2020-02-13T07:27:09-06:00 2019-09-30 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2018-10-01 591940256 COMMUNITY HOSPICE OF NORTHEAST FLORIDA COMM 9042685200 4266 SUNBEAM RD JACKSONVILLE FL 32257 CARLOS BOSQUE CFO 9042685200 2020-02-11 1 AMY BIBBY P00445891 8282542254 2020-02-11 24.241.144.70 2020-02-11 14:44:56 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 BEC9594289F9DCBB4F655B5045764FC48E5A1487 2018 2020-04-17 16:48:07Z SEE SCH O DISCLOSURE CARLOS BOSQUE 4266 SUNBEAM RD JACKSONVILLE FL 32257 115931935 0 X WWW.COMMUNITYHOSPICE.COM X 1984 FL ADVANCING PHILANTHROPY TO ENABLE COMMUNITY HOSPICE OF NORTHEAST FLORIDA TO FULFILL ITS MISSION AND VISION OF CARE, RESEARCH AND EDUCATION. 35 35 1124 822 0 0 1726451 1808647 105581580 110281771 1822988 1351617 2475070 2108439 111606089 115550474 127077 99859 0 0 64299792 62646090 0 0 0 50177995 50083903 114604864 112829852 -2998775 2720622 90196136 93476957 12560693 13253722 77635443 80223235 X ADVANCING PHILANTHROPY TO ENABLE COMMUNITY HOSPICE OF NORTHEAST FLORIDA TO FULFILL ITS MISSION AND VISION OF CARE, RESEARCH AND EDUCATION. 0 0 76880999 89543401 HOSPICE HOMECARE ESTABLISHED IN 1979, COMMUNITY HOSPICE & PALLIATIVE CARE IS AN INNOVATIVE NATIONAL LEADER IN PALLIATIVE AND HOSPICE CARE, PROVIDING PROGRAMS AND SERVICES TO MEET THE DIVERSE NEEDS OF THE COMMUNITIES IT SERVES. DURING ITS 40-YEAR HISTORY, THE JACKSONVILLE, FLORIDA-BASED NONPROFIT ORGANIZATION HAS SERVED OVER 200,000 ADULTS AND CHILDREN IN BAKER, CLAY, DUVAL, NASSAU AND ST. JOHNS COUNTIES, AND RECENTLY EXPANDED ITS SERVICE AREA TO INCLUDE 11 COUNTIES IN NORTH-CENTRAL FLORIDA. DURING FISCAL YEAR 2019, THE ORGANIZATION HELPED 14,565 PATIENTS AND THEIR FAMILIES LIVE BETTER WITH ADVANCED ILLNESS THROUGH HOSPICE CARE AND SUPPORT PROGRAMS. MOST OF THIS CARE IS PROVIDED IN THE HOME SETTING, INCLUDING PRIVATE RESIDENCES, NURSING HOMES AND ASSISTED LIVING COMMUNITIES. COMMUNITY HOSPICE & PALLIATIVE CARE ENSURES PATIENTS' COMFORT BY ADDRESSING THEIR PHYSICAL, EMOTIONAL AND SPIRITUAL NEEDS THROUGH INTERDISCIPLINARY CLINICAL CARE TEAMS, WHOSE MEMBERS MAKE UP MORE THAN HALF OF THE ORGANIZATION'S 900-PLUS EMPLOYEES, ALONG WITH THE SERVICES OF APPROXIMATELY 1,000 VOLUNTEERS. THE ORGANIZATION ALSO ASSISTS FAMILY CAREGIVERS THROUGH EDUCATION, ACCESS TO COMMUNITY RESOURCES AND BEREAVEMENT SUPPORT FOR UP TO 13 MONTHS AFTER A LOSS.THE COMMUNITY HOSPICE & PALLIATIVE CARE MISSION IS TO IMPROVE THE QUALITY OF LIFE FOR PATIENTS AND THEIR FAMILIES AND TO BE THE COMPASSIONATE GUIDE FOR END-OF-LIFE CARE IN OUR COMMUNITY. OUR GOAL IS TO PROVIDE COMFORT AND ADDRESS SYMPTOMS FROM LIFE-LIMITING CONDITIONS, AS WELL AS PROVIDE SUPPORTIVE CARE TO FAMILY MEMBERS AND OTHER LOVED ONES. THE ORGANIZATION FOCUSES ON ENHANCING THE QUALITY OF LIFE WHILE RESPECTING PATIENTS' CULTURAL BELIEFS AND VALUES. NO ONE IS EVER DENIED CARE DUE TO AN INABILITY TO PAY.COMMUNITY HOSPICE & PALLIATIVE CARE SUPPORT INCLUDES: IN-HOME NURSING; PHYSICIAN SERVICES; PSYCHOSOCIAL SERVICES; SPIRITUAL SUPPORT; CERTIFIED NURSING ASSISTANT (CNA) AND HOME HEALTH AIDE SERVICES; MEDICAL EQUIPMENT (SUCH AS WHEELCHAIRS, BEDS AND WALKERS); MEDICAL SUPPLIES (SUCH AS BANDAGES AND CATHETERS); DRUGS FOR SYMPTOM MANAGEMENT AND/OR PAIN RELIEF; BEREAVEMENT COUNSELING AND SUPPORT; PHYSICAL AND OCCUPATIONAL THERAPY; SPEECH, MUSIC, MASSAGE AND/OR PET THERAPY; AND DIETARY COUNSELING. THE ORGANIZATION ALSO OFFERS INPATIENT CARE, SHORT-TERM RESPITE CARE, VETERAN- AND CAREGIVER-FOCUSED SERVICES, AND SPECIALIZED CARE FOR THOSE OF THE JEWISH FAITH, CHILDREN'S PROGRAMS AND ADVANCE CARE PLANNING.A DEDICATED, INTERDISCIPLINARY TEAM OF PROFESSIONALS WORKS WITH PATIENTS TO HELP MANAGE THE PAIN AND SYMPTOMS ASSOCIATED WITH A LIFE-LIMITING ILLNESS, AND PROVIDES PERSONAL, RESPECTFUL CARE AND ASSISTANCE. THE ORGANIZATION HELPS EDUCATE PATIENTS AND THEIR CAREGIVERS ABOUT THE ILLNESS THEY HAVE AND WHAT TO EXPECT AS THE ILLNESS PROGRESSES, AND ABOUT MEDICINES AND THERAPIES TO HELP MANAGE PATIENT COMFORT. ON-CALL SERVICES ARE AVAILABLE 24 HOURS A DAY, SEVEN DAYS A WEEK. IN FISCAL YEAR 2019, OUR HOMECARE TEAMS PROVIDED 442,721 ROUTINE DAYS OF CARE. 16544012 20761250 HOSPICE INPATIENT CARE INPATIENT CARE, IF NEEDED, IS AVAILABLE IN ONE OF OUR NINE INPATIENT CENTERS, CALLED CENTERS FOR CARING. THESE FACILITIES ARE AVAILABLE FOR PATIENTS WHO NEED PAIN AND SYMPTOM MANAGEMENT AT AN ACUTE LEVEL UNAVAILABLE IN A HOMECARE SETTING. THE PATIENT STAYS UNTIL HIS/HER CONDITION AND SYMPTOMS ARE STABILIZED, TYPICALLY THREE TO FIVE DAYS OR LESS. OUR FACILITIES OFFER HOMELIKE SURROUNDINGS WITH GARDENS AND SERENE SETTINGS. IN FISCAL YEAR 2019, OUR STAFF PROVIDED 24,482 DAYS OF GENERAL INPATIENT CARE (GIP). 3892709 99859 PALLIATIVE CARE ESTABLISHED IN 2010, COMMUNITY PALLIATIVE CONSULTANTS PROVIDES PALLIATIVE CONSULTATIVE SERVICES THROUGH NINE LOCAL HOSPITALS OR WHEREVER THE PATIENT CALLS HOME. AT THE REQUEST OF THE PATIENT'S ATTENDING PHYSICIAN, SPECIALLY TRAINED PHYSICIANS AND ADVANCED PRACTICE REGISTERED NURSES (APRNS) TAKE THE TIME TO UNDERSTAND EACH INDIVIDUAL SITUATION AND THEN RECOMMEND OPTIONS TO MEET THE PATIENT'S PERSONAL GOALS OF CARE. COMMUNITY PALLIATIVE CONSULTANTS ALSO PROVIDES EDUCATION AND TRAINING OF HOSPITAL/FACILITY STAFF. PALLIATIVE CARE PROVIDES AN EXTRA LAYER OF SUPPORT FOR PATIENTS AND THEIR FAMILIES THROUGH A MULTIDISCIPLINARY TEAM FOCUSED ON PROVIDING RELIEF FROM THE SYMPTOMS, PAIN, AND STRESS ASSOCIATED WITH A SERIOUS ILLNESS OR COMPLEX CHRONIC CONDITION. IN FISCAL YEAR 2019, OUR PALLIATIVE CARE TEAM SAW 6,457 PATIENTS. MEDICARE CARE CHOICES MODEL IN 2015, COMMUNITY HOSPICE & PALLIATIVE CARE JOINED A SELECT GROUP OF PALLIATIVE AND HOSPICE PROVIDERS NATIONWIDE AS PARTICIPANTS IN A CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) FIVE-YEAR RESEARCH EFFORT: THE MEDICARE CARE CHOICES MODEL (MCCM). LAUNCHED IN JANUARY 2016, COMMUNITY CARE CHOICES IS BASED ON THE MCCM MODEL TO HELP PEOPLE WITH ADVANCED ILLNESS FIND GREATER ACCESS TO COMFORT CARE AND SUPPORT. THE MODEL PROVIDES SELECT HOSPICE SUPPORTIVE SERVICES, INCLUDING CASE MANAGEMENT AND CARE COORDINATION, IN A HOMECARE SETTING TO PATIENTS WHO MEET ELIGIBILITY CRITERIA FOR HOSPICE CARE AND ADDITIONAL CMS CRITERIA. IN FISCAL YEAR 2019, THE PROGRAM ADMITTED 53 PATIENTS.SPECIALIZED CARE FOR CHILDREN SINCE 2000, COMMUNITY HOSPICE & PALLIATIVE CARE HAS PROVIDED PALLIATIVE AND HOSPICE CARE AND SUPPORT FOR CHILDREN LIVING WITH LIFE-LIMITING AND LIFE-THREATENING CONDITIONS THROUGH COMMUNITY PEDSCARE, AN AWARD-WINNING PEDIATRIC CARE PROGRAM IN COLLABORATION WITH WOLFSON CHILDREN'S HOSPITAL, NEMOURS CHILDREN'S SPECIALTY CARE AND THE UNIVERSITY OF FLORIDA-JACKSONVILLE. THE PROGRAM, ONE OF ONLY A FEW COMMUNITY PEDIATRIC PROGRAMS IN THE UNITED STATES OFFERING BOTH PALLIATIVE AND HOSPICE CARE, PROVIDES CLINICAL, SOCIAL SERVICE, SPIRITUAL, CHILD LIFE, MEDICAL AND VOLUNTEER SUPPORT TO IMPROVE QUALITY OF LIFE FOR CHILDREN FROM PRENATAL TO AGE 21. TO DATE, THE PROGRAM HAS SERVED MORE THAN 1,600 PATIENTS WITH A CURRENT DAILY CENSUS IN FISCAL YEAR 2019 OF 286 PATIENTS.ADVANCE CARE PLANNING HONORING CHOICES FLORIDA IS A COMMUNITY COLLABORATIVE ADVANCE CARE PLANNING INITIATIVE OF COMMUNITY HOSPICE & PALLIATIVE CARE. THE PROGRAM LAUNCHED IN 2014 AND IS BASED ON A MODEL FROM RESPECTING CHOICES, A PIONEERING ACP PROGRAM IMPLEMENTING THROUGHOUT THE UNITED STATES, CANADA AND MANY COUNTRIES IN EUROPE AND ASIA. HONORING CHOICES FLORIDA IS DESIGNED TO SUSTAIN AN INTEGRATED, COMMUNITY-WIDE SYSTEM TO ENSURE PATIENTS' FUTURE HEALTH CARE PREFERENCES ARE DISCUSSED, DOCUMENTED AND HONORED. THE PROGRAM ENGAGES INDIVIDUALS THROUGH HEALTH CARE FACILITIES AND OTHER COMMUNITY-BASED VENUES THROUGH A SPECIALIZED ADVANCE CARE PLANNING DOCUMENT AND OFFERS TRAINED FACILITATORSMORE THAN 487 TO DATETO GUIDE INDIVIDUALS AND FAMILIES THROUGH THE PROCESS OF DISCUSSING AND DOCUMENTING THEIR HEALTH CARE WISHES. IN FISCAL YEAR 2019, FACILITATORS GUIDED OVER 4,073 CONVERSATIONS AND HELPED 2,830 INDIVIDUALS DOCUMENT THEIR WISHES AND PROGRAM STAFF PRESENTED IN 200 VENUES ON ADVANCE CARE PLANNING REACHING OVER 3,908 INDIVIDUALS.BEREAVEMENT SERVICES AND COMMUNITY GRIEF SUPPORT COMMUNITY HOSPICE & PALLIATIVE CARE OFFERS A VARIETY OF GRIEF AND LOSS SUPPORT SERVICES FOR THOSE WHO HAVE EXPERIENCED THE DEATH OF A LOVED ONE. THESE SERVICES PROVIDE SUPPORT OR GUIDANCE FOR DEALING WITH THE LOSS AND SORROW. SERVICES ARE AVAILABLE NOT ONLY TO SURVIVORS OF PATIENTS IN OUR HOSPICE CARE PROGRAM BUT TO ANYONE IN THE COMMUNITY WHO REQUESTS THEM. SERVICES INCLUDE BEREAVEMENT SUPPORT GROUPS HELD AT MANY LOCATIONS, UNDERSTANDING GRIEF (A PROGRAM FOR THE NEWLY BEREAVED), AN ANNUAL CANDLELIGHT SERVICE OF REMEMBRANCE, GRIEF CAMP FOR KIDS (CAMP HEALING POWERS) AND A PROGRAM TO COPE WITH GRIEF DURING THE HOLIDAY SEASON (NOVEMBER AND DECEMBER). HOSPICE PATIENTS' FAMILY MEMBERS MAY ALSO RECEIVE INDIVIDUAL AND FAMILY COUNSELING (INCLUDING CHILDREN AND TEENS). WE SEND LETTERS TO THE BEREAVED DURING THE YEAR AFTER THE DEATH, THESE INCLUDE HELPFUL HINTS AND INVITATIONS TO OUR SUPPORT ACTIVITIES. IN FISCAL YEAR 2019, MORE THAN 27,000 SUPPORT MAILINGS WERE SENT TO THE BEREAVED AND OVER 3,000 INDIVIDUALS TOOK ADVANTAGE OF ONE OR MORE OF THESE PROGRAMS. OUTREACH TO FAMILY CAREGIVERS AND MILITARY/VETERAN COMMUNITIES THE COMMUNITY HOSPICE & PALLIATIVE CARE COMMUNITY PROGRAMS DEPARTMENT MANAGES OUTREACH EFFORTS TO TWO LARGE STAKEHOLDER GROUPS IN OUR COMMUNITY. DEPARTMENT STAFF LED THE CAREGIVER COALITION OF NORTHEAST FLORIDA, AN ALLIANCE OF COMMUNITY-BASED NONPROFIT ORGANIZATIONS THAT SUPPORT STRONG FAMILY CAREGIVERS IN OUR COMMUNITY. TOGETHER, COALITION MEMBERS COORDINATE PROGRAMMING AND EDUCATION TO FAMILY CAREGIVERS AND THEIR LOVED ONES THROUGH CONFERENCES, AN ANNUAL EXPO, NEWSLETTER AND WEBSITE. COMMUNITY PROGRAMS ALSO LEADS OUTREACH TO ACTIVE-DUTY AND RETIRED MILITARY MEMBERS, EDUCATING THEM ABOUT ISSUES RELATED TO ADVANCED ILLNESS AND SUPPORT RESOURCES AVAILABLE TO THEM. THE COMMUNITY HOSPICE VETERANS PARTNERSHIP (CHVP) SUPPORTS VETERAN-CENTRIC INITIATIVES THROUGHOUT THE YEAR, INCLUDING A CAREGIVER CONFERENCE SPECIALIZED TO THE NEEDS OF MILITARY CAREGIVERS, SPECIAL APPRECIATION PROGRAMS FOR VETERANS ADMITTED INTO HOSPICE CARE, THE FIRST COAST CHAPTER OF THE VETERANS HISTORY PROJECT (VHP), AND OTHER EDUCATIONAL OUTREACH OPPORTUNITIES. IN FISCAL YEAR 2019, OUR OUTREACH PROGRAMS REACHED MORE THAN 1,693 VETERANS.VOLUNTEERSTHE NEARLY 1,000 COMMUNITY HOSPICE & PALLIATIVE CARE VOLUNTEERS ARE VITAL MEMBERS OF OUR TEAM. WHETHER OFFERING COMPANIONSHIP AND A LISTENING EAR TO PATIENTS AND FAMILY MEMBERS, HELPING WITH CLERICAL WORK AT ONE OF OUR OFFICE LOCATIONS OR ASSISTING AT FUNDRAISING EVENTS, THERE'S A VOLUNTEER OPPORTUNITY FOR EVERYONE. THRIFT SHOPS SINCE 2000, SHOPPERS, DONORS, AND VOLUNTEERS HAVE GENERATED NEARLY $4.6 MILLION FOR UNFUNDED AND UNDERFUNDED PROGRAMS FOR ADULTS AND CHILDREN IN OUR SERVICE AREA. NEW AND GENTLY USED CLOTHING, FURNITURE, HOUSEHOLD ITEMS, JEWELRY, COLLECTIBLES AND MORE FILL OUR LARGE CENTERS, WHICH ARE LOCATED AT 11173 BEACH BLVD. IN JACKSONVILLE, FL AND 845 BLANDING BLVD. IN ORANGE PARK, FL AND 1355 U.S HIGHWAY 1 SOUTH, ST. AUGUSTINE, FL.FOUNDATION THE COMMUNITY HOSPICE & PALLIATIVE CARE FOUNDATION IS DEDICATED TO ENABLING COMMUNITY HOSPICE & PALLIATIVE CARE TO FULFILL ITS MISSION AND VISION. FUNDS RAISED THROUGH THE FOUNDATION ENHANCE THE QUALITY OF LIFE FOR PATIENTS AND FAMILIES AND SUPPORT UNFUNDED AND UNDER-FUNDED PATIENT CARE, OUTREACH PROGRAMS, AND SERVICES FOR THOSE FACING ADVANCED ILLNESS AND GRIEF. DONOR SUPPORT PROVIDES COMMUNITY PROGRAMS AND COMPASSIONATE CARE TO ALL WHO NEED IT, REGARDLESS OF ABILITY TO PAY. ALIVIA CARE ALIVIA CARE IS A NURSE-LED, HOME-BASED CARE COORDINATION SERVICE FOR PATIENTS WITH AN ADVANCED ILLNESS, PROVIDING COMPLEX CARE MANAGEMENT AND A SUPPORT SYSTEM TO ENHANCE THE QUALITY OF LIFE OF A PATIENT AND THEIR CAREGIVERS WHEREVER THEY CALL HOME. ALIVIA CARE, A DIVISION OF COMMUNITY HOSPICE & PALLIATIVE CARE, HAS PARTNERED WITH SEVERAL MEDICAL PROVIDERS TO PROVIDE ADVANCED ILLNESS MANAGEMENT SERVICES TO THEIR PATIENTS. IN FISCAL YEAR 2019, WE PROVIDED CARE TO 264 PATIENTS. 97317720 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 161 0 1 1124 1 0 0 0 0 0 0 0 0 0 1 0 0 0 X 35 35 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 FL X X CARLOS BOSQUE CFO 9042685200 4266 SUNBEAM ROAD JACKSONVILLE FL 32257 FERNANDO ACOSTA-RUA CHAIR 2.00 X X 0 0 0 KEVIN ROBBINS 1ST VICE CHAIR 2.00 1.00 X X 0 0 0 CHRISTOPHER EMANS 2ND VICE CHAIR/SECRETARY 2.00 X X 0 0 0 JOHN W LOGUE TREASURER 2.00 X X 0 0 0 DR ROBERT C NUSS ASSISTANT TREASURER 2.00 X X 0 0 0 TRACY ARTHUR BOARD MEMBER 1.00 X 0 0 0 JASON BARRETT BOARD MEMBER 1.00 X 0 0 0 KATHERINE BATENHORST BOARD MEMBER 1.00 X 0 0 0 SCOTT S CAIRNS BOARD MEMBER 1.00 X 0 0 0 GERARDO COLON-OTERO MD BOARD MEMBER 1.00 X 0 0 0 NANCY L DAWSON MD BOARD MEMBER 1.00 X 0 0 0 COLONEL BILL DUDLEY BOARD MEMBER 1.00 X 0 0 0 SENATOR AUDREY GIBSON BOARD MEMBER 1.00 X 0 0 0 MARIE GNAGE PHD BOARD MEMBER 1.00 X 0 0 0 JOE GORDY BOARD MEMBER 1.00 X 0 0 0 DR ANN HARWOOD-NUSS BOARD MEMBER 1.00 X 0 0 0 RICHARD W HAWTHORNE BOARD MEMBER 1.00 X 0 0 0 REV MARSHA HOLMES BOARD MEMBER 1.00 X 0 0 0 PATRICE JONES DNP RN NE-BC BOARD MEMBER 1.00 X 0 0 0 T FITCH KING III BOARD MEMBER 1.00 X 0 0 0 SUE LEGER-KRALL ARNP PHD BOARD MEMBER 1.00 X 0 0 0 JOHN D LOGUE CFP BOARD MEMBER 1.00 1.00 X 0 0 0 RAY MATUZA BOARD MEMBER 1.00 X 0 0 0 MICHAEL MAYO FACHE BOARD MEMBER 1.00 X 0 0 0 AMBASSADOR MARILYN MCAFEE BOARD MEMBER 1.00 X 0 0 0 PATRICIA A MCELROY BOARD MEMBER 1.00 X 0 0 0 DAVID MEYER BOARD MEMBER 1.00 X 0 0 0 GREG MILLER MBA BOARD MEMBER 1.00 X 0 0 0 JOSEPH M MITRICK FACHE BOARD MEMBER 1.00 X 0 0 0 THE HONORABLE KRISTINA MOBLEY BOARD MEMBER 1.00 X 0 0 0 MARCIA C MORALES BOARD MEMBER 1.00 1.00 X 0 0 0 MARSHA OLIVER MBA BOARD MEMBER 1.00 X 0 0 0 ALLISON KORMAN SHELTON BOARD MEMBER 1.00 X 0 0 0 LARRY D WAGONER PHD LMFT BOARD MEMBER 1.00 X 0 0 0 MORRIE ZIMMERMAN BOARD MEMBER 1.00 X 0 0 0 SUSAN PONDER-STANSEL CEO 35.00 5.00 X 415496 0 58697 CARLOS BOSQUE CFO 28.00 2.00 X 195342 0 34477 PHILLIP WARD COO 40.00 X 276738 0 53431 MARY MCELROY SVP OF HOSPICE SERVICES 40.00 X 213691 0 34741 JOHN MCILVAINE SVP OF PALLIATIVE CARE 40.00 X 213539 0 45867 ANDREA FRITZ DEPUTY CFO 40.00 X 188971 0 57597 KENNY STEVENSON VP OF QUALITY AND COMPLIANCE 40.00 X 165966 0 21894 JAMES MONAHAN VP OF MARKETING AND COMMUNICATIONS 40.00 X 176928 0 36616 ANA SANCHEZ CMO 40.00 X 298134 0 18535 MARIA TIOMICO PHYSICIAN 40.00 X 249582 0 9362 JAMES BOMHARD PHYSICIAN 40.00 X 244964 0 13278 RUEBEN SMITH PHYSICIAN 40.00 X 244418 0 26595 RUTH STREETER PHYSICIAN 40.00 X 242556 0 26490 3126325 0 437580 49 0 1 0 CATHEDRAL GERONTOLOGY CENTER 333 EAST ASHLEY STREET JACKSONVILLE FL 32202 NURSING HOME ROOM & BOARD 1059678 TAYLOR CARE CENTER 6535 CHESTER AVENUE JACKSONVILLE FL 33217 NURSING HOME ROOM & BOARD 918596 LIFE CARE CTR -ORANGE PK 2145 KINGSLEY AVENUE ORANGE PARK FL 32073 NURSING HOME ROOM & BOARD 840581 WOODLAND GROVE HEALTH & REHAB 4325 SOUTHPOINT BLVD JACKSONVILLE FL 32216 NURSING HOME ROOM & BOARD 796240 PALM GARDEN OF JACKSONVILLE L 5725 SPRING PARK RD JACKSONVILLE FL 32216 NURSING HOME ROOM & BOARD 760768 53 1808647 1808647 PATIENT SERVICE REV 623000 89520521 89520521 NURSING HOME SUPPORT 623000 20761250 20761250 110281771 791899 791899 22880 0 22880 22880 22880 577056 0 17338 577056 -17338 559718 559718 1138189 364123 774066 774066 MISCELLANOUS REVENUE 623000 1254433 1254433 CAFE REVENUE 722210 53835 53835 MEDICAL RECORDS REVENU 900099 3225 3225 1311493 115550474 110304651 0 3437176 99859 99859 1865202 631797 1233405 51923 51923 48835188 39400229 9434959 1529219 1155077 374142 6841427 5816910 1024517 3523131 2913600 609531 189501 189501 567078 567078 40903 40903 56067 56067 14968 14968 2218320 1796547 421773 509292 230775 278517 3662541 2820346 842195 1061489 1061489 2366377 2366377 1361377 1251760 109617 258715 140431 118284 131 131 3459775 3459775 252742 252742 ROOM AND BOARD 22057008 22057008 MEDICAL SUPPLIES EXPENS 8302856 8302856 BAD DEBT EXPENSE 1408445 1408445 CHARITY CARE EXPENSES 1387856 1387856 908462 908462 112829852 97317720 15512132 0 4320 4420 13398787 9579946 7164150 7534790 650902 533770 3085494 3431755 70308785 28004388 37724791 42304397 26393343 27754344 1091412 1032565 682937 1300970 90196136 93476957 10066623 10538069 82160 2494070 2633493 12560693 13253722 X 77635443 80223235 77635443 80223235 90196136 93476957 2720622 -132830 0 X X 0 1 X 1 0 X 1711247 1550845 1904774 1726451 1808647 8701964 95054495 103225000 107483304 105581580 110302269 521646648 1164851 1179152 1037794 3381797 96765742 104775845 110552929 108487183 113148710 533730409 0 0 0 533730409 578072 873271 1019812 1037251 791899 4300305 578072 873271 1019812 1037251 791899 4300305 777616 1282817 1270655 1548363 1411888 6291339 98121430 106931933 112843396 111072797 115352497 544322053 0.98050 0.98230 0.00790 0.00800 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 60546 0 1 3754 64300 0 PART II-B, LINE 1: THE ORGANIZATION INCURRED EXPENSES BY LOBBYING AGAINST THE BILL TO TAKE HOSPICE OUT OF CON REPEAL LEGISLATION AND TO REMOVE HOSPICE FROM THE OPIOID BILL. ALSO, THE ORGANIZATION INCURRED EXPENSES BY LOBBYING TO EXPAND OUR PACE SERVICE AREA TO INCLUDE UNION, PUTNAME, AND BRADFORD COUNTIES. 4208118 4208118 39699897 14289867 25410030 7276935 2417138 4859797 15604190 11297383 4306807 3519645 3519645 42304397 DEFERRED COMPENSATION 2633493 2633493 X 114393911 -132830 364123 231293 114162618 1387856 1387856 115550474 111806119 364123 364123 111441996 1387856 1387856 112829852 PART X, LINE 2: COMMUNITY HOSPICE OF NORTHEAST FLORIDA AND ITS AFFILIATES ARE NOT-FOR-PROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPICE FOLLOWS THE FINANCIAL ACCOUNTING STANDARDS BOARD'S AUTHORITATIVE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR THE RECOGNITION AND MEASUREMENT OF THE BENEFITS OF INDIVIDUAL TAX POSITIONS IN THE CONSOLIDATED FINANCIAL STATEMENTS. TAX POSITIONS MUST MEET A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT IN ORDER FOR THE BENEFIT OF THOSE TAX POSITIONS TO BE RECOGNIZED IN THE HOSPICE'S CONSOLIDATED FINANCIAL STATEMENTS. THE HOSPICE HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2019. PART XI, LINE 2D - OTHER ADJUSTMENTS: THRIFT STORE EXPENSES INCLUDED ON FORM 990, PART VIII, LINE 10B 364,123. PART XI, LINE 4B - OTHER ADJUSTMENTS: CHARITY CARE INCLUDED IN REVENUES 1,387,856. PART XII, LINE 2D - OTHER ADJUSTMENTS: THRIFT STORE EXPENSES INCLUDED ON FORM 990, PART VIII, LINE 10B 364,123. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHARITY CARE INCLUDED IN REVENUES 1,387,856. 0 UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS INC 580 W 8TH ST JACKSONVILLE FL 32209 591867557 501(C)(3) 90011 PALLIATIVE CARE FELLOWSHIP 1 SCHEDULE I, PART II, LINE 1H IN SUPPORT AND ENHANCEMENT OF THE CLINICAL, EDUCATIONAL, AND RESEARCH PROGRAMS OF UNIVERSITY. PROVIDES A SETTING IN WHICH COLLEGE'S PHYSICIAN FELLOWS MAY PARTICPATE IN EDUCATION, RESEARCH, PATIENT CARE, AND ADMINISTRATIVE RESPONSBILITIES THROUGH THE COOPERATIVE EFFORTS WITH THE UNIVERSITY. X X X X X 0 1 0 0 0 0 0 0 0 SUSAN PONDER-STANSEL CEO 390491 0 0 0 25005 0 33350 0 25347 0 474193 0 0 0 CARLOS BOSQUE CFO 179265 0 0 0 16077 0 23879 0 10598 0 229819 0 0 0 PHILLIP WARD COO 257216 0 0 0 19522 0 32421 0 21010 0 330169 0 0 0 MARY MCELROY SVP OF HOSPICE SERVICES 191246 0 0 0 22445 0 25465 0 9276 0 248432 0 8858 0 JOHN MCILVAINE SVP OF PALLIATIVE CARE 186694 0 0 0 26845 0 24845 0 21022 0 259406 0 10704 0 ANDREA FRITZ DEPUTY CFO 182873 0 0 0 6098 0 24350 0 33247 0 246568 0 0 0 KENNY STEVENSON VP OF QUALITY AND COMPLIANCE 149480 0 0 0 16486 0 20016 0 1878 0 187860 0 4882 0 JAMES MONAHAN VP OF MARKETING AND COMMUNICATIONS 176750 0 0 0 178 0 4079 0 32537 0 213544 0 0 0 ANA SANCHEZ CMO 279097 0 0 0 19037 0 16635 0 1900 0 316669 0 18438 0 MARIA TIOMICO PHYSICIAN 241108 0 0 0 8474 0 7228 0 2134 0 258944 0 12781 0 JAMES BOMHARD PHYSICIAN 243582 0 0 0 1382 0 9112 0 4166 0 258242 0 286 0 RUEBEN SMITH PHYSICIAN 241108 0 0 0 3310 0 14461 0 12134 0 271013 0 13679 0 RUTH STREETER PHYSICIAN 241108 0 0 0 1448 0 14461 0 12029 0 269046 0 14829 0 PART I, LINE 4B NONQUALIFIED DEFERRED COMPENSATION - CERTAIN EMPLOYEES PARTICIPATE IN A 457(F) NON-QUALIFIED DEFERRED COMPENSATION PLAN SPONSORED BY THE ORGANIZATION. THE FOLLOWING AMOUNTS REPRESENT THE INCREASE IN VALUE RECEIVED UNDER THE TERMS OF THE PLAN. ANNA SANCHEZ - $8,385 MARIA TIOMICO - $7,228 JAMES BOMHARD - $7,381 REUBEN SMITH -$7,228 RUTH STREETER - $7,228 BRANDON WARD FAMILY MEMBER OF PHILLIP WARD 51923 COMPENSATION 0 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE OFFICERS AND THE IMMEDIATE PAST CHAIR, IF HE OR SHE CONTINUES TO SERVE ON THE BOARD, AND THE CHAIRS OF THE STRATEGIC PLANNING COMMITTEE, THE COMPLIANCE/QUALITY OVERSIGHT COMMITTEE AND THE NOMINATING AND BOARD DEVELOPMENT COMMITTEE. THE CHAIR OF THE COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION FOR CARING, INC. SHALL BE AN EX-OFFICIO MEMBER OF THE EXECUTIVE COMMITTEE WITHOUT VOTE. THE EXECUTIVE COMMITTEE SHALL MEET AT THE CALL OF THE CHAIR, OR, IN THE ABSENCE OF THE CHAIR, AT THE CALL OF THE FIRST VICE-CHAIR. THE EXECUTIVE COMMITTEE SHALL HAVE SUCH POWERS AS MAY BE DELEGATED BY THE BOARD OF DIRECTORS FROM TIME TO TIME. THE EXECUTIVE COMMITTEE SHALL ACT UPON INTERIM BUSINESS ARISING BETWEEN REGULAR MEETINGS OF THE BOARD OF DIRECTORS AND SHALL REPORT ITS ACTION AT THE NEXT MEETING OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL PERIODICALLY REVIEW THE PERFORMANCE OF THE PRESIDENT/CEO, AND SHALL REVIEW, FROM TIME TO TIME, PERSONNEL POLICIES, INCLUDING CONDITIONS OF EMPLOYMENT, AND SHALL MEET PERIODICALLY WITH THE PRESIDENT/CEO TO ASSESS PERSONNEL POLICIES AND WORKING CONDITIONS. THE COMMITTEE WILL REVIEW THE SALARY PLAN AND RECOMMEND CHANGES WHEN INDICATED. THE COMMITTEE SHALL OVERSEE THE ADMINISTRATION OF ANY AFFIRMATIVE ACTION PLAN. ACTIONS OF THE EXECUTIVE COMMITTEE PURSUANT TO THIS PARAGRAPH SHALL HAVE THE SAME EFFECT AS ACTIONS OF THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 2 THE HONORABLE MARCIA MORALES HOWARD AND MARCIA MORALES ARE BOTH BOARD MEMBERS AND ARE MOTHER AND DAUGHTER. DR ROBERT NUSS AND DR. ANN HARWOOD-NUSS ARE BOTH BOARD MEMBERS AND ARE HUSBAND AND WIFE. JOHN W. LOGUE AND JOHN D. LOGUE ARE BOTH BOARD MEMBERS AND ARE FATHER AND SON. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTANT WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. UPON COMPLETION, THE RETURN WAS REVIEWED IN ITS ENTIRETY BY THE BUDGET FINANCE COMMITTEE OF THE BOARD, FOLLOWED BY A PRESENTATION TO THE FULL BOARD FOR APPROVAL. FOLLOWING APPROVAL, THE RETURN WAS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS OF THE BOARD OF DIRECTORS ARE REQUIRED ANNUALLY TO COMPLETE AND SIGN A CONFLICT OF INTEREST POLICY IDENTIFYING RELATIONSHIPS THAT MAY GIVE RISE TO CONFLICT. OFFICERS AND KEY MANAGEMENT PERSONNEL ALSO COMPLETE A SURVEY REGARDING POTENTIAL BUSINESS RELATIONSHIPS WITH OTHER OFFICERS, DIRECTORS, AND KEY PERSONNEL.ANY PERSON DETERMINED TO HAVE A CONFLICT OF INTEREST IS REQUIRED TO RECUSE THEMSELVES FROM ANY VOTE RELATED TO THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMMITTEE OF THE BOARD REVIEWS AND MAKES DECISIONS ANNUALLY REGARDING COMPENSATION FOR EXECUTIVE STAFF. THE EXECUTIVE COMMITTEE RETAINED AN INDEPENDENT CONSULTANT TO CONDUCT A COMPREHENSIVE REVIEW OF THE COMPETITIVENESS AND REASONABLENESS OF THE COMPENSATION AND BENEFITS PROVIDED TO THE FOLLOWING POSITIONS: CEO, COO, CFO, SVP OF PALLIATIVE CARE, SVP HOSPICE SERVICES, VP DEPUTY CHIEF FINANCIAL OFFICER, VP COMPLIANCE AND QUALITY, AND VICE PRESIDENT EDUCATION & COMMUNITY ENGAGEMENT. A REVIEW OF COMPETITIVENESS AND REASONABLENESS FOR LIKE ORGANIZATIONS TO INCLUDE NOT-FOR-PROFIT POST ACUTE CARE PROVIDERS AND HOSPITALS OF COMPARABLE SIZE, REGARDLESS OF GEOGRAPHY WAS CONDUCTED. TARGET MARKET AT MEDIAN. FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION WILL PROVIDE ANY GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS UPON REQUEST. THIS CAN BE DONE IN PERSON, BY PHONE, VIA OUR WEBSITE OR ON WWW.GUIDESTAR.COM. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION FOR CARING 4266 SUNBEAM ROAD JACKSONVILLE FL 32257 593583920 FUNDRAISING FOR COMMUNITY HOSPICE OF NORTHEAST FLORIDA FL 501(C)(3) 13, TYPE I COMMUNITY HOSPICE OF NORTHEAST FLORIDA 1 PACE PARTNERS OF NORTHEAST FLORIDA INC 4266 SUNBEAM ROAD JACKSONVILLE FL 32257 364861283 PROGRAM FOR NURSING HOME PATIENTS FL 501(C)(3) LINE 12A, I COMMUNITY HOSPICE OF NORTHEAST FLORIDA 1 COMMUNITY MANAGEMENT COMPANY OF NORTHEAST FLORIDA INC 4266 SUNBEAM ROAD JACKSONVILLE FL 32257 EDUCATION AND CARING FOR THE ELDERLY FL COMMUNITY HOSPICE OF NORTHEAST FLORIDA C 1 0 1 0 1 0 0 0 0 1 0 1 1 0 1 1 1 1 0 0 COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION A 503048 FMV COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION C 1808647 FMV COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION O 801150 FMV SCHEDULE R, PART VII THE COMMUNITY MANAGEMENT COMPANY OF NORTHEAST FLORIDA, INC. WAS ESTABLISHED IN DECEMBER 2012 AND IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE AND EDUCATIONAL PURPOSES, INCLUDING THE PROVISION OF PALLIATIVE CARE SERVICES AND OTHER HEALTH SERVICES TO IMPROVE THE HEALTH SERVICES OF THE PEOPLE IN THE COMMUNITY IT SERVES. AS OF SEPTEMBER 30, 2019, COMMUNITY MANAGEMENT COMPANY OF NORTHEAST FLORIDA, INC. HAD NOT ENGAGED IN ANY FINANCIAL TRANSACTIONS AND THEIR APPLICATION FOR EXEMPTION WAS STILL IN THE PROCESS.