2017-11-15T11:59:53-06:00 2016-12-31 BKD LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2016-01-01 431209344 KANSAS CITY HOSPICE INC % TIM MCLANE KANS 8163632600 1500 MEADOW LAKE PARKWAY Suite STE KANSAS CITY MO 64114 DAVID WILEY CEO 2017-11-15 true Kevin R Ensminger CPA P01310558 8162216300 167.68.126.162 43372220173195000023 2017-11-15 P C1C50E2112E104B521C79236899132A3F332F384 5011C478CD965E1643EECA60D757D32451E947F9 2016 2017-02-10 21:41:12Z DAVID WILEY 1500 MEADOW LAKE PKWY STE 200 KANSAS CITY MO 64114 23234121 false X WWW.KANSASCITYHOSPICE.ORG X 1980 MO TO BRING EXPERT CARE, PEACE OF MIND, COMFORT, GUIDANCE AND HOPE TO PEOPLE WHO ARE AFFECTED BY LIFE-THREATENING AND LIFE-LIMITING ILLNESS. 20 19 350 305 0 2968038 6300652 18150904 16798845 0 0 5294 134624 21124236 23234121 0 0 0 0 13998532 14774276 0 0 0 7125704 8459845 21124236 23234121 0 15776035 15443532 10455019 12893245 5321016 2550287 X TO BRING EXPERT CARE, PEACE OF MIND, COMFORT, GUIDANCE AND HOPE TO PEOPLE WHO ARE AFFECTED BY LIFE-THREATENING AND LIFE-LIMITING ILLNESS. false false 18129295 0 16902990 SEE SCHEDULE O 18129295 true true false false false false false false false true true false false false false false false true false false false false false false false false false false false true false false false false false false false false false false false false false true true true false false true 133 0 true 350 true false false false false false false false false false false X 20 19 false false false false false false false true true false false true true true true true true true false false MO X TIM MCLANE 8163632600 1500 MEADOW LAKE PARKWAY SUITE 200 KANSAS CITY MO 64114 DONNA PAYNE CHAIRMAN 1.0 1.0 X X 0 0 0 LYNNE BROWN IMMEDIATE PAST CHAIR 1.0 0.0 X X 0 0 0 JODY A ABBOTT VICE CHAIR 1.0 1.0 X X 0 0 0 BILL TAMMEUS VICE CHAIR 1.0 0.0 X X 0 0 0 ALFRED BIGGS TREASURER 1.0 0.0 X X 0 0 0 MICHELLE STARK KAUFMAN SECRETARY 1.0 0.0 X X 0 0 0 STEVE JONES BOARD MEMBER 1.0 1.0 X 0 0 0 ELAINE MCINTOSH PRES/CEO THRU 9/21 40.0 1.0 X X 269865 0 14697 SHERRY AINSWORTH BOARD MEMBER 1.0 0.0 X 0 0 0 RICHARD H CULL BOARD MEMBER 1.0 0.0 X 0 0 0 SHEILAHN E DAVIS-WYATT BOARD MEMBER 1.0 1.0 X 0 0 0 NANCY DEBASIO BOARD MEMBER 1.0 0.0 X 0 0 0 BILL INTRATER BOARD MEMBER 1.0 0.0 X 0 0 0 RON JONES BOARD MEMBERS 1.0 0.0 X 0 0 0 BARBARA LUKERT BOARD MEMBER 1.0 0.0 X 0 0 0 FRAN MARTINSEN BOARD MEMBER 1.0 1.0 X 0 0 0 SUSAN PINGLETON BOARD MEMBER 1.0 0.0 X 0 0 0 ROBERT E PLUENNEKE BOARD MEMBER 1.0 0.0 X 0 0 0 JOHN M SINNETT JR BOARD MEMBER 1.0 1.0 X 0 0 0 ROBERT WOOD BOARD MEMBER 1.0 0.0 X 0 0 0 BILL DICHISER CHIEF FINANCIAL OFFICER 40.0 1.0 X 108303 0 41837 DAVID WILEY COO/CEO STARTING 9/21 40.0 1.0 X 188571 0 1870 JAY RISEMAN PHYSICIAN 40.0 0.0 X 152544 0 21592 PAMELA HARRIS PHYSICIAN 40.0 0.0 X 180106 0 29011 GLORIA SOENDKER DIRECTOR OF CLINICAL SERVICES 40.0 0.0 X 101262 0 2924 DAVID DUGAN PHYSICIAN 40.0 0.0 X 161936 0 22442 1162587 0 134373 7 false true false HMP BLUE SPRINGS BLUE SPRINGS MO 64014 MEDICAL EQUIPMENT 208805 MCCONNEL ASSOCIATES 1225 IRON ST NORTH KANSAS CITY MO 64116 PAVEMENT REPAIR 164100 VERIZON WIRELESS KANSAS CITY KANSAS CITY MO 64114 CELL PHONES 124125 ECLIPSE HEALTHCARE LLC KANSAS CITY KANSAS CITY MO 64116 THERAPY 116987 KENTFIELD PHARMACY UVANTA 11144 RENNER ROAD LENEXA KS 66219 PHARMACY 881583 6 6300652 6300652 PATIENT SERVICE REVENUE 621300 16185665 16185665 NURSING HOME SUPPORT 621300 613180 613180 16798845 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 MISCELLANEOUS REVENUE 900099 134624 134624 134624 23234121 16798845 134624 0 0 0 0 625143 504541 120602 0 11553982 9325004 2228978 130779 106934 23845 1607443 1135124 472319 856929 677456 179473 0 119346 119346 64654 64654 0 0 0 923438 529464 393974 0 125127 18355 106772 660267 486196 174071 351079 277352 73727 0 775711 199567 576144 377027 336627 40400 19085 19085 9769 4025 5744 252709 252709 0 802927 549944 252983 415816 415816 MEDICARE ROOM & BOARD 579272 579272 BAD DEBT EXPENSE 1903332 1903332 PATIENT TRANSPORTATION 90046 90046 MEDICAL SUPPLIES 449768 449768 540472 540472 23234121 18129295 5104826 0 123314 290952 9909 1744 0 0 3532070 3695995 0 0 0 0 0 0 0 0 277048 194065 20220555 8984173 11807527 11236382 0 0 0 0 0 0 0 0 26167 24394 15776035 15443532 2134909 2133171 0 0 0 17254 0 0 0 0 0 0 8320110 10742820 0 0 0 0 10455019 12893245 X 5287877 2517148 33139 33139 0 0 5321016 2550287 15776035 15443532 X 0 -2770729 X false true X true false X 2787926 2281380 3251854 2968038 6300652 17589850 20024584 20343706 18423933 18150904 16798845 93741972 0 0 0 22812510 22625086 21675787 21118942 23099497 111331822 0 0 0 111331822 284 2946 5 3235 0 284 2946 5 3235 0 74400 9738 31348 5294 134624 255404 22887194 22637770 21707140 21124236 23234121 111590461 0.99768 0.99828 0.00003 0.00003 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1337300 115812 87348 6417 1359347 1341121 52910 -49710 0 7021 1337300 1323359 87278 62589 6927 1341121 1285488 232007 187589 6547 1323359 1130348 102060 163938 110858 1285488 0.15680 0.84320 false true true 1571077 1571077 13039301 4532380 8506921 618810 260070 358740 4991367 4191723 799644 11236382 26501254 3267133 3267133 23234121 23234121 32694427 9460306 9460306 23234121 23234121 SCHEDULE D, PART V, LINE 4 THE ENDOWMENT FUNDS ARE REPORTED AS PERMANENTLY RESTRICTED NET ASSETS ON THE FINANCIAL STATEMENTS OF KANSAS CITY HOSPICE FOUNDATION. THE ENDOWMENT CONSISTS OF 2 DONOR RESTRICTED FUNDS. NET ASSETS ASSOCIATED WITH THE ENDOWMENT FUND ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR IMPOSED RESTRICTIONS. DONOR RESTRICTIONS CONFORM TO THE ORGANIZATION'S MISSION. THE POLSKY FAMILY SUPPORTING FOUNDATION ENDOWMENT, A DONOR RESTRICTED ENDOWMENT, OPERATES UNDER THE FOLLOWING GUIDELINES. THE PURPOSE OF THE ENDOWMENT IS TO PROVIDE FUNDS TO: 1) TEACH MEMBERS/OFFICERS/TRUSTEES/STAFF PRINCIPLES OF PRUDENT INVESTING AND BY RECEIVING AND CONSIDERING PERIODIC INVESTMENT RECOMMENDATIONS FROM NORMAN POLSKY OR HIS SUCCESSOR, AND/OR 2) FOSTER STAFF DEVELOPMENT THROUGH FORMAL EDUCATION, REGULAR TRAINING, ATTENDANCE AT INDUSTRY CONFERENCES AND EVENTS, AND WHATEVER OTHER STAFF PROGRAMS THE KCHF BOARD DETERMINES TO BE APPROPRIATE, AND/OR 3) FOSTER AND ENCOURAGE FUND RAISING BY HIRING A SUCCESSFUL PROFESSIONAL FUND RAISER CAPABLE OF TEACHING THE STAFF AND THE PROFESSIONAL VOLUNTEER OFFICERS OF KCH, AND/OR 4) FOSTER IMPROVED PUBLIC RELATIONS FOR KCH BY HIRING A PROFESSIONAL TO TEACH THE STAFF AND OFFICERS AND/OR 5) ENCOURAGE RESEARCH AND EDUCATION, EDUCATIONAL ACCREDITATION AND OTHER SIMILAR ACTIVITIES, AND/OR 6) ESTABLISH AN ARCHIVE OF KCHF TO PRESERVE THE HISTORY, AND/OR 7) ESTABLISH A PROGRAM RECOGNIZING AND UTILIZING MORE OF THE PAST OFFICERS, BOARD MEMBERS AND STAFF, AND/OR 8) CARRY ON ANY OTHER ACTIVITIES CONSISTENT WITH KCH TAX-EXEMPT STATUS AND AS DETERMINED BY KCH BOARD OF DIRECTORS, EXCEPT THAT NO PART OF THE ENDOWMENT PRINCIPAL MAY BE USED TO DEFRAY OPERATING EXPENSES SUCH AS, WITHOUT LIMITATION, RENT, PAYROLL, EMPLOYEE BENEFIT PROGRAMS, EQUIPMENT PURCHASES, LEASES, AND SUPPLIES-UNLESS SPECIFICALLY APPROVED IN WRITING IN ADVANCE BY PFSF. THE SECOND ENDOWMENT, THE COMMUNITY HEALTH GROUP ENDOWMENT, OPERATES UNDER THE FOLLOWING GUIDELINES: 1) TO ESTABLISH, OPERATE, SUPPORT, PROVIDE THE CAPITAL REQUIREMENTS OF, AND MAINTAIN HOSPITALS, INPATIENT FACILITIES, CLINICS, LABORATORIES, OFFICE BUILDINGS, PHARMACIES, AND ALL MEASURE OF FACILITIES AND PROGRAMS FOR OR RELATING TO, THE STUDY OR CARE OF THE HUMAN MIND AND BODY OR ANY PART THEREOF, AND 2) TO FOSTER THE HEALTH OF THE COMMUNITY AND TO ENGAGE IN EDUCATIONAL ACTIVITIES, RESEARCH AND OPERATIONS RELATED THERETO. SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D RELATED ORGANIZATION REVENUE $ 9,567,785 ELIMINATIONS $ (6,300,652) ------------- $ 3,267,133 SCHEDULE D, PART XII, LINE 2D RELATED ORGANIZATION EXPENSE $ 15,760,958 ELIMINATIONS $ (6,300,652) ------------- $ 9,460,306 X X X false true false false false false false false false ELAINE MCINTOSH PRES/CEO THRU 9/21 241076 0 0 0 28789 0 5098 0 9599 0 284562 0 0 0 BILL DICHISER CHIEF FINANCIAL OFFICER 108303 0 0 0 0 0 3458 0 38379 0 150140 0 0 0 DAVID WILEY COO/CEO STARTING 9/21 188571 0 0 0 0 0 0 0 1870 0 190441 0 0 0 JAY RISEMAN PHYSICIAN 152544 0 0 0 0 0 4107 0 17485 0 174136 0 0 0 PAMELA HARRIS PHYSICIAN 180106 0 0 0 0 0 250 0 28761 0 209117 0 0 0 DAVID DUGAN PHYSICIAN 161936 0 0 0 0 0 404 0 22038 0 184378 0 0 0 SCHEDULE J, PART I, LINE 4B ELAINE MCINTOSH, CEO, IS AWARDED BENEFITS INCLUDING THE CHOICE OF MUTUAL FUNDS, LIFE INSURANCE, AND OTHER SIMILAR ASSETS FOR 2016. AMOUNTS RELATING TO THIS PLAN WERE CREDITED TO A CAPITAL ACCUMULATION ACCOUNT. CONTRIBUTIONS MADE PRIOR TO 2013 CARRIED A 2-YEAR VESTING PERIOD. FORM 990, PART III, LINE 4A KANSAS CITY HOSPICE, INC IS A NONPROFIT ORGANIZATION OFFERING A RANGE OF SERVICES FOR PEOPLE OF ALL AGES AND AT ANY STAGE OF SERIOUS ILLNESS. WE'VE BEEN PROVIDING COMFORT AND CARE TO THE SERIOUSLY ILL AND THEIR FAMILIES IN THE GREATER KANSAS CITY AREA SINCE 1980. A) KANSAS CITY HOSPICE HOMECARE PROGRAM - KANSAS CITY HOSPICE PROVIDES IN HOME (WHETHER IT BE A HOME, LONG TERM CARE FACILITY, ASSISTED LIVING FACILITY OR OTHER TYPE OF HOME) CARE TO PATIENTS RESIDING IN TEN COUNTIES. IN THE KANSAS CITY METROPOLITAN AREA SPECIALLY TRAINED STAFF, OF MULTIPLE DISCIPLINES, HELPS PATIENTS AND THEIR LOVED ONES WITH THE CHALLENGES OF LIFE-THREATENING ILLNESSES. WE HAD 1,203 ADMISSIONS AND 64,413 TOTAL CARE DAYS IN THIS YEAR. B) INPATIENT FACILITY HOSPICE HOUSE - IN APRIL OF 2006, KANSAS CITY HOSPICE OPENED THE FIRST INPATIENT HOSPICE FACILITY IN THE KANSAS CITY METROPOLITAN AREA. THE KANSAS CITY HOSPICE HOUSE PROVIDES THE COMFORTS OF HOME COUPLED WITH THE ADDITION OF EXPERTS AT THE PATIENT'S SIDE. THE 32-BED FACILITY ADDRESSES NOT ONLY MEDICAL AND NURSING CARE FOR PATIENTS FACING ADVANCED ILLNESSES, BUT ALSO EMOTIONAL AND SPIRITUAL SUPPORT FOR PATIENTS AND THEIR FAMILIES. THIS PROGRAM IS A SUPPLEMENT TO OUR HOMECARE PROGRAM IN THAT IT IS USED WHEN MEDICAL PROBLEMS ARE TOO SERIOUS TO MANAGE IN THE HOME SETTING. WE HAD 644 ADMISSIONS AND 5,852 CARE DAYS IN THIS YEAR. C) KANSAS CITY HOSPICE PALLIATIVE HOME HEALTH PROGRAM - THE PALLIATIVE HOME HEALTH PROGRAM IS LIKE OUR HOSPICE PROGRAM. AN INTERDISCIPLINARY TEAM FOCUSES ON SPECIALIZED MANAGEMENT OF PAIN AND OTHER SYMPTOMS. THE TEAM ADDRESSES EMOTIONAL NEEDS OF THE PATIENT AND FAMILY. ITS GOAL IS TO MAKE THE MOST OF THE REMAINING LIFE OF THE PATIENT. THE PROGRAM SERVES PEOPLE WHO HAVE LIFE-THREATENING ILLNESSES, BUT WHO WANT TO CONTINUE SEEKING CURATIVE TREATMENT OR WHO DO NOT WISH TO ELECT HOSPICE CARE. KANSAS CITY HOSPICE ALSO HAS A PALLIATIVE MEDICINE PROGRAM WHICH IS A PHYSICIAN SERVICE FOCUSING ON IMPROVING THE QUALITY OF LIFE FOR PATIENTS FACING LIFE-LIMITING ILLNESSES. THE PROGRAM ALSO ASSISTS PATIENTS' FAMILIES. CARE IS CONCENTRATED ON PREVENTING AND RELIEVING SUFFERING THROUGH TREATING PAIN AND SYMPTOMS AS WELL AS BY PROVIDING EMOTIONAL AND SPIRITUAL SUPPORT. WE HAD 485 ADMISSIONS AND 32,708 CARE DAYS IN THIS YEAR. D) CAROUSEL PROGRAM - WE HAVE A PEDIATRIC PROGRAM. OUR TEAM OF PROFESSIONALS PROVIDES SUPPORT TO FAMILIES. WHEN HOME IS NOT THE IDEAL SETTING OUR HOSPICE HOUSE IS AVAILABLE. WE CARED FOR 40 FAMILIES IN 2016. ADDITIONAL SERVICES TO CHILDREN INCLUDES GRIEF SUPPORT GROUP AND INDIVIDUAL COUNSELING PROGRAMS CALLED SOLACE HOUSE. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN WAS PREPARED BY AN INDEPENDENT CERTIFIED PUBLIC ACCOUNTANT WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT OF KANSAS CITY HOSPICE, INC. THE KANSAS CITY HOSPICE, INC BOARD MEMBERS ARE PROVIDED A COPY OF THE KANSAS CITY HOSPICE, INC'S FORM 990 FOR PERSONAL REVIEW PRIOR TO SUBMISSION WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND OFFICERS ARE ASKED TO COMPLETE A CONFLICT OF INTEREST FORM ANNUALLY. THE KCH BOARD EXECUTIVE COMMITTEE REVIEWS ALL FORMS WITH CONFLICTS. BOARD MEMBERS WILL ABSTAIN FROM PARTICIPATION IN PERTINENT DISCUSSION IF APPLICABLE WHEN CONFLICT OF INTEREST SITUATIONS ARISE. THE CONFLICT OF INTEREST FORM IS COMPLETED ANNUALLY BY ALL ONGOING BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINES 15A & 15B THE CEO'S SALARY IS REVIEWED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. AN OUTSIDE COMPENSATION CONSULTANT'S COMPENSATION REVIEW IS RETAINED APPROXIMATELY EVERY THREE YEARS. THE CEO AND DIRECTOR OF HUMAN RESOURCES DETERMINE THE COMPENSATION FOR OFFICERS AND KEY MANAGEMENT PERSONNEL (WITH THE EXCEPTION OF THE CEO POSITION ITSELF). THREE SOURCES OF MARKET DATA ARE USED WHICH SPECIALIZE IN THE HOSPICE AND HEALTHCARE INDUSTRY. FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 REQUESTS FOR INFORMATION ON FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND THE CONFLICT OF INTEREST POLICY ARE EVALUATED ON A CASE BY CASE BASIS BY THE ORGANIZATION'S MANAGEMENT. FORM 990, PART XI, LINE 9 NET ASSETS TRANSFERRED TO FOUNDATION ($2,770,729) KANSAS CITY HOSPICE FOUNDATION INC 1500 MEADOW LAKE PKWY STE 200 KANSAS CITY MO 64114 431724085 SUPPORT MO 501(C)(3) 12A KC HOSPICE true NORTHCARE HOSPICE & PALLIATIVE CARE 2000 N VIVION KANSAS CITY MO 64118 431724225 HOSPICE MO 501(C)(3) 10 KC HOSPICE true false false true false false false false false false false false false true true true true true true true KANSAS CITY HOSPICE FOUNDATION C 6300652 FMV KANSAS CITY HOSPICE FOUNDATION R 2770729 FMV