GOOD SHEPHERD HOSPICE INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
GOOD SHEPHERD HOSPICE INC (EIN 20-5276923)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-11-05
IRS object ID
202123099349304372
Schema version
2020v4.0
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)
Return2021-11-05T16:02:06-05:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN350921680PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CROWE LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1401 East Las Olas Blvd Suite 1100AddressLine1Txt
CityFort LauderdaleCityNm
State AbbreviationFLStateAbbreviationCd
ZIP333014230ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN205276923EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Good Shepherd Hospice IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlGOODBusinessNameControlTxt
Phone8138718100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line112470 Telecom Drive Suite 300AddressLine1Txt
CityTemple TerraceCityNm
State AbbreviationFLStateAbbreviationCd
ZIP33637ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDavid J ONeilPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Signature2021-11-05SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstDavid JPersonFirstNm
Person LastONeilPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBRITTNEY KOCAJPreparerPersonNm
PTINP01320603PTIN
Phone9542028600PhoneNum
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1ANDREW MOLOSKY President & CEOBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line112470 Telecom DriveAddressLine1Txt
CityTemple TerraceCityNm
State AbbreviationFLStateAbbreviationCd
ZIP33637ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$40,026,961GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresschaptershealth.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2006FormationYr
Legal Domicile StateFLLegalDomicileStateCd
Activity Or MissionProvides hospice and palliative care services that relieve the suffering of persons residing in its communities affected by life-limiting illnesses and end-of-life issues so all may live as fully as possible.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee402TotalEmployeeCnt
Total Volunteers200TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$210,955PYContributionsGrantsAmt
CY Contributions Grants$3,884,754CYContributionsGrantsAmt
PY Program Service Revenue$36,170,377PYProgramServiceRevenueAmt
CY Program Service Revenue$36,140,618CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$10,307PYOtherRevenueAmt
CY Other Revenue$1,589CYOtherRevenueAmt
PY Total Revenue$36,391,639PYTotalRevenueAmt
CY Total Revenue$40,026,961CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$24,798,328PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$25,964,088CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$13,752,009PYOtherExpensesAmt
CY Other Expenses$14,081,803CYOtherExpensesAmt
PY Total Expenses$38,550,337PYTotalExpensesAmt
CY Total Expenses$40,045,891CYTotalExpensesAmt
PY Revenues Less Expenses-$2,158,698PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$18,930CYRevenuesLessExpensesAmt
Total Assets BOY$17,624,922TotalAssetsBOYAmt
Total Assets EOY$16,258,177TotalAssetsEOYAmt
Total Liabilities BOY$3,693,504TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,752,890TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$13,931,418NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$13,505,287NetAssetsOrFundBalancesEOYAmt
MissionGood Shepherd Hospice, Inc. provides hospice and palliative care services that relieve the suffering of persons residing in its communities affected by life-limiting illnesses and end-of-life issues so all may live as fully and comfortably as possible.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$33,108,796ExpenseAmt
Grant$0GrantAmt
Revenue$36,142,207RevenueAmt
DescA. PATIENT CARE - AS A NOT-FOR-PROFIT HOSPICE PROGRAM CERTIFIED BY THE FEDERAL MEDICARE PROGRAM, GOOD SHEPHERD HOSPICE PROVIDES A WIDE RANGE OF PALLIATIVE AND SUPPORTIVE CARE SERVICES TO HELP TERMINALLY ILL PATIENTS, THEIR FAMILIES AND THEIR LOVED ONES. Good Shepherd Hospice is a Medicare-certified agency that provides end-of-life care in Polk, Highlands, Monroe and Hardee counties in Florida. In 2020, Good Shepherd Hospice served 4,258 patients in its communities. Good Shepherd Hospice maintains 54% market share in Polk Highlands, Monroe and Hardee counties in 2020. These SERVICES ARE PROVIDED BY INTERDISCIPLINARY TEAMS COMPOSED OF QUALIFIED PROFESSIONALS AND TRAINED VOLUNTEERS. GOOD SHEPHERD HOSPICE ALSO HAS DEVELOPED AN EXTENSIVE NETWORK OF PARTNERSHIPS WITH HOSPITALS, ASSISTED LIVING FACILITIES AND NURSING HOMES TO IDENTIFY PATIENTS WHO WOULD BENEFIT FROM THE SERVICES AVAILABLE. (CONTINUED IN SCHEDULE O)Desc
Total Program Service Expenses$33,108,796TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee402EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldFLStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1David J ONeilBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8138718111PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line112470 Telecom drive Suite 300AddressLine1Txt
CityTemple TerraceCityNm
State AbbreviationFLStateAbbreviationCd
ZIP33637ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Andrew Molosky
PRESIDENT/CEO/CHAIR2.048.0Yes (X)Yes (X)$0$661,676$214,534
ANNE FURR
VICE CHAIR2.00Yes (X)Yes (X)$0$0$0
David J O'Neil
Chief Financial Officer2.048.0Yes (X)Yes (X)$0$605,296$142,604
DEAN FORMAN
Chief Operating Officer2.046.0Yes (X)Yes (X)$0$422,840$98,149
DERIC FEACHER
SECRETARY2.00Yes (X)Yes (X)$0$0$0
Ronald S Schonwetter MD
Chief Medical Officer2.046.0Yes (X)Yes (X)$0$814,280$132,260
CLIFFORD RHOADES
BOARD MEMBER2.02.0Yes (X)$0$0$0
James Joiner
BOARD MEMBER2.02.0Yes (X)$0$0$0
Michelle Heston
BOARD MEMBER2.00Yes (X)$0$0$0
Thomas Conger
BOARD MEMBER (through 9/2020)2.00Yes (X)$0$0$0
Willie Hogan
BOARD MEMBER (through 9/2020)2.00Yes (X)$0$0$0
Paola Delp
Chief Business Development Officer2.046.0Yes (X)$0$303,427$50,027
Sharon P Saucier
Chief Clinical & Compliance Officer2.046.0Yes (X)$0$403,805$84,925
Sheryl J Sypek
Chief Information Officer2.046.0Yes (X)$0$371,578$98,974
Kyle Zenkner
EXECUTIVE DIRECTOR40.00$191,738$0$69,713Yes (X)
Dale Rita Day
Clinical Administrator40.00$131,449$0$5,195Yes (X)
KENDRA HALL-FRANKS
STAFF PHYSICIAN40.00$261,668$0$54,165Yes (X)
Lynnette Canady
Nurse Practitioner40.00$138,702$0$35,850Yes (X)
Stuart Owens
Medical Director40.00$288,894$0$38,565Yes (X)
Susan Moffitt
Nurse Practitioner Preceptor40.00$153,481$0$21,963Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,165,933TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,582,902TotReportableCompRltdOrgAmt
Total Other Compensation$1,046,925TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K12IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Related Organizations$1,360,200RelatedOrganizationsAmt
Government Grants$2,524,554GovernmentGrantsAmt
Total Contributions$3,884,754TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPatient Service RevenueDesc
Business624100BusinessCd
Total Revenue Column$36,140,618TotalRevenueColumnAmt
Related Or Exempt Func Income$36,140,618RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$36,140,618TotalProgramServiceRevenueAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescDIETARY SERVICESDesc
Business900099BusinessCd
Total Revenue Column$1,589TotalRevenueColumnAmt
Related Or Exempt Func Income$1,589RelatedOrExemptFuncIncomeAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,589OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$40,026,961TotalRevenueColumnAmt
Related Or Exempt Func Income$36,142,207RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$250,411TotalAmt
Program Services$250,411ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$20,622,176TotalAmt
Program Services$17,665,586ProgramServicesAmt
Management And General$2,956,590ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,746,047TotalAmt
Program Services$3,179,980ProgramServicesAmt
Management And General$566,067ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,345,454TotalAmt
Program Services$1,163,702ProgramServicesAmt
Management And General$181,752ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$328,818TotalAmt
Management And General$328,818ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$58,965TotalAmt
Management And General$58,965ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$509,843TotalAmt
Program Services$253,170ProgramServicesAmt
Management And General$256,673ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$153,768TotalAmt
Program Services$19,188ProgramServicesAmt
Management And General$134,580ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$726,552TotalAmt
Program Services$292,984ProgramServicesAmt
Management And General$433,568ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$810,486TotalAmt
Program Services$927ProgramServicesAmt
Management And General$809,559ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,624,006TotalAmt
Program Services$2,164,770ProgramServicesAmt
Management And General$459,236ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$582,792TotalAmt
Program Services$566,143ProgramServicesAmt
Management And General$16,649ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$47,483TotalAmt
Program Services$28,059ProgramServicesAmt
Management And General$19,424ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$20,811TotalAmt
Management And General$20,811ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$423,163TotalAmt
Management And General$423,163ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
Drugs$1,998,356$1,998,356
PATIENT SERVICES$1,294,937$1,294,937
INPATIENT AND RESPITE$1,427,308$1,427,308
MEDICAL, OXYGEN & IV SUPPLIES, AND DME$2,217,705$2,217,705

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$856,810TotalAmt
Program Services$585,570ProgramServicesAmt
Management And General$271,240ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$40,045,891TotalAmt
Program Services$33,108,796ProgramServicesAmt
Management And General$6,937,095ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,761,918BOYAmt
EOY$3,011,933EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$0LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$0LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$12,863,004BOYAmt
EOY$13,246,244EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$17,624,922BOYAmt
EOY$16,258,177EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,844,954BOYAmt
EOY$1,710,858EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$848,550BOYAmt
EOY$1,042,032EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,693,504BOYAmt
EOY$2,752,890EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$12,856,251BOYAmt
EOY$12,318,292EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,075,167BOYAmt
EOY$1,186,995EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$13,931,418BOYAmt
EOY$13,505,287EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$17,624,922BOYAmt
EOY$16,258,177EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$18,930ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$407,201OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

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$109,085CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$113,582CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$113,582CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$210,955CurrentTaxYearMinus1YearAmt
Current Tax Year$3,884,754CurrentTaxYearAmt
Total$4,431,958TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$32,277,601CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$35,492,647CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$36,665,669CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$36,170,377CurrentTaxYearMinus1YearAmt
Current Tax Year$36,140,618CurrentTaxYearAmt
Total$176,746,912TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$32,386,686CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$35,606,229CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$36,779,251CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$36,381,332CurrentTaxYearMinus1YearAmt
Current Tax Year$40,025,372CurrentTaxYearAmt
Total$181,178,870TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$2,124,284CurrentTaxYearAmt
Total$2,124,284TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$2,124,284CurrentTaxYearAmt
Total$2,124,284TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$179,054,586PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$14,401CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$12,538CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,853CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,307CurrentTaxYearMinus1YearAmt
Current Tax Year$1,589CurrentTaxYearAmt
Total$50,688TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$32,401,087CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$35,618,767CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$36,791,104CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$36,391,639CurrentTaxYearMinus1YearAmt
Current Tax Year$40,026,961CurrentTaxYearAmt
Total$181,229,558TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.9880PublicSupportCY509Pct
Public Support PY5090.9997PublicSupportPY509Pct
Investment Income CY0InvestmentIncomeCYPct
Investment Income PY0.0InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule A, Part III, Line 12 Other IncomeFormAndLineReferenceDesc
ExplanationDESCRIPTION - OTHER INCOME, COLUMN A - 14401.0, COLUMN B - 12538.0, COLUMN C - 11853.0, COLUMN D - 10307.0, COLUMN E - 1589.0, COLUMN F - 50688.0;ExplanationTxt

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$1,017,221BeginningYearBalanceAmt
Contributions$23,350ContributionsAmt
End Year Balance$1,040,571EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$987,153BeginningYearBalanceAmt
Contributions$30,068ContributionsAmt
End Year Balance$1,017,221EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$966,052BeginningYearBalanceAmt
Contributions$21,101ContributionsAmt
End Year Balance$987,153EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$952,006BeginningYearBalanceAmt
Contributions$14,046ContributionsAmt
End Year Balance$966,052EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$938,429BeginningYearBalanceAmt
Contributions$13,577ContributionsAmt
End Year Balance$952,006EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.0611BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.9389PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.0TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (true)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (true)RelatedOrgListSchRInd

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
Beneficial interest in net assets of Chapters Health Foundation$12,940,121
Amounts due from 3rd parties$306,123
FieldValueIRS element (for citing)
Total Book Value Other Assets$13,246,244TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescTHIRD PARTY SETTLEMENTSDesc
Amt$1,042,032Amt
FieldValueIRS element (for citing)
Total Liability$1,042,032TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$40,138,788TotalRevEtcAuditedFinclStmtAmt
Other Revenue$111,827OtherRevenueAmt
Revenue Not Reported$111,827RevenueNotReportedAmt
Revenue Subtotal$40,026,961RevenueSubtotalAmt
Other Revenues Not Included$0OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$40,026,961TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$40,045,891TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$0OtherExpensesIncludedAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$40,045,891ExpensesSubtotalAmt
Other Expenses Not Included$0OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$40,045,891TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part V, Line 4 Intended uses of endowment fundsThe Building Endowment fund provides funds for the necessary maintenance and facility upkeep of all Chapters Health System (CHS) facilities; the Children's Endowment fund provides funds for specific equipment and staffing to meet the needs of pediatric patients, grieving children and families; The Medical Student endowment provides funds to the Medical Student Program that educates future physicians on the importance of end-of-life care. These endowments are held by Chapters Health Foundation, Inc. (CHF), a related organization, and the programs and facilities of CHF support Good Shepherd Hospice, Inc.
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteChapters and the affiliate organizations are 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 of being realized on examination. For tax positions not meeting the "more likely than not" test, no tax benefit is recorded. The applicable Forms 990 have not been subject to examination by the Internal Revenue Service or the state of Florida for the last three years. CHS does not expect the total amount of unrecognized tax benefits to significantly change in the next 12 months. CHS recognizes interest and/or penalties related to income tax matters in income tax expense. CHS did not have any amounts accrued for interest and penalties at December 31, 2020 and 2019.
Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990CHANGE IN Beneficial interest in net assets of Chapters Health Foundation - 111827

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 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
DEAN FORMAN
Chief Operating Officer$0$378,934$0$33,075$0$10,831$0$70,863$0$27,286$0$520,989$0$33,075
Andrew Molosky
PRESIDENT/CEO/CHAIR$0$596,550$0$51,026$0$14,100$0$174,406$0$40,129$0$876,210$0$51,026
David J O'Neil
Chief Financial Officer$0$463,862$0$41,386$0$100,048$0$86,444$0$56,161$0$747,900$0$41,386
Ronald S Schonwetter MD
Chief Medical Officer$0$502,721$0$44,325$0$267,234$0$92,078$0$40,181$0$946,540$0$44,325
Paola Delp
Chief Business Development Officer$0$294,515$0$0$0$8,912$0$45,167$0$4,860$0$353,454$0$0
Sharon P Saucier
Chief Clinical & Compliance Officer$0$354,927$0$0$0$48,878$0$62,692$0$22,233$0$488,730$0$0
Sheryl J Sypek
Chief Information Officer$0$292,542$0$26,578$0$52,458$0$58,537$0$40,437$0$470,552$0$26,578
Kyle Zenkner
EXECUTIVE DIRECTOR$176,458$0$13,526$0$1,754$0$18,343$0$51,369$0$261,451$0$13,526$0
Lynnette Canady
Nurse Practitioner$134,213$0$3,181$0$1,308$0$3,621$0$32,229$0$174,552$0$3,181$0
KENDRA HALL-FRANKS
STAFF PHYSICIAN$254,256$0$5,642$0$1,770$0$5,972$0$48,193$0$315,833$0$5,642$0
Susan Moffitt
Nurse Practitioner Preceptor$148,809$0$3,304$0$1,368$0$4,625$0$17,339$0$175,444$0$3,304$0
Stuart Owens
Medical Director$285,108$0$0$0$3,786$0$3,450$0$35,115$0$327,459$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensationTHE PRESIDENT & CEO IS PAID BY CHAPTERS HEALTH SYSTEM, INC. (A RELATED ORGANIZATION). CHAPTERS HEALTH SYSTEM USES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, FORMS 990 OF OTHER ORGANIZATIONS, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO DETERMINE HIS COMPENSATION. GOOD SHEPHERD HOSPICE, INC. RELIES ON CHAPTERS HEALTH SYSTEM TO ENSURE COMPENSATION IS REASONABLE.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planCHS (a related organization) HAS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN WHICH SOME OF THE INTERESTED PERSONS PARTICIPATE. DURING THE YEAR, THE FOLLOWING PAYMENTS WERE MADE BY CHS INTO THE SERP PLANS OF THE PARTICIPANTS: A.Molosky $164,655 R.Schonwetter $83,578 D.O'Neil $77,943 S.Saucier $54,141 S.Sypek $49,986 D.Forman $62,312 P.Delp $44,476 M.Zenkner $14,072

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS(continued from Part III) THE STAFF AND VOLUNTEERS OF GOOD SHEPHERD HOSPICE ADDRESS THE PHYSICAL, EMOTIONAL, SOCIAL AND SPIRITUAL NEEDS OF HOSPICE PATIENTS AND THEIR FAMILIES BY OFFERING MEDICAL SERVICES, NURSING SERVICES, SOCIAL WORK SERVICES, PASTORAL CARE SERVICES, COUNSELING SERVICES AND BEREAVEMENT SERVICES. THESE HOSPICE SERVICES ARE AVAILABLE 24-HOURS-A-DAY, SEVEN-DAYS-A-WEEK, AND ARE TAILORED TO ADDRESS SPECIFIC PATIENT AND FAMILY NEEDS OR PREFERENCES AT ANY TIME DURING THE LENGTH OF CARE. IN ADDITION, THE ORGANIZATION PROVIDES PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, DIETARY COUNSELING, HOME HEALTH AIDE SERVICES, HOMEMAKER SERVICES AND INFUSION THERAPY AS NEEDED. GOOD SHEPHERD HOSPICE PROVIDES PATIENTS WITH ALL PRESCRIBED MEDICATIONS, MEDICAL SUPPLIES AND DURABLE MEDICAL EQUIPMENT, SUCH AS HOSPITAL BEDS, WALKERS AND OXYGEN EQUIPMENT RELATED TO THE HOSPICE DIAGNOSIS. THESE SERVICES AND EQUIPMENT ARE PROVIDED REGARDLESS OF RACE, COLOR, CREED, AGE, GENDER, SEXUAL ORIENTATION, RELIGION, NATIONAL ORIGIN, DISEASE DIAGNOSIS OR ABILITY TO PAY. Good Shepherd Hospice provided $1,534,000 in charity care in 2020. B. HOSPICE IN-PATIENT FACILITIES - GOOD SHEPHERD HOSPICE OPERATES THREE HOSPICE HOUSES WHICH CAN ADMIT PATIENTS 24 HOURS PER DAY, SEVEN DAYS PER WEEK. THIS ALLOWS HOSPICE PATIENTS TO AVOID HOSPITAL EMERGENCY ROOMS AND THE POTENTIAL FOR UNWANTED OR UNNEEDED TESTS AND PROCEDURES. AT TIMES, PATIENTS REQUIRE A HIGHER LEVEL OF CARE THAN WHAT CAN BE PROVIDED AT HOME. THE HOSPICE HOUSES OFFER A "HOME AWAY FROM HOME;" THE FOCUS IS ON SPECIALIZED CARE IN A WARM HOME-LIKE ENVIRONMENT. FAMILY MEMBERS AND LOVED ONES CAN VISIT AND STAY WITH THEIR LOVED ONES IN A SERENE SETTING, AS OFTEN, AND FOR AS LONG AS THEY LIKE. THE HOSPICE HOUSE TEAMS ARE COMPOSED OF PHYSICIANS, NURSES, SOCIAL WORKERS, CHAPLAINS, NURSING ASSISTANTS, PHARMACISTS, DIETITIANS, THERAPISTS, AND TRAINED VOLUNTEERS. C. GRIEF COUNSELING - GOOD SHEPHERD HOSPICE OFFERS GRIEF COUNSELING AND BEREAVEMENT SERVICES TO THE COMMUNITY IN A VARIETY OF FORMATS. FACILITATED GROUP COUNSELING SESSIONS ALLOW GRIEVING INDIVIDUALS TO EXPRESS THEIR GRIEF WHILE RECEIVING SUPPORT FROM OTHERS IN SIMILAR SITUATIONS. THESE SESSIONS ARE OFFERED IN A VARIETY OF DAYS, TIMES, AND LOCATIONS. GRIEVING CHILDREN HAVE SPECIAL NEEDS; THEY ARE OFTEN TOO YOUNG TO UNDERSTAND OR EXPRESS THE PAIN THEY FEEL WITH THE LOSS OF A LOVED ONE. THE GOOD SHEPHERD HOSPICE BETHANY CENTER IS A SAFE PLACE WHERE GRIEVING CHILDREN CAN VISIT AND PARTICIPATE IN A NUMBER OF AGE-APPROPRIATE HANDS-ON ACTIVITIES THAT HELP THEM LEARN TO EXPRESS THEIR GRIEF. EACH YEAR, THE GOOD SHEPHERD HOSPICE CAMP BRAVE HEART GIVES YOUNGSTERS WHO HAVE LOST A LOVED ONE THE OPPORTUNITY TO MEET OTHER CHILDREN IN SIMILAR CIRCUMSTANCES, AND ENJOY THE GREAT OUTDOORS WHILE PARTICIPATING IN INDIVIDUAL AND GROUP ACTIVITIES DESIGNED TO BE OUTLETS FOR THEIR EMOTIONS. ALL OF THESE SERVICES ARE AVAILABLE TO EVERYONE IN THE COMMUNITY, NOT JUST THOSE WHOSE LOVED ONE DIED IN HOSPICE. D. The company has 200 trained volunteers whose donated time is valued at $289,416. VOLUNTEERS UNDERGO A VIGOROUS TRAINING PROGRAM AND SCREENING PROCESS BEFORE MEETING WITH PATIENTS AND FAMILY MEMBERS. VOLUNTEERS SERVE IN A NUMBER OF ROLES, INCLUDING PATIENT COMPANION, CAREGIVER COMPANION, CAREGIVER RESPITE, OFFICE VOLUNTEER, SPECIAL EVENTS VOLUNTEER AND MANY MORE. E. CAREGIVER PROGRAM - THIS PROGRAM PROVIDES ASSISTANCE IN THE HOME BASED ON THE PATIENT AND FAMILY NEEDS, ON A SLIDING-FEE SCALE BASIS. THIS ENABLES PATIENTS TO STAY IN THEIR HOME AND IS AN INTERIM SUPPORT WHEN A PRIVATE CAREGIVER IS TO BE HIRED OR THE PATIENT IS WAITING FOR NURSING HOME PLACEMENT. F. CLINICAL PASTORAL EDUCATION (CPE) - ACCREDITED BY THE ASSOCIATION FOR CLINICAL PASTORAL EDUCATION, INC. (ACPE) TO OFFER PROGRAMS AT THE LEVEL I AND LEVEL II. THE ASSOCIATION FOR CLINICAL PASTORAL EDUCATION, INC. IS RECOGNIZED BY THE U.S. DEPARTMENT OF EDUCATION AS AN ACCREDITING AGENCY. CLINICAL PASTORAL EDUCATION IS INTERFAITH PROFESSIONAL EDUCATION FOR MINISTRY TO PERSONS WITH SPIRITUAL AND EMOTIONAL NEEDS. ALL CHAPLAINS EMPLOYED BY GOOD SHEPHERD ARE REQUIRED TO HAVE A MINIMUM OF ONE UNIT OF CPE. G. NATIONAL INSTITUTE FOR JEWISH HOSPICE (NIJH) ACCREDITATION - NIJH IS THE RESOURCE CENTER FOR HOSPICE CARE OF JEWISH PATIENTS. GOOD SHEPHERD HOSPICE PARTICIPATES IN ORDER TO EDUCATE STAFF, PHYSICIANS, NURSES, SOCIAL WORKERS, VOLUNTEERS, AND CHAPLAINS INVOLVED IN THE TREATMENT AND CARE OF TERMINALLY ILL JEWISH PATIENTS. GOOD SHEPHERD HOSPICE STAFF RECEIVES ANNUAL EDUCATION ON THE SPIRITUAL NEEDS OF JEWISH PATIENTS AND FAMILIES. HUMANE PALLIATIVE STRATEGIES THAT ARE TAILORED TO THE NEEDS OF JEWISH PATIENTS THAT TAKE INTO ACCOUNT THE CELEBRATION OF THE JEWISH HIGH HOLY DAYS AND OTHER NEEDS AND WISHES HAVE BEEN DEVELOPED. GOOD SHEPHERD HOSPICE STAFF RECEIVES EDUCATION ON JEWISH MEDICAL ETHICS, ADVANCE DIRECTIVES, LIVING WILLS, TREATMENT OF BODY AFTER DEATH, GLOSSARY OF JEWISH TERMS AND HOLY DAYS AND OBSERVANCE. H. HOSPICEHELP24 - GOOD SHEPHERD HOSPICE'S SPECIALIZED TRIAGE PROGRAM PROVIDES PATIENTS AND FAMILIES WITH DIRECT ACCESS TO HOSPICE PROFESSIONALS, INSTEAD OF HAVING THEM GO THROUGH AN ANSWERING SERVICE, LIKE MANY HOSPICES USE. GOOD SHEPHERD HOSPICE'S DEDICATED STAFF WORKS TO COORDINATE AND MEET THE NEEDS OF PATIENTS AND FAMILIES INCLUDING ACCESS TO ALL DISCIPLINES. PATIENT INFORMATION IS ACCESSIBLE BY COMPUTER TO ASSIST HOSPICE STAFF IN CARING FOR THE PATIENT AND FAMILY. I. JOINT COMMISSION ACCREDITATION - TO ENSURE THAT PATIENTS AND FAMILIES RECEIVE THE HIGHEST QUALITY OF END-OF-LIFE CARE, GOOD SHEPHERD HOSPICE UNDERGOES JOINT COMMISSION ACCREDITATION. JOINT COMMISSION ACCREDITATION IS NOT REQUIRED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES TO OBTAIN LICENSURE. GOOD SHEPHERD HOSPICE BELIEVES THAT UNDERGOING THIS VOLUNTARY ACCREDITATION PROCESS EVERY THREE YEARS REINFORCES THE COMPANY MISSION TO PROVIDE OUTSTANDING HOSPICE CARE.
Form 990, Part VI, Line 15a PROCESS FOR DETERMINING COMPENSATIONThe organization engaged an independent compensation consultant to assist in establishing a Compensation Charter that details the organization's procedures for setting compensation of the President/CEO and all other officers and key employees of the organization. The Compensation Charter established the Compensation Committee, the independent body responsible for establishing the compensation of the President/CEO. The Compensation Committee relies on a recent compensation study performed by an independent compensation consultant, which is done on an annual basis, that provides compensation data for similarly qualified persons in comparable organizations to support its decision-making process and reports its activities to the Board of Directors at the next regularly scheduled meeting. The Compensation Committee adequately documents its compensation determinations in the meeting minutes on a timely basis. this process took place during the year. The president/CEO of Good Shepherd Hospice, Inc. is paid by Chapters Health System, Inc. The form 990 instructions indicate when the CEO is not paid by the filing organization, the question should be answered "no".
Form 990, Part VI, Line 15b PROCESS FOR DETERMINING COMPENSATIONThe compensation of all other officers and key employees is determined by the president/ceo. The president/ceo uses COMPARABILITY DATA AND AN INDEPENDENT COMPENSATION CONSULTANT TO DETERMINE THE COMPENSATION. THE DECISIONS ARE DOCUMENTED IN EACH EMPLOYEE'S file. This process took place this year.
Form 990, Part VI, Line 1a Delegate broad authority to a committeeThe Executive committee, made up of The President and CEO, COO, CFO, Chief Medical Officer, the Vice Chairperson of the Board and the Secretary, shall carry out the work of the Board of Directors between meetings and make recommendations to the Board of Directors for its action. The Executive Committee shall have all the authority of the Board of Directors except as may be limited by Florida Law and subject to the approval of the Sole Member.
Form 990, Part VI, Line 6 Classes of members or stockholdersThe organization has a Sole Member, Chapters Health System, Inc. that both elects the members of the governing body of Good Shepherd Hospice, Inc. and also approves certain significant decisions made by the governing body of Good Shepherd Hospice, Inc.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyThe organization's Sole Member, Chapters Health System, Inc., nominates and elects the members of the organization's Board of Directors and may appoint replacement directors when a vacancy occurs.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersWithout the written approval of the organization's Sole Member, Chapters Health System, Inc., the organization's governing body is not permitted to: (A) Sell, lease, or dispose of assets, merge, combine or otherwise or reorganize with any other entity, convert its corporate structure to another form or enter into any management services agreement; (B) Enter into any loan facility, borrow any funds or pledge or hypothecate any or all of its assets as security for any borrowing; (C) Change the character or nature of the organization's business to something other than the operation of a hospice; (D) Remove or appoint the President and CEO; (E) Execute any deed, mortgage, note or bond; (F) Adopt or amend the annual operating and/or capital budgets proposed by the President and CEO and the management of the organization; (G) Make any contribution or distribution of assets or property to any person; (H) Amend the Articles of Incorporation of the Corporation; (I) Dissolve, liquidate or otherwise cease to exist as a Florida Not-for-Profit Corporation which is exempt from taxation under Section 501(c)(3) of the Internal Revenue Code; (J) Form, DISSOLVE, LIQUIDATE, SELL, MERGE OR OTHERWISE TRANSFER OWNERSHIP OR CONTROL OF any subsidiary corporation; or (K) Acquire, enjoy, utilize, and dispose of patents, copyrights, and trademarks and any licenses and other rights or interests thereunder or therein.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyThe organization retains an independent tax advisor to assist management in the preparation and review of its IRS Form 990. Prior to filing the return, management and the independent tax advisor review the return and all required schedules with the Compensation Committee of the Board of Directors. The Compensation Committee is composed of independent directors of the Company. Upon completion of its review, the Compensation Committee recommends to the Executive Committee of the Board of Directors that management be authorized to sign and file the return. Under the Company's by laws the Executive Committee has the authority to take this action on behalf of the Board of Directors. A complete copy of the Form 990 is provided to the full board prior to filing with the IRS and the Executive Committee reports its activities to the Board of Directors on a quarterly basis.
Form 990, Part VI, Line 12c Conflict of interest policyAnnually, each officer, director and key employee signs an acknowledgement and disclosure form attesting that they have read the Conflict of Interest Policy and agreeing to comply fully with its terms and conditions during their services with Chapters Health System, Inc. (CHS) and Affiliates. They further agree that if, at any time subsequent to the submission of the disclosure form, they become aware of any actual or potential conflict of interest or the information previously submitted becomes inaccurate or incomplete, they will promptly notify the CHS Board of Directors, the President and CEO of Chapters Health System, Inc. and the Good Shepherd Hospice board of directors. DETERMINATION OF AND REMEDIES FOR CONFLICTS OF INTEREST 1. Disclosure. In connection with any actual or possible conflict of interest, an interested person must disclose the existence of his or her financial interest and must be given the opportunity to disclose all material facts to the Directors (and members of committees) considering the proposed transaction or arrangement. The disclosure shall be made as soon as practicable following the realization by the interested person that an actual or possible conflict of interest exists. Ordinarily, disclosures by interested persons should be to the Chairperson of the Board. When an actual or possible conflict of interest becomes apparent in the course of a Board meeting (or committee meeting), the interested person shall immediately disclose his or her financial interest and related material facts to the presiding Director or officer at such meeting. 2. Determining Whether a Conflict of Interest Exists. After disclosure of the financial interest and all material facts, and after any discussion with the interested person, the interested person shall leave the Board (or committee) meeting while the determination of a conflict of interest is discussed and voted upon. The remaining Board (or committee) members shall decide if a conflict of interest exists. 3. Procedures for Addressing the Conflict of Interest. (a) An interested person who has a conflict of interest may make a presentation at the Board (or committee) meeting, but after such presentation, he or she shall leave the meeting during the discussion of, and the vote on, the transaction or arrangement that result in the conflict of interest. The interested person who has a conflict of interest will not be counted as present for determining a majority with respect to the vote on the transaction or arrangement that results in the conflict of interest. (b) The Chairperson of the Board (or committee) shall, if appropriate, appoint a disinterested person or committee to investigate alternatives to the proposed transaction or arrangement. (c) After exercising due diligence, the Board (or Committee) shall determine whether CHS and Affiliates can obtain a more advantageous transaction or arrangement with reasonable efforts from a person or business entity that would not give rise to a conflict of interest. (d)If a more advantageous transaction or arrangement is not reasonably attainable under circumstances that would not give rise to a conflict of interest, the Board (or committee) shall determine by a majority vote of the disinterested Directors (or committee members) whether the transaction or arrangement is in the best interest of CHS and Affiliates and for its own benefit and whether the transaction is fair and reasonable to CHS and Affiliates and shall make its decision as to whether to enter into the transaction or arrangement in conformity with such determination. Violations of the Conflicts of Interest Policy (a) If the Board (or committee) has reasonable cause to believe that an interested person has failed to disclose actual or possible conflicts of interest, it shall inform the interested person of the basis for such belief and afford the interested person an opportunity to explain the alleged failure to disclose. (b) If, after hearing the response of the interested person and making such further investigation as may be warranted under the circumstances, the Board (or committee) determines that the interested person has in fact failed to disclose an actual or possible conflict of interest, it shall take such action as it determines to be appropriate, including corrective and disciplinary action. RECORD OF PROCEEDINGS The minutes of the Board (and each committee) shall contain: 1. The name of each person who disclosed or otherwise was found to have a financial interest in connection with an actual or possible conflict of interest, the nature of the financial interest, any action taken to determine whether a conflict of interest was present, and the Board's (or committee's) decision as to whether a conflict of interest in fact existed. 2. The names of the persons who were present for discussions and votes relating to the transaction or arrangement, the content of the discussion, including any alternatives to the proposed transaction or arrangement, and a record of any votes taken in connection therewith. PERIODIC REVIEWS To ensure that CHS and Affiliates operate in a manner consistent with their charitable purposes and that it does not engage in activities that could jeopardize their status as organizations exempt from federal income tax, periodic reviews shall be conducted. CHS and Affiliates may, but need not, use an outside advisor to conduct a periodic review. The periodic review shall include, at a minimum, the following subjects: 1. Whether compensation arrangements and benefits are reasonable and are the results of arm's-length bargaining. 2. Whether agreements to provide health care and agreements with other health care providers, employees and third party payers further the charitable purposes of CHS and Affiliates and do not result in private inurement or impermissible private benefit.
Form 990, Part VI, Line 19 Required documents available to the publicThe organization's articles of incorporation are filed with and viewable by the public at the official website of the Florida Department of State, Division of Corporations. The organization's Bylaws and conflict of interest policy are not made available to the public. Unaudited financial statements of the organization are filed and viewable by the public at the official website of the State of Florida, Division of Consumer Services. The organization is required to file its audited consolidated financial statements and other financial information with its annual Medicare cost report. This information is subject to a public records request. In addition, the organization reports its financial performance each year in its Annual Report, copies of which are available to the public upon request.
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesCHANGE IN Beneficial interest in net assets of Chapters Health Foundation - 111827; Net Asset Transfer - -519028;
Schedule O COVID-19 PandemicIn March 2020, the World Health Organization declared a pandemic related to the rapidly spreading coronavirus ("COVID-19") outbreak, which has led to a global health emergency. The extent to which the COVID-19 pandemic may impact the financial condition or results of CHS' operations is uncertain and cannot be predicted fully at this time. The nature and extent of the final impact may depend on a number of factors, including: the duration and extent of the pandemic; the nature and duration of the pandemic's impact on CHS' healthcare services, and the nature and duration of the pandemic's impact on the CHS' business partners, vendors, and patients, all of which are uncertain and cannot be predicted fully. CHS continues to evaluate the impact of the COVID-19 pandemic on its business and to monitor pandemic related developments. The Coronavirus Aid, Relief, and Economic Security Act ("CARES Act") became law on March 27, 2020. This Federal response to the market volatility and instability resulting from the coronavirus pandemic includes provisions to support individuals and businesses in the form of loans, grants, and tax changes, among other types of relief. The CARES Act authorized $175 billion in payments to be distributed through the Public Health and Social Services Emergency Fund ("Provider Relief Funds" or "PRF"). Payments from the PRF are not loans; however, PRF funds are required to be paid back if not fully utilized by June 30, 2021. During the year ended December 31, 2020, CHS received payments of $9,350,198 from the Provider Relief Fund. CHS has elected to account for the PRF proceeds received as a conditional contribution in accordance with Subtopic 958-605. Under Subtopic 958-605, the PRF proceeds are initially recorded as a deferred grant liability and subsequently recognized as other operating revenue when CHS has substantially met all terms and conditions of the grant. CHS' assessment of whether the terms and conditions for amounts received have been substantially met considers, among other things, the terms of the CARES Act and the Consolidation Appropriation Act of 2021 (CAA), and all other interpretive guidance issued by the U.S. Department of Human and Health Services. Such guidance sets forth the allowable methods for quantifying eligible healthcare related expenses and lost revenues. Only healthcare related expenses attributable to coronavirus that another source has not reimbursed and is not obligated to reimburse are eligible to be claimed. Based on CHS' assessment, the Organization has recognized $9,350,198 which is included in other operating revenue in the consolidated statements of operations and changes in net assets. There are no remaining funds at December 31, 2020.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
CHAPTERS HEALTH SYSTEM INC
12470 TELECOM DRIVE STE 300TEMPLE TERRACEFL33637592264957PARENTFL501(c)(3)Type IINAfalse
LIFEPATH HOSPICE INC
12470 TELECOM DRIVE STE 300TEMPLE TERRACEFL33637205276870HOSPICE CAREFL501(c)(3)10CHSfalse
CHAPTERS HEALTH HOME CONNECT INC
12470 TELECOM DRIVE STE 300TEMPLE TERRACEFL33637275158323LONG-TERM CAREFL501(c)(3)10CHSfalse
CHAPTERS HEALTH FOUNDATION INC
12470 TELECOM DRIVE suite 300TEMPLE TERRACEFL33637593467282foundationFL501(c)(3)7CHSfalse
HERNANDO PASCO HOSPICE INC
12470 TELECOM DRIVE suite 300TEMPLE TERRACEFL33637592217929hospice careFL501(c)(3)10CHSfalse
HOSPICE OF OKEECHOBEE INC
12470 TELECOM DRIVE suite 300TEMPLE TERRACEFL33637592831397HOSPICE CAREFL501(c)(3)7CHSfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

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