2016-03-02T10:10:27-06:00 2015-09-30 461497033 EKS&H LLLP 7979 E TUFTS AVENUE SUITE 400 DENVER CO 802372521 990 2014-10-01 841453050 PIKES PEAK HOSPICE FOUNDATION PIKE 7196333400 2550 TENDERFOOT HILL STREET COLORADO SPRINGS CO 80906 MARTHA BARTON PRESIDENT & CEO 7196333400 2016-02-29 1 DORI J EGGETT P00645252 3037409400 2014 2016-08-17 19:52:53Z MARTHA BARTON 2550 TENDERFOOT HILL STREET COLORADO SPRINGS CO 80906 2237879 0 X WWW.PIKESPEAKHOSPICE.ORG X 1998 CO TO GENERATE AND DISTRIBUTE FUNDS IN SUPPORT OF PIKES PEAK HOSPICE & PALLIATIVE CARE, INC. 15 14 0 0 0 0 903349 1054050 0 0 498663 387179 29 56 1402041 1441285 545215 601071 0 0 244122 235258 0 0 401677 263907 296146 1053244 1132475 348797 308810 13831489 13886334 137178 192847 13694311 13693487 THE MISSION OF PIKES PEAK HOSPICE FOUNDATION IS TO GENERATE AND DISTRIBUTE FUNDS IN SUPPORT OF PIKES PEAK HOSPICE & PALLIATIVE CARE, INC., SERVE THE CHARITABLE INTERESTS OF OUR DONORS AND PRUDENTLY MANAGE THEIR GIFTS. 0 0 601071 601071 PIKES PEAK HOSPICE FOUNDATION IS A SUPPORTING ORGANIZATION FOR PIKES PEAK HOSPICE & PALLIATIVE CARE, INC. WHICH PROVIDED SERVICES TO 1,697 PATIENTS IN FISCAL YEAR 2015. AMOUNT TRANSFERRED TO PPHPC WAS $601,071 IN FISCAL YEAR 2015. 601071 1 1 0 0 0 0 0 1 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 15 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X VALERIE HERL 7196333400 2550 TENDERFOOT HILL STREET COLORADO SPRINGS CO 80906 X MARTHA BARTON PRESIDENT/CEO 1.00 40.00 X X 0 193763 1643 BRIAN WAGNER CHAIR 1.00 X X 0 0 0 BILL BERENZ IMMEDIATE PAST CHAIR 1.00 X X 0 0 0 DANIEL KORLESKI VICE CHAIR 1.00 X X 0 0 0 STEVE HOCHSTETTER TREASURER 1.00 X X 0 0 0 MARY OSBORNE SECRETARY 1.00 X X 0 0 0 ERIN EILMES TRUSTEE 1.00 X 0 0 0 SHARON HARE BOARD LIAISON 1.00 1.00 X 0 0 0 DIRK HOBBS TRUSTEE 1.00 X 0 0 0 BRIAN HOMME TRUSTEE 1.00 X 0 0 0 WILLIAM HYBL JR TRUSTEE 1.00 X 0 0 0 SUE MULVIHILL TRUSTEE 1.00 X 0 0 0 RANDALL STILES TRUSTEE 1.00 X 0 0 0 BRENDA WHITLOCK TRUSTEE 1.00 X 0 0 0 WILLIAMS JOHANNSEN MEMBER AT LARGE 1.00 X 0 0 0 JOAN SELMAN EXECUTIVE DIRECTOR 40.00 X 0 103897 919 0 297660 2562 0 0 1 0 0 29855 1024195 28887 1054050 302189 302189 881584 796594 84990 84990 84990 MISCELLANEOUS INCOME 900099 56 56 56 1441285 0 0 387235 601071 601071 104917 5246 99671 103020 2060 100960 692 14 678 9551 191 9360 17078 342 16736 8213 8213 43757 43757 161129 161129 5601 5601 15054 15054 19703 19703 25730 25730 2073 2073 OTHER EXPENSES 13143 13143 BAD DEBT EXPENSE 1743 1743 1132475 601071 129727 401677 300 300 1482720 1088146 96063 98069 1475 1568 276837 35324 177344 241513 10952368 11198767 1121219 1257971 13831489 13886334 126904 183195 10274 9652 137178 192847 X 9510372 9380222 1210284 1216235 2973655 3097030 13694311 13693487 13831489 13886334 X 308810 -398285 88651 X 0 1 X 1 0 X X 1 PIKES PEAK HOSPICE & PALLIATIVE CARE 840816047 9 1 601071 0 1 601071 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 20000 137500 X 0 2516747 26851 -23395 143352 2376851 2395647 20937 256751 156588 2516747 2137361 62548 310034 114296 2395647 1708366 203440 344561 119006 2137361 1777404 9333 25890 104261 1708366 0.81330 0.18670 0 0 41138 35324 5814 235699 235699 241513 BENEFICIAL INTEREST IN PERPETUAL TRUST 1163998 BENEFICIAL INTEREST IN CHARITABLE REMAINDER TRUST 93973 1257971 ANNUITY OBLIGATIONS 9652 9652 X 1131651 -398285 88651 -309634 1441285 0 1441285 531404 0 531404 601071 601071 1132475 PART III, LINE 4: THE ARTWORK IS MAINTAINED FOR AN AESTHETIC ENVIRONMENT FOR THE PATIENTS. PART V, LINE 4: PERMANENTLY RESTRICTED ENDOWMENT FUNDS ARE THOSE FOR WHICH DONORS HAVE STIPULATED UNDER TERMS OF THE GIFT INSTRUMENT THAT THE PRINCIPAL OF THE FUND IS NOT EXPENDABLE AND IS TO BE INVESTED FOR THE PURPOSE OF PRODUCING PRESENT AND FUTURE INCOME. THE INCOME GENERATED IS AVAILABLE FOR ANY AND ALL USES REQUIRED BY PIKES PEAK HOSPICE TO FURTHER AND ENHANCE END-OF-LIFE CARE SERVICES OFFERED TO THE COMMUNITY. TEMPORARILY RESTRICTED NET ASSETS ARE RESTRICTED BY THE DONORS FOR VARIOUS PROGRAMS. BOARD DESIGNATED FUNDS ARE UNRESTRICTED FUNDS THAT THE PPHF BOARD OF TRUSTEES HAS DETERMINED WILL BE RETAINED AND INVESTED. THE PRINCIPAL AS WELL AS THE INCOME IS AVAILABLE FOR ANY AND ALL USES REQUIRED BY PPHPC WITH APPROVAL OF THE PPHF BOARD OF TRUSTEES. PART X, LINE 2: THE ORGANIZATION APPLIES A MORE-LIKELY-THAN-NOT MEASUREMENT METHODOLOGY TO REFLECT THE CONSOLIDATED FINANCIAL STATEMENT IMPACT OF UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A RETURN. AFTER EVALUATING THE TAX POSITIONS TAKEN, NONE ARE CONSIDERED TO BE UNCERTAIN. THEREFORE, NO AMOUNTS HAVE BEEN RECOGNIZED AS OF SEPTEMBER 30, 2015 AND 2014. IF INCURRED, INTEREST AND PENALTIES ASSOCIATED WITH TAX POSITIONS ARE RECORDED IN THE PERIOD ASSESSED AS OTHER EXPENSE. NO INTEREST OR PENALTIES HAVE BEEN ASSESSED AS OF SEPTEMBER 30, 2015 AND 2014. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF BENEFICIAL INTEREST IN CHARITABLE REMAINDER TRUST -6,383. CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUST 96,524. CHANGE IN VALUE OF BENEFICIAL INTEREST IN CGA TRUST -1,490. PART XII, LINE 4B - OTHER ADJUSTMENTS: TRANSFERS TO PIKES PEAK HOSPICE AND PALLIATIVE CARE 601,071. 1 PIKES PEAK HOSPICE & PALLIATIVE CARE INC 2550 TENDERFOOT HILL STREET COLORADO SPRINGS CO 80906 840816047 501(C)(3) 601071 ORGANIZATION SUPPORTS PIKES PEAK HOSPICE & PALLIATIVE CARE, INC. 1 PART I, LINE 2: THE ENTITIES ARE RELATED. 0 0 0 0 0 0 0 0 0 MARTHA BARTON PRESIDENT/CEO 0 190913 0 2850 0 0 0 1643 0 0 0 195406 0 0 X 1 20000 FMV X 1 1038 VALUE UPON RECEIPT X COMPUTER SERVER LICENSES 1 6599 DONOR VALUED X GIFT CERTIFICATE FOR PRIVATE DINNER 1 1250 DONOR VALUED 0 1 0 FORM 990, PART VI, SECTION A, LINE 1 THE FOUNDATION'S EXECUTIVE COMMITTEE SHALL BE AUTHORIZED TO ACT IN THE PLACE OF THE FOUNDATION BOARD BETWEEN MEETINGS AND SHALL BE AUTHORIZED TO TAKE ALL ACTION NECESSARY IN THE EVENT THAT SUCH ACTION CANNOT WAIT FOR THE NEXT REGULARLY SCHEDULED FOUNDATION BOARD MEETING. IN THE EVENT THE EXECUTIVE COMMITTEE TAKES ACTION IN THE PLACE OF THE FOUNDATION BOARD BETWEEN REGULARLY SCHEDULED MEETINGS, THE EXECUTIVE COMMITTEE SHALL REPORT ALL SUCH ACTION TO THE FOUNDATION BOARD AT THE NEXT REGULARLY SCHEDULED MEETING. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE TREASURER AND VP OF BUSINESS SERVICES AND IS THEN PRESENTED TO THE AUDIT COMMITTEE FOR APPROVAL. AN ELECTRONIC COPY OF THE 990 IS FORWARDED TO THE ENTIRE BOARD OF DIRECTORS FOR THEIR INDIVIDUAL REVIEW. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL EDUCATION TO BOARD MEMBERS AND STAFF. ALL CONFLICTS ADDRESSED BY OFFICERS AND CONTRACT LEGAL COUNSEL AS NEEDED. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE AT THE ORGANIZATION'S LOCATION AND ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A PIKES PEAK HOSPICE & PALLIATIVE CARE, INC. PAYS THE SALARIES FOR THE ORGANIZATION'S EMPLOYEES. THEREFORE, THE ORGANIZATION DOES NOT REPORT ANY COMPENSATION ON W-2S OR 1099-MISCS FOR ITS EMPLOYEES. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF BENEFICIAL INTEREST IN CHARITABLE REMAINDER TRUST -6,383. CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUST 96,524. CHANGE IN VALUE OF BENEFICIAL INTEREST IN CGA TRUST -1,490. PIKES PEAK HOSPICE & PALLIATIVE CARE INC 2550 TENDERFOOT HILL STREET COLORADO SPRINGS CO 80906 840816047 CARE OF TERMINALLY ILL CO 501(C)(3) LINE 9 N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0