2017-05-12T19:09:02-05:00 2016-06-30 946214841 ARMANINO LLP 50 W SAN FERNANDO ST STE 500 SAN JOSE CA 95113 990 2015-07-01 942497618 HOSPICE OF SANTA CRUZ COUNTY HOSP 8314303000 940 DISC DRIVE SCOTTS VALLEY CA 95066 MICHAEL MILWARD CHIEF EXECUTIVE OFFICER 8314303000 2017-05-12 1 RANDY PETERSON P01300203 4082006400 2017-05-12 2015 2021-01-29 14:40:06Z MICHAEL MILWARD 940 DISC DRIVE SCOTTS VALLEY CA 95066 20720411 0 X HOSPICESANTACRUZ.ORG X 1978 CA HOSPICE SERVICE AND SUPPORT FOR TERMINAL PATIENTS AND THEIR FAMILIES. 20 20 186 71 0 0 1034196 2901066 17912376 17672333 -2011 44985 205528 49814 19150089 20668198 0 0 0 0 11609924 12702865 0 0 358509 5772329 5790443 17382253 18493308 1767836 2174890 10737587 13161753 1964427 2225126 8773160 10936627 HOSPICE OF SANTA CRUZ COUNTY HONORS THE CHOICES OF INDIVIDUALS AND FAMILIES BY PROVIDING EXEMPLARY END-OF-LIFE CARE AND GRIEF SUPPORT TO OUR COMMUNITY. 0 0 15294607 17676279 1,061 PATIENTS AND FAMILIES RECEIVED 66,747 DAYS OF EXPERT END-OF-LIFE CARE FROM HOSPICE TEAMS OF MEDICAL DIRECTORS, NURSES, SOCIAL WORKERS, CHAPLAINS, HOSPICE AIDES, AND VOLUNTEERS. ADDITIONALLY, 2,399 GRIEF SUPPORT SESSIONS WERE PROVIDED TO HOSPICE FAMILIES AND GRIEVING COMMUNITY MEMBERS OF ALL AGES. 15294607 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 89 0 186 0 0 0 0 0 0 1 1 0 0 0 0 X 20 20 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X THE ORGANIZATION 8314303000 940 DISC DRIVE SCOTTS VALLEY CA 95066 MARILYN CALCIANO PRESIDENT 6.00 X X 0 0 0 SALLY GREEN - TO 0815 VICE PRESIDENT 4.00 X X 0 0 0 DICK CLARK - TO 1216 TREASURER/VICE PRESIDENT 4.00 X X 0 0 0 CHARLOTTE KIM MD SECRETARY 3.00 X X 0 0 0 GEOFF CARAS DIRECTOR 2.00 X 0 0 0 MARY CULLEY - TO 1215 DIRECTOR 2.00 X 0 0 0 CARA DISIMONE DIRECTOR 2.00 X 0 0 0 ALICIA FLORES DIRECTOR 2.00 X 0 0 0 MARGARET GORDON DIRECTOR 2.00 X 0 0 0 SARAH GOYETTE - TO 0117 DIRECTOR 2.00 X 0 0 0 KATHLEEN GRAVE DIRECTOR 2.00 X 0 0 0 MONICA HAMILTON DIRECTOR 2.00 X 0 0 0 CAROLYN MECOZZI DIRECTOR 2.00 X 0 0 0 SHOSHANA HELMAN MD - TO 0315 DIRECTOR 2.00 X 0 0 0 JOHN SCHUYLER - TO 1215 DIRECTOR 2.00 X 0 0 0 RACHEL WEDEEN DIRECTOR 2.00 X 0 0 0 BOB KASWEN DIRECTOR 2.00 X 0 0 0 DAVID DOOLIN DIRECTOR 2.00 X 0 0 0 ED SACKS - TO 1215 DIRECTOR 2.00 X 0 0 0 MICHAEL PAUL DIRECTOR 2.00 X 0 0 0 RENEE MELLO DIRECTOR 2.00 X 0 0 0 MICHAEL MILWARD CEO 40.00 X 267260 0 39595 ADAM SHORE CFO 40.00 X 201678 0 13375 MICHELLE DAHLKEMPER COO 40.00 X 200317 0 15151 CATHERINE CONWAY CHIEF COMMUNICATIONS OFFICER 40.00 X 143041 0 15667 PATRICIA DUNBAR PATIENT CARE MANAGER 40.00 X 129298 0 15796 JUDITH HUMBLE CHIEF COMPLIANCE OFFICER 40.00 X 147709 0 17185 CHARLEA TARMAS MASSION CHIEF MEDICAL DIRECTOR 36.00 X 246493 0 39595 EMILIA SCHAMBECK PATIENT CARE MANAGER 40.00 X 120998 0 19251 AMY HARTE NURSE 40.00 X 115490 0 21077 1572284 0 196692 16 0 1 0 0 156762 2744304 668106 2901066 PATIENT FEES 621610 17181470 17181470 PRIVATE INSURANCE 621610 480344 480344 BEREAVEMENT INCOME 621610 7357 7357 SELF PAY PATIENT FEES 621610 3162 3162 17672333 44985 44985 49257 49257 20703 156762 46858 -26155 -26155 28121 5355 22766 22766 MISCELLANEOUS 621610 3946 3946 3946 20668198 17676279 0 90853 648194 157792 490402 10057802 8430086 1381271 246445 1170424 946873 195461 28090 826445 668594 138016 19835 12768 8703 3807 258 19850 13530 5919 401 262402 127740 131948 2714 47552 34639 11885 1028 250587 202725 41848 6014 11293 11293 23358 18896 3901 561 187969 152067 31391 4511 562305 454905 93905 13495 ROOM & BOARD 1208817 1208817 MEDICATIONS 665156 665156 PATIENT CARE SERVICES 648086 648086 COMMUNICATION-PAGER/COM 498128 396622 86963 14543 1392172 1159376 212182 20614 18493308 15294607 2840192 358509 4524977 3712812 1233507 3019023 4224312 102435 105970 4542332 1380529 2464685 3161803 482392 470969 144075 252380 10737587 13161753 1510264 1666562 365845 344907 88318 213657 1964427 2225126 X 8251378 10454688 84888 44970 436894 436969 8773160 10936627 10737587 13161753 2174890 -11423 0 X X 0 1 X 1 0 X 712650 792964 682746 1034196 2767070 5989626 712650 792964 682746 1034196 2767070 5989626 383242 5606384 35859 57825 47982 45701 94242 281609 6271235 83500012 0.89400 0.76030 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 0 PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF CALIFORNIA HOSPICE & PALLIATIVE CARE ASSOCIATION AND NATIONAL HOSPICE & PALLIATIVE CARE ORGANIZATION, BOTH OF WHICH LOBBY. 482392 75 -11423 75 470969 488670 100 -6378 482392 478547 10075 48 488670 478399 100 48 478547 478201 150 48 478399 0.92780 0.07220 0 0 558850 558850 1441150 456717 984433 754147 270723 483424 942270 653089 289181 845915 845915 3161803 DEFERRED COMPENSATION LIABILITIES 120188 SELF-INSURANCE LIABILITY 93469 213657 X 20705116 -11423 1483 46858 36918 20668198 0 20668198 18541649 1483 46858 48341 18493308 0 18493308 PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND FROM STATE FRANCHISE TAX UNDER REVENUE AND TAXATION CODE SECTION 23701(D), BUT IS SUBJECT TO TAXES ON UNRELATED BUSINESS INCOME WHEN EARNED. FOR THE YEAR ENDING JUNE 30, 2016, NO PROVISION FOR INCOME TAXES HAVE BEEN RECORDED ON THE FINANCIAL STATEMENTS. AS OF THE YEAR ENDED JUNE 30, 2016, THE ORGANIZATION IS CURRENT IN ALL FEDERAL AND STATE TAX FILING OBLIGATIONS AND THE RETURNS ARE SUBJECT TO STANDARD STATUTE OF LIMITATIONS APPLICABLE UNDER THE GOVERNING FEDERAL AND STATE TAX STATUTES. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING DIRECT EXPENSES 46,858. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING DIRECT EXPENSES 46,858. OKTOBERFEST 100814 100814 8100 3417 3956 150 7848 GOLF 66744 52542 14202 1738 13080 351 1717 1 9907 3406 6501 6501 177465 156762 20703 9838 16497 4307 150 16066 46858 -26155 28121 5355 0 0.00000 28121 5355 5355 22766 CA 0 ORGANIZATION IS ALLOWED BY THE CALIFORNIA ATTORNEY GENERAL TO CONDUCT RAFFLES. 0 0 0 1.00000 ADAM SHORE 940 DISC DRIVE SCOTTS VALLEY CA 95066 0 0 X X X X 0 0 0 0 0 0 0 0 0 MICHAEL MILWARD CEO 239624 0 27636 0 0 0 20400 0 19195 0 306855 0 0 0 ADAM SHORE CFO 184748 0 16930 0 0 0 1800 0 11575 0 215053 0 0 0 MICHELLE DAHLKEMPER COO 183298 0 17019 0 0 0 1800 0 13351 0 215468 0 0 0 CATHERINE CONWAY CHIEF COMMUNICATIONS OFFICER 136448 0 6593 0 0 0 2400 0 13267 0 158708 0 0 0 JUDITH HUMBLE CHIEF COMPLIANCE OFFICER 140903 0 6806 0 0 0 1170 0 16015 0 164894 0 0 0 CHARLEA TARMAS MASSION CHIEF MEDICAL DIRECTOR 235009 0 11484 0 0 0 20400 0 19195 0 286088 0 0 0 X 1 7022 FMV X 1 644448 FMV X COIN 1 16636 FMV 0 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 CFO AND CEO REVIEW 990 WHEN COMPLETED BY CPA FIRM. A COPY OF THE 990 IS EMAILED TO BOARD MEMBERS BEFORE THE 990 IS FILED. FORM 990, PART VI, SECTION B, LINE 12C PURPOSE OF THE CONFLICT OF INTEREST POLICY IS TO PROTECT HSCC'S INTEREST WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN OFFICER OR DIRECTOR OF THE ORGANIZATION. OFFICERS AND DIRECTORS REVIEW AND SIGN AN ANNUAL STATEMENT INDICATING UNDERSTANDING AND ADHERENCE TO THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 MARKET DATA ON SALARIES FOR CEO AND CFO POSITIONS IN THE HEALTHCARE AND HOSPICE FIELD IS COMPILED AND REVIEWED ANNUALLY BY HR DIRECTOR. REPORT BY AN INDEPENDENT CONSULTANT, CONSIDERING MARKET AND GEOGRAPHIC FACTORS, WAS PRESENTED TO THE ORGANIZATION'S COMPENSATION COMMITTEE, WHICH REVIEWS AND RECOMMENDS ANY SALARY ADJUSTMENT TO FULL BOARD OF DIRECTORS. BOARD OF DIRECTORS REVIEW AND VOTE ON PROPOSED SALARY CHANGES. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS, POLICIES, AND ANNUAL 990 INFORMATION RETURNS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. ANNUAL FINANCIAL RESULTS ARE PUBLISHED IN THE ORGANIZATION'S ANNUAL REPORT. FORM 990, PART XI, LINE 2C: THE OVERSIGHT AND SELECTION PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.