2020-12-08T15:30:48-06:00 2019-12-31 592922169 SALTMARSH CLEAVELAND AND GUND 900 NORTH 12TH AVENUE PENSACOLA FL 32501 990 2019-01-01 465132177 COVENANT HEALTH AND COMMUNITY SERVICES INC COVE 8504332155 5041 N 12TH AVE PENSACOLA FL 32504 MARTY FRANKLIN CFO 8504332155 2020-12-08 1 CHARLES F GUND JR CPA P00138367 8504358300 2020-12-08 2019 2022-09-23 18:48:47Z COVENANT CARE JEFF MISLEVY 5041 N 12TH AVE PENSACOLA FL 32504 14087058 0 X WWW.CHOOSECOVENANT.ORG X 2014 FL COVENANT HEALTH AND COMMUNITY SERVICES, INC. WAS FORMED TO ACT AS THE PARENT (SEE SCHEDULE O) (CONTINUATION FROM PART I, LINE 1) CORPORATION OF COVENANT HOSPICE AND ITS AFFILIATES. 11 10 369 0 0 0 0 0 14042911 14082578 3323 4480 7819 0 14054053 14087058 0 0 0 0 14536101 16975111 0 0 0 -1928204 -695835 12607897 16279276 1446156 -2192218 14781036 13133550 13759563 14304295 1021473 -1170745 X COVENANT HEALTH AND COMMUNITY SERVICES, INC. WAS FORMED TO ACT AS THE PARENT CORPORATION OF THE FOUR CORPORATIONS DESCRIBED IN SECTION 501(C)(3) OF THE CODE, COVENANT HOSPICE, INC., COVENANT HOSPICE FOUNDATION, INC., ALZHEIMERS FAMILY SERVICES, INC., (SEE SCHEDULE O) (CONTINUATION FROM PART III, LINE 1) AND COVENANT AT HOME, INC. AS WELL AS COVENANT PALLIATIVE CARE SERVICES, LLC AND COVENANT HOME HEALTH HOLDING, LLC. 0 0 COVENANT HEALTH AND COMMUNITY SERVICES, INC. WAS FORMED TO ACT AS THE PARENT CORPORATION OF THE FOUR CORPORATIONS DESCRIBED IN SECTION 501(C)(3) OF THE CODE, COVENANT HOSPICE, INC., COVENANT HOSPICE FOUNDATION, INC., ALZHEIMERS FAMILY SERVICES, INC., AND COVENANT AT HOME, INC. AS WELL AS THE TWO DISREGARDED ENTITES COVENANT PALLIATIVE CARE SERVICES, LLC, AND COVENANT HOME HEALTH HOLDINGS, LLC. COVENANT HOME HEALTH HOLDINGS, LLC IS THE SINGLE MEMBER OF COVENANT HOME HEALTH CARE, LLC, COVENANT HOME HEALTH CARE 3, LLC, COVENANT HOME HEALTH CARE 4, LLC, COVENANT HOME HEALTH CARE 5, LLC, COVENANT HOME HEALTH CARE 6, LLC, COVENANT HOME HEALTH CARE 7, LLC, COVENANT HOME HEALTH CARE 8, LLC, COVENANT HOME HEALTH CARE 9, LLC, COVENANT HOME HEALTH CARE 10, LLC AND COVENANT HOME HEALTH CARE 11, LLC. 7836210 14059463 HOME HEALTH CARE SERVICES - COVENANT CARE IS MAKING A GREATER PROMISE, OFFERING ADDITIONAL SKILLED, HOME-BASED MEDICAL SERVICES AND THERAPIES FOR THOSE:I.RECOVERING FROM SURGERYII.RECOVERING FROM AN ACCIDENT OR INJURYIII.DEALING WITH A SERIOUS ILLNESS OR DISABILITY 49799 23115 PALLIATIVE CARE SERVICES - COVENANT CARE'S PALLIATIVE CARE SERVICES CAN ASSIST PATIENT WHO NEED RELIEF FROM PAIN AND ALLEVIATE DISTRESSING SYMPTOMS. PALLIATIVE CARE CAN BE OFFERED ANY TIME DURING DIAGNOSIS AND TREATMENT OF MANY LONG-TERM CONDITIONS. OUR FOCUS IS TO RELIEVE THE PHYSICAL, SOCIAL, EMOTIONAL AND SPIRITUAL SUFFERING THAT OFTEN ACCOMPANIES A CHRONIC OR COMPLEX ILLNESS. 7886009 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 18 0 1 369 1 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X MARTY FRANKLIN 8504322155 5401 N 12TH AVE PENSACOLA FL 32504 TOM OWENS CHAIRMAN 4.00 12.00 X X 0 0 0 RODNEY GUTTMANN VICE-CHAIRMAN 4.00 12.00 X X 0 0 0 CAREY KING SECRETARY 4.00 12.00 X X 0 0 0 XAN SMITH TREASURER 4.00 12.00 X X 0 0 0 JEFF MISLEVY PRESIDENT/CEO 4.00 52.00 X X 671407 0 41844 MILLER CALDWELL DIRECTOR 4.00 4.00 X 0 0 0 JAMIE CAMPBELL DIRECTOR 4.00 4.00 X 0 0 0 DON HAFERKAMP DIRECTOR 4.00 4.00 X 0 0 0 BRETT PARRA DIRECTOR 4.00 4.00 X 0 0 0 STEVE SARROS DIRECTOR 4.00 4.00 X 0 0 0 KENT SKOLROOD DIRECTOR 4.00 4.00 X 0 0 0 ODIN BERG CSO 4.00 52.00 X 332581 0 21738 TODD FISHER COO 4.00 48.00 X 312444 0 26871 MARTIN FRANKLIN CFO 4.00 48.00 X 211099 0 19041 AARON WEST VP ADVANCEMENT 4.00 48.00 X 214093 0 26594 PAMELA CAMPBELL ASSOCIATE VP OF HOME HEALT 40.00 X 220418 0 18985 AMY BAJJALY VP ORGANIZATIONAL ENGAGEME 40.00 X 166141 0 6484 JUDI ASHLINE ASSOCIATE VP OF REVENUE CYCLE 40.00 X 138319 0 17806 KARA BENEDICT SENIOR DIRECTOR, ORGANIZAT 40.00 X 135051 0 1846 2401553 0 181209 16 0 1 0 MEDLINE INDUSTRIES THREE LAKES DRIVE NORTHFIELD IL 60093 MEDICAL SUPPLIES 315051 SASAMBA LLC 5210 LEWIS ROAD AGOURA HILLS CA 91356 EMR SOFTWARE 119556 2 HOME HEALTH CARE SERVICES 621610 14059463 14059463 PALLATIVE CARE SERVICES 623990 23115 23115 14082578 4480 4480 14087058 14082578 0 4480 14193055 5557278 8635777 98636 48564 50072 1694354 745287 949067 989066 426354 562712 343502 343502 330 330 225510 225510 257073 257073 433968 433968 194363 194363 346103 346103 567057 377289 189768 235833 235833 98883 98883 51746 51746 MEDICAL SUPPLIES 381731 381731 BAD DEBT EXPENSE 164816 164816 START UP COSTS 90364 90364 SALARY ALLOCATION -4508273 -4508273 421159 3403 417756 16279276 7886009 8393267 0 37428 787250 1201436 746 2260780 2247312 17606 98198 540070 188181 271768 351889 9075225 9073350 1916793 574805 14781036 13133550 1555799 2119561 6700000 7650000 5503764 4534734 13759563 14304295 X 1021473 -1170745 1021473 -1170745 14781036 13133550 -2192218 0 X X 0 1 X 1 0 X 8549082 13370990 14042911 14082578 50045561 8549082 13370990 14042911 14082578 50045561 0 0 0 50045561 253 1541 3323 4480 9597 253 1541 3323 4480 9597 8549335 13372531 14046234 14087058 50055158 X 323904 188181 135723 216166 216166 351889 DUE TO COVENANT HOSPICE, INC. 4534734 4534734 X PART X, LINE 2: CHCS, HOSPICE, THE FOUNDATION, AFS, CAH AND CPCS ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. X 0 1 X X X 0 0 0 0 0 0 0 0 0 JEFF MISLEVY PRESIDENT/CEO 440884 0 230523 0 0 0 505 0 41339 0 713251 0 0 0 ODIN BERG CSO 255102 0 68706 0 8773 0 825 0 20913 0 354319 0 0 0 TODD FISHER COO 239251 0 59058 0 14135 0 177 0 26694 0 339315 0 0 0 MARTIN FRANKLIN CFO 184566 0 26533 0 0 0 105 0 18936 0 230140 0 0 0 AARON WEST VP ADVANCEMENT 186826 0 27267 0 0 0 329 0 26265 0 240687 0 0 0 PAMELA CAMPBELL ASSOCIATE VP OF HOME HEALT 169540 0 29035 0 21843 0 335 0 18650 0 239403 0 0 0 AMY BAJJALY VP ORGANIZATIONAL ENGAGEME 138806 0 21922 0 5413 0 379 0 6105 0 172625 0 0 0 JUDI ASHLINE ASSOCIATE VP OF REVENUE CYCLE 129014 0 9305 0 0 0 74 0 17732 0 156125 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY STAFF WITH THE ASSISTANCE OF AND REVIEW BY AN INDEPENDENT ACCOUNTING FIRM BEFORE IT IS SIGNED AND SUBMITTED. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE SENT ANNUALLY TO MEMBERS OF THE BOARD OF DIRECTORS, AND ALL KEY STAFF MEMBERS REPORTABLE ON THE FORM 990. THE FORMS ARE REVIEWED FOR RESPONSES INDICATING A POSSIBLE CONFLICT OF INTEREST. IN ADDITION, THE DIRECTOR OF ACCOUNTING REVIEWS TRANSACTIONS WITH VENDORS WITH WHICH THE BOARD MAY BE AFFILIATED TO DETERMINE THAT ALL TRANSACTIONS ARE MADE AT ARM'S LENGTH. IF A POSSIBLE CONFLICT IS IDENTIFIED, THE PERSON WITH A CONFLICT IS PROHIBITED FROM PARTICIPATING IN THE BOARD OF DIRECTORS DELIBERATIONS AND DECISIONS IN THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 TO DETERMINE THE CEO'S, OTHER OFFICERS', AND OTHER EMPLOYEES' COMPENSATION, COVENANT HEALTH AND COMMUNITY SERVICES, INC. PROCURES SALARY COMPARABILITY DATA AND HIRES AN INDEPENDENT FIRM TO DO A SALARY COMPARISON FOR ALL SENIOR ADMINISTRATIVE STAFF. THE SALARY COMPARISON WITH THE INDEPENDENT FIRM IS UNDERTAKEN ANNUALLY. THE CEO'S COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD WITH INSIGHT GIVEN FROM THE SALARY COMPARISON OF THE INDEPENDENT FIRM. THIS PROCESS IS DONE ANNUALLY AND IS DOCUMENTED. THE PROCESS WAS LAST PERFORMED IN 2018. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ARE AVAILABLE ON WRITTEN REQUEST. FORM 990, PART XII, LINE 2C THE EXECUTIVE COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT. THIS PROCEDURE HAS NOT CHANGED DURING THE YEAR. COVENANT HOME HEALTH HOLDINGS LLC 5401 N 12TH AVE PENSACOLA FL 32504 811010716 SINGLE MEMBER OF COVENANT HOME HEALTH CARE, LLC FL 229428 15956960 COVENANT HEALTH AND COMMUNITY SERVICES INC COVENANT PALLIATIVE CARE SERVICES LLC 5401 N 12TH AVE PENSACOLA FL 32504 464822066 PALLIATIVE SERVICES FL 23115 25207 COVENANT HEALTH AND COMMUNITY SERVICES INC COVENANT HOME HEALTH CARE LLC 5401 N 12TH AVE PENSACOLA FL 32504 262335536 HOME HEALTH CARE SERVICE FL 13846515 7585044 COVENANT HEALTH AND COMMUNITY SERVICES INC COVENANT HOME HEALTH CARE 3 LLC 5401 N 12TH AVE PENSACOLA FL 32504 841850981 HOME HEALTH CARE SERVICE FL 11302 174386 COVENANT HEALTH AND COMMUNITY SERVICES INC COVENANT HOME HEALTH CARE 4 LLC 5401 N 12TH AVE PENSACOLA FL 32504 841866523 HOME HEALTH CARE SERVICE FL 0 27484 COVENANT HEALTH AND COMMUNITY SERVICES INC COVENANT HOME HEALTH CARE 5 LLC 5401 N 12TH AVE PENSACOLA FL 32504 841803949 HOME HEALTH CARE SERVICE FL 8478 180077 COVENANT HEALTH AND COMMUNITY SERVICES INC COVENANT HOME HEALTH CARE 6 LLC 5401 N 12TH AVE PENSACOLA FL 32504 841790239 HOME HEALTH CARE SERVICE FL 13963 194200 COVENANT HEALTH AND COMMUNITY SERVICES INC COVENANT HOME HEALTH CARE 7 LLC 5401 N 12TH AVE PENSACOLA FL 32504 841811553 HOME HEALTH CARE SERVICE FL 14060 129014 COVENANT HEALTH AND COMMUNITY SERVICES INC COVENANT HOME HEALTH CARE 8 LLC 5401 N 12TH AVE PENSACOLA FL 32504 841838540 HOME HEALTH CARE SERVICE FL 0 26982 COVENANT HEALTH AND COMMUNITY SERVICES INC COVENANT HOME HEALTH CARE 9 LLC 5401 N 12TH AVE PENSACOLA FL 32504 841875410 HOME HEALTH CARE SERVICE FL 0 16493 COVENANT HEALTH AND COMMUNITY SERVICES INC COVENANT HOME HEALTH CARE 10 LLC 5401 N 12TH AVE PENSACOLA FL 32504 841895925 HOME HEALTH CARE SERVICE FL 0 0 COVENANT HEALTH AND COMMUNITY SERVICES INC COVENANT HOME HEALTH CARE 11 LLC 5401 N 12TH AVE PENSACOLA FL 32504 841916945 HOME HEALTH CARE SERVICE FL 0 0 COVENANT HEALTH AND COMMUNITY SERVICES INC COVENANT HOSPICE INC 5041 N 12TH AVE PENSACOLA FL 32504 592208300 PROVIDES CARE TO TERMINALLY ILL PATIENTS FL 501(C)(3) LINE 7 COVENANT HEALTH AND COMMUNITY SERVICES INC 1 COVENANT HOSPICE FOUNDATION INC 5041 N 12TH AVE PENSACOLA FL 32504 593060139 FUNDRAISING FL 501(C)(3) LINE 12A, I COVENANT HEALTH AND COMMUNITY SERVICES INC 1 ALZHEIMERS FAMILY SERVICES INC 5041 N 12TH AVE PENSACOLA FL 32504 593394242 SUPPORT TO ALZHEIMERS PATIENTS AND FAMILIES FL 501(C)(3) LINE 7 COVENANT HEALTH AND COMMUNITY SERVICES INC 1 COVENANT AT HOME INC 5041 N 12TH AVE PENSACOLA FL 32504 322543765 HOME HEALTH CARE FL 501(C)(3) LINE 10 COVENANT HEALTH AND COMMUNITY SERVICES INC 1 0 0 0 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 COVENANT HOSPICE INC E 4534734 FAIR VALUE COVENANT HOSPICE FOUNDATION INC D 24311 FAIR VALUE COVENANT AT HOME INC D 114032 FAIR VALUE COVENANT HOSPICE INC O 4242045 FAIR VALUE COVENANT ALZHEIMER'S SERVICES O 1827 FAIR VALUE COVENANT HOSPICE FOUNDATION INC O 93042 FAIR VALUE COVENANT MEMORY CARE CENTER O 171359 FAIR VALUE