CHAPTERS HEALTH FOUNDATION INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- CHAPTERS HEALTH FOUNDATION INC (EIN 59-3467282)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-08
- IRS object ID
- 201703129349303650
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-08T17:03:33-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 350921680 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE HORWATH LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 West Wacker Drive Suite 2600 | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 606061224 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 593467282 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Hospice Foundation Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HOSP | BusinessNameControlTxt |
| Phone | 8138718111 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12470 telecom drive suite 300 | AddressLine1Txt |
| City | temple terrace | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33637 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID J O'NEIL | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Signature | 2017-11-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | NICOLE BENCIK | PreparerPersonNm |
| PTIN | P00756195 | PTIN |
| Phone | 3128997000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2018-03-14 21:41:22Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HPH Foundation | BusinessNameLine1Txt |
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kathy Fernandez president & ceo | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12470 telecom drive suite 300 | AddressLine1Txt |
| City | temple terrace | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33637 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $278,520 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | chaptershealth.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1997 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION OPERATES TO ADVANCE UNDERSTANDING, PARTICIPATION & SUPPORT OF THE MISSION & PROGRAMS OF HERNANDO-PASCO HOSPICE, INC. & ITS AFFILIATEs, holding our community's sacred trust through sound stewardship. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 4 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $637,562 | PYContributionsGrantsAmt |
| CY Contributions Grants | $133,909 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $367,030 | PYInvestmentIncomeAmt |
| CY Investment Income | $144,611 | CYInvestmentIncomeAmt |
| PY Other Revenue | $38,480 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $1,043,072 | PYTotalRevenueAmt |
| CY Total Revenue | $278,520 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $7,289,860 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $14,861 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $124,907 | PYOtherExpensesAmt |
| CY Other Expenses | $45,742 | CYOtherExpensesAmt |
| PY Total Expenses | $7,429,628 | PYTotalExpensesAmt |
| CY Total Expenses | $45,742 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$6,386,556 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $232,778 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,390,491 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,680,262 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $282,352 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $254,237 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,108,139 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,426,025 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE ORGANIZATION OPERATES TO ADVANCE UNDERSTANDING, PARTICIPATION AND SUPPORT OF THE MISSION AND PROGRAMS OF HERNANDO-PASCO HOSPICE, INC. AND ITS AFFILIATED NOT-FOR-PROFIT ORGANIZATIONS, holding our community's sacred trust through sound stewardship. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $3,467 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | Hospice Foundation Inc. is a not for profit organization that was formed solely to provide financial support to Hernando-Pasco Hospice, Inc. THE ORGANIZATION ACCEPTS DONATIONS FROM THE PUBLIC. THE NET PROCEEDS OF THESE VARIOUS ACTIVITIES FLOW TO HERNANDO-PASCO HOSPICE, INC., (hph) TO SUPPORT ITS END-OF-LIFE HOSPICE SERVICES WITHIN HPH'S THREE COUNTY SERVICE AREA. BY DIRECTION OF THE BOARD OF DIRECTORS, ANY REQUESTS RECEIVED FLOW TO A BOARD DESIGNATED ENDOWMENT TO BE INVESTED TO HELP SECURE THE FUTURE OF HPH. | Desc |
| Total Program Service Expenses | $3,467 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | FL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVID O'NEIL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8138718167 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12470 TELECOM DRIVE | AddressLine1Txt |
| City | TEMPLE TERRACE | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33637 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| Kathy L Fernandez | |||||||
| president/ceo | 2.0 | 48.0 | Yes (X) | Yes (X) | $0 | $938,062 | $108,635 |
| Thomas Barb | |||||||
| President (PARTIAL YEAR) | 5.0 | 40.0 | Yes (X) | Yes (X) | $0 | $332,925 | $1,601 |
| Clarence Prevatt Jr | |||||||
| chairman | 1.5 | 2.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Theresa Brock | |||||||
| Vice Chair | 1.5 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Michael McHugh | |||||||
| secretary/treasurer | 1.5 | 2.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Randall Woodruff | |||||||
| Board Member | 1.5 | 4.0 | Yes (X) | $0 | $0 | $0 | |
| David J O'Neil | |||||||
| CHIEF FINANCIAL OFFICER | 2.0 | 48.0 | Yes (X) | $0 | $436,837 | $134,347 | |
| Hubert Darrell White Jr | |||||||
| CHIEF LEGAL OFFICER | 2.0 | 48.0 | Yes (X) | $0 | $363,611 | $232,437 | |
| Peggy I Bertels | |||||||
| Chief Operating Officer (partial year) | 2.0 | 48.0 | Yes (X) | $0 | $453,769 | $21,923 | |
| Donald D Evans | |||||||
| Chief Integration and Business Development Officer | 2.0 | 48.0 | Yes (X) | $0 | $242,431 | $59,815 | |
| Audra Farish | |||||||
| Chief Human Resources officer | 2.0 | 48.0 | Yes (X) | $0 | $275,906 | $60,360 | |
| Sharon P Saucier | |||||||
| Chief Clinical & Compliance Officer | 2.0 | 48.0 | Yes (X) | $0 | $243,011 | $34,047 | |
| Ronald S Schonwetter MD | |||||||
| chief medical officer | 2.0 | 48.0 | Yes (X) | $0 | $712,979 | $291,095 | |
| Sheryl J Sypek | |||||||
| Chief Information Officer (partial year) | 2.0 | 46.0 | Yes (X) | $0 | $196,128 | $59,480 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,195,659 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,003,740 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $133,909 | AllOtherContributionsAmt |
| Total Contributions | $133,909 | TotalContributionsAmt |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $0 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $144,611 | TotalRevenueColumnAmt |
| Exclusion | $144,611 | ExclusionAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $278,520 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $144,611 | ExclusionAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,191 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $10,191 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,084 | TotalAmt |
| Management And General | $32,084 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Total | $3,467 | TotalAmt |
| Program Services | $3,467 | ProgramServicesAmt |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,742 | TotalAmt |
| Program Services | $3,467 | ProgramServicesAmt |
| Management And General | $42,275 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $637,834 | BOYAmt |
| EOY | $756,190 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,147,913 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,147,913 | BOYAmt |
| EOY | $2,147,913 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,566,940 | BOYAmt |
| EOY | $3,740,013 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,804 | BOYAmt |
| EOY | $36,146 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,390,491 | BOYAmt |
| EOY | $6,680,262 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,652 | BOYAmt |
| EOY | $3,842 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $278,700 | BOYAmt |
| EOY | $250,395 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $282,352 | BOYAmt |
| EOY | $254,237 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,108,139 | BOYAmt |
| EOY | $6,426,025 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,108,139 | BOYAmt |
| EOY | $6,426,025 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,390,491 | BOYAmt |
| EOY | $6,680,262 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $232,778 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $82,730 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $2,378 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type2 | Yes (X) | SupportingOrgType2Ind |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HERNANDO PASO HOSPICE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 592217929 | EIN |
| Organization Type | 9 | OrganizationTypeCd |
| Governing Document Listed | Yes (true) | GoverningDocumentListedInd |
| Support | $0 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (true) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | false | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | false | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | false | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | false | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | false | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | false | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | false | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | false | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | false | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | false | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | false | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | false | ContributionControllerInd |
| Contribution Family | false | ContributionFamilyInd |
| Contribution35 Controlled | false | Contribution35ControlledInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Majority Dir Trst Supported Org | Yes (true) | MajorityDirTrstSupportedOrgInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,147,913 | OtherCostOrOtherBasisAmt |
| Book Value | $2,147,913 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,147,913 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | GIFT ANNUITY OBLIGATIONS | Desc |
| Amt | $250,395 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $250,395 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | FormAndLineReferenceDesc |
| Explanation | CHS, LPH, GSH, CHC, HPH, HPH Foundation and the Foundation have been recognized by the Internal Revenue Service (IRS) as not-for-profit corporations and are exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code (IRC) and also from state income taxes under the provisions of Chapter 220.13 of the Florida Income Tax Code. Palliative Care, Pharmacy, and Staffing are also deemed to be tax-exempt as limited liability companies with CHS as sole member. CHS and its affiliated entities income tax returns are subject to review and examination by federal, state and local authorities. CHS and its affiliated entities are not aware of any activities that would jeopardize its tax-exempt status. CHS and its affiliated entities are subject to tax on unrelated business income for management fees received but are not aware of any activities that are subject to excise or other taxes. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Kathy L Fernandez | ||||||||||||||
| president/ceo | $0 | $497,200 | $0 | $112,329 | $0 | $328,533 | $0 | $80,884 | $0 | $27,751 | $0 | $1,046,697 | $0 | $112,329 |
| Thomas Barb | ||||||||||||||
| President (PARTIAL YEAR) | $0 | $55,276 | $0 | $45,000 | $0 | $232,649 | $0 | $1,601 | $0 | $0 | $0 | $334,526 | $0 | $45,000 |
| David J O'Neil | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $0 | $340,107 | $0 | $84,343 | $0 | $12,387 | $0 | $99,872 | $0 | $34,475 | $0 | $571,184 | $0 | $84,343 |
| Hubert Darrell White Jr | ||||||||||||||
| CHIEF LEGAL OFFICER | $0 | $288,834 | $0 | $71,985 | $0 | $2,792 | $0 | $208,380 | $0 | $24,057 | $0 | $596,048 | $0 | $71,985 |
| Peggy I Bertels | ||||||||||||||
| Chief Operating Officer (partial year) | $0 | $171,166 | $0 | $71,550 | $0 | $211,053 | $0 | $0 | $0 | $21,923 | $0 | $475,692 | $0 | $71,550 |
| Donald D Evans | ||||||||||||||
| Chief Integration and Business Development Officer | $0 | $205,867 | $0 | $26,497 | $0 | $10,067 | $0 | $55,459 | $0 | $4,356 | $0 | $302,246 | $0 | $26,497 |
| Audra Farish | ||||||||||||||
| Chief Human Resources officer | $0 | $215,249 | $0 | $53,000 | $0 | $7,657 | $0 | $58,430 | $0 | $1,930 | $0 | $336,266 | $0 | $53,000 |
| Sharon P Saucier | ||||||||||||||
| Chief Clinical & Compliance Officer | $0 | $234,621 | $0 | $0 | $0 | $8,390 | $0 | $19,938 | $0 | $14,109 | $0 | $277,058 | $0 | $0 |
| Ronald S Schonwetter MD | ||||||||||||||
| chief medical officer | $0 | $403,973 | $0 | $104,275 | $0 | $204,731 | $0 | $256,452 | $0 | $34,643 | $0 | $1,004,074 | $0 | $297,797 |
| Sheryl J Sypek | ||||||||||||||
| Chief Information Officer (partial year) | $0 | $174,263 | $0 | $15,000 | $0 | $6,865 | $0 | $39,928 | $0 | $19,552 | $0 | $255,608 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | THE PRESIDENT & CEO OF HOSPICE foundation, INC. IS PAID BY CHAPTERS HEALTH SYSTEM, INC. (A RELATED ORGANIZATION). CHS USES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEYS OR STUDIES, FORMS 990 OF OTHER ORGANIZATIONS, AND APPROVAL BY THE BOARD OR COMMITTEE TO DETERMINE HER COMPENSATION. HOSPICE foundation , INC. RELIES ON CHS TO ENSURE COMPENSATION IS REASONABLE. |
| Schedule J, Part I, Line 4a Severance or change-of-control payment | THE FOLLOWING SEVERANCE PAYMENTS WERE MADE IN 2016: THOMAS BARB - $232,649 PEGGY BERTELS - $193,152 |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | CHS (a related organization) has a supplemental executive retirement plan (SERP) in which some of the interested persons participate. During 2016, the following payments were made by CHS into the SERP plans of the participants: KATHY FERNANDEZ - $311,631 Ronald Schonwetter - $175,929 H. DARRELL WHITE - $150,484 DAVID O'NEIL - $30,577 AUDRA FARISH - $18,777 DONALD EVANS - $16,274 SHARON SAUCIER - $16,800 THE FOLLOWING DISTRIBUTIONS WERE PAID DURING 2016: Ronald Schonwetter - $193,522 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 15a PROCESS FOR DETERMINING COMPENSATION OF TOP MANAGEMENT OFFICIAL | The organization engaged an independent compensation consultant to assist in establishing a Compensation Charter that details the organization's procedures for setting compensation of the President/CEO and all other officers and key employees of the organization. The Compensation Charter established the Compensation Committee, the independent body responsible for establishing the compensation of the President/CEO. The Compensation Committee relies on a recent compensation study performed by an independent compensation consultant, which is done on an annual basis, that provides compensation data for similarly qualified persons in comparable organizations to support its decision-making process and reports its activities to the Board of Directors at the next regularly scheduled meeting. The Compensation Committee adequately documents its compensation determinations in the meeting minutes on a timely basis. The president/CEO of HOSPICE FOUNDATION Inc. is paid by Chapters Health System, Inc. The form 990 instructions indicate when the CEO is not paid by the filing organization, the question should be answered "no". |
| Form 990, Part VI, Line 15b PROCESS FOR DETERMINING COMPENSATION OF OTHER OFFICERS | the compensation of all other officers and key employees is determined by the president/ceo. the president/ceo uses COMPARABILITY DATA AND AN INDEPENDENT COMPENSATION CONSULTANT TO DETERMINE THE COMPENSATION. THE DECISIONS ARE DOCUMENTED IN EACH EMPLOYEE'S file. |
| Form 990, Part VI, Line 1a Delegate broad authority to a committee | THE EXECUTIVE COMMITTEE, MADE UP OF THE CHAIRPERSON OF THE BOARD, THE PRESIDENT/CEO, THE VICE CHAIRPERSON OF THE BOARD AND THE SECRETARY, SHALL HAVE ALL THE AUTHORITY OF THE BOARD OF DIRECTORS EXEPT AS MAY BE LIMITED BY FLORIDA LAW AND SUBJECT TO THE APPROVAL oF THE SOLE MEMBER. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | The Sole Member of the Corporation shall be Hernando-Pasco Hospice, Inc. Any additional members must be elected by the Sole Member. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | The sole member of the corporation, Hernando-Pasco Hospice, Inc. HAS THE AUTHORITY TO APPOINT THE MEMBERS OF THE BOARD. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | Without the written approval of the Sole Member, the Corporation shall not: A. Sell, lease, or dispose of assets, merge, combine or otherwise or reorganize with any other entity, convert its corporate structure to another form or enter into any management services agreement; B. ENTER INTO ANY LOAN FACILITY, BORROW ANY FUNDS OR PLEDGE OR HYPOTHECATE ANY OR ALL OF ITS ASSETS AS SECURITY FOR ANY BORROWING; C. CHANGE THE PURPOSE, CHARACTER OR NATURE OF THE CORPORATION'S BUSINESS TO OTHER THAN A TAX-EXEMPT, NOT FOR PROFIT CORPORATION ORGANIZED AND OPERATED EXCLUSIVELY FOR THE BENEFIT AND SUPPORT OF THE TAX-EXEMPT PURPOSES AND MISSION OF THE SOLE MEMBER; D. MAKE ANY CONTRIBUTION OR DISCTRIBUTION OF ASSETS OR PROPERTY TO ANY PERSON OTHER THAN THE SOLE MEMBER; E. AMEND THE ARTICLES OF INCORPORATION OF THE CORPORATION; OR F. DISSOLVE, LIQUIDATE OR OTHERWISE CEASE TO EXIST AS A FLORIDA NOT-FOR-PROFIT CORPORATION WHICH IS EXEMPT FROM TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | The organization retains an independent tax advisor to assist management in the preparation and review of its IRS Form 990. Prior to filing the return, management and the independent tax advisor review the return and all required schedules with the Compensation Committee of the Board of Directors. The Compensation Committee is composed of independent directors of the Company. Upon completion of its review, the Compensation Committee recommends to the Executive Committee of the Board of Directors that management be authorized to sign and file the return. Under the Company's by laws the Executive Committee has the authority to take this action on behalf of the Board of Directors. A copy of the Form 990 is provided to the full board prior to filing with the IRS and the Executive Committee reports its activities to the Board of Directors on a quarterly basis. |
| Form 990, Part VI, Line 12c Conflict of interest policy | Annually, each officer, director and key employee signs an acknowledgement and disclosure form attesting that they have read the Conflict of Interest Policy and agreeing to comply fully with its terms and conditions during their services with Chapters Health System, Inc. (CHS) and Affiliates. They further agree that if, at any time subsequent to the submission of the disclosure form, they become aware of any actual or potential conflict of interest or the information previously submitted becomes inaccurate or incomplete, they will promptly notify the CHS Board of Directors, the President and CEO of Chapters Health System, Inc., and the Hernando Pasco Hospice, Inc.' board of directors. DETERMINATION OF AND REMEDIES FOR CONFLICTS OF INTEREST 1. Disclosure. In connection with any actual or possible conflict of interest, an interested person must disclose the existence of his or her financial interest and must be given the opportunity to disclose all material facts to the Directors (and members of committees) considering the proposed transaction or arrangement. The disclosure shall be made as soon as practicable following the realization by the interested person that an actual or possible conflict of interest exists. Ordinarily, disclosures by interested persons should be to the Chairperson of the Board. When an actual or possible conflict of interest becomes apparent in the course of a Board meeting (or committee meeting), the interested person shall immediately disclose his or her financial interest and related material facts to the presiding Director or officer at such meeting. 2. Determining Whether a Conflict of Interest Exists. After disclosure of the financial interest and all material facts, and after any discussion with the interested person, the interested person shall leave the 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. 3. Procedures for Addressing the Conflict of Interest. (a) An interested person who has a conflict of interest may make a presentation at the Board (or committee) meeting, but after such presentation, he or she shall leave the meeting during the discussion of, and the vote on, the transaction or arrangement that result in the conflict of interest. The interested person who has a conflict of interest will not be counted as present for determining a majority with respect to the vote on the transaction or arrangement that results in the conflict of interest. (b) The Chairperson of the Board (or committee) shall, if appropriate, appoint a disinterested person or committee to investigate alternatives to the proposed transaction or arrangement. (c) After exercising due diligence, the Board (or Committee) shall determine whether CHS and Affiliates can obtain a more advantageous transaction or arrangement with reasonable efforts from a person or business entity that would not give rise to a conflict of interest. (d)If a more advantageous transaction or arrangement is not reasonably attainable under circumstances that would not give rise to a conflict of interest, the Board (or committee) shall determine by a majority vote of the disinterested Directors (or committee members) whether the transaction or arrangement is in the best interest of CHS and Affiliates and for its own benefit and whether the transaction is fair and reasonable to CHS and Affiliates and shall make its decision as to whether to enter into the transaction or arrangement in conformity with such determination. Violations of the Conflicts of Interest Policy (a) If the Board (or committee) has reasonable cause to believe that an interested person has failed to disclose actual or possible conflicts of interest, it shall inform the interested person of the basis for such belief and afford the interested person an opportunity to explain the alleged failure to disclose. (b) If, after hearing the response of the interested person and making such further investigation as may be warranted under the circumstances, the Board (or committee) determines that the interested person has in fact failed to disclose an actual or possible conflict of interest, it shall take such action as it determines to be appropriate, including corrective and disciplinary action. RECORD OF PROCEEDINGS The minutes of the Board (and each committee) shall contain: 1. The name of each person who disclosed or otherwise was found to have a financial interest in connection with an actual or possible conflict of interest, the nature of the financial interest, any action taken to determine whether a conflict of interest was present, and the Board's (or committee's) decision as to whether a conflict of interest in fact existed. 2. The names of the persons who were present for discussions and votes relating to the transaction or arrangement, the content of the discussion, including any alternatives to the proposed transaction or arrangement, and a record of any votes taken in connection therewith. PERIODIC REVIEWS To ensure that CHS and Affiliates operate in a manner consistent with their charitable purposes and that it does not engage in activities that could jeopardize their status as organizations exempt from federal income tax, periodic reviews shall be conducted. CHS and Affiliates may, but need not, use an outside advisor to conduct a periodic review. The periodic review shall include, at a minimum, the following subjects: 1. Whether compensation arrangements and benefits are reasonable and are the results of arm's-length bargaining. 2. Whether agreements to provide health care and agreements with other health care providers, employees and third party payers further the charitable purposes of CHS and Affiliates and do not result in private inurement or impermissible private benefit. |
| Form 990, Part VI, Line 19 Required documents available to the public | THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE FILED WITH AND VIEWABLE BY THE PUBLIC AT THE OFFICIAL WEBSITE OF THE FLORIDA DEPARTMENT OF STATE, DIVISION OF CORPORATIONS. THE ORGANIZATION'S BYLAWS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. UNAUDITED FINANCIAL STATEMENTS OF THE ORGANIZATION ARE FILED AND VIEWABLE BY THE PUBLIC AT THE OFFICIAL WEBSITE OF THE STATE OF FLORIDA, DIVISION OF CONSUMER SERVICES. IN ADDITION, THE ORGANIZATION REPORTS ITS FINANCIAL PERFORMANCE EACH YEAR IN ITS ANNUAL REPORT, COPIES OF WHICH ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | change in fair value of split interest agreement - 2378; |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| HERNANDO PASCO HOSPICE INC | ||||||||||
| 12470 TELECOM DRIVE suite 300 | TEMPLE TERRACE | FL | 33637 | 592217929 | hospice care | FL | 501(c)(3) | 10 | CHS | false |
| CHAPTERS HEALTH SYSTEM INC | ||||||||||
| 12470 TELECOM DRIVE suite 300 | TEMPLE TERRACE | FL | 33637 | 592264957 | PARENT | FL | 501(c)(3) | Type II | NA | false |
| LIFEPATH HOSPICE INC | ||||||||||
| 12470 TELECOM DRIVE suite 300 | TEMPLE TERRACE | FL | 33637 | 205276870 | HOSPICE CARE | FL | 501(c)(3) | 10 | CHS | false |
| JUDGE ALVA CARVER FOUNDATION INC | ||||||||||
| 12470 TELECOM DRIVE suite 300 | TEMPLE TERRACE | FL | 33637 | 200187631 | SUPPORT | FL | 501(c)(3) | PF | CHS | false |
| CHAPTERS HEALTH HOME CONNECT INC | ||||||||||
| 12470 TELECOM DRIVE suite 300 | TEMPLE TERRACE | FL | 33637 | 275158323 | LONG-TERM CARE | FL | 501(c)(3) | 10 | CHS | false |
| GOOD SHEPHERD HOSPICE INC | ||||||||||
| 12470 TELECOM DRIVE SUITE 300 | TEMPLE TERRACE | FL | 33637 | 205276923 | HOSPICE CARE | FL | 501(c)(3) | 10 | CHS | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
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