2018-11-15T16:31:10-06:00 2017-12-31 450250958 EIDE BAILLY LLP 7001 E BELLEVIEW AVE STE 700 DENVER CO 80237 990 2017-01-01 471820492 HALCYON HOSPICE HALC 3033212828 501 S CHERRY NO 700 DENVER CO 80246 TIM BOWEN CHEIF EXECUTIVE OFFICER 3033212828 2018-11-15 1 KYLE FRITCH CPA P01313374 3037705700 2018-11-13 50.203.234.82 2018-11-15 10:32:12 MS P 38E7B26ACDED65A6206348105EC66FC115FD0A44 B602D594AFD2B0B327E07A06F36CA6A7E42546D0 2017 2019-02-21 02:37:17Z SONIA FOSSEN 501 S CHERRY NO 700 DENVER CO 80246 19038918 0 X WWW.HALCYONHOSPICE.ORG X 2014 CO PROVIDING HEALTH CARE SERVICES AND SUPPORT TO PEOPLE WITH END OF LIFE AND LIFE THREATENING ILLNESSES AND THEIR FAMILIES IN THE METRO DENVER AREA AND SURRONDING COUNTIES. 5 4 45 125 0 0 47410 39836 17095190 18997596 0 1486 1506 0 17144106 19038918 0 0 0 0 11103758 11731627 0 0 0 7023864 6758926 18127622 18490553 -983516 548365 9377815 9905708 9889678 9869206 -511863 36502 X HALCYON HOSPICE IS COMMITTED TO A STANDARD OF EXCELLENCE IN PROVIDING SENSITIVE, PATIENT-CENTERED HEALTH CARE TO HOSPICE PATIENTS AND FAMILIES. 0 0 12126080 18997596 HOSPICE CARE IS DISTINGUISHED FROM TRADITIONAL CARE BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) AS END OF LIFE CARE THAT DOES NOT INCLUDE CURATIVE MEASURERS FOR THOSE WITH LIFE-LIMITING ILLNESSES AND GIVEN A PROGNOSIS OF LESS THAN SIX MONTHS TO LIVE. THE INTER-DISCIPLINARY TEAM INCLUDES A PHYSICIAN, REGISTERED NURSE, CHAPLAIN, AND SOCIAL WORKER. PATIENTS INCLUDE THOSE WHO QUALIFY FOR MEDICARE AND MEDICAID AND OTHER VARIOUS INSURANCE PROGRAMS, AS WELL AS THOSE WHO ARE UNDERINSURED AND UNINSURED, VETERANS AND CHILDREN. HALCYON HOSPICE ALSO RUNS A PALLIATIVE CARE PROGRAM, WHICH COORDINATES CARE AND SERVICES FOR PEOPLE COPING WITH CHRONIC ILLNESS AND ASSISTS INDIVIDUALS DURING THE TIMES OF TRANSITION THROUGH AN INTEGRATED PERSONALIZED CARE PLAN AND 24-7 SUPPORT. THIS TYPE OF PALLIATIVE CARE IS AVAILABLE BEFORE A PATIENT IS ELIGIBLE FOR HOSPICE CARE. PALLIATIVE CARE (1) RELIEVES PAIN AND OTHER SYMPTOMS, (2) INCREASES COMFORT FOR PATIENTS AND MAY INCLUDE CURATIVE MEASURES, AND (3) PROVIDES PRACTICAL ASSISTANCE FOR PATIENTS AND CAREGIVERS AT HOME. 12126080 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 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 0 0 0 1 58 0 1 45 1 0 0 0 0 0 0 0 0 0 0 X 5 4 1 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 CO X RON FERET 3033212828 501 S CHERRY STREET STE 700 DENVER CO 80246 ADELE PHELAN CHAIR/SECRETARY 1.00 2.00 X X 0 0 0 JOHN HORAN VICE CHAIR (THRU 11/17) 1.00 2.00 X X 0 0 0 JEFF KIPP TREASURER 1.00 0.00 X X 0 0 0 ANDREA COLEMAN DIRECTOR 1.00 0.00 X 0 0 0 BILL MCKEE DIRECTOR 1.00 0.00 X 0 0 0 TIM BOWEN DIRECTOR AND CHIEF EXECUTIVE OFFICER 1.00 43.00 X X 0 659289 68428 KEVIN WILLIAMS CHIEF FINANCIAL OFFICER 1.00 43.00 X 0 246794 51179 JOHN BLASCHKE CHIEF INFORMATION OFFICER 1.00 43.00 X 0 231907 50373 JANE BEDROSIAN VP OF HUMAN RESOURCES 1.00 43.00 X 0 189849 53840 MELINDA EGGING VP OF QUALITY & COMPLIANCE (THRU 08/17) 1.00 43.00 X 0 174045 29872 ROB GRABER PRESIDENT 40.00 0.00 X 108893 0 33268 SONIA B FOSSEN CLINICAL SERVICES DIR./VP (FROM 11/17) 40.00 0.00 X 124799 0 25779 MEREDITH BRADY CARE COORDINATOR 40.00 0.00 X 110840 0 8777 CHAD HARTMANN DIRECTOR OF BUSINESS DEVELOPMENT 40.00 0.00 X 126785 0 6717 KELLY MINCINSKI DIRECTOR OF BUSINESS DEVELOPMENT 40.00 0.00 X 111083 0 34822 SUSAN WEST CARE COORDINATOR 40.00 0.00 X 100964 0 8861 683364 1501884 371916 6 0 1 0 CARE SYNERGY 501 S CHERRY STREET STE 700 DENVER CO 80246 MANAGEMENT SERVICES 783436 ALLISON CARE CENTER 1660 ALLISON STREET LAKEWOOD CO 80214 NURSING HOME SERVICES 571990 COLORADO LUTHERAN HOME 7991 W 71ST AVE ARVADA CO 80004 NURSING HOME SERVICES 327783 LIFE CARE CENTER OF LITTLETON 1500 W MINERAL AVE LITTLETON CO 80120 NURSING HOME SERVICES 278281 COLUMBINE WEST HEALTH & REHAB 940 WORTHINGTON CIRCLE FORT COLLINS CO 80526 NURSING HOME SERVICES 275817 16 39836 39836 PATIENT SERVICE REVENUE 623000 18996738 18996738 858 858 18997596 1486 1486 19038918 18997596 0 1486 292739 29274 263465 9665330 6406912 3258418 1067883 683891 383992 705675 496824 208851 1729887 375259 1354628 44734 44734 108779 36998 71781 35711 2525 33186 223628 223628 61140 1860 59280 142146 142146 219428 219428 DIRECT PATIENT EXPENSES 3491888 3491843 45 BAD DEBT 570714 570714 ANSWERING SERVICES 40493 40493 RECRUITING 25048 25048 65330 29980 35350 18490553 12126080 6364473 0 386189 1320682 3471868 3291740 17263 10218 300590 204130 169237 96460 5291258 5144608 42000 42000 9377815 9905708 855425 1904062 7471 9034253 7957673 9889678 9869206 X -511863 36502 -511863 36502 9377815 9905708 548365 0 X 0 1 X 1 0 X 42735 49207 47410 39836 179188 2109587 14274939 17096551 18997596 52478673 2152322 14324146 17143961 19037432 52657861 0 0 0 52657861 145 1486 1631 145 1486 1631 2152322 14324146 17144106 19038918 52659492 X 56895 40315 16580 91661 42408 49253 152034 121407 30627 96460 DUE TO CARE SYNERGY 591431 DUE TO HOSPICE OF METRO DENVER 2116242 LONG TERM NOTE PAYABLE TO HOSPICE OF METRO DENVER 5250000 7957673 X 19038918 0 19038918 0 19038918 18490553 0 18490553 0 18490553 PART X, LINE 2: WE ARE ORGANIZED AS A COLORADO NONPROFIT CORPORATION, HAVE BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3), QUALIFY FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A)(VIII), AND HAVE BEEN CLASSIFIED AS AN ORGANIZATION OTHER THAN A PRIVATE FOUNDATION UNDER SECTION 509(A)(2). WE ARE REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, WE ARE SUBJECT TO INCOME TAX ON NET INCOME DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO OUR EXEMPT PURPOSE. WE HAVE DETERMINED THAT WE ARE NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAVE NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990-T) WITH THE IRS. 0 1 0 0 0 0 0 1 0 TIM BOWEN DIRECTOR AND CHIEF EXECUTIVE OFFICER 0 489382 0 142140 0 27767 0 49202 0 19225 0 727716 0 0 KEVIN WILLIAMS CHIEF FINANCIAL OFFICER 0 209982 0 36812 0 0 0 41894 0 9285 0 297973 0 0 JOHN BLASCHKE CHIEF INFORMATION OFFICER 0 183457 0 48450 0 0 0 24056 0 26317 0 282280 0 0 JANE BEDROSIAN VP OF HUMAN RESOURCES 0 165057 0 24792 0 0 0 37369 0 16472 0 243690 0 0 MELINDA EGGING VP OF QUALITY & COMPLIANCE (THRU 08/ 0 160731 0 13314 0 0 0 21623 0 8249 0 203917 0 0 SONIA B FOSSEN CLINICAL SERVICES DIR./VP (FROM 11/1 118549 0 6250 0 0 0 16494 0 9285 0 150578 0 0 0 PART I, LINE 3 THE ORGANIZATION RELIED ON A RELATED ORGANIZATION THAT USED ONE OR MORE OF THESE METHODS TO ESTABLISH THE COMPENSATION OF OFFICERS. PART I, LINE 4B CARE SYNERGY, A RELATED TAX-EXEMPT ORGANIZATION, ESTABLISHED A SECTION 457(F) NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR THE EXCLUSIVE BENEFIT OF CERTAIN EXECUTIVES. FUNDS ARE SUBJECT TO RISK OF FORFEITURE BY PLAN PARTICIPANTS AND ARE AVAILABLE TO THE CREDITORS OF CARE SYNERGY. IN ACCORDANCE WITH THE BOARD OF DIRECTORS' INTENT, CARE SYNERGY WILL FUND INDIVIDUAL PARTICIPANT ACCOUNTS THROUGH INVESTMENT OPTIONS DIRECTED BY THE PARTICIPANTS. THE DEFERRED COMPENSATION PLAN IS PARTIALLY FUNDED, AND CARE SYNERGY REPORTS THE DEFERRALS AND RELATED FUNDING IN ACCRUED EXPENSES AND INVESTMENTS, RESPECTIVELY, IN THE BALANCE SHEET. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE 457(F) NON-QUALIFIED DEFERRED COMPENSATION PLAN IN 2017, FOR WHICH THE EXPENSE WAS INCURRED BY THE SPONSORING ORGANIZATIONS, BUT THE FUNDS HAVE NOT VESTED OR BEEN PAID OUT TO THESE INDIVIDUALS: TIM BOWEN (CARE SYNERGY CEO): $84,416 KEVIN WILLIAMS (CARE SYNERGY CFO): ($29,666) NET CREDIT DUE TO FORFEITURE JOHN BLASCHKE (CARE SYNERGY CIO): $33,109 JANE BEDROSIAN (CARE SYNERGY VP OF HUMAN RESOURCES): $24,267 MELINDA EGGING (CARE SYNERGY VP OF QUALITY): $18,045 PART I, LINE 7 THE COMPENSATION COMMITTEE OF CARE SYNERGY, A RELATED TAX-EXEMPT ORGANIZATION, ANNUALLY REVIEWS THE PERFORMANCES OF THE EXECUTIVE STAFF AND OTHER STAFF TO DETERMINE IF ADDITIONAL COMPENSATION IN THE FORM OF BONUSES WILL BE PAID. DURING CALENDAR YEAR ENDED DECEMBER 31, 2017, THE ORGANIZATION AWARDED THE PRESIDENT, CLINICAL SERVICE DIRECTOR, CARE COORDINATORS, AND DIRECTORS OF DEVELOPMENT A BONUS BASED ON REVIEW OF THEIR PERFORMANCES AND SERVICES TO THE ORGANIZATION. SCHEDULE J, PART II: THE COMPENSATION PAID TO THE CEO/DIRECTOR, CFO, CIO, VP OF HUMAN RESOURCES, AND VP OF QUALITY AND COMPLIANCE IS PAID FOR BY CARE SYNERGY, A RELATED TAX-EXEMPT ORGANIZATION. CARE SYNERGY'S COMPENSATION COMMITTEE ENGAGES AN INDEPENDENT THIRD-PARTY COMPENSATION AND BENEFITS CONSULTANT TO CONDUCT A MARKET ANALYSIS, WHICH INCLUDES COMPARISONS OF SIMILARLY SIZED HOSPICES AND OTHER HEALTHCARE ORGANIZATIONS, TO DETERMINE COMPENSATION AMOUNTS FOR THESE INDIVIDUALS. FORM 990, PART VI, SECTION A, LINE 2 THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, CHIEF INFORMATION OFFICER, VP OF HUMAN RESOURCES, AND THE VP OF QUALITY AND COMPLIANCE ARE OFFICERS OF AND EMPLOYED BY CARE SYNERGY, A RELATED EXEMPT ORGANIZATION. THESE INDIVIDUALS ARE ALSO OFFICERS OF THE HOSPICE OF METRO DENVER, PIKES PEAK HOSPICE AND PALLIATIVE CARE, AND PATHWAYS HOSPICE. THEREFORE, BUSINESS RELATIONSHIPS EXIST BETWEEN THESE INDIVIDUALS. FORM 990, PART VI, SECTION A, LINE 3 CARE SYNERGY, A RELATED EXEMPT ORGANIZATION, PERFORMED EXECUTIVE MANAGEMENT SERVICES INCLUDING FINANCE AND ACCOUNTING, PAYROLL, INFORMATION TECHNOLOGY, HUMAN RESOURCES, QUALITY MANAGEMENT, COMPLIANCE, HIGH LEVEL RISK MANAGEMENT, AND GROUP CONTRACTING SERVICES. SEE FORM 990, PART VII FOR COMPENSATION PAID BY THE RELATED MANAGEMENT COMPANY. FORM 990, PART VI, SECTION A, LINE 6 HALCYON HOSPICE'S SOLE MEMBER IS CARE SYNERGY, A COLORADO NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER, CARE SYNERGY HAS THE POWER TO ELECT AND REMOVE DIRECTORS OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS INITIALLY REVIEWED BY THE CONTROLLER AND THE CHIEF FINANCIAL OFFICER. AFTER THE INITIAL REVIEW HAS BEEN COMPLETED, A FINAL COPY IS GIVEN TO THE FULL BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY BY THE BOARD OF DIRECTORS. EACH MEMBER OF THE BOARD OF DIRECTORS AND SENIOR MANAGEMENT IS ASKED TO DISCLOSE ANNUALLY ANY BUSINESS VENTURES, OWNERSHIP INTERESTS OR SERVICES THAT COULD CREATE A CONFLICT OF INTEREST. THE EXISTENCE OF ANY POTENTIAL CONFLICT OF INTEREST SHALL BE DISCLOSED TO BOARD OF DIRECTORS, WHO SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE GOVERNING 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. IN THE EVENT A CONFLICT OF INTEREST DOES EXISTS, AN INTERESTED PERSON MAY MAKE A PRESENTATION TO THE GOVERNING BOARD OR COMMITTEE, BUT AFTER THE PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE CONFLICT OF INTEREST. THE CHAIRPERSON OF THE GOVERNING BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE ORGANIZATION CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMING WITH THE ABOVE DETERMINATION, IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. FORM 990, PART VI, SECTION B, LINE 15A THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS FOR CARE SYNERGY, A RELATED TAX-EXEMPT ORGANIZATION, FUNCTIONS AS THE COMPENSATION COMMITTEE. THEY ENGAGE AN INDEPENDENT THIRD-PARTY COMPENSATION AND BENEFITS CONSULTANT TO CONDUCT A MARKET ANALYSIS OF COMPENSATION AND BENEFITS FOR ALL TOP MANAGEMENT AND TOP FINANCIAL OFFICIALS OF THE ORGANIZATION. THE ANALYSIS INCLUDES COMPARISONS OF SIMILARLY SIZED HOSPICE AND OTHER HEALTHCARE ORGANIZATIONS. THE CONSULTING FIRM ALSO EVALUATES THE REASONABLENESS OF EXECUTIVE COMPENSATION FROM AN INTERMEDIATE SANCTIONS PERSPECTIVE. ANY COMPENSATION OR BENEFIT CHANGES FOR TOP MANAGEMENT AND FINANCIAL OFFICIALS ARE APPROVED BY THE EXECUTIVE COMMITTEE OF THE CARE SYNERGY BOARD OF DIRECTORS AND DOCUMENTED IN THE COMMITTEE MINUTES. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST. REQUEST FORMS ARE AVAILABLE AT THE FRONT DESK AND CAN BE REQUESTED IN PERSON OR OVER THE PHONE. COMFORT BRIDGE DBA CARE SYNERGY 501 S CHERRY ST STE 700 DENVER CO 80246 471820366 ADMINISTRATIVE SUPPORT SERVICES TO RELATED ORGANIZATIONS CO 501(C)(3) LINE 12B, II N/A 0 PATHWAYS HOSPICE 305 CARPENTER ROAD FORT COLLINS CO 80525 840782874 HOSPICE AND PALLIATIVE CARE SERVICES CO 501(C)(3) LINE 7 COMFORT BRIDGE DBA CARE SYNERGY 0 HOSPICE OF METRO DENVER INC DBA THE DENVER HOSPICE & OPTIO HEALTH SERVICES 501 S CHERRY ST STE 700 DENVER CO 80246 840743121 HOSPICE AND PALLIATIVE CARE SERVICES CO 501(C)(3) LINE 10 COMFORT BRIDGE DBA CARE SYNERGY 0 PIKES PEAK HOSPICE AND PALLIATIVE CARE INC 2550 TENDERFOOT HILL STREET COLORADO SPRINGS CO 80906 840816047 HOSPICE AND PALLIATIVE CARE SERVICES CO 501(C)(3) LINE 10 COMFORT BRIDGE DBA CARE SYNERGY 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 1 1 1 0 0