2016-01-29T13:05:28-06:00 2015-09-30 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2014-10-01 561249146 HOSPICE AT GREENSBORO INC HOSP 3366212500 2500 SUMMIT AVENUE GREENSBORO NC 27405 PATRICIA A SOENKSEN PRESIDENT/CEO 3366212500 2016-01-28 1 JOHN NORMAN P01506766 7049985200 2014 2016-04-25 22:37:26Z HOSPICE & PALLIATIVE CARE OF GREENSBORO PATRICIA A SOENKSEN 2500 SUMMIT AVENUE GREENSBORO NC 27405 21803614 0 X WWW.HOSPICEGSO.ORG X 1979 NC THE ORGANIZATION PROVIDES NURSING AND SUPPORT TO THE TERMINALLY ILL AND THEIR FAMILIES 16 16 261 330 0 0 4678399 1674550 18913280 19965256 1363892 155663 44433 8145 25000004 21803614 0 0 0 0 12850056 13040600 0 0 314816 7905057 8000522 20755113 21041122 4244891 762492 30910355 14759107 3220694 2808824 27689661 11950283 THE MISSION OF HOSPICE AND PALLIATIVE CARE OF GREENSBORO IS TO ENHANCE THE QUALITY OF LIFE BY PROVIDING EXPERT INTERDISCIPLINARY CARE, CONSULTATION, SUPPORT AND EDUCATION FOR THOSE AFFECTED BY SERIOUS ILLNESS, DEATH OR GRIEF. 0 0 16749708 17735614 HOSPICE IS A COMPREHENSIVE, TEAM-ORIENTED PROGRAM OF MEDICAL CARE, PAIN MANAGEMENT, EMOTIONAL AND SPIRITUAL SUPPORT PROVIDED FOR TERMINALLY ILL PATIENTS AND THEIR FAMILIES. 182944 138163 COUNSELING AND EDUCATION CENTER (CEC) PROVIDES INDIVIDUAL AND GROUP COUNSELING FOR GRIEF AND LOSS OF FAMILIES OF HOSPICE PATIENTS AND THE COMMUNITY. 771199 522942 KIDS PATH PROVIDES HOME CARE FOR MEDICALLY FRAGILE AND TERMINALLY ILL CHILDREN, COUNSELING AND SUPPORT FOR CHILDREN EXPERIENCEING SERIOUS ILLNESS OR LOSS, AND CONSULTATION FOR ADULTS WHO CARE FOR CHILDREN EXPERIENCING GRIEF AND LOSS. 17703851 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 1 78 0 1 261 1 0 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X PATRICIA A SOENKSEN 3366212500 2500 SUMMIT AVENUE GREENSBORO NC 27405 JIM ROSKELLY BOARD MEMBER 1.00 X 0 0 0 RON JOHNSON BOARD MEMBER 1.00 X 0 0 0 LISA MOORE DUCK BOARD MEMBER 1.00 X 0 0 0 YOULAND WILLIAMS BOARD MEMBER 1.00 X 0 0 0 BARBARA RUBY BOARD MEMBER 1.00 X 0 0 0 RICK MORGAN BOARD MEMBER 1.00 X 0 0 0 REV DR ERIC D COLE BOARD MEMBER 1.00 X 0 0 0 CAROLYNN RICE BOARD MEMBER 1.00 X 0 0 0 BONNIE MCALISTER BOARD MEMBER 1.00 X 0 0 0 ANN LINEWEAVER BOARD MEMBER 1.00 X 0 0 0 DR HAYWOOD INGRAM BOARD MEMBER 1.00 X 0 0 0 SHARON COULTER JAMES BOARD MEMBER 1.00 X 0 0 0 NOEL BURT BOARD MEMBER 1.00 X 0 0 0 JEFFREY JONES BOARD MEMBER 1.00 X 0 0 0 DR PATRICK WRIGHT CHAIR 1.00 X X 0 0 0 SUSAN F SHUMAKER SEC./TREASURER 1.00 X X 0 0 0 MARY MAGRINAT VICE CHAIR 1.00 X X 0 0 0 JAMES T HAIGLER JR CFO 40.00 2.00 X 124573 0 17422 PATRICIA A SOENKSEN PRESIDENT/CEO 40.00 10.00 X 173194 0 18643 JUAN C MONGUILOD CHIEF MEDICAL OFFICER 40.00 X 204614 0 31353 SUSAN COX CHIEF CLINICAL OFFICER 40.00 X 127885 0 15336 DONALD E HERTWECK PHYSICIAN 40.00 X 175699 0 29503 JOHN E FELDMANN PHYSICIAN 32.00 X 127728 0 18758 STEPHEN E MILLER PHYSICIAN 40.00 X 168610 0 18440 PETER B REKLIS DIRECTOR OF INFORMATION SYSTEMS 40.00 X 111585 0 16551 1213888 0 166006 8 0 1 0 PROCARE PBM 1267 PROFESSIONAL PARKWAY GAINESVILLE GA 30507 PHARMACY BENEFITS MANAGER 957040 ADVANCED HOME CARE INC PO BOX 65081 CHARLOTTE NC 28265 DME/IV 868834 CONE HEALTH 1200 NORTH ELM STREET GREENSBORO NC 27401 HEALTHCARE 630218 GOLDEN LIVING CENTER 100 FIANNA WAY FT SMITH AR 72919 NURSING FACILITY 428673 LOMAX CONSTRUCTION INC PO BOX 35169 GREENSBORO NC 27425 GENERAL CONTRACTOR 255554 17 1674550 68391 1674550 NET PATIENT SERVICE REVENUE 623000 19965256 19965256 19965256 155663 155663 MISCELLANEOUS REVENUE 900099 8145 8145 8145 21803614 19973401 0 155663 296701 296701 9226211 7645854 1364494 215863 2752635 2206053 483725 62857 765053 622190 125324 17539 7650 7650 36182 36182 595 595 21776 21776 159915 50350 94061 15504 758119 398996 358535 588 323643 317501 6142 24718 24718 653905 653905 341586 235333 105119 1134 PATIENT SERVICES AND SU 5551062 5546475 4587 CONTINUING EDUCATION AN 71184 18653 52331 200 DUES AND SUBSCRIPTIONS 49056 8541 40515 FUNDRAISING PROJECT COS 1131 1131 21041122 17703851 3022455 314816 150 150 2442918 2728219 1417615 203662 1907383 2046173 1768534 69551 93008 13164431 6114315 7447641 7050116 15463842 2265284 392721 372495 30910355 14759107 2041667 2213447 1179027 595377 3220694 2808824 X 22299633 11360023 1682373 590260 3707655 0 27689661 11950283 30910355 14759107 X 762492 -236706 -16265164 X X 0 1 X 1 0 X 1545560 1221578 1330835 4799556 1675709 10573238 1545560 1221578 1330835 4799556 1675709 10573238 10573238 452521 474893 660911 1365291 155663 3109279 121434 30429 53727 1218 8145 214953 13897470 0.76080 0.74270 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 13117019 536392 -486155 80630 21040 13065586 11567867 832749 779952 44335 19214 13117019 9705366 403116 1520257 37975 22897 11567867 7849077 230799 1675222 -30862 -18870 9804830 7139037 809168 -74170 -7222 -17736 7898993 0.64830 0.28500 0.06670 1 0 1077796 1077796 8365400 3664957 4700443 3721235 2449358 1271877 7050116 LONG TERM INVESTMENTS 2265284 F 2265284 X PART V, LINE 4: THE ENDOWMENT FUNDS ARE USED TO FUND CONTINUING OPERATIONS AND SPECIAL PROJECTS OF THE ORGANIZATION. IN THE PRIOR YEAR RETURN THIS LINE INCLUDED A BOARD DESIGNATED AMOUNT THAT WAS NOT A TRUE ENDOWMENT. THE AMOUNTS SHOWN IN THE CURRENT YEAR HAVE BEEN ADJUSTED TO REFLECT THE REMOVAL OF THIS AMOUNT FROM THE NOTE. PART X, LINE 2: THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AS DEFINED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") WITH EXEMPTION FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. THE ORGANIZATION FOLLOWS GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE GUIDANCE HAS HAD NO IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS. X X X X X 0 0 0 0 0 0 0 0 0 PATRICIA A SOENKSEN PRESIDENT/CEO 172481 0 0 0 713 0 11948 0 6696 0 191838 0 0 0 JUAN C MONGUILOD CHIEF MEDICAL OFFICER 204452 0 0 0 162 0 15170 0 16183 0 235967 0 0 0 DONALD E HERTWECK PHYSICIAN 175591 0 0 0 108 0 12993 0 16510 0 205202 0 0 0 STEPHEN E MILLER PHYSICIAN 167238 0 0 0 1372 0 7895 0 10545 0 187050 0 0 0 X 1 215 FMV X 145 FMV X 9748 FMV X 11 2457 FMV X 21 17895 FMV X OTHER - FUNERAL EXPENSES 4 33693 FMV X OTHER-TOYS 10 3818 FMV X OTHER - ENTERTAINMENT 2 220 FMV X OTHER - FURNITURE 1 200 FMV 0 0 0 ENDOWMENT INVESTMENTS 2014-10-01 13117022 INVESTMENT STATEMENTS 471169471 HOSPICE FOUNDATION OF GREATER GREENSBORO 2500 SUMMIT AVENUE GREENSBORO NC 27405 501(C)(3) NOTE RECEIVABLE 2014-10-01 1768534 AMORTIZATION SCHEDULE OF NOTE 471169471 HOSPICE FOUNDATION OF GREATER GREENSBORO 2500 SUMMIT AVENUE GREENSBORO NC 27405 501(C)(3) PLEDGES RECEIVABLE 2014-10-01 1196364 LISTING OF OUTSTANDING PLEDGES 471169471 HOSPICE FOUNDATION OF GREATER GREENSBORO 2500 SUMMIT AVENUE GREENSBORO NC 27405 501(C)(3) CASH 2014-10-01 100590 BANK STATEMENT 471169471 HOSPICE FOUNDATION OF GREATER GREENSBORO 2500 SUMMIT AVENUE GREENSBORO NC 27405 501(C)(3) 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 7A MOSES H. CONE MEMORIAL HOSPITAL MAY ELECT EIGHT OF THE SIXTEEN MEMBERS OF THE BOARD OF DIRECTORS DUE TO THEIR INVESTMENT IN HOSPICE AT GREENSBORO. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE FINANCE COMMITTEE AND, ONCE APPROVED, IS REVIEWED WITH THE FULL BOARD OF DIRECTORS BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL NEW EMPLOYEES SIGN A CONFLICT OF INTEREST POLICY. IN ADDITION, THE BOARD OF DIRECTORS REVIEW AND UPDATE THE CONFLICT OF INTEREST POLICY ANNUALLY BEFORE SIGNING THEMSELVES. FORM 990, PART VI, SECTION B, LINE 15 THE CEO'S SALARY IS EVALUATED BY THE BOARD OF DIRECTORS ANNUALLY. THE CEO'S BASE SALARY IS DETERMINED USING BENCHMARK MARKET DATA OBTAINED FROM THE HOSPICE SALARY AND BENEFITS REPORT PUBLISHED BY THE HOSPITAL AND HEALTHCARE COMPENSATION SERVICE IN COOPERATION WITH THE NATIONAL ASSOCIATION FOR HOMECARE AND HOSPICE. THIS IS THE MOST COMPREHENSIVE SURVEY DONE BY HOSPICE ORGANIZATIONS AND IT IS WIDELY USED. AT THE BEGINNING OF EVERY FISCAL YEAR, THE BOARD CHAIR AND THE CEO JOINTLY DEVELOP QUANTIFIABLE OBJECTIVES TO MEASURE AND EVALUATE THE CEO'S PERFORMANCE. THESE INCLUDE INDICATORS SUCH AS: STRATEGIC PLANNING, ESTABLISHMENT OF THE FOUNDATION, ATTAINING CON APPROVAL FOR THREE ADDITIONAL BEDS AT BEACON PLACE, AND RESULTS OF THE FAMILY EVALUATION OF HOSPICE CARE SURVEY TOOL. THE ORGANIZATION MAINTAINS A SALARY SCHEDULE FOR ALL EXEMPT AND NON-EXEMPT POSITIONS. COMPENSATION FOR OFFICERS AND OTHER KEY EMPLOYEES IS DETERMINED THROUGH THE USE OF THIS SCHEDULE. EACH IS REVIEWED ANNUALLY BY COMPARING TO BENCHMARK POSITIONS WITHIN THE HOSPICE MARKET AND RELATED SALARY AND WAGE DATA. WHERE NEEDED, APPROPRIATE AND FEASIBLE, PAY RANGES MY BE MODIFIED, WITH BOARD APPROVAL, TO MORE CLOSELY REFLECT THE MARKET. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAIALBLE UPON REQUEST. FORM 990, PART XI, LINE 9: NONCASH CONTRIBUTIONS NOT INCLUDED ON FINANCIAL STATEMENTS -68,391. TRANSFER OF NET ASSETS TO HOSPICE FOUNDATION OF GREATER GREENSBORO -16,196,773. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. HOSPICE FOUNDATION OF GREATER GREENSBORO 2500 SUMMIT AVENUE GREENSBORO NC 27405 471169471 FOUNDATION NC 501(C)(3) LINE 11A, I HOSPICE AT GREENSBORO 1 0 1 1 0 0 0 0 0 1 0 0 1 1 1 1 1 1 1 1 HOSPICE FOUNDATION OF GREATER GREENSBORO I 16196773 INTERCOMPANY TRANSFER HOSPICE FOUNDATION OF GREATER GREENSBORO C 1239026 INTERCOMPANY TRANSFER