2018-05-01T15:41:03-05:00 2017-06-30 946214841 Armanino LLP 50 W San Fernando St Ste 500 San Jose CA 95113 990 2016-07-01 942497618 Hospice of Santa Cruz County HOSP 8314303000 940 Disc Drive Scotts Valley CA 95066 MICHAEL MILWARD CHIEF EXECUTIVE OFFICER 8314303000 2018-04-20 1 Lawrence S Kuechler P00233621 4082006400 2018-04-20 38.104.135.22 2018-04-20 17:15:31 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 1660D9D96D1CA10093BC688201E7BDF3C13909DD 2016 2021-01-29 14:40:06Z MICHAEL MILWARD 940 Disc Drive Scotts Valley CA 95066 21052269 0 X HOSPICESANTACRUZ.ORG X 1978 CA HOSPICE SERVICE AND SUPPORT FOR TERMINAL PATIENTS AND THEIR FAMILIES. 20 20 189 113 0 0 2901066 958027 17672333 19984034 44985 5098 49814 58506 20668198 21005665 0 0 0 0 12702865 14526110 0 0 411985 5790443 6394558 18493308 20920668 2174890 84997 13161753 13505396 2225126 2433396 10936627 11072000 HOSPICE OF SANTA CRUZ COUNTY HONORS THE CHOICES OF INDIVIDUALS AND FAMILIES BY PROVIDING EXEMPLARY END-OF-LIFE CARE AND GRIEF SUPPORT TO OUR COMMUNITY. 0 0 16889566 19984034 1,089 PATIENTS AND FAMILIES RECEIVED 72,051 DAYS OF EXPERT END-OF-LIFE CARE FROM HOSPICE TEAMS OF MEDICAL DIRECTORS, NURSES, SOCIAL WORKERS, CHAPLAINS, HOSPICE AIDES, AND VOLUNTEERS. ADDITIONALLY, 2,145 GRIEF SUPPORT SESSIONS WERE PROVIDED TO HOSPICE FAMILIES AND GRIEVING COMMUNITY MEMBERS OF ALL AGES. 16889566 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 77 0 189 1 0 0 0 0 0 1 1 0 0 0 0 X 20 20 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X The Organization 8314303000 940 Disc Drive Scotts Valley CA 95066 Kathleen Grave PRESIDENT 6.00 X X 0 0 0 Bob Kaswen VICE PRESIDENT 4.00 X X 0 0 0 Renee Mello TREASURER 4.00 X X 0 0 0 Margaret Gordon SECRETARY 3.00 X X 0 0 0 Alicia Flores DIRECTOR 2.00 X 0 0 0 Beth Hansman DIRECTOR 2.00 X 0 0 0 Cara DiSimone DIRECTOR 2.00 X 0 0 0 Carolyn Mecozzi DIRECTOR 2.00 X 0 0 0 Charlotte Kim DIRECTOR 2.00 X 0 0 0 David Doolin DIRECTOR 2.00 X 0 0 0 David Kluger DIRECTOR 2.00 X 0 0 0 Dick Clark DIRECTOR to 12/2016 2.00 X 0 0 0 Geoff Caras DIRECTOR to 1/2017 2.00 X 0 0 0 Kuntal Thaker DIRECTOR 2.00 X 0 0 0 Marilyn Calciano DIRECTOR 2.00 X 0 0 0 Michael Paul DIRECTOR to 8/2017 2.00 X 0 0 0 Monica Hamilton DIRECTOR 2.00 X 0 0 0 Rachel Wedeen DIRECTOR 2.00 X 0 0 0 Sarah Goyette DIRECTOR TO 1/2017 2.00 X 0 0 0 RUTH MEHR DIRECTOR 2.00 X 0 0 0 MICHAEL MILWARD CEO 40.00 X 275597 0 37817 ADAM SHORE CFO 40.00 X 198263 0 12712 CATHERINE CONWAY CHIEF COMMUNICATIONS OFFIC 40.00 X 152526 0 15467 Kieran Shah Chief Strategy Officer 40.00 X 149830 0 7710 Sally Ann Adelus Chief Clinical Officer 40.00 X 180904 0 2488 JUDITH HUMBLE CHIEF COMPLIANCE OFFICER 40.00 X 139109 0 17381 Charlea Tarmas Massion Chief Medical Director 40.00 X 244121 0 38518 EMILIA SCHAMBECK PATIENT CARE MANAGER 40.00 X 125773 0 19520 PATRICIA DUNBAR PATIENT CARE MANAGER 40.00 X 122151 0 14747 LISA M FLORES SR. DIRECTOR OF IT 40.00 X 126533 0 11514 1714807 0 177874 21 0 1 0 MANNING DEVELOPMENT INC 9020 SOQUEL DRIVE SUITE 100 APTOS CA 95003 CONSTRUCTION 273312 L KERSHNER DESIGN 911 CENTER ST SUITE D SANTA CRUZ CA 95060 COMMERCIAL INTERIOR DESIGN 104503 2 120320 837707 958027 PATIENT FEES 621610 19270945 19270945 PRIVATE INSURANCE 621610 537035 537035 PALLIATIVE CARE AND OTHER 621610 141476 141476 SELF PAY PATIENT FEES 621610 18636 18636 BEREAVEMENT INCOME 621610 15942 15942 19984034 5098 5098 49593 49593 20867 120320 39545 -18678 -18678 34650 7059 27591 27591 21005665 19984034 0 63604 1112643 200387 912256 11212328 9239048 1705456 267824 54588 42430 10422 1736 1251591 1073963 140897 36731 894960 686748 187310 20902 11256 11256 20525 20525 366909 209625 149590 7694 133376 103186 26684 3506 453121 362848 73870 16403 233547 192443 34565 6539 20847 17178 3085 584 253112 208564 37461 7087 588161 484645 87048 16468 ROOM & BOARD 1404627 1404627 MEDICATIONS 669273 669273 PATIENT CARE SERVICES 619776 619776 SUPPLIES 332561 322989 8049 1523 1287467 1051836 210643 24988 20920668 16889566 3619117 411985 3712812 3151384 1233507 533964 4224312 2413507 105970 126467 4650914 1224396 3161803 3426518 470969 3521228 252380 332328 13161753 13505396 1666562 1797584 344907 322788 213657 313024 2225126 2433396 X 10454688 10455264 44970 179667 436969 437069 10936627 11072000 13161753 13505396 X 84997 45940 4436 X X 0 1 X 1 0 X 792964 682746 1034196 2767070 958027 6235003 792964 682746 1034196 2767070 958027 6235003 112308 6122695 57825 47982 45701 94242 54691 300441 6535444 89845397 0.93680 0.89400 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 0 Part II-B, Line 1: THE ORGANIZATION IS A MEMBER OF CALIFORNIA HOSPICE & PALLIATIVE CARE ASSOCIATION AND NATIONAL HOSPICE & PALLIATIVE CARE ORGANIZATION, BOTH OF WHICH LOBBY. 470969 100 45940 517009 482392 75 -11423 75 470969 488670 100 -6378 482392 478547 10075 48 488670 478399 100 48 478547 0.85000 0.15000 0 0 558850 558850 1441150 493621 947529 1760195 366624 1393571 890719 364151 526568 3426518 ENDOWED AGENCY FUND HELD AT COMMUNITY FOUNDATION OF SCC 516909 F NON ENDOWED AGENCY FUND HELD AT COMMUNITY FOUNDATION OF SCC 2255086 F CERTIFICATE OF DEPOSITS 749233 C 3521228 DEFERRED COMPENSATION LIABILITIES 199937 SELF-INSURANCE LIABILITY 113087 313024 X 21098988 45940 1365 41582 88887 21010101 -4436 -4436 21005665 20963615 1365 41582 42947 20920668 0 20920668 Part V, Line 4: THE ORGANIZATION'S ENDOWMENT FUNDS CONSISTS OF FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES TO SUPPORT THE ORGANIZATIONS PROGRAMS. THE ORGANIZATION HAS A POLICY OF CLASSIFYING INVESTMENT INCOME ON ENDOWMENT FUNDS AS TEMPORARILY RESTRICTED UNTIL SUCH TIME AS SPECIFICALLY BUDGETED FOR SPENDING AND APPROVED BY THE BOARD. Part X, Line 2: The Organization is exempt from federal income tax under Internal Revenue Code Section 501(c)(3) and from state franchise tax under Revenue and Taxation Code Section 23701(d), but is subject to taxes on unrelated business income when earned. For the year ending June 30, 2017, no provision for income taxes have been recorded on the financial statements. As of the year ended June 30, 2017, the Organization is current in all federal and state tax filing obligations and the returns are subject to standard statute of limitations applicable under the governing federal and state tax statutes. Part XI, Line 2d - Other Adjustments: FUNDRAISING DIRECT EXPENSES 41,582. Part XI, Line 4b - Other Adjustments: RAFFLE NON CASH PRIZES -4,436. Part XII, Line 2d - Other Adjustments: FUNDRAISING DIRECT EXPENSES 41,582. OKTOBERFEST 61966 58038 3928 1763 4278 3283 150 5523 GOLF 77912 60973 16939 1170 8315 8610 2894 3 1309 1309 3559 141187 120320 20867 2933 12593 11893 150 11976 39545 -18678 34650 1450 4436 1173 0 34650 1450 4436 1173 7059 27591 CA 0 ORGANIZATION IS ALLOWED BY THE CALIFORNIA ATTORNEY GENERAL TO CONDUCT RAFFLES. 0 0 0 1.00000 ADAM SHORE 940 DISC DRIVE SCOTTS VALLEY CA 95066 0 0 X X X X 0 0 0 0 0 0 0 0 0 MICHAEL MILWARD CEO 243992 0 31605 0 0 0 20400 0 17417 0 313414 0 0 0 ADAM SHORE CFO 181493 0 16770 0 0 0 1799 0 10913 0 210975 0 0 0 CATHERINE CONWAY CHIEF COMMUNICATIONS OFFIC 147497 0 5029 0 0 0 2400 0 13067 0 167993 0 0 0 Kieran Shah Chief Strategy Officer 140345 0 9485 0 0 0 947 0 6763 0 157540 0 0 0 Sally Ann Adelus Chief Clinical Officer 178205 0 2699 0 0 0 2400 0 88 0 183392 0 0 0 JUDITH HUMBLE CHIEF COMPLIANCE OFFICER 133913 0 5196 0 0 0 1170 0 16211 0 156490 0 0 0 Charlea Tarmas Massion Chief Medical Director 235661 0 8460 0 0 0 20400 0 18118 0 282639 0 0 0 Form 990, Part VI, Section B, line 11b CFO and CEO review 990 when completed by CPA firm. A copy of the 990 is furnished to the Finance Committee and to the board members before the 990 is filed. Form 990, Part VI, Section B, line 12c PURPOSE OF THE CONFLICT OF INTEREST POLICY IS TO PROTECT HSCC'S INTEREST WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN OFFICER OR DIRECTOR OF THE ORGANIZATION. OFFICERS AND DIRECTORS REVIEW AND SIGN AN ANNUAL STATEMENT INDICATING UNDERSTANDING AND ADHERENCE TO THE POLICY. Form 990, Part VI, Section B, line 15 MARKET DATA ON SALARIES FOR CEO AND CFO POSITIONS IN THE HEALTHCARE AND HOSPICE FIELD IS COMPILED AND REVIEWED ANNUALLY BY HR DIRECTOR. REPORT BY AN INDEPENDENT CONSULTANT, CONSIDERING MARKET AND GEOGRAPHIC FACTORS, WAS PRESENTED TO THE ORGANIZATION'S COMPENSATION COMMITTEE, WHICH REVIEWS AND RECOMMENDS ANY SALARY ADJUSTMENT TO FULL BOARD OF DIRECTORS. BOARD OF DIRECTORS REVIEW AND VOTE ON PROPOSED SALARY CHANGES. Form 990, Part VI, Section C, line 19 All governing documents, policies, and annual 990 information returns are available to the public upon request. Annual financial results are published in the organization's annual report. Form 990, Part XI, line 9: RAFFLE NON CASH PRIZES 4,436. FORM 990, PART XI, LINE 2C: THE OVERSIGHT AND SELECTION PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.