MONTGOMERY HOSPICE INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- MONTGOMERY HOSPICE INC (EIN 52-1114719)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-09-05
- IRS object ID
- 201722489349300147
- 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 | 2017-09-05T10:48:08-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 901 N GLEBE ROAD SUITE 200 | AddressLine1Txt |
| City | ARLINGTON | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22203 | 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 | 521114719 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONTGOMERY HOSPICE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MONT | BusinessNameControlTxt |
| Phone | 3019214400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1355 PICCARD DRIVE NO 100 | AddressLine1Txt |
| City | ROCKVILLE | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 20850 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANN MITCHELL | PersonNm |
| Person Title | PRESIDENT & CEO | PersonTitleTxt |
| Phone | 3019214400 | PhoneNum |
| Signature | 2017-08-21 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | YUNG-HEE GALLINARO | PreparerPersonNm |
| PTIN | P00035293 | PTIN |
| Phone | 5712279500 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.137.57.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-08-21 | IPDt |
| IP Tm | 08:35:40 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 59B53FFCCAC8D9707D774CF4CBA105A4CA80244F | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | D4C9CCF27C82EE891DBBD0A0F5B8A17B08786766 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ANN MITCHELL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1355 PICCARD DRIVE NO 100 | AddressLine1Txt |
| City | ROCKVILLE | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 20850 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $30,028,167 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MONTGOMERYHOSPICE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1979 | FormationYr |
| Legal Domicile State | MD | LegalDomicileStateCd |
| Activity Or Mission | TO GENTLE THE JOURNEY THROUGH SERIOUS ILLNESS AND LOSS WITH SKILL AND COMPASSION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 22 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 21 | VotingMembersIndependentCnt |
| Total Employee | 319 | TotalEmployeeCnt |
| Total Volunteers | 315 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,870,904 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,312,176 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $22,248,199 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $24,503,528 | CYProgramServiceRevenueAmt |
| PY Investment Income | $994,036 | PYInvestmentIncomeAmt |
| CY Investment Income | $389,867 | CYInvestmentIncomeAmt |
| PY Other Revenue | $17,876 | PYOtherRevenueAmt |
| CY Other Revenue | -$55,073 | CYOtherRevenueAmt |
| PY Total Revenue | $25,131,015 | PYTotalRevenueAmt |
| CY Total Revenue | $26,150,498 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | 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 | $17,587,788 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $19,812,513 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $427,840 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,210,607 | PYOtherExpensesAmt |
| CY Other Expenses | $5,653,881 | CYOtherExpensesAmt |
| PY Total Expenses | $22,798,395 | PYTotalExpensesAmt |
| CY Total Expenses | $25,466,394 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,332,620 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $684,104 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $23,943,011 | TotalAssetsBOYAmt |
| Total Assets EOY | $25,647,701 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,223,267 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,001,811 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $21,719,744 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $22,645,890 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO GENTLE THE JOURNEY THROUGH SERIOUS ILLNESS AND LOSS WITH SKILL AND COMPASSION. TO BRING COMFORT BY PROVIDING COMPASSIONATE, PROFESSIONAL CARE TO COMMUNITY RESIDENTS WHO ARE FACING SERIOUS ILLNESS AND LOSS. TO PROVIDE DIGNITY FOR THE DYING AND UNCONDITIONAL COMPASSION, THROUGH DEDICATION AND COLLABORATION. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $22,970,926 | ExpenseAmt |
| Revenue | $24,503,528 | RevenueAmt |
| Desc | HOSPICE AND BEREAVEMENT SERVICES: THE ORGANIZATION PROVIDES SPECIALIZED MEDICAL AND PSYCHOSOCIAL END-OF-LIFE CARE TO MONTGOMERYCOUNTY, MARYLAND RESIDENTS LIVING WITH A LIFE LIMITING ILLNESS, AS WELL AS, THEIR FAMILIES, WITH AN INTERDISCIPLINARY TEAM OF TRAINED PROFESSIONALS (AND VOLUNTEERS). IN ADDITION TO CONVENTIONAL MEDICAL CARE, MONTGOMERY HOSPICE USES HOLISTIC THERAPIES AND SERVICES FOR COMFORT AND SYMPTOM RELIEF, CUSTOMIZED FOR EACH PATIENT. IN 2016, MONTGOMERY HOSPICE SERVED 2,132 PATIENTS AND THEIR FAMILIES. AMONG THE TOTAL PATIENTS SERVED, 17 WERE CHILDREN AND 64 WERE EITHER UNINSURED OR UNDERINSURED. OUR INPATIENT UNIT, CASEY HOUSE, IS THE ONLY ALL-HOSPICE ACUTE FACILITY IN MONTGOMERY COUNTY. IN 2016, 483 PATIENTS WITH SERIOUS PAIN OR OTHER SYMPTOMS RECEIVED INTENSIVE NURSING AND MEDICAL CARE AND ATTENTION AT CASEY HOUSE. MONTGOMERY HOSPICE ALSO PROVIDED BEREAVEMENT SERVICES TO ALMOST 5,800 INDIVIDUALS AND 3,000 YOUNG ADULTS, AND END-OF-LIFE CARE EDUCATION TO MORE THAN 1,450 PEOPLE, INCLUDING HEALTHCARE PROFESSIONALS, AND INTERACTED WITH 2,800 MORE AT COMMUNITY HEALTH FAIRS. | Desc |
| Total Program Service Expenses | $22,970,926 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 12 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 319 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 22 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 21 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MD | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MONICA ESCALANTE CFO | PersonNm |
| Phone | 3019214400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1355 PICCARD DRIVE | AddressLine1Txt |
| City | ROCKVILLE | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 20850 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| ANN MITCHELL | ||||||||
| PRESIDENT & CEO | 46.00 | Yes (X) | Yes (X) | $229,389 | $0 | $14,388 | ||
| PAUL E ALPUCHE JR ESQ | ||||||||
| CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| STERLING KING JR DRPH | ||||||||
| IMMEDIATE PAST CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| LYA MALL KARM MD | ||||||||
| VICE CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BERYL L FEINBERG | ||||||||
| IMMEDIATE PAST CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DEBORA S MCGREGOR | ||||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL G BANKS ESQ | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BRIAN A CARPENTER MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SENATOR BRIAN J FELDMAN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SAFIA S KADIR ESQ | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ELMA M LEVY | ||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BARRY R MEIL | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| GERMAN PARAUD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DARREN M POPKIN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| STEVEN V ROBERTS | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RONALD J RUBIN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KATHY TORRENCE | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RANDALL P WAGNER MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DONGMEI WANG MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DELEGATE BONNIE L CULLISON | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| AMY E DIAS ESQ | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CESAR E PALACIOS | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BRADLEY H COLTON | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SUSAN L GLOVER | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SURESH K GUPTA MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DIANE K KUWAMURA ESQ | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CYNTHIA A MESMER | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MONICA ESCALANTE | ||||||||
| CFO/COO | 45.00 | Yes (X) | $184,199 | $0 | $11,546 | |||
| GEOFFREY COLEMAN MD | ||||||||
| MEDICAL DIRECTOR | 44.00 | $201,087 | $0 | $23,703 | Yes (X) | |||
| MILLICENT WHYTE-HIGGINS | ||||||||
| SR. VP OF NURSING SERVICES | 52.00 | $161,377 | $0 | $12,387 | Yes (X) | |||
| GRACE HUFFMAN | ||||||||
| ASSOCIATE MEDICAL DIRECTOR | 41.00 | $136,398 | $0 | $852 | Yes (X) | |||
| JANET CAUFFIEL | ||||||||
| VP OF HUMAN RESOURCES | 42.00 | $144,232 | $0 | $6,077 | Yes (X) | |||
| CHANTAL HLONTOR | ||||||||
| PRIMARY NURSE | 61.00 | $132,412 | $0 | $390 | Yes (X) | |||
| HELEN WELLS | ||||||||
| PRIMARY NURSE | 47.00 | $117,743 | $0 | $12,253 | Yes (X) | |||
| MARLENE BRADFORD | ||||||||
| VP OF PHILANTHROPY | 43.00 | $116,888 | $0 | $11,237 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,423,725 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $92,833 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 20 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HOSPICE PHARMACY SOLUTIONS | |||||
| PO BOX 93689 | SOUTHLAKE | TX | 76092 | PHARMACY | $914,657 |
| MEDLINE INDUSTRIES INC | |||||
| BOX 382075 | PITTSBURGH | PA | 15251 | MEDICAL SUPPLIES | $443,548 |
| ADVANCED THERAPEUTICS | |||||
| 9200 RUMSEY RD SUITE 105 | COLUMBIA | MD | 21045 | MEDICAL EQUIPMENT | $414,486 |
| JOERNS HEALTHCARE | |||||
| 2430 WHITEHALL PARK DR SUITE 100 | CHARLOTTE | NC | 28273 | MEDICAL EQUIPMENT | $332,257 |
| FAVORITE HEALTHCARE STAFFING | |||||
| PO BOX 8033 | KANSAS CITY | MO | 641803356 | TEMPORARY NURSING SERVICE | $157,030 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $51,502 | FederatedCampaignsAmt |
| Fundraising | $46,920 | FundraisingAmt |
| All Other Contributions | $1,213,754 | AllOtherContributionsAmt |
| Noncash Contributions | $10,709 | NoncashContributionsAmt |
| Total Contributions | $1,312,176 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $24,503,528 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $24,503,528 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $24,503,528 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $503,953 | TotalRevenueColumnAmt |
| Exclusion | $503,953 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,752,747 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,866,833 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$114,086 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$114,086 | TotalRevenueColumnAmt |
| Exclusion | -$114,086 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | -$46,920 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $46,920 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $10,836 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$57,756 | TotalRevenueColumnAmt |
| Exclusion | -$57,756 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,683 | TotalRevenueColumnAmt |
| Exclusion | $2,683 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,683 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $26,150,498 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $24,503,528 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $334,794 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $866,425 | TotalAmt |
| Program Services | $410,258 | ProgramServicesAmt |
| Management And General | $394,678 | ManagementAndGeneralAmt |
| Fundraising | $61,489 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,877,726 | TotalAmt |
| Program Services | $14,477,487 | ProgramServicesAmt |
| Management And General | $1,144,768 | ManagementAndGeneralAmt |
| Fundraising | $255,471 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $375,634 | TotalAmt |
| Program Services | $333,973 | ProgramServicesAmt |
| Management And General | $35,656 | ManagementAndGeneralAmt |
| Fundraising | $6,005 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,521,150 | TotalAmt |
| Program Services | $1,274,462 | ProgramServicesAmt |
| Management And General | $218,298 | ManagementAndGeneralAmt |
| Fundraising | $28,390 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,171,578 | TotalAmt |
| Program Services | $1,037,971 | ProgramServicesAmt |
| Management And General | $109,955 | ManagementAndGeneralAmt |
| Fundraising | $23,652 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,685 | TotalAmt |
| Management And General | $27,685 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,396 | TotalAmt |
| Management And General | $42,396 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,025 | TotalAmt |
| Management And General | $53,025 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,548,991 | TotalAmt |
| Program Services | $1,508,947 | ProgramServicesAmt |
| Management And General | $40,044 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,031 | TotalAmt |
| Program Services | $97,031 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $408,221 | TotalAmt |
| Program Services | $35,725 | ProgramServicesAmt |
| Management And General | $371,329 | ManagementAndGeneralAmt |
| Fundraising | $1,167 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $204,393 | TotalAmt |
| Program Services | $11,381 | ProgramServicesAmt |
| Management And General | $177,345 | ManagementAndGeneralAmt |
| Fundraising | $15,667 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $609,550 | TotalAmt |
| Program Services | $255,280 | ProgramServicesAmt |
| Management And General | $354,270 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $339,002 | TotalAmt |
| Program Services | $335,603 | ProgramServicesAmt |
| Management And General | $2,959 | ManagementAndGeneralAmt |
| Fundraising | $440 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,441 | TotalAmt |
| Program Services | $46,809 | ProgramServicesAmt |
| Management And General | $4,176 | ManagementAndGeneralAmt |
| Fundraising | $34,456 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,452 | TotalAmt |
| Management And General | $16,452 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $221,032 | TotalAmt |
| Program Services | $144,201 | ProgramServicesAmt |
| Management And General | $76,831 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,021 | TotalAmt |
| Program Services | $36,720 | ProgramServicesAmt |
| Management And General | $65,301 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| PHARMACY PURCHASES | $919,110 | $919,110 | ||
| MEDICAL SUPPLIES | $535,836 | $535,836 | ||
| EQUIPMENT LEASE/PURCHAS | $318,748 | $5,959 | $312,789 | |
| DUES & PUBLICATION | $66,931 | $10,050 | $55,755 | $1,126 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,016 | TotalAmt |
| Program Services | $1,494,123 | ProgramServicesAmt |
| Management And General | -$1,436,084 | ManagementAndGeneralAmt |
| Fundraising | -$23 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,466,394 | TotalAmt |
| Program Services | $22,970,926 | ProgramServicesAmt |
| Management And General | $2,067,628 | ManagementAndGeneralAmt |
| Fundraising | $427,840 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $700 | BOYAmt |
| EOY | $700 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,947,032 | BOYAmt |
| EOY | $4,782,309 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,061 | BOYAmt |
| EOY | $49,316 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,082,727 | BOYAmt |
| EOY | $2,933,323 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $324,909 | BOYAmt |
| EOY | $330,237 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,999,769 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,142,138 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,940,242 | BOYAmt |
| EOY | $2,857,631 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,606,340 | BOYAmt |
| EOY | $14,694,185 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,943,011 | BOYAmt |
| EOY | $25,647,701 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,175,041 | BOYAmt |
| EOY | $2,939,325 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,226 | BOYAmt |
| EOY | $62,486 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,223,267 | BOYAmt |
| EOY | $3,001,811 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,397,678 | BOYAmt |
| EOY | $17,491,598 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,015,283 | BOYAmt |
| EOY | $791,914 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,306,783 | BOYAmt |
| EOY | $4,362,378 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,719,744 | BOYAmt |
| EOY | $22,645,890 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,943,011 | BOYAmt |
| EOY | $25,647,701 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $684,104 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $242,042 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $791,825 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $794,435 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,301,665 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,870,904 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,354,491 | CurrentTaxYearAmt |
| Total | $7,113,320 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $22,144,610 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $21,088,768 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $20,898,450 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $22,349,027 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $24,465,613 | CurrentTaxYearAmt |
| Total | $110,946,468 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $22,936,435 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $21,883,203 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $23,200,115 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $24,219,931 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $25,820,104 | CurrentTaxYearAmt |
| Total | $118,059,788 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $118,059,788 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,975 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,480 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $335,335 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $361,494 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $503,953 | CurrentTaxYearAmt |
| Total | $1,211,237 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,975 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,480 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $335,335 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $361,494 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $503,953 | CurrentTaxYearAmt |
| Total | $1,211,237 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,166 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $34,827 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,794 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $17,477 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,683 | CurrentTaxYearAmt |
| Total | $73,947 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $22,952,576 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $21,921,510 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $23,545,244 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $24,598,902 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $26,326,740 | CurrentTaxYearAmt |
| Total | $119,344,972 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.98920 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99320 | PublicSupportPY509Pct |
| Investment Income CY | 0.01010 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00620 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | OTHER INCOME - 2012 AMOUNT: $ 6,000. 2013 AMOUNT: $ 32,205. 2014 AMOUNT: $ 357. 2015 AMOUNT: $ 15,772. 2016 AMOUNT: $ 42. MEALS - NON-PATIENT - 2012 AMOUNT: $ 3,166. 2013 AMOUNT: $ 2,622. 2014 AMOUNT: $ 1,518. 2015 AMOUNT: $ 1,705. 2016 AMOUNT: $ 2,641. GAIN ON LEASE TERMINATION - 2014 AMOUNT: $ 7,919. | ExplanationTxt |
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
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,562,932 | BeginningYearBalanceAmt |
| Contributions | $800 | ContributionsAmt |
| Investment Earnings Or Losses | $347,615 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $177,956 | OtherExpendituresAmt |
| End Year Balance | $6,733,391 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,733,056 | BeginningYearBalanceAmt |
| Contributions | $590 | ContributionsAmt |
| Investment Earnings Or Losses | -$8,524 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $162,190 | OtherExpendituresAmt |
| End Year Balance | $6,562,932 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,220,799 | BeginningYearBalanceAmt |
| Contributions | $2,458,595 | ContributionsAmt |
| Investment Earnings Or Losses | $190,966 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $137,304 | OtherExpendituresAmt |
| End Year Balance | $6,733,056 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,877,148 | BeginningYearBalanceAmt |
| Contributions | $71,994 | ContributionsAmt |
| Investment Earnings Or Losses | $396,770 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $125,113 | OtherExpendituresAmt |
| End Year Balance | $4,220,799 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,695,745 | BeginningYearBalanceAmt |
| Contributions | $36,095 | ContributionsAmt |
| Investment Earnings Or Losses | $268,010 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $122,702 | OtherExpendituresAmt |
| End Year Balance | $3,877,148 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.30300 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.64790 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.04910 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,082,200 | OtherCostOrOtherBasisAmt |
| Book Value | $1,082,200 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,506,838 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,123,299 | DepreciationAmt |
| Book Value | $1,383,539 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $264,187 | OtherCostOrOtherBasisAmt |
| Depreciation | $36,046 | DepreciationAmt |
| Book Value | $228,141 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $594,962 | OtherCostOrOtherBasisAmt |
| Depreciation | $585,758 | DepreciationAmt |
| Book Value | $9,204 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $551,582 | OtherCostOrOtherBasisAmt |
| Depreciation | $397,035 | DepreciationAmt |
| Book Value | $154,547 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,857,631 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $26,388,058 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $242,042 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $37,707 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $10,836 | OtherRevenueAmt |
| Revenue Not Reported | $290,585 | RevenueNotReportedAmt |
| Revenue Subtotal | $26,097,473 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $53,025 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $53,025 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $26,150,498 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $25,461,912 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $37,707 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $10,836 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $48,543 | ExpensesNotReportedAmt |
| Expenses Subtotal | $25,413,369 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $53,025 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $53,025 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $25,466,394 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE ENDOWMENT FUNDS RESULTED FROM DONOR-RESTRICTED FUNDS FOR SUPPORT OF SEVERAL HOSPICE PROGRAM ACTIVITIES. CONTRIBUTIONS FROM MAJOR DONORS WERE RESTRICTED TO THE OPERATIONS, MAINTENANCE AND PATIENT CARE AT THE HOSPICE'S INPATIENT ACUTE CARE FACILITY. DONORS HAVE ALSO CONTRIBUTED TO THE FUNDING OF NURSING SERVICES PROVIDED AT THE INPATIENT HOSPICE. THE HOSPICE IN-HOME SERVICES ARE BEING SUPPORTED TO PROVIDE MEDICAL CARE SERVICES BY PHYSICIANS, NURSES, SOCIAL WORKERS AND HOSPICE AIDES. THE ENDOWMENTS ALSO SUPPORT CHARITY CARE AND THE UNCOMPENSATED SERVICES PROVIDED TO PATIENTS AND THEIR FAMILIES THROUGH BEREAVEMENT AND PASTORAL CARE SUPPORT. |
| PART X, LINE 2: | THE HOSPICE IS A TAX-EXEMPT ENTITY AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). PALLIATIVE MEDICINE IS A LIMITED LIABILITY COMPANY WHOSE OPERATING RESULTS FLOW THROUGH TO THE HOSPICE, WHICH IS ITS SOLE CORPORATE MEMBER. NEITHER OF THESE ENTITIES ARE CLASSIFIED AS A PRIVATE FOUNDATION AS DEFINED BY THE INTERNAL REVENUE SERVICE. THE IRC PROVIDES FOR TAXATION OF UNRELATED BUSINESS INCOME UNDER CERTAIN CIRCUMSTANCES. THE HOSPICE AND ITS AFFILIATED ENTITIES HAVE NO SIGNIFICANT UNRELATED BUSINESS INCOME; HOWEVER, SUCH STATUS IS SUBJECT TO FINAL DETERMINATION UPON EXAMINATION OF THE RELATED INCOME TAX RETURNS BY THE APPROPRIATE TAXING AUTHORITIES. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | SPECIAL EVENT EXPENSES 10,836. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | SPECIAL EVENT EXPENSES 10,836. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | TREE OF LIGHTS | Event1Nm |
| Charitable Contri Event1 | $46,920 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | -$46,920 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $2,350 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $1,500 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $300 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $6,686 | OtherDirectExpensesEvent1Amt |
| Charitable Contributions Tot | $46,920 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | -$46,920 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $2,350 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $1,500 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $300 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $6,686 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $10,836 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$57,756 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANN MITCHELL | ||||||||||||||
| PRESIDENT & CEO | $219,139 | $0 | $10,250 | $0 | $0 | $0 | $6,857 | $0 | $7,531 | $0 | $243,777 | $0 | $0 | $0 |
| MONICA ESCALANTE | ||||||||||||||
| CFO/COO | $183,949 | $0 | $250 | $0 | $0 | $0 | $5,611 | $0 | $5,935 | $0 | $195,745 | $0 | $0 | $0 |
| GEOFFREY COLEMAN MD | ||||||||||||||
| MEDICAL DIRECTOR | $200,837 | $0 | $250 | $0 | $0 | $0 | $6,606 | $0 | $17,097 | $0 | $224,790 | $0 | $0 | $0 |
| MILLICENT WHYTE-HIGGINS | ||||||||||||||
| SR. VP OF NURSING SERVICES | $161,127 | $0 | $250 | $0 | $0 | $0 | $4,952 | $0 | $7,435 | $0 | $173,764 | $0 | $0 | $0 |
| JANET CAUFFIEL | ||||||||||||||
| VP OF HUMAN RESOURCES | $143,982 | $0 | $250 | $0 | $0 | $0 | $4,733 | $0 | $1,344 | $0 | $150,309 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE BOARD CHAIRPERSON, BOARD VICE CHAIRPERSON, BOARD SECRETARY, BOARD TREASURER, IMMEDIATE PAST CHAIRPERSON, AND THE PRESIDENT/CEO, AND SUCH OTHER BOARD MEMBERS AS THE BOARD MAY DEEM APPROPRIATE. IT SHALL HAVE AUTHORITY TO CONDUCT ESSENTIAL HOSPICE BUSINESS BETWEEN BOARD MEETINGS, WHEN DELAY IN ACTION WOULD BE DETRIMENTAL TO THE HOSPICE, EXCEPT AS TO THE MATTERS LISTED BELOW AS WELL AS ANY OTHERS IMPOSED BY THE BOARD: 1. AMENDING THE ARTICLES OF INCORPORATION OR THE BYLAWS; 2. APPROVING A PLAN OF MERGER OR CONSOLIDATION; 3. FILLING VACANCIES ON THE HOSPICE BOARD OR THE FOUNDATION BOARD OR REMOVING DIRECTORS OR OFFICERS OF EACH BOARD FROM OFFICE; 4. APPOINTING OR REMOVING MEMBERS OF THE EXECUTIVE COMMITTEE; 5. APPOINTING OR REMOVING ANY OFFICER, THE MEDICAL DIRECTOR OR THE PRESIDENT/CEO, WITHOUT THE APPROVAL OF A MAJORITY OF THE BOARD; 6. APPROVING SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, THE PROPERTY OR ASSETS OF THE HOSPICE; OR 7. APPROVING VOLUNTARY DISSOLUTION OF THE HOSPICE OR REVOCATION OF VOLUNTARY DISSOLUTION PROCEEDINGS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS REVIEWED BY THE PRESIDENT AND MEMBERS OF THE FINANCE COMMITTEE BEFORE FILING. THE CHAIRMAN GIVES A SUMMARY REPORT TO THE BOARD. BOARD MEMBERS CAN REQUEST A COPY OF THE FORM 990 RETURN. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL INDIVIDUALS, UPON APPOINTMENT TO THE BOARD OF DIRECTORS, ANY BOARD DESIGNATED COMMITTEE, OR MONTGOMERY HOSPICE STAFF OR VOLUNTEER POSITION, SHALL BE REQUIRED TO EXAMINE AND SIGN AN INDIVIDUAL STATEMENT REGARDING CONFLICT OF INTEREST. IN THE EVENT A CONFLICT OF INTEREST OR POTENTIAL CONFLICT ARISES, THE CONFLICT OF INTEREST STATEMENT MUST PROMPTLY BE UPDATED AND BROUGHT TO THE ATTENTION OF THE PRESIDENT/CEO AND/OR CHAIRMAN OF THE BOARD. IF THE MATTER CONCERNS A STAFF MEMBER OR VOLUNTEER, THE CHANGE SHOULD BE PRESENTED TO THE INDIVIDUAL'S SUPERVISOR. THE INDIVIDUAL BOARD MEMBERS, WHO HAVE A CONFLICT OF INTEREST WITH THEIR CURRENT BUSINESS RELATIONSHIP AND THE HOSPICE, WILL WITHDRAW THEMSELVES FROM BOARD DISCUSSIONS AND VOTING. |
| FORM 990, PART VI, SECTION B, LINE 15A | REVIEW FOR PRESIDENT/CEO IS CONDUCTED ANNUALLY BY CERTAIN MEMBERS OF THE EXECUTIVE COMMITTEE. MEMBERS MAY INTERVIEW PRESIDENT/CEO'S COLLEAGUES CONCERNING THEIR INTERACTION AND RELATIONSHIP WITH PRESIDENT/CEO. OTHER ANALYSIS INCLUDES A WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE EXECUTIVE COMMITTEE. KEY EMPLOYEES ARE GIVEN ANNUAL PERFORMANCE REVIEWS BY THEIR IMMEDIATE SUPERVISOR INCLUDING THE PRESIDENT/CEO. THE PERFORMANCE SUMMARY IS REVIEWED AND DISCUSSED WITH THE PRESIDENT/CEO. AN ANALYSIS OF COMPARABLE STAFF POSITIONS AND SIMILAR HOSPICE ORGANIZATIONS IS DONE BY HR DEPARTMENT. DATA FROM BENCHMARK REPORTS PROVIDED BY NHPCO AND MVI ARE ALSO USED IN THIS ANALYSIS. THE MOST RECENT YEAR IN WHICH THE COMPENSATION PROCESS WAS REVIEWED WAS 2016. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ALSO SUMMARIZED ON THE ORGANIZATION'S WEBSITE. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PALLIATIVE MEDICINE CONSULTANTS OF GREATER WASHINGTON LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1355 PICCARD DR SUITE 100O | AddressLine1Txt |
| City | ROCKVILLE | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 20850 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 522343635 | EIN |
| Primary Activities | TO OFFER A CONTINUUM OF CARE FOR PATIENTS WITH ADVANCED ILLNESS | PrimaryActivitiesTxt |
| Legal Domicile State | MD | LegalDomicileStateCd |
| Total Income | -$1,494 | TotalIncomeAmt |
| End Of Year Assets | $11,688 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONTGOMERY HOSPICE INC | BusinessNameLine1Txt |
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