2018-05-07T14:18:51-05:00 2017-12-31 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2017-01-01 561452373 HOSPICE OF CLEVELAND COUNTY INC HOSP 7044874677 951 WENDOVER HEIGHTS DRIVE SHELBY NC 281503565 MYRA MCGINNIS PRESIDENT/CEO 7044874677 2018-04-26 1 JOHN NORMAN P01506766 7049985200 2018-04-26 2017 2022-09-23 18:48:47Z HOSPICE CLEVELAND COUNTY MYRA MCGINNIS 951 WENDOVER HEIGHTS DRIVE SHELBY NC 281503565 12277164 0 X WWW.HOSPICECARES.CC X 1984 NC HOSPICE OF CLEVELAND COUNTY PROVIDES CARE AND SUPPORT TO PATIENTS WITH A LIFE-LIMITING ILLNESS. 15 15 201 168 0 0 481722 517499 12373776 11447013 258470 224715 42340 68765 13156308 12257992 0 0 0 0 6949124 6975223 0 0 0 5003721 4893779 11952845 11869002 1203463 388990 24847891 26178855 1296207 1212530 23551684 24966325 HOSPICE CLEVELAND COUNTY EXISTS TO PROVIDE HIGH QUALITY SKILLED COMPASSIONATE CARE AND SUPPORT FOR INDIVIDUALS WITH A LIFE-LIMITING ILLNESS, THEIR FAMILIES, AND THE COMMUNITY, REGARDLESS OF THEIR ABILITY TO PAY. 0 0 6668170 8733624 HOSPICE CLEVELAND COUNTY PROVIDES COMPREHENSIVE END OF LIFE HEALTHCARE FOR TERMINALLY ILL PATIENTS AND THEIR FAMILIES DURING THE FINAL STAGES OF ILLNESS. DURING 2017, HOSPICE CLEVELAND COUNTY PROVIDED 50,415 DAYS OF HOMECARE INCLUDING 12,309 DAYS OF NURSING HOME AND HOSPITAL INPATIENT CARE. HOSPICE CLEVELAND COUNTY SERVED 755 HOMECARE PATIENTS IN 2017. HOSPICE CLEVELAND COUNTY'S INTERDISCIPLINARY TEAMS CONSISTING OF PHYSICIANS, NURSES, HOSPICES AIDES, SOCIAL WORKERS, AND OTHER SUPPORTIVE PERSONNEL PROVIDED OVER 33,659 VISITS DURING 2017. 3095997 2584288 HOSPICE CLEVELAND COUNTY OWNS AND OPERATES TWO HOSPICE HOUSES THAT PROVIDE HOSPICE INPATIENT AND RESIDENTIAL CARE FOR TERMINALLY ILL PATIENTS DURING THE FINAL STAGES OF ILLNESS. THE WENDOVER HOSPICE HOUSE HAS 16 BEDS AND THE TESTA FAMILY HOSPICE HOUSE HAS 8 BEDS. DURING 2017, HOSPICE CLEVELAND COUNTY PROVIDED 7,088 DAYS OF CARE IN THESE FACILITIES. HOSPICE CLEVELAND COUNTY SERVED 366 PATIENTS IN THE HOSPICE HOUSES IN 2017. 494126 129101 PALLIATIVE CARE CLEVELAND PROVIDES A PROGRAM OF PAIN CONTROL, SYMPTOM MANAGEMENT AND ASSISTANCE WITH DIFFICULT DECISION MAKING. DURING 2017, PALLIATIVE CARE CLEVELAND COUNTY SERVED 520 PATIENTS. 10258293 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 41 0 1 201 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X PAM BENFIELD 7044874677 951 WENDOVER HEIGHTS DRIVE SHELBY NC 28150 ALEX BELL BOARD MEMBER 1.00 X X 0 0 0 THOMAS WHITE BOARD MEMBER 1.00 X 0 0 0 KATIE BORDERS BOARD MEMBER 1.00 X 0 0 0 SCOTT FRANKLIN BOARD MEMBER 1.00 X 0 0 0 JENNIE LAMBERT BOARD MEMBER 1.00 X 0 0 0 LARRY DOOLEY BOARD MEMBER 1.00 X 0 0 0 ANDREA LESLIE-FITE BOARD MEMBER 1.00 X 0 0 0 JT SCRUGGS BOARD MEMBER 1.00 X 0 0 0 JOSEPH TYSINGER BOARD MEMBER 1.00 X X 0 0 0 CHARLES WEBBER BOARD MEMBER 1.00 X 0 0 0 BECKY BROWN BOARD MEMBER 1.00 X X 0 0 0 JOHN PORTER BOARD MEMBER 1.00 X 0 0 0 JONATHAN RHODES BOARD MEMBER 1.00 X 0 0 0 FORREST THOMPSON BOARD MEMBER 1.00 X X 0 0 0 GREG GRIER BOARD MEMBER 1.00 X 0 0 0 MYRA MCGINNIS PRESIDENT/CEO 45.30 X 156596 0 13116 PAM BENFIELD VP OF FINANCIAL SERVICES 46.60 X 81721 0 9776 LEE ANN LONG VP OF CLINICAL SERVICES 44.40 X 106803 0 10509 THERESA ISAACS NURSE PRACTITIONER 49.30 X 102656 0 10360 ERIC PARKER NURSE PRACTITIONER 39.60 X 101098 0 5307 548874 0 49068 4 0 1 0 HOSPICE & PALLIATIVE CARE CHARLOTTE 1420 EAST SEVENTH STREET CHARLOTTE NC 28204 CONTRACTED PHYSICIAN SERVICES 113193 1 103295 5569 408635 227010 517499 PATIENT REVENUE 621610 11447013 11447013 11447013 230495 230495 15750 0 15750 15750 15750 5780 -5780 -5780 -5780 53464 5569 13392 40072 40072 HOSPICE ITEMS - NET 900099 243 243 12700 12700 12943 12257992 11447013 0 293480 345120 345120 5303732 4688864 614868 136792 119009 17783 774123 673487 100636 415456 361447 54009 12279 12279 46032 46032 294290 223112 71178 33040 33040 127984 59936 68048 99854 12981 86873 243349 128367 114982 158116 156425 1691 22704 15155 7549 497021 497021 42179 42179 PURCHASED SERVICES 1808556 1808556 SUPPLIES 872252 872252 BAD DEBT EXPENSES 289996 289996 THRIFT STORE EXPENSES 198926 198926 147201 119719 27482 11869002 10258293 1610709 0 5199905 5944184 3471146 3613332 102279 47067 1188276 1093881 27201 24788 77225 43507 11531036 5409003 6568495 6122033 8091081 9241531 122283 48532 24847891 26178855 995905 917071 300302 295459 1296207 1212530 X 23224020 24680684 164405 122382 163259 163259 23551684 24966325 24847891 26178855 X 388990 1019936 -60323 66038 X 0 1 X 1 0 X 318197 824110 313180 345339 517499 2318325 318197 824110 313180 345339 517499 2318325 298788 2019537 112022 259024 217005 272029 246245 1106325 254 -74 180 277 349 12943 13569 3438399 58729009 0.58730 0.58660 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 297 297 0 PART II-B, LINE 1: THE ORGANIZATION BELONGS TO THE NATIONAL HOSPICE & PALLIATIVE CARE ORGANIZATION WHICH HAS ESTIMATED THAT 3.83% OF ITS PROVIDER DUES WERE USED FOR SPECIFIC LOBBYING PURPOSES. MEMBERSHIP DUES IN 2017 WERE $7,744.25 WHICH EQUATES TO $297 THAT WOULD BE ATTRIBUTABLE TO LOBBYING ACTIVITIES. 425311 55489 65222 546022 412449 11046 12862 11046 425311 398923 35730 -11474 10730 412449 300821 87961 19660 9519 398923 261411 9804 39410 9804 300821 0.57800 0.29900 0.12300 0 0 810679 810679 8291759 3801713 4490046 799004 447291 351713 1629594 1159999 469595 6122033 ESTIMATED THIRD PARTY LIABILITY 295459 295459 X 12026250 -219989 -219989 12246239 11753 11753 12257992 11670080 4 4 11670076 198926 198926 11869002 PART V, LINE 4: TO SUPPORT OPERATIONS AS NEEDED. PART X, LINE 2: THE ORGANIZATION FOLLOWS THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE INCOME TAX STANDARD. THIS STANDARD PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PRINCIPLES FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE IMPLEMENTATION OF THIS STANDARD HAD NO IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ORGANIZATION HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF DECEMBER 31, 2017. PART XI, LINE 2D - OTHER ADJUSTMENTS: INVESTMENT FEES -60,323. THRIFT STORE EXPENSES -198,926. GAIN/LOSS ON BENEFICIAL INTEREST 38,456. OTHER RESTRICTED CONTRIBUTIONS 804. PART XI, LINE 4B - OTHER ADJUSTMENTS: OTHER RESTRICTED CONTRIBUTIONS RECEIVED 800. CONTRIBUTION TO FOREVER FUND 10,953. PART XII, LINE 2D - OTHER ADJUSTMENTS: ROUNDING 4. PART XII, LINE 4B - OTHER ADJUSTMENTS: THRIFT STORE EXPENSES 198,926. SPRING CHICKEN DINNER 21877 21877 3096 1142 FALL CHICKEN DINNER 20880 20880 2756 1192 1 5569 5569 1095 48326 5569 42757 5852 3429 9281 33476 X 1 1 X X X 0 0 0 0 0 0 0 0 0 MYRA MCGINNIS PRESIDENT/CEO 147204 0 7808 0 1584 0 4722 0 8394 0 169712 0 0 0 PART I, LINE 1A HOSPICE OF CLEVELAND COUNTY, INC. PAYS A PORTION OF MONTHLY DUES FOR EMPLOYEES WHO CHOOSE TO JOIN THE LOCAL YMCA PROGRAM. THIS IS REPORTED AS TAXABLE FRINGE IN THE EMPLOYEES PAYROLL EARNINGS AND TAXED APPROPRIATELY. X 13190 SALES VALUE - FMV X 213820 SALES VALUE - FMV 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S PRESIDENT/CEO WILL REVIEW AND APPROVE FORM 990 AND WILL PRESENT IT TO THE FINANCE COMMITTEE BEFORE IT IS FILED. THE FINANCE COMMITTEE WILL THEN PRESENT THE PREPARED FORM 990 TO THE BOARD OF DIRECTORS FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MAINTAINS A CONFLICT OF INTEREST POLICY THAT COVERS ALL EMPLOYEES AND BOARD MEMBERS. EACH YEAR THE CONFLICT OF INTEREST POLICY IS REVIEWED BY EMPLOYEES THROUGH AN ON-LINE EDUCATION MODULE CALLED HCC CORPORATE COMPLIANCE. SENIOR LEADERSHIP AND ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE, SIGN, AND DATE AN ANNUAL CONFLICT OF INTEREST DISCLOSURE FORM. ALL DISCLOSURES BY BOARD MEMBERS ARE REVIEWED AND APPROVED BY THE BOARD CHAIRPERSON. FORM 990, PART VI, SECTION B, LINE 15 ALL BOARD MEMBERS EVALUATE THE PRESIDENT/CEO THROUGH AN ON-LINE EVALUATION WEBSITE, PROVIDING RATINGS FOR EACH JOB RESPONSIBILITY. THE SCORES ARE AGGREGATED BY SENIOR STAFF AND THEN PRESENTED TO THE PERSONNEL COMMITTEE FOR REVIEW. THE COMPENSATION INCREASE IS DETERMINED BY USING THE ORGANIZATION'S COMPENSATION RATING SYSTEM, WHICH TIES EVALUATION SCORES TO SALARY INCREASES. THE COMMITTEE ALSO REVIEWS COMPARATIVE SALARY DATA FROM SURVEYS CONDUCTED BY INDEPENDENT VENDORS. THE PERSONNEL COMMITTEE PRESENTS THE EVALUATION RESULTS AND COMPENSATION RECOMMENDATION TO THE BOARD FOR APPROVAL. THE PRESIDENT/CEO DOES A REVIEW OF SALARY SURVEYS TO ESTABLISH SALARY RANGE GUIDELINES FOR ALL POSITIONS. THESE SALARY RANGES ARE THEN APPROVED BY THE PERSONNEL COMMITTEE. AN ANNUAL PERFORMANCE REVIEW IS COMPLETED EACH YEAR AND ANY ADJUSTMENT TO COMPENSATION IS DETERMINED USING THE ORGANIZATION'S COMPENSATION RATING SYSTEM, WHICH TIES EVALUATION SCORES TO SALARY INCREASES. FORM 990, PART VI, SECTION C, LINE 19 REQUESTS FOR REVIEW OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS MUST BE SUBMITTED TO HOSPICE OF CLEVELAND COUNTY, INC. IN WRITING AND MUST INCLUDE THE NAME, ADDRESS, AND TELEPHONE NUMBER OF THE INDIVIDUAL OR ENTITY MAKING THE REQUEST. ALL REQUESTS ARE SUBMITTED TO THE PRESIDENT/CEO FOR REVIEW. THE DOCUMENTS ARE MADE AVAILABLE WITHIN TWO WEEKS OF RECEIPT OF THE WRITTEN REQUEST. THE DOCUMENTS ARE AVAILABLE FOR REVIEW AT THE HOSPICE OF CLEVELAND COUNTY. INC. ADMINISTRATIVE OFFICE BUILDING. FORM 990, PART XI, LINE 9: CHANGE IN DISCOUNT FOR PLEDGES RECEIVABLE 1,393. CHANGE IN ENDOWMENT HELD BY OTHERS 28,953. CHANGE IN ALLOWANCE FOR UNCOLLECTIBLE PLEDGES 48,611. TRANSFER OF SPENDABLE PORTION OF ENDOWMENT TO FOREVER FUND -10,953. NET ASSETS RELEASED FROM RESTRICTIONS FOR RESPITE CARE -5,611. WRITE OFF OF UNCOLLECTIBLE PLEDGES -35,611. GAIN/LOSS ON BENEFICIAL INTEREST 38,456. OTHER RESTRICTED CONTRIBUTIONS 800.