2015-04-20T12:08:15-05:00 2014-12-31 410746749 CLIFTONLARSONALLEN LLP 101 NORTH TRYON STREET SUITE 1000 CHARLOTTE NC 28246 990 2014-01-01 561452373 HOSPICE OF CLEVELAND COUNTY INC HOSP 7044874677 951 WENDOVER HEIGHTS DRIVE SHELBY NC 281503565 MYRA MCGINNIS PRESIDENT/CEO 7044874677 2015-04-20 1 P01506766 7049985200 2014 2016-03-07 17:11:31Z HOSPICE CLEVELAND COUNTY MYRA MCGINNIS 951 WENDOVER HEIGHTS DRIVE SHELBY NC 281503565 13272692 0 X WWW.HOSPICECARES.CC X 1984 NC HOSPICE OF CLEVELAND COUNTY PROVIDES CARE AND SUPPORT TO PATIENTS WITH A LIFE-LIMITING ILLNESS. 17 17 203 200 -74 0 318197 824110 11053929 12021797 112782 254067 38265 37775 11523173 13137749 0 0 0 0 6006592 6348570 0 0 0 4497731 4389462 10504323 10738032 1018850 2399717 20035431 22503042 1379405 1371697 18656026 21131345 HOSPICE CLEVELAND COUNTY EXISTS TO PROVIDE HIGH QUALITY SKILLED COMPASSIONATE CARE AND SUPPORT FOR INDIVIDUALS WITH A LIFE-LIMITING ILLNESS, THEIR FAMILIES, AND THE COMMUNITY, REGARDLESS OF THEIR ABILITY TO PAY. 0 0 5674021 8705675 HOSPICE CLEVELAND COUNTY PROVIDES COMPREHENSIVE END OF LIFE HEALTHCARE FOR TERMINALLY ILL PATIENTS AND THEIR FAMILIES DURING THE FINAL STAGES OF ILLNESS. DURING 2014, HOSPICE CLEVELAND COUNTY PROVIDED 53,721 DAYS OF HOMECARE INCLUDING 12,685 DAYS OF NURSING HOME AND HOSPITAL INPATIENT CARE. HOSPICE CLEVELAND COUNTY SERVED 715 HOMECARE PATIENTS IN 2014. HOSPICE CLEVELAND COUNTY'S INTERDISCIPLINARY TEAMS CONSISTING OF PHYSICIANS, NURSES, HOSPICE AIDES, SOCIAL WORKERS, AND OTHER SUPPORTIVE PERSONNEL PROVIDED OVER 32,691 VISITS DURING 2014. 3019245 3129042 HOSPICE CLEVELAND COUNTY OWNS AND OPERATES TWO HOSPICE HOUSES THAT PROVIDE HOSPICE INPATIENT AND RESIDENTIAL CARE FOR TERMINALLY ILL PATIENTS DURING THE FINAL STAGES OF ILLNESS. THE WENDOVER HOSPICE HOUSE HAS 16 BEDS AND THE KINGS MOUNTAIN HOSPICE HOUSE HAS 8 BEDS. DURING 2014, HOSPICE CLEVELAND COUNTY PROVIDED 7,908 DAYS OF CARE IN THESE FACILITIES. HOSPICE CLEVELAND COUNTY SERVED 403 PATIENTS IN THE HOSPICE HOUSES IN 2014. 550482 187080 PALLIATIVE CARE CLEVELAND COUNTY PROVIDES A PROGRAM OF PAIN CONTROL, SYMPTOM MANAGEMENT AND ASSISTANCE WITH DIFFICULT DECISION MAKING. DURING 2014, PALLIATIVE CARE CLEVELAND COUNTY SERVED 594 PATIENTS. 9243748 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 31 0 203 1 0 0 0 0 0 0 1 1 0 0 0 X 17 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X PAM BENFIELD 7044874677 951 WENDOVER HEIGHTS DRIVE SHELBY NC 28150 ALEX BELL BOARD MEMBER 1.00 X 0 0 0 ANDREA LESLIE-FITE BOARD MEMBER 1.00 X 0 0 0 BECKY BROWN BOARD MEMBER 1.00 X X 0 0 0 BRENDA LOVELACE BOARD MEMBER 1.00 X 0 0 0 CARYL AUSTELL BOARD MEMBER 1.00 X 0 0 0 MIKE RIBADENEYRA BOARD MEMBER 1.00 X 0 0 0 FORREST THOMPSON BOARD MEMBER 1.00 X 0 0 0 GREG MCINNIS BOARD MEMBER 1.00 X 0 0 0 JENNIE LAMBERT BOARD MEMBER 1.00 X X 0 0 0 JOSEPH TYSINGER BOARD MEMBER 1.00 X 0 0 0 KATHY WILSON BOARD MEMBER 1.00 X X 0 0 0 PAMELA ENLOE BOARD MEMBER 1.00 X 0 0 0 PETE MOORE BOARD MEMBER 1.00 X 0 0 0 REX GIBBS BOARD MEMBER 1.00 X 0 0 0 ROBBY REYNOLDS BOARD MEMBER 1.00 X X 0 0 0 STEVE PADGETT BOARD MEMBER 1.00 X 0 0 0 WILLIAM THOMPSON BOARD MEMBER 1.00 X 0 0 0 JASON BEAM VICE PRESIDENT OF ADMINISTRATIVE SERVICES 49.30 X 92151 0 18707 LEE ANN LONG VICE PRESIDENT OF CLINICAL SERVICES 46.60 X 100854 0 20473 MYRA MCGINNIS PRESIDENT/CEO 48.30 X 133136 0 27027 DR JAMES POTTS HOSPICE MEDICAL DIRECTOR 58.00 X 188611 0 38288 DR REBECCA LOVE HOSPICE PHYSICIAN/VP PALLIATIVE CARE 60.20 X 168173 0 34139 682925 0 138634 4 0 1 0 0 92691 731419 824110 PATIENT REVENUE 621610 12021797 12021797 12021797 259024 259024 116461 121418 -4957 -4957 -4957 51374 13525 37849 37849 HOSPICE ITEMS - NET 900099 -74 -74 -74 13137749 12021797 -74 291916 326141 326141 4990033 4404294 585739 118072 98000 20072 525909 436504 89405 388415 322384 66031 31378 31378 90747 63219 27528 29868 29868 133427 58948 74479 106187 20526 85661 273719 154305 119414 188618 179600 9018 28179 11983 16196 550242 550242 42423 42423 PURCHASED SERVICES 1547042 1547042 SUPPLIES 954597 954597 BAD DEBT EXPENSES 273646 273646 PROFESSIONAL FEES 63577 63577 75812 75013 799 10738032 9243748 1494284 0 5820682 5474576 3330228 3434692 247498 548643 970797 1080346 28882 16272 70990 99145 10456830 4118448 6733107 6338382 2823859 5483447 9388 27539 20035431 22503042 970111 950216 409294 421481 1379405 1371697 X 18176412 20341316 253872 558292 225742 231737 18656026 21131345 20035431 22503042 X 2399717 164260 -42287 -46371 X X 0 1 X 1 0 X 791778 398738 251474 318197 824110 2584297 791778 398738 251474 318197 824110 2584297 627391 1956906 40682 43107 46773 112022 259024 501608 -395 -2295 -698 254 -74 -3208 -6019 3049 -2728 -5698 3076999 42569383 0.63600 0.76670 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 437 437 0 PART II-B, LINE 1: THE ORGANIZATION BELONGS TO THE NATIONAL HOSPICE & PALLIATIVE CARE ORGANIZATION WHICH HAS ESTIMATED THAT 6.5% OF ITS PROVIDER DUES WERE USED FOR SPECIFIC LOBBYING PURPOSES. 2014 MEMBERSHIP DUES WERE $6,716 WHICH EQUATES TO $437 THAT WOULD BE ATTRIBUTABLE TO LOBBYING ACTIVITIES. 300821 87961 19660 0 9519 398923 261411 9804 39410 9804 300821 238989 9968 22422 9968 261411 238989 238989 0.42000 0.58000 0 0 295737 295737 7750239 2750638 4999601 1723478 1033418 690060 687376 334392 352984 6338382 ESTIMATED THIRD PARTY LIABILITY 421481 421481 X 12631357 -42287 -42287 12673644 464105 464105 13137749 10738032 0 10738032 0 10738032 PART V, LINE 4: PERMANENT ENDOWMENT FUND ($231,737) PLUS BOARD-DESIGNATED QUASI-ENDOWMENT FOREVER FUND ($167,186). PART X, LINE 2: THE ORGANIZATION FOLLOWS THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATIONS FINANCIAL STATEMENTS IN ACCORDANCE WITH THE INCOME TAX STANDARD. THIS STANDARD PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PRINCIPLES FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE IMPLEMENTATION OF THIS STANDARD HAD NO IMPACT ON THE ORGANIZATIONS FINANCIAL STATEMENTS. THE ORGANIZATION HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF DECEMBER 31, 2014. PART XI, LINE 2D - OTHER ADJUSTMENTS: INVESTMENT FEES -42,287. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTION FOR FOREVER FUND 9,519. RESTRICTED PLEDGES RECEIVED 440,000. OTHER RESTRICTED CONTRIBUTIONS RECEIVED 8,591. ENDOWMENT FUND CONTRIBUTION 5,995. CORKS & TAPS 30663 30663 4652 3631 CHICKEN DINNER 11862 11862 2713 308 1 7509 7509 94 1558 50034 50034 94 4652 2713 5497 12956 37078 X 1 1 X X X 0 0 0 0 0 0 0 0 0 MYRA MCGINNIS PRESIDENT/CEO 125548 0 6596 0 992 0 0 0 27027 0 160163 0 0 0 DR JAMES POTTS HOSPICE MEDICAL DIRECTOR 187611 0 1000 0 0 0 0 0 38288 0 226899 0 0 0 DR REBECCA LOVE HOSPICE PHYSICIAN/VP PALLIATIVE CARE 167173 0 1000 0 0 0 0 0 34139 0 202312 0 0 0 PART I, LINE 1A HOSPICE OF CLEVELAND COUNTY, INC. PAYS A PORTION OF MONTHLY DUES FOR EMPLOYEES WHO CHOOSE TO JOIN THE LOCAL YMCA PROGRAM. THIS IS REPORTED AS TAXABLE FRINGE IN THE EMPLOYEES PAYROLL EARNINGS AND TAXED APPROPRIATELY. X 7488 SALES VALUE - FMV X 108940 SALES VALUE - FMV 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S PRESIDENT/CEO WILL REVIEW AND APPROVE FORM 990 AND WILL PRESENT IT TO THE FINANCE COMMITTEE BEFORE IT IS FILED. THE FINANCE COMMITTEE WILL THEN PRESENT THE PREPARED FORM 990 TO THE BOARD OF DIRECTORS FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MAINTAINS A CONFLICT OF INTEREST POLICY THAT COVERS ALL EMPLOYEES AND BOARD MEMBERS. EACH YEAR THE CONFLICT OF INTEREST POLICY IS REVIEWED BY EMPLOYEES THROUGH AN ON-LINE EDUCATION MODULE CALLED HCC CORPORATE COMPLIANCE. SENIOR LEADERSHIP AND ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE, SIGN, AND DATE AN ANNUAL CONFLICT OF INTEREST DISCLOSURE FORM. ALL DISCLOSURES BY BOARD MEMBERS ARE REVIEWED AND APPROVED BY THE BOARD CHAIRMAN. FORM 990, PART VI, SECTION B, LINE 15 THE PRESIDENT/CEO DOES A REVIEW OF SALARY SURVEYS TO ESTABLISH SALARY RANGE GUIDELINES FOR ALL POSITIONS. THESE SALARY RANGES ARE THEN APPROVED BY THE PERSONNEL COMMITTEE. AN ANNUAL PERFORMANCE REVIEW IS COMPLETED EACH YEAR AND ANY ADJUSTMENT TO COMPENSATION IS DETERMINED AT THAT TIME. FORM 990, PART VI, SECTION C, LINE 19 REQUESTS FOR REVIEW OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS MUST BE SUBMITTED TO HOSPICE OF CLEVELAND COUNTY, INC. IN WRITING AND MUST INCLUDE THE NAME, ADDRESS, AND TELEPHONE NUMBER OF THE INDIVIDUAL OR ENTITY MAKING THE REQUEST. ALL REQUESTS ARE SUBMITTED TO THE PRESIDENT/CEO FOR APPROVAL. UPPON APPROVAL, THE DOCUMENTS ARE MADE AVAILABLE WITHIN TWO WEEKS OF RECEIPT OF THE WRITTEN REQUEST. THE DOCUMENTS ARE AVAILABLE FOR REVIEW AT THE HOSPICE OF CLEVELAND COUNTY. INC. ADMINISTRATIVE OFFICE BUILDING. FORM 990, PART XI, LINE 9: CHANGE IN DISCOUNT FOR PLEDGES RECEIVED -40,155. OTHER RESTRICTED CONTRIBUTIONS RECEIVED -5,316. CHANGE IN ALLOWANCE FOR UNCOLLECTIBLE PLEDGES -900. FORM 990, PART XII, LINE 2C NO CHANGE FROM PRIOR YEAR.