2015-08-17T12:45:00-05:00 2014-09-30 593070669 MOORE STEPHENS LOVELACE PA 311 PARK PLACE BLVD SUITE 100 CLEARWATER FL 337593923 990 2013-10-01 593467282 HOSPICE FOUNDATION INC HOSP 7278637971 12470 TELECOM DRIVE TEMPLE TERRACE FL 33637 THOMAS BARB CHIEF EXECUTIVE OFFICER 7278637971 2015-08-18 1 KURT A ALTER CPA P00059492 7275314477 2013 2016-02-25 16:41:14Z HPH FOUNDATION THOMAS BARB 12470 TELECOM DRIVE TEMPLE TERRACE FL 33637 16495833 0 X WWW.HPH-HOSPICE.ORG/DONATIONS-SPECIAL-GIFTS X 1997 FL THE ORGANIZATION OPERATES TO ADVANCE UNDERSTANDING, PARTICIPATION AND SUPPORT OF THE MISSION AND PROGRAMS OF HERNANDO-PASCO HOSPICE, INC. AND ITS AFFILIATED NON-FOR-PROFIT ORGANIZATIONS, HONORING OUR COMMUNITY'S SACRED TRUST THROUGH SOUND STEWARDSHIP. 6 4 0 0 0 0 1561876 1922480 0 0 1144608 1477564 262847 -291755 2969331 3108289 748629 1111105 0 0 282375 225634 0 0 218650 142803 155562 1173807 1492301 1795524 1615988 19854653 21215600 254199 258849 19600454 20956751 THE ORGANIZATION OPERATES TO ADVANCE UNDERSTANDING, PARTICIPATION AND SUPPORT OF THE MISSION AND PROGRAMS OF HERNANDO-PASCO HOSPICE, INC. AND ITS AFFILIATED NOT-FOR-PROFIT ORGANIZATIONS, HONORING OUR COMMUNITY'S SACRED TRUST THROUGH SOUND STEWARDSHIP. 0 0 1129705 1111105 2045451 THE ORGANIZATION ACCEPTS DONATIONS FROM THE PUBLIC AND CONDUCTS ITS OWN FUND RAISING ACTIVITIES. THE ORGANIZATION ALSO OPERATES TWO THRIFT STORES, BOTH IN PASCO COUNTY. THE NET PROCEEDS OF THESE VARIOUS ACTIVITIES FLOW TO HERNANDO-PASCO HOSPICE, INC., (HPH) TO SUPPORT ITS END-OF-LIFE HOSPICE SERVICES WITHIN HPH'S THREE COUNTY SERVICE AREA. BY DIRECTION OF THE BOARD OF DIRECTORS, ANY BEQUESTS RECEIVED FLOW TO A BOARD DESIGNATED ENDOWMENT TO BE INVESTED TO HELP SECURE THE FUTURE OF HPH. 1129705 1 1 0 0 0 0 0 0 0 1 0 1 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 4 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X JILL FITZPATRICK 8138718167 12470 TELECOM DRIVE TEMPLE TERRANCE FL 33637 CLARENCE PREVATT CHAIRMAN 1.50 1.50 X X 0 0 0 THERESA BROCK VICE CHAIRMAN 1.50 1.50 X X 0 0 0 MIKE MCHUGH SECRETARY/TREASURER 1.50 0.00 X X 0 0 0 GEORGE GERMANN DIRECTOR 1.50 1.50 X 0 0 0 THOMAS BARB PRESIDENT/CEO 5.00 40.00 X X 0 242235 71244 W RICHARD YOUNG VP BUSINESS SERVICES/CFO 5.00 40.00 X X 0 164894 11093 0 407129 82337 0 0 1 0 WESTGATE SQUARE CENTER 10912 N 56 STREET TEMPLE TERRACE FL 33614 RENT 115234 EAST RICHEY SQUARE CENTER INC 6137 SR 54 NEW PORT RICHEY FL 34653 RENT 114651 2 44325 1878155 1922480 837279 837279 13390109 12749824 640285 640285 640285 126686 26412 100274 100274 734279 611308 122971 122971 FORGIVENESS OF INTERCOMPANY DEBT 999999 -515000 -515000 -515000 3108289 122971 0 1062838 1111105 1111105 189649 16635 49917 123097 20742 1037 5393 14312 15243 762 3963 10518 62155 62155 630 630 28480 28480 16412 16412 17065 17065 5286 4020 1266 4832 166 522 4144 2726 2726 17976 17976 1492301 1129705 143946 218650 1200 1200 23065 12159 280238 0 13162 13162 16419372 12406642 3117616 8782437 19854653 21215600 45474 43107 208725 215742 254199 258849 X 19600454 20956751 19600454 20956751 19854653 21215600 X 1615988 -241086 -18605 X X 0 1 X 1 0 X X X 0 0 0 HERNANDO PASCO HOSPICE INC 592217929 9 1 1 1 1111105 1 1111105 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 17536785 1102336 1230811 6496107 62155 13311670 17674898 703223 940187 1710000 71523 17536785 15070741 568584 2101015 65442 17674898 14173831 736083 222534 61707 15070741 12090177 716682 1429498 62526 14173831 1.00000 0.00000 0.00000 0 0 0 MONEY MARKET 752567 F ANNUITY FUNDS 370900 F REIT - ENDOWMENT 453445 F STOCK/EQUITIES 4145961 F BONDS 6683769 F 12406642 LEGACY FUND 38603 DEPOSITS 11509 DUE FROM AFFILIATES 8732325 8782437 GIFT ANNUITY OBLIGATIONS 215742 215742 3906334 241086 637719 878805 3027529 62155 18605 80760 3108289 2067865 637719 637719 1430146 62155 62155 1492301 PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUNDS ARE INTENDED TO PROVIDE FUTURE CASH FLOW FOR OPERATION AND OTHER DESIGNATED UNRESTRICTED PURPOSES USED BY THE BOARD OF DIRECTORS OF HERNANDO PASCO HOSPICE, INC. PART XI, LINE 2D - OTHER ADJUSTMENTS: THRIFT STORE COGS 611,308. FUNDRAISING EVENT EXPENSES 26,411. PART XI, LINE 4B - OTHER ADJUSTMENTS: GIFT ANNUITY ADJUSTMENT 18,605. PART XII, LINE 2D - OTHER ADJUSTMENTS: THRIFT STORE COGS 611,308. FUNDRAISING EVENT EXPENSES 26,411. TREE OF LIFE 111108 111108 23703 GET ROLLING FOR HOSPICE 15578 15578 2709 126686 126686 26412 26412 100274 0 HERNANDO PASCO HOSPICE INC 12470 TELECOM DRIVE TEMPLE TERRACE FL 33637 592217929 501(C)(3) 1111105 GENERAL SUPPORT PART I, LINE 2: THE ORGANIZATIONS SOLE PURPOSE IS TO SUPPORT HERNANDO-PASCO HOSPICE, INC, (HPH) A RELATED 501(C)(3) ORGANIZATION. THE MAJORITY OF THE BOARD MEMBERS OF THE ORGANIZATION ARE ALSO BOARD MEMBERS OF HPH AND OVERSEE ALL ALLOCATIONS OF THE GRANT MONEY. 0 1 0 0 0 0 0 0 0 THOMAS BARB PRESIDENT/CEO 0 242235 0 0 0 0 0 60000 0 11244 0 313479 0 0 W RICHARD YOUNG VP BUSINESS SERVICES/CFO 0 164894 0 0 0 0 0 0 0 11093 0 175987 0 0 PART I, LINE 4B HERNANDO PASCO HOSPICE, INC. MAINTAINS A NONQUALIFIED EMPLOYEE DEFERRED COMPENSATION PLAN, OPEN TO CERTAIN KEY EMPLOYEES UNDER INTERNAL REVENUE CODE SECTION 457(F). THE 457(F) PLAN PROVIDES FOR VOLUNTARY CONTRIBUTIONS TO BE MADE ON BEHALF OF ELIGIBLE PARTICIPANTS. THESE FUNDS REMAIN THE PROPERTY OF HERNANDO PASCO HOSPICE, INC., WHO ALSO HAS A FIDUCIARY DUTY OF ACCOUNTABILITY FOR THESE FUNDS. CONTRIBUTIONS ARE AT THE DISCRETION OF THE BOARD OF DIRECTORS. NO CURRENT YEAR CONTRIBUTIONS WERE MADE. THE PARTICIPANTS WILL RECEIVE A LUMP SUM PAYMENT ON THEIR NORMAL RETIREMENT DATE, AS DEFINED BY THE PLAN, OR AT CERTAIN OTHER SPECIFIC EVENTS AS ALSO DEFINED IN THE PLAN. HERNANDO PASCO HOSPICE, INC. ALSO OFFERS A NONQUALIFIED PENSION BENEFIT THROUGH A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR ONE KEY EXECUTIVE OFFICER. THE PARTICIPANT WILL RECEIVE A LUMP SUM BENEFIT PAYMENT ON HIS NORMAL RETIREMENT DATE, AS DEFINED BY THE PLAN, OR AT CERTAIN OTHER SPECIFIC EVENTS AS ALSO DEFINED IN THE PLAN. THIS IS CALCULATED TO BE THE DISCOUNTED AMOUNT OF ANNUAL INCOME, PAYABLE FOR THE ESTIMATED REMAINING LIFE OF THE PARTICIPANT, EQUAL TO 2.5% OF THE PARTICIPANT'S FINAL AVERAGE COMPENSATION MULTIPLIED BY HIS YEARS OF SERVICE. NO BENEFIT SHALL ACCRUE TO THE PARTICIPANT AFTER HIS NORMAL RETIREMENT DATE. FORM 990, PART VI, SECTION A, LINE 7A COMPOSITION OF THE BOARD OF TRUSTEES: THE TOTAL MEMBERSHIP OF THE BOARD OF TRUSTEES SHALL AT ALL TIMES BE REPRESENTED BY THE HOSPICE COMMUNITY OF ENTITIES AS FOLLOWS: (A) CARE SECTOR: FOUR TRUSTEES SHALL BE CURRENT MEMBERS IN GOOD STANDING OF THE BOARD OF DIRECTORS OF HERNANDO PASCO HOSPICE, INC. (THE CURRENT OPERATING ENTITY). SUCH TRUSTEES SHALL BE APPOINTED BY THE BOARD OF DIRECTORS OF HERNANDO PASCO HOSPICE, INC. AND SHALL SERVE UNTIL THEY ARE NO LONGER MEMBERS OF SUCH BOARD OR UNTIL THEY ARE REPLACED BY THE BOARD, WHICHEVER OCCURS FIRST. (B) MANAGEMENT SECTOR: ONE TRUSTEE SHALL BE THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF HERNANDO PASCO HOSPICE, INC. WHO SHALL SERVE UNTIL HE RESIGNS OR IS TERMINATED FROM OFFICE BY HERNANDO PASCO HOSPICE, INC. ONE TRUSTEE SHALL BE A PERSON EMPLOYED IN A MANAGERIAL POSITION BY HERNANDO PASCO HOSPICE, INC. AND SHALL BE APPOINTED BY THE HPH BOARD OF DIRECTORS. HE/SHE SHALL SERVE UNTIL S/HE IS NO LONGER EMPLOYED BY HERNANDO PASCO HOSPICE, INC. OR UNTIL REPLACED BY HPH BOARD OF DIRECTORS, WHICHEVER OCCURS FIRST. (C) AT LARGE SECTOR: ONE TRUSTEE SHALL BE APPOINTED ANNUALLY BY THE BOARD OF TRUSTEES OF HOSPICE FOUNDATION, INC. FORM 990, PART VI, SECTION A, LINE 7B RESTRICTIONS ON AUTHORITY OF THE BOARD OF TRUSTEES: NOTWITHSTANDING ANYTHING IN THE BYLAWS TO THE CONTRARY, UNLESS OTHERWISE APPROVED BY THE AFFIRMATIVE VOTE OF NOT LESS THAN SEVENTY-FIVE PERCENT OF BOTH THE BOARD OF TRUSTEES AND THE BOARD OF DIRECTORS OF HERNANDO PASCO HOSPICE, INC., THE BOARD OF TRUSTEES SHALL NOT HAVE THE AUTHORITY TO DO ANY OF THE FOLLOWING ACTS ON BEHALF OF THE CORPORATION: (A) AMEND, REPEAL OR ALTER, IN WHOLE OR IN PART, ANY PROVISION OF THE CORPORATION'S ARTICLE OF INCORPORATION OR BYLAWS, OR ADOPT NEW ARTICLES OF INCORPORATION OR BYLAWS; (B) REMOVE ANY TRUSTEE FROM OFFICE PRIOR TO THE EXPIRATION OF SUCH TRUSTEE'S TERM; (C) SELL, LEASE OR OTHERWISE DISPOSE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; (D) MERGE OR CONSOLIDATE THE CORPORATION WITH OR INTO ANY CORPORATION, PARTNERSHIP, LIMITED LIABILITY COMPANY OR OTHER ENTITY, OR ENTER INTO ANY PARTNERSHIP, JOINT VENTURE OR ALLIANCE, OR FORM ANY SUBSIDIARY, OR DISSOLVE AND WIND UP THE CORPORATION; (E) CHANGE THE NAME OR PURPOSE OF THE CORPORATION OR CHANGE THE NATURE OF THE BUSINESS OF THE CORPORATION OR DO ANY ACT THAT WOULD MAKE IT IMPOSSIBLE TO CARRY ON THE ORDINARY BUSINESS OF THE CORPORATION OR CHANGE THE PRINCIPAL PLACE OF BUSINESS OF THE CORPORATION; (F) ADMIT ANY PERSON OR ENTITY AS A MEMBER OF THE CORPORATION OR ISSUE, BY SALE, OPTION, WARRANT, FOR PROPERTY, SERVICES OR OTHERWISE, ANY ADDITIONAL VOTING MEMBERSHIP INTERESTS IN THE CORPORATION; (G) ENTER INTO, GIVE OR GRANT ANY MORTGAGES, DEEDS OF TRUST, PLEDGES OR OTHER SECURITY INTERESTS, IN ANY REAL PROPERTY OWNED OR ACQUIRED BY THE CORPORATION, OR ANY PORTION THEREOF; (H) FILE FOR BANKRUPTCY, APPOINT A RECEIVER OR TRUSTEE TO MAKE A TRANSFER FOR THE BENEFIT OF CREDITORS; OR (I) ESTABLISH OR MODIFY ANY TAX-RELATED STRATEGY OR POSITION, OR OTHERWISE TAKE ANY ACTION WHICH WOULD HAVE A MATERIAL IMPACT ON THE TAX MATTERS RELATING TO THE CORPORATION, INCLUDING ANY DECISION TO CHANGE THE TAX-EXEMPT STATUS OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE 990 IS PROVIDED TO THE BOARD OF DIRECTORS BEFORE BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY COVERS ALL "INTERESTED PERSONS," WHICH INCLUDES OFFICERS, DIRECTORS, MEMBERS OF ANY COMMITTEE OF THE BOARD, AND MEMBERS OF THE IMMEDIATE FAMILIES OF SUCH INDIVIDUALS. THE DESIGNATED COMPLIANCE OFFICER ROUTINELY REVIEWS THE EXISTING RELATIONSHIPS BETWEEN THE HOSPICE AND ITS "INTERESTED PERSONS", OTHER CARE PROVIDERS, EDUCATIONAL INSTITUTIONS AND PAYERS TO ASSURE THAT ALL RELATIONSHIPS ARE WITHIN THE LAW AND REGULATIONS. IF ANY CONFLICTS OF INTEREST ARE FOUND TO EXIST, THE COMPLIANCE OFFICER IMMEDIATELY REPORTS THE POTENTIAL CONFLICT TO THE CHIEF EXECUTIVE OFFICER. ANY VOTING MEMBER INVOLVED IN A CONFLICT OF INTEREST MUST IMMEDIATELY DISCLOSE IT TO THE CHAIRMAN OF THE BOARD AND IS DISALLOWED FROM VOTING ON ANY MATTERS RELATING TO ANY TRANSACTION WITH AN "INTERESTED PERSON" OR ENTITY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: GIFT ANNUITY ADJUSTMENT -18,605. FORM 990, PART XII, LINE 2C THE FINANCE COMMITTEE IS RESPONSIBLE FOR OVERSIGHT OF THE AUDITED FINANCIALS AND FOR INTERVIEWING INDEPENDENT ACCOUNTANTS. THEY MAKE THEIR RECOMMENDATION TO THE FULL BOARD, WHO VOTE TO SELECT THE INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. HERNANDO PASCO HOSPICE INC 12470 TELECOM DRIVE TEMPLE TERRACE FL 33637 592217929 PROVIDE MEDICAL AND SUPPORT SERVICES TO INDIVIDUALS FACING TERMINAL ILLNESS. FL 501(C)(3) LINE 9 N/A 0 HPH REAL ESTATE INC 12470 TELECOM DRIVE TEMPLE TERRACE FL 33637 593467283 PROVIDE AND MAINTAIN PHYSICAL FACILITIES FOR RELATED 501(C)(3) ORGANIZATIONS FL 501(C)(2) HERNANDO PASCO HOSPICE INC 0 HPH SOUTH INC 12470 TELECOM DRIVE TEMPLE TERRACE FL 33637 271436121 PROVIDE HOSPICE AND RELATED HEALTH CARE SERVICES FL HERNANDO PASCO HOSPICE INC C 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0