COVENANT HOSPICE FOUNDATION INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- COVENANT HOSPICE FOUNDATION INC (EIN 59-3060139)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-11
- IRS object ID
- 201643169349303564
- Schema version
- 2015v2.1
- 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 | 2016-11-11T14:02:04-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | 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 | AddressLine1Txt |
| Address Line2 | Suite 2600 | AddressLine2Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 606061224 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 593060139 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Covenant Hospice Foundation Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COVE | BusinessNameControlTxt |
| Phone | 8504332155 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5041 N 12th Avenue | AddressLine1Txt |
| City | Pensacola | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32504 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ODIN BERG | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Signature | 2016-10-25 | 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 | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEFF MISLEVY | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5041 N 12th Avenue | AddressLine1Txt |
| City | Pensacola | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32504 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,646,148 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.choosecovenant.org/hospice | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1991 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | The organization's mission is to provide funding to Covenant Hospice, Inc. in order to supplement charity and indigent care. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $642,137 | PYContributionsGrantsAmt |
| CY Contributions Grants | $692,158 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $15,356 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $101,563 | CYProgramServiceRevenueAmt |
| PY Investment Income | $207,408 | PYInvestmentIncomeAmt |
| CY Investment Income | $181,067 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$106,618 | PYOtherRevenueAmt |
| CY Other Revenue | -$102,702 | CYOtherRevenueAmt |
| PY Total Revenue | $758,283 | PYTotalRevenueAmt |
| CY Total Revenue | $872,086 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $558,978 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $603,766 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $28,886 | PYOtherExpensesAmt |
| CY Other Expenses | $109,472 | CYOtherExpensesAmt |
| PY Total Expenses | $587,864 | PYTotalExpensesAmt |
| CY Total Expenses | $713,238 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $170,419 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $158,848 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,542,810 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,499,473 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $203,270 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $194,004 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,339,540 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,305,469 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The organization's mission is to provide funding to Covenant Hospice, Inc. in order to supplement charity and indigent care. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $703,014 | ExpenseAmt |
| Grant | $603,766 | GrantAmt |
| Revenue | $101,563 | RevenueAmt |
| Desc | THE PURPOSE OF COVENANT HOSPICE FOUNDATION, INC. IS TO RECEIVE AND MAINTAIN A FUND OR FUNDS OF REAL OR PERSONAL PROPERTY, TO USE PRIMARILY FOR THE FINANCIAL SUPPORT AND ENCOURAGEMENT OF THE HEALTH CARE AND COMMUNITY SUPPORT PROGRAMS OF COVENANT HOSPICE, INC. IN 2015, THE AMOUNT TRANSFERRED HELPED SUPPORT THE COSTS OF UNFUNDED PROGRAMS OF COVENANT HOSPICE, INC. THESE UNFUNDED PROGRAMS INCLUDE SERVICES FROM THE FOLLOWING DEPARTMENTS: CHAPLAINS, BEREAVEMENT, CHILDREN, AND VOLUNTEERS. PALLIATIVE CARE SERVICES ARE ALSO OFFERED TO PATIENTS after life-limiting diagnoses, but before they are ready for hospice. | Desc |
| Total Program Service Expenses | $703,014 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | 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 | false | 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 | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | 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 | Yes (true) | 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 | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | 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 | false | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Karen Young | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8504332155 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5041 N 12th Avenue | AddressLine1Txt |
| City | Pensacola | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32504 | 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 |
|---|---|---|---|---|---|---|---|
| BILL GREENHUT | |||||||
| CHAIRMAN | 4.0 | 12.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JT YOUNG | |||||||
| VICE-CHAIRMAN | 4.0 | 12.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| TERESA DOS SANTOS | |||||||
| SECRETARY | 4.0 | 12.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| HARRIS REYNOLDS | |||||||
| TREASURER | 4.0 | 12.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JEFFREY M MISLEVY | |||||||
| PRESIDENT/CEO | 4.0 | 52.0 | Yes (X) | Yes (X) | $0 | $422,785 | $22,695 |
| JAMES S CAMPBELL ESQ | |||||||
| PAST CHAIRMAN | 4.0 | 8.0 | Yes (X) | $0 | $0 | $0 | |
| BOB VAN SLYKE | |||||||
| DIRECTOR | 4.0 | 4.0 | Yes (X) | $0 | $0 | $0 | |
| JOHN R FOGG | |||||||
| DIRECTOR | 4.0 | 0 | Yes (X) | $0 | $0 | $0 | |
| ROBERT MILLS | |||||||
| DIRECTOR | 4.0 | 8.0 | Yes (X) | $0 | $0 | $0 | |
| BOB PETERSON | |||||||
| DIRECTOR | 4.0 | 4.0 | Yes (X) | $0 | $0 | $0 | |
| ROBIN D HERR | |||||||
| PAST CHAIRMAN (partial year) | 4.0 | 4.0 | Yes (X) | $0 | $0 | $0 | |
| STEVE SOUTHERLAND II | |||||||
| DIRECTOR (PARTIAL YEAR) | 4.0 | 0 | Yes (X) | $0 | $0 | $0 | |
| ODIN BERG | |||||||
| CFO | 4.0 | 52.0 | Yes (X) | $0 | $228,289 | $20,693 | |
| CHERYL HAMILTON | |||||||
| COO | 4.0 | 48.0 | Yes (X) | $0 | $260,087 | $16,583 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $911,161 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $59,971 | 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 |
| Fundraising | $507,552 | FundraisingAmt |
| All Other Contributions | $184,606 | AllOtherContributionsAmt |
| Total Contributions | $692,158 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Palliative Care Services | Desc |
| Business | 612610 | BusinessCd |
| Total Revenue Column | $101,563 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $101,563 | RelatedOrExemptFuncIncomeAmt |
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 | $101,563 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $96,671 | TotalRevenueColumnAmt |
| Exclusion | $96,671 | ExclusionAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $656,541 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $572,145 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $84,396 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $84,396 | TotalRevenueColumnAmt |
| Exclusion | $84,396 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $88,095 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $507,552 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $188,912 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$100,817 | TotalRevenueColumnAmt |
| Exclusion | -$100,817 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $11,120 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $13,005 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,885 | TotalRevenueColumnAmt |
| Exclusion | -$1,885 | ExclusionAmt |
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 | $872,086 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $101,563 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $78,365 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $603,766 | TotalAmt |
| Program Services | $603,766 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,041 | TotalAmt |
| Management And General | $10,041 | 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 | $183 | TotalAmt |
| Management And General | $183 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| shared employees | $87,759 | $87,759 |
| service charges | $4,970 | $4,970 |
| Admin Support | $5,078 | $5,078 |
| miscellaneous | $1,441 | $1,441 |
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 | $713,238 | TotalAmt |
| Program Services | $703,014 | ProgramServicesAmt |
| Management And General | $10,224 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $270,002 | BOYAmt |
| EOY | $226,434 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $263,522 | BOYAmt |
| EOY | $354,186 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,853 | BOYAmt |
| EOY | $19,670 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | $0 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,974,433 | BOYAmt |
| EOY | $3,899,183 | 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 | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,542,810 | BOYAmt |
| EOY | $4,499,473 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $621 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $203,270 | BOYAmt |
| EOY | $193,383 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $203,270 | BOYAmt |
| EOY | $194,004 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,301,862 | BOYAmt |
| EOY | $4,265,568 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,678 | BOYAmt |
| EOY | $39,901 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,339,540 | BOYAmt |
| EOY | $4,305,469 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,542,810 | BOYAmt |
| EOY | $4,499,473 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $158,848 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$191,047 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$1,872 | 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $374,594 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $666,734 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $611,970 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $642,137 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $692,158 | CurrentTaxYearAmt |
| Total | $2,987,593 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $374,594 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $666,734 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $611,970 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $642,137 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $692,158 | CurrentTaxYearAmt |
| Total | $2,987,593 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $248,493 | SubstantialContributorsTotAmt |
| Public Support Total170 | $2,739,100 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $85,840 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $81,669 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $43,021 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $79,663 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $96,671 | CurrentTaxYearAmt |
| Total | $386,864 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $314,721 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $130,299 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $96,756 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $105,611 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $99,215 | CurrentTaxYearAmt |
| Total | $746,602 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $4,121,059 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $0 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.6647 | PublicSupportCY170Pct |
| Public Support PY170 | 0.6695 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part II, Line 10 Other Income | FormAndLineReferenceDesc |
| Explanation | DESCRIPTION - GROSS INCOME FROM FUNDRAISING, COLUMN A - 314721.0, COLUMN B - 101424.0, COLUMN C - 60579.0, COLUMN D - 88555.0, COLUMN E - 88095.0, COLUMN F - 653374.0; DESCRIPTION - GROSS INCOME FROM GAMING EVENTS, COLUMN A - 0.0, COLUMN B - 28875.0, COLUMN C - 36177.0, COLUMN D - 17056.0, COLUMN E - 11120.0, COLUMN F - 93228.0; | ExplanationTxt |
Schedule D IRS990ScheduleD
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Intercompany Payables | $177,236 |
| Gift Annuity Obligation | $16,147 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $193,383 | 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 | CHCS, Hospice, the Foundation, AFS and CPCS are exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | MASK PARADE | Event1Nm |
| Gross Receipts Event1 | $135,759 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $104,064 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $31,695 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $17,471 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $23,000 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $3,000 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $4,132 | OtherDirectExpensesEvent1Amt |
| Event2 | LIFE'S A DANCE | Event2Nm |
| Gross Receipts Event2 | $81,545 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $53,075 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $28,470 | GrossRevenueEvent2Amt |
| Rent Facility Costs Event2 | $2,200 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $0 | FoodAndBeverageEvent2Amt |
| Entertainment Event2 | $35,215 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $1,036 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 17 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $378,343 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $350,413 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $27,930 | GrossRevenueOtherEventsAmt |
| Rent Fclty Costs Other Events | $8,610 | RentFcltyCostsOtherEventsAmt |
| Food And Beverage Other Events | $39,843 | FoodAndBeverageOtherEventsAmt |
| Entertainment Other Events | $16,755 | EntertainmentOtherEventsAmt |
| Oth Direct Expnss Other Events | $37,650 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $595,647 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $507,552 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $88,095 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $28,281 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $62,843 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $54,970 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $42,818 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $188,912 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$100,817 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Covenant Hospice Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5041 N 12th Avenue | AddressLine1Txt |
| City | Pensacola | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32504 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 592208300 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $603,766 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Valuation Method Used | N/A | ValuationMethodUsedDesc |
| Non Cash Assistance | N/A | NonCashAssistanceDesc |
| Purpose Of Grant | TO HELP SUPPORT PROGRAMS OF COVENANT HOSPICE, INC. | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. | FormAndLineReferenceDesc |
| Explanation | Grant funds to Covenant Hospice, Inc., a 501(c)(3) organization, are used to help support its unfunded programs. These unfunded programs include: children's Program, Bereavement, Chaplain, and indigent patient care. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | 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 (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JEFFREY M MISLEVY | ||||||||||||||
| PRESIDENT/CEO | $0 | $370,803 | $0 | $6,189 | $0 | $45,793 | $0 | $0 | $0 | $22,695 | $0 | $445,480 | $0 | $0 |
| ODIN BERG | ||||||||||||||
| CFO | $0 | $223,954 | $0 | $4,335 | $0 | $0 | $0 | $2,284 | $0 | $18,409 | $0 | $248,982 | $0 | $0 |
| CHERYL HAMILTON | ||||||||||||||
| COO | $0 | $225,276 | $0 | $34,811 | $0 | $0 | $0 | $0 | $0 | $16,583 | $0 | $276,670 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | FormAndLineReferenceDesc |
| Explanation | The organization's President & CEO is paid by Covenant Hospice, Inc. (a related organization). The compensation of the organization's President & CEO is determined using an independent compensation consultant, compensation surveys or studies and approval by the board. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 15a COMPENSATION OF THE TOP MANAGEMENT OFFICIAL | THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IS COMPENSATED BY COVENANT HOSPICE, INC. COVENANT HOSPICE, INC. PROCURES SALARY COMPARABILITY DATA AND HIRES AN INDEPENDENT FIRM TO DO A SALARY COMPARISON FOR ALL SENIOR ADMINISTRATIVE STAFF. THE SALARY COMPARISON WITH THE INDEPENDENT FIRM IS UNDERTAKEN ANNUALLY. THE CEO'S COMPENSATION IS REVIEWED AND APPROVED BY THE COVENANT HOSPICE BOARD WITH INSIGHT GIVEN FROM THE SALARY COMPARISON OF THE INDEPENDENT FIRM. THIS PROCESS IS DONE ANNUALLY AND IS DOCUMENTED. THE PROCESS WAS LAST PERFORMED IN 2015. BECAUSE THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IS NOT COMPENSATED BY THE FILING ORGANIZATION, THIS QUESTION IS MARKED "NO" IN ACCORDANCE WITH FORM 990 INSTRUCTIONS. |
| Form 990, Part VI, Line 15b COMPENSATION OF OTHER OFFICERS | THE ORGANIZATION'S OTHER OFFICERS ARE PAID BY COVENANT HOSPICE, INC., A RELATED ORGANIZATION. COVENANT HOSPICE, INC. PROCURES SALARY COMPARABILITY DATA AND HIRES AN INDEPENDENT FIRM TO DO A SALARY COMPARISON FOR ALL SENIOR ADMINISTRATIVE STAFF. THE SALARY COMPARISON WITH THE INDEPENDENT FIRM IS UNDERTAKEN ANNUALLY. THIS PROCESS WAS LAST PERFORMED IN 2015. BECAUSE THE ORGANIZATION'S OTHER OFFICERS ARE NOT COMPENSATED BY THE FILING ORGANIZATION, THIS QUESTION IS MARKED "NO" IN ACCORDANCE WITH FORM 990 INSTRUCTIONS. |
| Form 990, Part VI, Line 1a Delegate broad authority to a committee | PURSUANT TO THE ORGANIZATION'S BYLAWS, SECTION 5.1: THERE SHALL BE A STANDING HOSPICE FOUNDATION EXECUTIVE COMMITTEE CONSISTING OF THE CHAIRPERSON, VICE CHAIRPERSON, SECRETARY, TREASURER, AND THE IMMEDIATE PAST CHAIRPERSON OF THE BOARD, IF SUCH PAST CHAIRPERSON REMAINS A HOSPICE FOUNDATION DIRECTOR. IF THE CHAIRPERSON OF HOSPICE FOUNDATION BOARD IS NOT THE SAME INDIVIDUAL AS THE CHAIRPERSON OF THE Covenant Health and Community Services, Inc (CHCS) BOARD, THEN THE CHAIRPERSON OF THE CHCS BOARD SHALL ALSO BE A VOTING MEMBER OF THE HOSPICE FOUNDATION EXECUTIVE COMMITTEE. THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF HOSPICE FOUNDATION SHALL BE A VOTING MEMBER OF THE HOSPICE FOUNDATION EXECUTIVE COMMITTEE AND ALL OTHER COMMITTEES. THE CHAIRPERSON OF THE FOUNDATION BOARD SHALL BE THE CHAIRPERSON OF THE HOSPICE FOUNDATION EXECUTIVE COMMITTEE. THE HOSPICE FOUNDATION EXECUTIVE COMMITTEE SHALL MEET TO REVIEW POLICY AND PROCEDURES OF HOSPICE FOUNDATION AND MAKE RECOMMENDATIONS RELATIVE THERETO TO THE HOSPICE FOUNDATION BOARD OR TO THE HOSPICE BOARD, AND SHALL HAVE SUCH FURTHER RESPONSIBILITIES AS DESIGNATED BY THE HOSPICE FOUNDATION BOARD BY RESOLUTION, BUT ONLY AS ALSO AUTHORIZED BY THE CHCS BOARD. |
| Form 990, Part VI, Line 4 Significant changes to organizational documents | The organization amended its bylaws in 2015 to reflect a change in the organization's sole member. The organization's sole member is now Covenant Health and Community Services, Inc (CHCS). CHCS elects the board members of Covenant Hospice Foundation, Inc. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | The organization's sole member is Covenant Health and Community Services, Inc (CHCS). CHCS elects the board members of Covenant Hospice Foundation, Inc. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | Covenant Health and Community Services, Inc elects the board members of Covenant Hospice Foundation, Inc. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | The following actions require written approval from Covenant Health and Community Services, Inc: -The appointment or the removal of a member of the Board of Directors. -The incurrence of any single indebtedness or other obligations in excess of $500,000 or in the aggregate during any 12 months of indebtedness or obligations in excess of $1,000,000. -The transfer of assets of the Corporation in one or more transactions with a value in excess of $1,000,000 or any transfer if the aggregate transfers in the preceding 12 months exceeds a value of $2,000,000. -Any single capital expenditure in excess of $500,000 or any capital expenditure if in the aggregate there will be capital expenditures in excess of $1,000,000 for the prior 12 months. -Dissolution of the Corporation. -A merger of the Corporation into another entity where the Corporation is not the surviving entity. -An amendment to the Articles of Incorporation or the Bylaws. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | The Form 990 is reviewed by staff with the assistance of and review by an independent accounting firm before it is signed and submitted. |
| Form 990, Part VI, Line 12c Conflict of interest policy | Conflict of Interest statements are sent annually to members of the Board of Directors, and all key staff members reportable on the Form 990. The forms are reviewed for responses indicating a possible conflict of interest. In addition, the Director of Accounting reviews transactions with vendors with which the Board may be affiliated to determine that all transactions are made at arm's length. If a possible conflict is identified, the person with a conflict is prohibited from participating in the Board of Directors deliberations and decisions in the transaction. |
| Form 990, Part VI, Line 19 Required documents available to the public | Governing documents, financial statements and the organization's conflict of interest policy are available on written request. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | Changes in split interest - -1872; |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COVENANT PALLIATIVE CARE SERVICES LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5041 NORTH 12TH AVE | AddressLine1Txt |
| City | PENSACOLA | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32504 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 464822066 | EIN |
| Primary Activities | PALLIATIVE SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Total Income | $101,563 | TotalIncomeAmt |
| End Of Year Assets | $9,809 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COVENANT HOSPICE FOUNDATION | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| COVENANT HOSPICE INC | ||||||||||
| 5041 N 12TH AVENUE | PENSACOLA | FL | 32504 | 592208300 | PROVIDES CARE TO TERMINALLY ILL PATIENTS | FL | 501(c)(3 | 7 | Covenant Health and Community Services Inc | false |
| ALZHEIMERS FAMILY SERVICES INC | ||||||||||
| 5041 N 12TH AVENUE | PENSACOLA | FL | 32504 | 593394242 | SUPPORT TO ALZHEIMERS PATIENTS AND FAMILIES | FL | 501(c)(3 | 7 | Covenant Health and Community Services Inc | false |
| Covenant Health and Community Services Inc | ||||||||||
| 5041 N 12TH AVE | PENSACOLA | FL | 32504 | 465132177 | PARENT CORPORATION OF COVENANT HOSPICE, COVENANT HOSPICE FOUNDATION, & ALZHEIMERS FAMILY SERVICES. | FL | 501(c)(3 | 9 | NA | false |
| COVENANT AT HOME INC | ||||||||||
| 5041 N 12TH AVE | PENSACOLA | FL | 32504 | 352543765 | HOME HEALTH CARE | FL | 501(c)(3 | 7 | COVENANT HEALTH AND COMMUNITY SERVICES INC | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | 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 | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Comments