationFMVMethodOfAmountDeterminationTxt

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