2016-11-15T10:30:51-06:00 2015-12-31 BKD LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2015-01-01 431209344 KANSAS CITY HOSPICE INC % BILL DICHISER KANS 8163632600 1500 MEADOW LAKE PARKWAY Suite STE KANSAS CITY MO 64114 BILL DICHISER CFO 2016-05-15 true Kevin Ensminger CPA P01310558 8162216300 2015 2017-02-10 21:41:12Z DAVID WILEY 1500 MEADOW LAKE PKWY STE 200 KANSAS CITY MO 64114 21124236 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. 21 20 327 636 0 3251854 2968038 18423933 18150904 5 0 31348 5294 21707140 21124236 0 0 0 0 14670608 13998532 0 0 0 7036527 7125704 21707135 21124236 5 0 15649562 15776035 8989939 10455019 6659623 5321016 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 16473998 0 18150904 SEE SCHEDULE O 16473998 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 136 0 true 327 true false false false false false false false false false false X 21 20 false false false false false false false true true false false true true true true true true true false false MO X BILL DICHISER 8163632600 1500 MEADOW LAKE PARKWAY SUITE 200 KANSAS CITY MO 64114 LYNNE BROWN CHAIRMAN (1/1/15 - 4/23/15) 1.0 0.0 X X 0 0 0 MICHELLE STARK KAUFMAN SECRETARY 1.0 0.0 X X 0 0 0 ROBERT HILL TREASURER (1/1/15 - 4/23/15) 1.0 0.0 X X 0 0 0 NANCY DEBASIO BOARD MEMBER 1.0 0.0 X 0 0 0 ALFRED BIGGS TREASURER (4/24/15 - 12/31/15) 1.0 0.0 X 0 0 0 STEVE JONES BOARD MEMBER 1.0 1.0 X 0 0 0 KEITH ASHCRAFT VICE CHAIR (1/1/15 - 2/20/15) 1.0 0.0 X 0 0 0 SHERRY AINSWORTH BOARD MEMBER 1.0 0.0 X 0 0 0 FRAN MARTINSEN BOARD MEMBER 1.0 1.0 X 0 0 0 SHEILAHN E DAVIS-WYATT BOARD MEMBER 1.0 1.0 X 0 0 0 MIKE O'FLAHERTY BOARD MEMBER 1.0 1.0 X 0 0 0 LEE STANFORD BOARD MEMBER 1.0 1.0 X 0 0 0 JODY A ABBOTT BOARD MEMBER 1.0 1.0 X 0 0 0 BILL INTRATER BOARD MEMBER 1.0 0.0 X 0 0 0 ROBERT WOOD BOARD MEMBER 1.0 0.0 X 0 0 0 BARBARA LUKERT BOARD MEMBER 1.0 0.0 X 0 0 0 SUSAN PINGLETON BOARD MEMBER 1.0 0.0 X 0 0 0 DONNA PAYNE CHAIRMAN (4/24/15 - 12/31/15) 1.0 1.0 X 0 0 0 ELAINE MCINTOSH PRESIDENT/CEO 40.0 1.0 X X 431552 0 10832 BILL TAMMEUS VICE CHAIR 1.0 0.0 X X 0 0 0 RON JONES BOARD MEMBERS 1.0 0.0 X 0 0 0 RICHARD H CULL 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 DAVID WILEY CHIEF OPERATING OFFICER 40.0 1.0 X 162218 0 12111 BILL DICHISER CHIEF FINANCIAL OFFICER 40.0 1.0 X 107206 0 38716 JAY RISEMAN PHYSICIAN 40.0 0.0 X 192349 0 23072 PAMELA HARRIS PHYSICIAN 40.0 0.0 X 167846 0 31384 1061171 0 116115 5 false true false HMP BLUE SPRINGS BLUE SPRINGS MO 64014 MEDICAL EQUIPMENT 227104 HARTSOOK SHAWNEE MISSION SHAWNEE MISSION KS 66225 CONSULTATION 127636 VERIZON WIRELESS KANSAS CITY KANSAS CITY MO 64114 CELL PHONES 122597 VILLAGE SHALOM OVERLAND PARK OVERLAND PARK KS 66209 PATIENT SERVICES 109967 CONSOLIDATED COMMUNICATIONS LENEXA LENEXA KS 66215 TELECOMMUNICATIONS 105982 6 2968038 2968038 PATIENT SERVICE REVENUE 621300 17249226 17249226 NURSING HOME SUPPORT 621300 901678 901678 18150904 0 0 0 0 0 0 0 0 0 0 MISCELLANEOUS REVENUE 900099 5294 5294 5294 21124236 18150904 5294 0 0 0 0 762635 626958 135677 0 10813971 8890110 1923861 23139 18920 4219 1588393 789252 799141 810394 663462 146932 0 110653 110653 60441 60441 0 0 0 749497 412969 336528 92832 30968 61864 562531 533061 29470 344114 271850 72264 0 722016 233669 488347 376321 340754 35567 5855 5855 18072 5390 12682 165083 9078 156005 0 874943 604211 270732 528671 528671 MEDICARE ROOM & BOARD 884225 884225 0 BAD DEBT EXPENSE 254594 254594 0 PATIENT TRANSPORTATION 99172 99172 0 MEDICAL SUPPLIES 359486 359486 0 917198 917198 21124236 16473998 4650238 0 259907 123314 13386 9909 0 0 2302550 3532070 0 0 0 0 0 0 0 0 224013 277048 20058734 8251207 12604841 11807527 207026 0 0 0 0 0 0 0 37839 26167 15649562 15776035 1842418 2134909 0 0 0 0 0 0 0 0 0 0 6940495 8320110 0 0 207026 0 8989939 10455019 X 6626484 5287877 33139 33139 0 0 6659623 5321016 15649562 15776035 X 0 -1338607 X false true X true false X 2541632 2787926 2281380 3251854 2968038 13830830 19670337 20024584 20343706 18423933 18150904 96613464 0 0 0 22211969 22812510 22625086 21675787 21118942 110444294 0 0 0 110444294 423 284 2946 5 3658 0 423 284 2946 5 3658 0 65577 74400 9738 31348 5294 186357 22277969 22887194 22637770 21707140 21124236 110634309 0.99828 0.99768 0.00003 0.00004 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1341121 52910 -49710 0 7021 1337300 1323359 87278 62589 6927 1341121 1285488 232007 187589 6547 1323359 1130348 102060 163938 110858 1285488 1128922 1426 1130348 0.14620 0.85380 false true true 1571077 1571077 13038247 4085030 8953217 618810 174052 444758 4756331 3923099 833232 74269 69026 5243 11807527 23983976 2859740 2859740 21124236 21124236 26270116 5145880 5145880 21124236 21124236 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 $ 5,827,778 ELIMINATIONS $(2,968,038) ----------- $ 2,859,740 SCHEDULE D, PART XII, LINE 2D RELATED ORGANIZATION EXPENSE $ 8,113,918 ELIMINATIONS $(2,968,038) ----------- $ 5,145,880 X X false true false false false false false false false ELAINE MCINTOSH PRESIDENT/CEO 237717 0 0 0 193835 0 1197 0 9635 0 442384 0 0 0 DAVID WILEY CHIEF OPERATING OFFICER 162218 0 0 0 0 0 0 0 12111 0 174329 0 0 0 JAY RISEMAN PHYSICIAN 192349 0 0 0 0 0 886 0 22186 0 215421 0 0 0 PAMELA HARRIS PHYSICIAN 167846 0 0 0 0 0 250 0 31134 0 199230 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 2015. 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 9 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 1,192 ADMISSIONS AND 70,115 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 952 ADMISSIONS AND 6,425 CARE DAYS IN THIS YEAR. C) KANSAS CITY HOSPICE PALLIATIVE HOME CARE PROGRAM - THE PALLIATIVE HOME CARE 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 369 ADMISSIONS AND 23,648 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 38 FAMILIES IN 2015. 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 COMMITIEE 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 ($1,338,607) KANSAS CITY HOSPICE FOUNDATION INC 1500 MEADOW LAKE PKWY STE 200 KANSAS CITY MO 64114 431724085 SUPPORT MO 501(C)(3) 11A KC HOSPICE true NORTHCARE HOSPICE 2000 N VIVION KANSAS CITY MO 64118 431724225 HOSPICE MO 501(C)(3) 9 KC HOSPICE true false false true false false false false false false false false true true true true true true true KANSAS CITY HOSPICE FOUNDATION C 2968038 FMV KANSAS CITY HOSPICE FOUNDATION R 1338607 FMV