2018-11-15T17:22:51-06:00 2017-12-31 450250958 EIDE BAILLY LLP 7001 E BELLEVIEW AVE STE 700 DENVER CO 80237 990 2017-01-01 841453050 PIKES PEAK HOSPICE FOUNDATION PIKE 7196333400 2550 TENDERFOOT HILL STREET COLORADO SPRINGS CO 80906 GLORIA A BROOKS MPA FACHE PRESIDENT 7196333400 2018-11-15 1 KYLE FRITCH CPA P01313374 3037705700 2018-11-15 50.203.234.82 2018-11-15 15:59:54 MS P 38E7B26ACDED65A6206348105EC66FC115FD0A44 B602D594AFD2B0B327E07A06F36CA6A7E42546D0 2017 2019-02-21 02:37:17Z GLORIA A BROOKS 2550 TENDERFOOT HILL STREET COLORADO SPRINGS CO 80906 2384708 0 X WWW.PIKESPEAKHOSPICE.ORG X 1998 CO TO GENERATE AND DISTRIBUTE FUNDS IN SUPPORT OF PIKES PEAK HOSPICE AND PALLIATIVE CARE, INC. 13 13 0 13 0 0 524431 1219081 0 0 82444 593358 0 0 606875 1812439 691858 945989 0 0 58457 196998 0 0 407427 170306 266971 920621 1409958 -313746 402481 15911778 16914605 746609 173433 15165169 16741172 THE MISSION OF PIKES PEAK HOSPICE FOUNDATION IS TO GENERATE AND DISTRIBUTE FUNDS IN SUPPORT OF PIKES PEAK PALLIATIVE CARE, INC., SERVE THE CHARITABLE INTERESTS OF OUR DONORS AND PRUDENTLY MANAGE THEIR GIFTS. 0 0 945989 945989 PIKES PEAK HOSPICE FOUNDATION IS A SUPPORTING ORGANIZATION FOR PIKES PEAK HOSPICE & PALLIATIVE CARE, INC., WHICH PROVIDED SERVICES TO 2,307 PATIENTS FOR THE PERIOD ENDING 12/31/2017. THE AMOUNT TRANSFERRED TO PPHPC WAS $945,989 IN THE SAME TIME PERIOD. 945989 1 1 0 0 0 0 0 1 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 1 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 CO X RON FERET 3033212828 501 S CHERRY STREET STE 700 DENVER CO 80246 X DAN KORLESKI CHAIR 1.00 X X 0 0 0 BRIAN WAGNER IMMEDIATE PAST CHAIR 1.00 X X 0 0 0 STEVE HOCHSTETTER VICE CHAIR 1.00 X X 0 0 0 BILL JOHANNSEN SECRETARY 1.00 X X 0 0 0 BRIAN HOMME TREASURER 1.00 X X 0 0 0 ERIN EILMES MEMBER AT LARGE 1.00 X 0 0 0 SHARON HARE TRUSTEE/BOARD LIASON 1.00 1.00 X 0 0 0 WILLIAM HYBL TRUSTEE 1.00 X 0 0 0 SUSAN MULVIHILL TRUSTEE 1.00 X 0 0 0 RAY NUNN TRUSTEE 1.00 X 0 0 0 RANDALL STILES TRUSTEE 1.00 X 0 0 0 MICHELLE TALARICO TRUSTEE 1.00 X 0 0 0 BRENDA WHITLOCK TRUSTEE 1.00 X 0 0 0 JOAN SELMAN EXECUTIVE DIRECTOR 40.00 1.00 X 0 110416 10795 MARTHA BARTON PRESIDENT & CEO (THRU 5/17) 1.00 40.00 X 0 109933 15018 GLORIA A BROOKS PRESIDENT & CEO (FROM 6/17) 1.00 40.00 X 0 107109 21054 0 327458 46867 0 0 0 0 0 24521 1194560 68629 1219081 365627 365627 800000 572269 227731 227731 227731 1812439 0 0 593358 945989 945989 180779 180779 184 184 2670 2670 13365 13365 2351 2351 13020 13020 52594 52594 1200 1200 114670 114670 10387 10387 606 606 26044 26044 2271 2271 3781 3781 20160 20160 1048 1048 FUNCTIONS AND EVENTS 5290 5290 DUES AND SUBSCRIPTIONS 2195 2195 EDUCATION 360 360 DIRECT PATIENT EXPENSES 195 195 10799 3948 6851 1409958 945989 56542 407427 300 726516 592051 656272 38300 5459 5305 214138 37289 177569 176849 13057479 15100383 1288183 1001717 15911778 16914605 746609 36835 0 136598 746609 173433 X 10352896 11911106 1150496 1377011 3661777 3453055 15165169 16741172 15911778 16914605 X 402481 1575603 -402081 X 0 1 X 1 0 X X X 1 PIKES PEAK HOSPICE AND PALLIATIVE CARE INC 840816047 10 1 945989 0 1 945989 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 173000 X 0 3147820 121560 426941 125165 3571156 2993626 123966 54209 23981 3147820 2376851 495864 216834 95923 2993626 2516747 26851 -23395 143352 2376851 2395647 20937 256751 156588 2516747 0.00000 0.74890 0.25110 0 0 41138 37289 3849 173000 173000 176849 BENEFICIAL INTEREST IN TRUSTS 887814 ASSETS - FUNERAL PLANS 113903 1001717 DUE TO AFFILIATED ENTITIES 136598 136598 X 3335448 1575603 1575603 1759845 52594 52594 1812439 1357364 0 1357364 52594 52594 1409958 PART III, LINE 4: ARTWORK IS MAINTAINED FOR AN AESTHETIC ENVIRONMENT FOR PATIENTS. PART V, LINE 4: OUR ENDOWMENT CONSISTS OF A SINGLE POOLED FUND ESTABLISHED BY DONORS TO PROVIDE ANNUAL FUNDING FOR FUTURE OPERATIONS. PART X, LINE 2: PIKES PEAK HOSPICE AND PALLIATIVE CARE, INC. AND PIKES PEAK HOSPICE FOUNDATION ARE ORGANIZED AS COLORADO NONPROFIT CORPORATIONS AND 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 ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3), QUALIFY FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTIONS 170(B)(1)(A)(VI) AND (VIII), AND HAVE BEEN DETERMINED NOT TO BE PRIVATE FOUNDATIONS UNDER SECTIONS 509(A)(1) AND (3), RESPECTIVELY. EACH ENTITY IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE ENTITIES ARE SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO THEIR EXEMPT PURPOSES. WE HAVE DETERMINED THAT EACH ENTITY IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND THEY HAVE NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990-T) WITH THE IRS. 0 PIKES PEAK HOSPICE & PALLIATIVE CARE INC 2500 TENDERFOOT HILL STREET COLORADO SPRINGS CO 80906 840816047 501(C)3 945989 GENERAL SUPPORT 1 0 PART I, LINE 2: FUNDS GIVEN TO PIKES PEAK HOSPICE AND PALLIATIVE CARE, INC. SCHEDULE I, PART I LINE 2 PIKES PEAK HOSPICE IS A SUPPORTED ORGANIZATION OF THE FOUNDATION & SOLE CORPORATE MEMBER OF THE FOUNDATION. NO SPECIFIC MONITORING OF GRANT FUNDS EXISTS SINCE FUNDS ARE ALL RAISED BY THE FOUNDATION FOR USE BY THE HOSPICE. X 3 16307 SELLING PRICE X 3 11362 FAIR MARKET VALUE X BURIAL PLOTS AND CONCRETE VAULTS 4 39240 FAIR MARKET VALUE X JEWELRY 1 1720 FAIR MARKET VALUE 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 1 THE FOUNDATION'S EXECUTIVE COMMITTEE SHALL BE AUTHORIZED TO ACT IN THE PLACE OF THE FOUNDATION BOARD BETWEEN MEETINGS AND SHALL BE AUTHORIZED TO TAKE ALL ACTION NECESSARY IN THE EVENT THAT SUCH ACTION CANNOT WAIT FOR THE NEXT REGULARLY SCHEDULED FOUNDATION BOARD MEETING. IN THE EVENT THE EXECUTIVE COMMITTEE TAKES ACTION IN THE PLACE OF THE FOUNDATION BOARD BETWEEN REGULARLY SCHEDULED MEETINGS, THE EXECUTIVE COMMITTEE SHALL REPORT ALL SUCH ACTION TO THE FOUNDATION BOARD AT THE NEXT REGULARY SCHEDULED MEETING. FORM 990, PART VI, SECTION A, LINE 2 THE PRESIDENT/CEO IS EMPLOYED BY PIKES PEAK HOSPICE AND PALLIATIVE CARE INC. (PPHPC), A RELATED TAX-EXEMPT ORGANIZATION. BOARD MEMBER SHARON HARE IS ALSO A BOARD MEMBER OF PPHPC. THEREFORE, BUSINESS RELATIONSHIPS EXIST BETWEEN THESE INDIVIDUALS. FORM 990, PART VI, SECTION A, LINE 3 PIKES PEAK HOSPICE AND PALLIATIVE CARE, INC., A RELATED EXEMPT ORGANIZATION, PERFORMED MANAGEMENT SERVICES INCLUDING FINANCE AND ACCOUNTING, PAYROLL, INFORMATION TECHNOLOGY, HUMAN RESOURCES, QUALITY MANAGEMENT, COMPLIANCE, AND HIGH LEVEL RISK MANAGEMENT SERVICES. FORM 990, PART VI, SECTION A, LINE 6 PIKES PEAK HOSPICE AND PALLIATIVE CARE, INC. IS THE SOLE MEMBER OF THE FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER, PIKES PEAK HOSPICE AND PALLIATIVE CARE, INC. HAS THE POWER TO ELECT AND REMOVE DIRECTORS OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE TREASURER AND THE CHIEF FINANCIAL OFFICER AND IS THEN PROVIDED TO THE BOARD OF TRUSTEES PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL EDUCATION IS PROVIDED TO THE BOARD MEMBERS OFFICERS, AND STAFF. ALL CONFLICTS ARE ADDRESSED BY OFFICERS AND CONTRACT LEGAL COUNSEL AS NEEDED. BOARD MEMBERS ARE REQUIRED TO SIGN AN ANNUAL CONFLICT OF INTEREST STATEMENT. BOARD MEMBERS WHO HAVE A CONFLICT WITH RESPECT TO A MATTER BEFORE THE BOARD ARE DIRECTED TO DISCLOSE THE CONFLICT AND ABSTAIN FROM VOTING ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 PIKES PEAK HOSPICE AND PALLIATIVE CARE, A RELATED TAX-EXEMPT ORGANIZATION, PROVIDES COMPREHENSIVE SALARY COMPARISON DATA FOR THE PRESIDENT/CEO AND THE EXECUTIVE DIRECTOR POSITION ANNUALLY TO THE PPHPC BOARD OF DIRECTORS, CHAIR, VICE CHAIR, AND SECRETARY. THEY REVIEW THE DATA AND PROVIDE SALARY/COMPENSATION RECOMMENDATIONS TO THE BOARD OF DIRECTORS' EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE BRINGS THE RECOMMENDATIONS TO THE BOARD OF DIRECTORS FOR APPROVAL. COMPENSATION SURVEYS ARE UTILIZED AND REVIEWED TO ENSURE THE SALARY RANGE IS APPROPRIATE; AFTER REVIEW AND APPROVAL BY THE BOARD, MARKET ADJUSTMENT IS APPLIED. THIS PROCESS IS COMPLETED BY PPHPC'S PERFORMANCE AND COMPENSATION TASK FORCES (PCTF). PCTF USES THE FOLLOWING MARKET SALARY SURVEYS THAT ARE RELEVANT TO CURRENT POSITIONS AND INDUSTRY, REVIEWED AT LEAST ANNUALLY, MULTI-VIEW INCORPORATED (MVI) HOSPICE COMPENSATION SURVEY - MOUNTAIN STATES EMPLOYERS COUNCIL (MSEC) - HEALTH CARE COMPENSATION SURVEY - COLORADO COMPENSATION SURVEY - NON-PROFIT COMPENSATION SURVEY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND FINANCIALS STATEMENTS ARE AT THE ORGANIZATION'S LOCATION AND ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A - EMPLOYEE WAGES PIKES PEAK HOSPICE & PALLIATIVE CARE, INC. (PPHPC) PAYS THE SALARIES FOR THE ORGANIZATION'S EMPLOYEES. THEREFORE, THE ORGANIZATION DOES NOT REPORT ANY COMPENSATION ON W-2S OR 1099-MISCS FOR ITS EMPLOYEES. IN ADDITION, THE SALARY, BENEFITS, AND PAYROLL TAX EXPENSES SHOWN ON LINES 7, 8, 9, AND 10 OF PART IX REPRESENT AMOUNTS PAID BY THE FOUNDATION TO PPHPC FOR THESE EMPLOYEES SERVICES. FORM 990, PART XI, LINE 9: RESTATEMENT OF EST. FAIR VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUST -402,081. PIKES PEAK HOSPICE AND PALLIATIVE CARE INC 2550 TENDERFOOT HILL STREET COLORADO SPRINGS CO 80906 840816047 CARE OF THE TERMINALLY ILL CO 501(C)(3) LINE 10 N/A 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0