2015-02-13T12:21:08-06:00 2014-09-30 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2013-10-01 591940256 COMMUNITY HOSPICE OF NORTHEAST FLORIDA COMM 9042685200 4266 SUNBEAM RD JACKSONVILLE FL 32257 CARLOS BOSQUE CFO 9042685200 2015-02-12 1 AMY BIBBY P00445891 8282542254 2013 2016-02-25 16:41:14Z CARLOS BOSQUE 4266 SUNBEAM RD JACKSONVILLE FL 32257 95465396 0 X WWW.COMMUNITYHOSPICE.COM X 1984 FL HOSPICE IN HOME CARE OF TERMINALLY ILL PATIENTS AND COMPREHENSIVE GUIDANCE AND SUPPORT FOR PATIENTS AND THEIR FAMILIES. 37 37 1067 889 0 0 1808531 1556637 95223451 90591957 903582 1888094 120962 1006902 98056526 95043590 1400676 23621 0 0 52223419 49840727 0 0 0 42367651 41605683 95991746 91470031 2064780 3573559 75914999 80054796 7868188 8376229 68046811 71678567 X TO IMPROVE THE QUALITY OF LIFE FOR PATIENTS AND FAMILIES AND BE THE COMPASSIONATE GUIDE FOR END-OF-LIFE CARE IN OUR COMMUNITY. 1 0 64217314 71616184 HOSPICE HOMECAREESTABLISHED IN 1979, COMMUNITY HOSPICE OF NORTHEAST FLORIDA IS THE FIRST AND ONLY LOCALLY BASED, NONPROFIT HOSPICE PROGRAM TO SERVE RESIDENTS OF THE FIRST COAST. EACH DAY, THE ORGANIZATION HELPS APPROXIMATELY 1,250 PATIENTS AND THEIR FAMILIES LIVE BETTER WITH ADVANCED ILLNESS. MOST HOSPICE CARE IS PROVIDED WHERE PATIENTS LIVE, WHETHER THAT IS A PRIVATE RESIDENCE, NURSING HOME, OR ASSISTED LIVING FACILITY, AS WELL AS IN THE HOSPITAL OR IN ONE OF SEVEN COMMUNITY HOSPICE INPATIENT CARE CENTERS.COMMUNITY HOSPICE ENSURES PATIENTS' COMFORT BY ADDRESSING THEIR PHYSICAL, EMOTIONAL AND SPIRITUAL NEEDS THROUGH AN INTERDISCIPLINARY TEAM OF MORE THAN 850 HOSPICE PROFESSIONALS AND 889 VOLUNTEERS. THE ORGANIZATION ALSO ASSISTS FAMILY CAREGIVERS THROUGH EDUCATION, ACCESS TO COMMUNITY RESOURCES, AND BEREAVEMENT SUPPORT AFTER A LOSS. THE COMMUNITY HOSPICE MISSION IS TO IMPROVE THE QUALITY OF LIFE FOR PATIENTS AND THEIR FAMILIES AND TO BE THE COMPASSIONATE GUIDE FOR END-OF-LIFE CARE IN OUR COMMUNITY. OUR GOAL IS TO PROVIDE COMFORT AND ADDRESS SYMPTOMS FROM LIFE-LIMITING CONDITIONS, AS WELL AS PROVIDE SUPPORTIVE CARE TO FAMILY MEMBERS AND OTHER LOVED ONES. THE ORGANIZATION FOCUSES ON ENHANCING QUALITY OF LIFE WHILE RESPECTING THE PATIENTS' CULTURE, BELIEFS AND VALUES. NO ONE IS EVER DENIED CARE DUE TO AN INABILITY TO PAY.COMMUNITY HOSPICE COMPASSIONATE CARE INCLUDES: IN-HOME NURSING CARE; PHYSICIAN SERVICES; PSYCHOSOCIAL SERVICES; SPIRITUAL SUPPORT; CERTIFIED NURSING ASSISTANT (CNA), HOME HEALTH AIDE SERVICES; MEDICAL EQUIPMENT (SUCH AS WHEELCHAIRS AND WALKERS); MEDICAL SUPPLIES (SUCH AS BANDAGES AND CATHETERS); DRUGS FOR SYMPTOM MANAGEMENT OR PAIN RELIEF; BEREAVEMENT COUNSELING AND SUPPORT; PHYSICAL AND OCCUPATIONAL THERAPY; SPEECH THERAPY; DIETARY COUNSELING.A DEDICATED TEAM OF HOSPICE PROFESSIONALS WORK WITH PATIENTS TO HELP MANAGE THE PAIN AND SYMPTOMS ASSOCIATED WITH A LIFE-LIMITING ILLNESS, AND PROVIDE PERSONAL, RESPECTFUL CARE AND ASSISTANCE. THIS INCLUDES EMOTIONAL AND SPIRITUAL SUPPORT. THE ORGANIZATION TEACHES PATIENTS AND THEIR CAREGIVERS ABOUT THE DISEASE AND WHAT TO EXPECT IN FUTURE STAGES, AS WELL AS ABOUT MEDICINES AND WAYS TO INCREASE COMFORT. ON-CALL SERVICES ARE AVAILABLE 24 HOURS A DAY, 7 DAYS A WEEK. LAST YEAR 362,062 DAYS OF CARE WERE PROVIDED BY OUR HOMECARE TEAMS. 14270514 18969553 HOSPICE INPATIENT CAREINPATIENT CARE, IF NEEDED, IS AVAILABLE IN ONE OF OUR FIVE INPATIENT CENTERS. OUR INPATIENT FACILITIES ARE AVAILABLE FOR PATIENTS NEEDING PAIN AND SYMPTOM MANAGEMENT AT AN ACUTE LEVEL UNABLE TO BE CARRIED OUT IN A HOME SETTING. WE ALSO PROVIDE CARE TO PATIENTS HERE THAT IT IS NON- ACUTE IF IT IS NOT FEASIBLE FOR THE PATIENT TO REMAIN IN THEIR HOME. OUR FACILITIES ARE HOMELIKE SURROUNDINGS WITH GARDENS AND SERENE SETTINGS. WE HAVE LOCATED THESE FACILITIES THROUGHOUT OUR 5 COUNTY SERVICE AREA TO ALLOW FAMILIES TO RECEIVE THIS SERVICE WITHOUT A LONG DRIVE TO BE WITH THEIR LOVED ONES. LAST YEAR 24,541 DAYS OF CARE WERE PROVIDED IN OUR INPATIENT FACILITIES. 792806 22609 6220 PALLIATIVE CARETHROUGH COMMUNITY PALLIATIVE CONSULTANTS LAUNCHED IN 2010, PALLIATIVE CONSULT SERVICES ARE PROVIDED THROUGH SEVERAL LOCAL HOSPITALS. AT THE REQUEST OF THE PATIENT'S ATTENDING PHYSICIAN, SPECIALLY TRAINED PHYSICIANS AND ADVANCED REGISTERED NURSE PRACTITIONERS (ARNPS) TAKE THE TIME TO UNDERSTAND THEN RECOMMEND OPTIONS TO MEET THE PATIENT'S PERSONAL GOALS OF CARE. COMMUNITY PALLIATIVE CONSULTANTS ALSO PROVIDES EDUCATION AND TRAINING OF HOSPITAL/FACILITY STAFF. PALLIATIVE CARE PROVIDES AN EXTRA LAYER OF SUPPORT FOR PATIENTS AND THEIR FAMILIES THROUGH A MULTIDISCIPLINARY TEAM FOCUSED ON PROVIDING RELIEF FROM THE SYMPTOMS, PAIN AND STRESS ASSOCIATED WITH A SERIOUS ILLNESS OR COMPLEX CHRONIC CONDITION. LAST YEAR OUR PALLIATIVE CARE PROGRAM DID 9,053 PATIENT VISITS IN OUR LOCAL HOSPITALS. 1012 1012 79280634 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 169 0 1 1067 1 0 0 0 0 0 0 0 0 0 1 0 X 37 37 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 FL X X CARLOS BOSQUE CFO 9042685200 4266 SUNBEAM ROAD JACKSONVILLE FL 32257 FERNANDO ACOSTA-RUA CHAIR 3.00 1.00 X X 0 0 0 JOE MITRICK 1ST VICE CHAIR 2.00 X X 0 0 0 MORRIE ZIMMERMAN 2ND VICE CHAIR 1.00 X X 0 0 0 JOHN W LOGUE TREASURER 2.00 1.00 X X 0 0 0 DR ROBERT NUSS ASSISTANT TREASURER 1.00 X X 0 0 0 JOHN HAYT SECRETARY 2.00 X X 0 0 0 MOODY CHISHOLM BOARD MEMBER 1.00 X 0 0 0 GERARDO COLON-OTERO BOARD MEMBER 1.00 X 0 0 0 BARBARA CONE BOARD MEMBER 1.00 X 0 0 0 JOHN J DIAMOND BOARD MEMBER 1.00 X 0 0 0 CHRISTOPHER EMANS BOARD MEMBER 1.00 X 0 0 0 CAROLE GARDNER BOARD MEMBER 1.00 X 0 0 0 JOE GORDY BOARD MEMBER 1.00 X 0 0 0 DAVID HALLMAN BOARD MEMBER 1.00 X 0 0 0 DR ANN HARWOOD-NUSS BOARD MEMBER 1.00 X 0 0 0 HON MARCIA M HOWARD BOARD MEMBER 1.00 X 0 0 0 BRIAN HUTCHESON THRU 72014 BOARD MEMBER 1.00 X 0 0 0 CAL JACKSON THRU 92014 BOARD MEMBER 1.00 X 0 0 0 PATRICE JONES BOARD MEMBER 1.00 X 0 0 0 JOY KORMAN BOARD MEMBER 1.00 X 0 0 0 RABBI JOSHUA LIEF BOARD MEMBER 1.00 X 0 0 0 HILARY MATHEWS BOARD MEMBER 1.00 X 0 0 0 RAY MATUZA BOARD MEMBER 1.00 X 0 0 0 AMBASSADOR MARILYN MCAFEE BOARD MEMBER 1.00 X 0 0 0 JOSH MCGRAW BOARD MEMBER 1.00 1.00 X 0 0 0 ESTELLE MCKISSICK THRU 92014 BOARD MEMBER 1.00 X 0 0 0 GREG MILLER BOARD MEMBER 1.00 X 0 0 0 MARCIA MORALES BOARD MEMBER 1.00 1.00 X 0 0 0 PAULA RINGHAVER BOARD MEMBER 1.00 X 0 0 0 SCOTT CAIRNS BOARD MEMBER 1.00 X 0 0 0 LARRY WAGONER BOARD MEMBER 1.00 X 0 0 0 SCOTT WITT BOARD MEMBER 1.00 X 0 0 0 SENATOR AUDREY GIBSON BOARD MEMBER 1.00 X 0 0 0 RICHARD HAWTHORNE BOARD MEMBER 1.00 X 0 0 0 MARSHA OLIVER BOARD MEMBER 1.00 X 0 0 0 KEVIN ROBBINS BOARD MEMBER (EX-OFFICIO) 1.00 X 0 0 0 KYLE SANDERS BOARD MEMBER 1.00 X 0 0 0 ALLISON KORMAN SHELTON BOARD MEMBER 1.00 X 0 0 0 KEITH STEIN MD BOARD MEMBER 1.00 X 0 0 0 BRYAN UPCHURCH BOARD MEMBER 1.00 X 0 0 0 LARRY WILF MD BOARD MEMBER 1.00 1.00 X 0 0 0 SUSAN PONDER-STANSEL PRESIDENT/CEO 40.00 10.00 X 390660 0 104264 CARLOS BOSQUE CFO 30.00 5.00 X 205694 0 48509 PHILLIP WARD CHIEF OF BUS. OPER. 40.00 X 278685 0 90705 STEPHEN CLARK CMO (OCT 2013-APRIL 2014 40.00 X 244304 0 24983 KATHLEEN JOHNSON VP OF WORKFORCE DEV. 40.00 X 379092 0 30021 JOHN MCILVAINE VP BUS. DEVELOPMENT 40.00 X 199912 0 39936 ANDREA FRITZ DEPUTY CFO 40.00 X 199004 0 73143 KATHRYN MCILVAINE VP OF COMMUNITCATION (10/13-4/14) 40.00 X 164630 0 35204 MARY MCELROY SENIOR VP OF HOSPICE SRVCS. 40.00 X 182496 0 14819 WILDRICK STEVENSON CHIEF COMPLIANCE OFFICER 40.00 X 152338 0 33703 ANDREW DAIGLE PHYSICIAN 40.00 X 199822 0 22980 REUBEN SMITH PHYSICIAN 40.00 X 185215 0 14281 PAUL BORGMAN PHYSICIAN 40.00 X 195879 0 72214 DONALD TWIGGS PHYSICIAN 40.00 X 199703 0 17777 JENNIFER CONTIN PHYSICIAN 40.00 X 187060 0 14426 3364494 0 636965 29 0 1 0 INPATIENT CONSULTANTS OF FL PO BOX 513500 LOS ANGELES CA 900513500 CONTRACTED PHYSICIAN SERVICES 1693079 SOUTHPOINT TERRACE 4325 SOUTHPOINT BLVD JACKSONVILLE FL 32216 SKILLED NURSING FACILITY 971119 PALM GARDEN 5725 SPRING PARK ROAD JACKSONVILLE FL 32216 SKILLED NURSING FACILITY 847737 TAYLOR CARE CENTER 6535 CHESTER AVENUE JACKSONVILLE FL 33217 SKILLED NURSING FACILITY 809075 CATHEDRAL GERONTOLOGY CENTER 333 EAST ASHLEY STREET JACKSONVILLE FL 32202 SKILLED NURSING FACILITY 669297 43 1556637 19300 1556637 PATIENT SERVICE REVENU 623000 71616184 71616184 NURSING HOME SUPPORT 623000 18969553 18969553 OTHER PROGRAM SERVICE 623000 6220 6220 90591957 690000 690000 1225471 0 27377 1225471 -27377 1198094 1198094 1213829 394429 819400 819400 MISCELLANOUS REVENUE 623000 102339 102339 CAFE REVENUE 722210 82421 82421 VENDING REVENUE 722210 2742 2742 187502 95043590 90591957 0 2894996 23621 23621 2376576 484088 1892488 37788856 31677688 6111168 1204239 865764 338475 5496907 4568202 928705 2974149 2536525 437624 144963 144963 188107 188107 48685 48685 76621 76621 19272 19272 2451448 2279644 171804 334416 96562 237854 3115074 2387242 727832 410989 410989 2130680 2130680 1182503 996662 185841 244919 140714 104205 6084 6084 2678778 2678778 652374 652374 ROOM AND BOARD 20204696 20204696 MEDICAL SUPPLIES EXPENS 6299642 6299642 CHARITY CARE EXPENSES 1076710 1076710 DIETARY 246481 246481 93241 93241 91470031 79280634 12189397 0 2150 3350 20065207 16671765 4920406 7481088 537255 612138 3069515 2836098 53318879 17863840 30791622 35455039 16342158 16817756 103681 65585 83005 111977 75914999 80054796 6510458 7071224 150446 14938 1207284 1290067 7868188 8376229 X 68046811 71678567 68046811 71678567 75914999 80054796 3573559 58197 0 X 0 1 X 1 0 X 4143926 3553298 1568604 1808531 1560561 12634920 74775457 90287048 93920661 95223451 90590457 444797074 78919383 93840346 95489265 97031982 92151018 457431994 0 0 0 457431994 279251 386772 550386 724645 690000 2631054 279251 386772 550386 724645 690000 2631054 120962 187502 308464 79198634 94227118 96039651 97877589 93028520 460371512 0.99360 0.99500 0.00570 0.00470 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 76621 0 1 5687 82308 0 PART II-B, LINE 1: THE ORGANIZATION INCURRED EXPENSES BY CALLING ON MEMBERS OF NORTH FLORIDA DELEGATION REGARDING PACE LEGISLATION, FUNDING FOR "MONEY FOLLOWS THE PERSON" GRANT FOR FLORIDA, PARTNERS IN CARE-MEDICAID, MEDICAID MANAGED CARE CONCERNS, CERTIFICATE OF NEED SUPPORT FOR HOSPICE THE ORGANIZATION WAS A MEMEBER OF THE FOLLOWING ORGANIZATIONS THAT ENGAGED IN LOBBYING ON BEHALF OF ITS MEMBERS: NATIONAL ASSOCIATION FOR HOME CARE & HOSPICE FLORIDA HEALTH CARE ASSOCIATION FLORIDA HOSPICES AND PALLIATIVE CARE NHPCO 3127499 3127499 31969646 9067705 22901941 4724262 1026389 3697873 13054309 7769746 5284563 443163 443163 35455039 DEFERRED COMPENSATION 1290067 1290067 X 95495204 58197 393417 451614 95043590 0 95043590 91863448 393417 393417 91470031 0 91470031 PART X, LINE 2: INCOME TAXES- COMMUNITY HOSPICE OF NORTHEAST FLORIDA, INC. AND ITS AFFILIATE ARE NOT-FOR-PROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPICE FOLLOWS THE FASB'S AUTHORITATIVE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR RECOGNITION AND MEASUREMENT OF THE BENEFITS OF INDIVIDUAL TAX POSITIONS IN THE CONSOLIDATED FINANCIAL STATEMENTS. TAX POSITIONS MUST MEET A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT IN ORDER FOR THE BENEFIT OF THOSE TAX POSITIONS TO BE RECOGNIZED IN THE HOSPICE'S CONSOLIDATED FINANCIAL STATEMENTS. THE HOSPICE HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2014. PART XI, LINE 2D - OTHER ADJUSTMENTS: THRIFT STORE EXPENSES INCLUDED ON FORM 990, PART VIII, LINE 10B 393,417. PART XII, LINE 2D - OTHER ADJUSTMENTS: THRIFT STORE EXPENSES INCLUDED ON FORM 990, PART VIII, LINE 10B 393,417. 0 UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS INC 653 WEST 8TH STREET JACKSONVILLE FL 32209 591867557 501(C)(3) 22609 PALLIATIVE CARE FELLOWSHIP 1 SCHEDULE I, PART II, LINE 1H THE PALLIATIVE CARE FELLOWSHIP IS FOR THE SUPPORT AND ENHANCEMENT OF THE CLINICAL, EDUCATIONAL, AND RESEARCH PROGRAMS OF THE UNIVERSITY, PROVIDES A SETTING IN WHICH COLLEGE'S PHYSICIAN FELLOWS MAY PARTICIPATE IN EDUCATION, RESEARCH, PATIENT CARE, AND ADMINISTRATIVE RESPONSIBILITIES THROUGH COOPERATIVE EFFORTS WITH THE UNIVERSITY. X X X X X X 0 0 0 0 0 0 0 0 0 SUSAN PONDER-STANSEL PRESIDENT/CEO 322180 0 50980 0 17500 0 77987 0 26277 0 494924 0 0 0 CARLOS BOSQUE CFO 170874 0 20450 0 14370 0 31407 0 17102 0 254203 0 0 0 PHILLIP WARD CHIEF OF BUS. OPER. 233540 0 27645 0 17500 0 64635 0 26070 0 369390 0 0 0 STEPHEN CLARK CMO (OCT 2013-APRIL 2014 217769 0 26535 0 0 0 7430 0 17553 0 269287 0 0 0 KATHLEEN JOHNSON VP OF WORKFORCE DEV. 158379 0 0 0 220713 0 17156 0 12865 0 409113 0 0 0 JOHN MCILVAINE VP BUS. DEVELOPMENT 182314 0 3608 0 13990 0 30928 0 9008 0 239848 0 0 0 ANDREA FRITZ DEPUTY CFO 164140 0 20456 0 14408 0 47395 0 25748 0 272147 0 0 0 KATHRYN MCILVAINE VP OF COMMUNITCATION (10/13-4/14) 150138 0 2971 0 11521 0 26418 0 8786 0 199834 0 0 0 MARY MCELROY SENIOR VP OF HOSPICE SRVCS. 178926 0 3570 0 0 0 5507 0 9312 0 197315 0 0 0 WILDRICK STEVENSON CHIEF COMPLIANCE OFFICER 126544 0 15125 0 10669 0 18304 0 15399 0 186041 0 0 0 ANDREW DAIGLE PHYSICIAN 199072 0 0 0 750 0 6253 0 16727 0 222802 0 0 0 REUBEN SMITH PHYSICIAN 184465 0 0 0 750 0 5647 0 8634 0 199496 0 0 0 PAUL BORGMAN PHYSICIAN 195129 0 0 0 750 0 55511 0 16703 0 268093 0 0 0 DONALD TWIGGS PHYSICIAN 198953 0 0 0 750 0 6149 0 11628 0 217480 0 0 0 JENNIFER CONTIN PHYSICIAN 180733 0 0 0 6327 0 5792 0 8634 0 201486 0 0 0 FORM 990, PART III, LINE 2 COMMUNITY HOSPICE OPERATES THRIFT STORES IN THE COMMUNITY TO RAISE FUNDS FOR UNFUNDED PATIENT CARE. THESE THRIFT STORES WERE PREVIOUSLY MANAGED BY COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION FOR CARING, INC. FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE OFFICERS AND THE IMMEDIATE PAST CHAIR, IF HE OR SHE CONTINUES TO SERVE ON THE BOARD, AND THE CHAIRS OF THE STRATEGIC PLANNING COMMITTEE, THE COMPLIANCE/QUALITY OVERSIGHT COMMITTEE AND THE NOMINATING AND BOARD DEVELOPMENT COMMITTEE. THE CHAIR OF THE COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION FOR CARING, INC. SHALL BE AN EX-OFFICIO MEMBER OF THE EXECUTIVE COMMITTEE WITHOUT VOTE. THE EXECUTIVE COMMITTEE SHALL MEET AT THE CALL OF THE CHAIR, OR, IN THE ABSENCE OF THE CHAIR, AT THE CALL OF THE FIRST VICE-CHAIR. THE EXECUTIVE COMMITTEE SHALL HAVE SUCH POWERS AS MAY BE DELEGATED BY THE BOARD OF DIRECTORS FROM TIME TO TIME. THE EXECUTIVE COMMITTEE SHALL ACT UPON INTERIM BUSINESS ARISING BETWEEN REGULAR MEETINGS OF THE BOARD OF DIRECTORS AND SHALL REPORT ITS ACTION AT THE NEXT MEETING OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL PERIODICALLY REVIEW THE PERFORMANCE OF THE PRESIDENT/CEO, AND SHALL REVIEW, FROM TIME TO TIME, PERSONNEL POLICIES, INCLUDING CONDITIONS OF EMPLOYMENT, AND SHALL MEET PERIODICALLY WITH THE PRESIDENT/CEO TO ASSESS PERSONNEL POLICIES AND WORKING CONDITIONS. THE COMMITTEE WILL REVIEW THE SALARY PLAN AND RECOMMEND CHANGES WHEN INDICATED. THE COMMITTEE SHALL OVERSEE THE ADMINISTRATION OF ANY AFFIRMATIVE ACTION PLAN. ACTIONS OF THE EXECUTIVE COMMITTEE PURSUANT TO THIS PARAGRAPH SHALL HAVE THE SAME EFFECT AS ACTIONS OF THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 2 JOHN MCILAINE AND KATHY MCILVAINE ARE BOTH KEY EMPLOYEES AND ARE HUSBAND AND WIFE. THE HONORABLE MARCIA MORALES HOWARD AND MARCIA MORALES ARE BOTH BOARD MEMBERS AND ARE MOTHER AND DAUGHTER. DR ROBERT NUSS AND DR. ANN HARWOOD-NUSS ARE BOTH BOARD MEMBERS AND ARE HUSBAND AND WIFE. FORM 990, PART VI, SECTION B, LINE 11 THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTANT WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. UPON COMPLETION, THE RETURN WAS REVIEWED IN ITS ENTIRETY BY THE BUDGET FINANCE COMMITTEE OF THE BOARD, FOLLOWED BY A PRESENTATION TO THE FULL BOARD FOR APPROVAL. FOLLOWING APPROVAL, THE RETURN WAS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS OF THE BOARD OF DIRECTORS ARE REQUIRED ANNUALLY TO COMPLETE AND SIGN A CONFLICT OF INTEREST POLICY IDENTIFYING RELATIONSHIPS THAT MAY GIVE RISE TO CONFLICT. OFFICERS AND KEY MANAGEMENT PERSONNEL ALSO COMPLETE A SURVEY REGARDING POTENTIAL BUSINESS RELATIONSHIPS WITH OTHER OFFICERS, DIRECTORS, AND KEY PERSONNEL.ANY PERSON DETERMINED TO HAVE A CONFLICT OF INTEREST IS REQUIRED TO RECUSE THEMSELVES FROM ANY VOTE RELATED TO THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMMITTEE OF THE BOARD REVIEWED AND MAKES DECISIONS ANNUALLY REGARDING COMPENSATION FOR EXECUTIVE STAFF. THE EXECUTIVE COMMITTEE RETAINED AN INDEPENDENT CONSULTANT TO CONDUCT A COMPREHENSIVE REVIEW OF THE COMPETITIVENESS AND REASONABLENESS OF THE COMPENSATION AND BENEFITS PROVIDED TO THE FOLLOWING POSITIONS: CEO, COO, CFO, SVP OF BUSINESS INTEGRATION, SVP HOSPICE SERVICES, DEPUTY CHIEF FINANCIAL OFFICER,VP COMPLIANCE AND QUALITY, VP CHIEF INFORMATION OFFICER, VP HUMAN RESOURCES, AND CHIEF MEDICAL OFFICER HOSPICE. A REVIEW OF COMPETITIVENESS AND REASONABLENESS FOR LIKE ORGANIZATIONS TO INCLUDE NOT-FOR-PROFIT POST ACUTE CARE PROVIDERS AND HOSPITALS OF COMPARABLE SIZE, REGARDLESS OF GEOGRAPHY WAS CONDUCTED. TARGET MARKET AT MEDIAN. FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION WILL PROVIDE ANY GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS UPON REQUEST. THIS CAN BE DONE IN PERSON, BY PHONE, VIA OUR WEBSITE OR ON WWW.GUIDESTAR.COM. THE ORGANIZATION PUBLISHES A COMMUNITY REPORT IN THE LOCAL SUNDAY NEWSPAPER THAT PROVIDES SUMMARY INFORMATION OF THE PREVIOUS YEAR. COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION FOR CARING 4266 SUNBEAM ROAD JACKSONVILLE FL 32257 593583920 FUNDRAISING FOR COMMUNITY HOSPICE OF NORTHEAST FLORIDA FL 501(C)(3) 13, TYPE I COMMUNITY HOSPICE OF NORTHEAST FLORIDA 1 COMMUNITY MANAGEMENT COMPANY OF NORTHEAST FLORIDA INC 4266 SUNBEAM ROAD JACKSONVILLE FL 32257 EDUCATION AND CARING FOR THE ELDERLY FL COMMUNITY HOSPICE OF NORTHEAST FLORIDA C 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION A 124715 FMV COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION C 1556637 FMV COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION O 209827 FMV SCHEDULE R, PART VII THE COMMUNITY MANAGEMENT COMPANY OF NORTHEAST FLORIDA, INC. WAS ESTABLISHED IN DECEMBER 2012 AND IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE AND EDUCATIONAL PURPOSES, INCLUDING THE PROVISION OF PALLIATIVE CARE SERVICES AND OTHER HEALTH SERVICES TO IMPROVE THE HEALTH SERVICES OF THE PEOPLE IN THE COMMUNITY IT SERVES. AS OF SEPTEMBER 20, 2014, COMMUNITY MANAGEMENT COMPANY OF NORTHEAST FLORIDA, INC. HAD NOT ENGAGED IN ANY FINANCIAL TRANSACTIONS AND THEIR APPLICATION FOR EXEMPTION WAS STILL IN THE PROCESS.