HOSPICE OF RANDOLPH COUNTY INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
HOSPICE OF RANDOLPH COUNTY INC (EIN 56-1376378)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-11-12
IRS object ID
201533169349304738
Schema version
2014v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2015-11-12T15:27:17-06:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN560570567PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1D M J & CO PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1703 GREEN VALLEY ROAD SUITE 201AddressLine1Txt
CityGREENSBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27408ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN561376378EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HOSPICE OF RANDOLPH COUNTY INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHOSPBusinessNameControlTxt
Phone3366729300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1416 VISION DRIVEAddressLine1Txt
CityASHEBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27203ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRHONDA BURCH MOFFITTPersonNm
Person TitleCEO/PRESIDENTPersonTitleTxt
Phone3366729300PhoneNum
Signature2015-11-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonERIC DUTTON CPAPreparerPersonNm
PTINP01218304PTIN
Phone3362759886PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerRHONDA BURCH MOFFITTPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1416 VISION DRIVEAddressLine1Txt
CityASHEBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27203ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$6,889,935GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.HOSPICEOFRANDOLPH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1981FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionMISSION: HOSPICE OF RANDOLPH COUNTY SERVES AS AN EDUCATION LEADER WHILE PROMOTING QUALITY OF LIFE AND SUPPORTING PATIENTS AND THEIR FAMILIES IN PREPARING FOR COMPLETION OF LIFE. ACTIVITIES: TO PROVIDE SUPPORT AND EMOTIONAL ASSISTANCE TO PATIENTS AND THEIR FAMILIES WITH PAIN MANAGEMENT, SYMPTOM CONTROL, AND REHABILITATION DURING EMOTIONAL CRISIS RELATED TO END-OF-LIFE CARE. SPECIAL THERAPIES, ACUTE CARE, CONTINUOUS CARE, AND RESPITE AND ROUTINE HOME CARE ARE REIMBURSED BY REVENUE RESOURCES ALONG WITH SOME SUPPLIES, DURABLE MEDICAL EQUIPMENT, AND DRUGS. SERVICES ARE DELIVERED UNDER A HOLISTIC PLAN OF CARE.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee114TotalEmployeeCnt
Total Volunteers70TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$139,678PYContributionsGrantsAmt
CY Contributions Grants$248,735CYContributionsGrantsAmt
PY Program Service Revenue$6,172,840PYProgramServiceRevenueAmt
CY Program Service Revenue$6,504,556CYProgramServiceRevenueAmt
PY Investment Income$3,739PYInvestmentIncomeAmt
CY Investment Income$3,548CYInvestmentIncomeAmt
PY Other Revenue$83,633PYOtherRevenueAmt
CY Other Revenue$105,211CYOtherRevenueAmt
PY Total Revenue$6,399,890PYTotalRevenueAmt
CY Total Revenue$6,862,050CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$4,579,927PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$4,718,629CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$72,234CYTotalFundraisingExpenseAmt
PY Other Expenses$1,977,683PYOtherExpensesAmt
CY Other Expenses$2,133,835CYOtherExpensesAmt
PY Total Expenses$6,557,610PYTotalExpensesAmt
CY Total Expenses$6,852,464CYTotalExpensesAmt
PY Revenues Less Expenses-$157,720PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$9,586CYRevenuesLessExpensesAmt
Total Assets BOY$8,545,202TotalAssetsBOYAmt
Total Assets EOY$8,586,450TotalAssetsEOYAmt
Total Liabilities BOY$1,605,858TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,637,675TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$6,939,344NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$6,948,775NetAssetsOrFundBalancesEOYAmt
MissionHOSPICE OF RANDOLPH COUNTY SERVES AS AN EDUCATIONAL LEADER WHILE PROMOTING QUALITY OF LIFE AND SUPPORTING PATIENTS AND THEIR FAMILIES IN PREPARING FOR COMPLETION OF LIFE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$4,781,916ExpenseAmt
Revenue$6,517,452RevenueAmt
DescPROVIDE SUPPORT AND EMOTIONAL ASSISTANCE TO PATIENTS AND THEIR FAMILIES WITH PAIN MANAGEMENT, SYMPTOM CONTROL, REHABILITATION AND EMOTIONAL CRISIS. SPECIAL THERAPIES, ACUTE CARE, CONTINUOUS CARE, RESPITE AND ROUTINE HOME CARE ARE REIMBURSED BY THE ABOVE REVENUE RESOURCES ALONG WITH SOME SUPPLIES, DURABLE MEDICAL EQUIPMENT, AND DRUGS. SERVICES ARE DELIVERED UNDER A HOLISTIC PLAN OF CARE. DURING 2014, HOSPICE OF RANDOLPH COUNTY PROVIDED 48,013 DAYS OF PATIENT CARE FOR ITS 772 HOSPICE, HOME HEALTH, AND KIDS PATH PATIENTS.Desc
Total Program Service Expenses$4,781,916TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of ArtYes (1)CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document27IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee114EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNCStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CAREY DURHAMBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3366729300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1416 VISION DRIVEAddressLine1Txt
CityASHEBOROCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27203ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeInd
SANDRA J ALLEN
DIRECTOR1.00Yes (X)$0$0$0
RICK CRAWFORD
DIRECTOR1.00Yes (X)$0$0$0
NEAL GRIFFIN
DIRECTOR1.00Yes (X)$0$0$0
CANDICE GARRETT
DIRECTOR1.00Yes (X)$0$0$0
DR MALKIAT DHATT
DIRECTOR1.00Yes (X)$0$0$0
STEVE EBLIN
DIRECTOR1.00Yes (X)$0$0$0
GLENN M PUGH
DIRECTOR1.00Yes (X)$0$0$0
ROXANNE TAYLOR
DIRECTOR1.00Yes (X)$0$0$0
CURT LORIMER
DIRECTOR1.00Yes (X)$0$0$0
BEN C MORGAN
DIRECTOR1.00Yes (X)$0$0$0
RHONDA BURCH MOFFITT
CEO/PRESIDENT40.00$109,261$0$14,181Yes (X)
CAREY M DURHAM
CFO40.00$88,684$0$12,994Yes (X)
JOHN S ROGERS
SECRETARY1.00$0$0$0Yes (X)
STUART FOUNTAIN
TREASURER1.00$0$0$0Yes (X)
CHRISTINE MCCARTY MD
BOARD CHAIR1.00$13,100$0$0Yes (X)
SCOTT A MURKIN MD
MEDICAL DIRECTOR40.00$177,534$0$22,932Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$388,579TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$50,107TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
HOSPICE PHARMACIA
1601 CHERRY ST SUITE 1700PHILADELPHIAPA19102PATIENT MEDICATIONS$417,050
ADVANCED HOMECARE
PO BOX 18049GREENSBORONC27419MEDICAL SUPPLIES$223,079
UNIVERSAL HEALTHCARE
7166 JORDAN ROADRAMSEURNC27316PATIENT CARE FACILITY$157,572
GRAYBRIER NURSING & RET CTR
116 LANE DRIVETRINITYNC27370PATIENT CARE FACILITY$146,601
HOLLADAY SURGICAL SUPPLY
2551 LANDMARK DRWINSTONSALEMNC27103MEDICAL SUPPLIES$144,436
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt
Federated Campaigns$7,019FederatedCampaignsAmt
All Other Contributions$241,716AllOtherContributionsAmt
Noncash Contributions$4,340NoncashContributionsAmt
Total Contributions$248,735TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICARE PAYMENTS621610$5,890,123$5,890,123
PRIVATE INSURANCE621610$327,827$327,827
MEDICAID PAYMENTS621610$286,606$286,606
FieldValueIRS element (for citing)
Total Program Service Revenue$6,504,556TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,548TotalRevenueColumnAmt
Exclusion$3,548ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$120,200FundraisingGrossIncomeAmt
Fundraising Direct Expenses$27,885FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$92,315TotalRevenueColumnAmt
Exclusion$92,315ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,896TotalRevenueColumnAmt
Related Or Exempt Func Income$12,896RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$12,896OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,862,050TotalRevenueColumnAmt
Related Or Exempt Func Income$6,517,452RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$95,863ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$438,686TotalAmt
Management And General$438,686ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$3,506,184TotalAmt
Program Services$2,884,053ProgramServicesAmt
Management And General$562,333ManagementAndGeneralAmt
Fundraising$59,798FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$57,960TotalAmt
Program Services$52,246ProgramServicesAmt
Management And General$4,631ManagementAndGeneralAmt
Fundraising$1,083FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$440,839TotalAmt
Program Services$347,549ProgramServicesAmt
Management And General$86,723ManagementAndGeneralAmt
Fundraising$6,567FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$274,960TotalAmt
Program Services$192,669ProgramServicesAmt
Management And General$77,505ManagementAndGeneralAmt
Fundraising$4,786FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$21,343TotalAmt
Management And General$21,343ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$63,434TotalAmt
Management And General$63,434ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$184,732TotalAmt
Program Services$172,084ProgramServicesAmt
Management And General$12,648ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$64,041TotalAmt
Management And General$64,041ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$244,607TotalAmt
Management And General$244,607ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$36,684TotalAmt
Management And General$36,684ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICINES AND DRUGS$474,451$474,451
DURABLE MEDICAL EQUIPME$211,202$211,202
MEDICAL AND OFFICE SUPP$172,620$148,814$23,806
CATERING SERVICES$83,796$83,796

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$576,925TotalAmt
Program Services$215,052ProgramServicesAmt
Management And General$361,873ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$6,852,464TotalAmt
Program Services$4,781,916ProgramServicesAmt
Management And General$1,998,314ManagementAndGeneralAmt
Fundraising$72,234FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,014,492BOYAmt
EOY$1,054,068EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,676,915BOYAmt
EOY$1,678,899EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$10,413BOYAmt
EOY$1,923EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$763,034BOYAmt
EOY$947,096EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$98,884BOYAmt
EOY$94,055EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$6,952,137LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,323,252LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$4,856,780BOYAmt
EOY$4,628,885EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$124,684BOYAmt
EOY$181,524EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$8,545,202BOYAmt
EOY$8,586,450EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$438,112BOYAmt
EOY$505,679EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,167,746BOYAmt
EOY$1,131,996EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,605,858BOYAmt
EOY$1,637,675EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$6,939,344BOYAmt
EOY$6,948,775EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,939,344BOYAmt
EOY$6,948,775EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$8,545,202BOYAmt
EOY$8,586,450EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$9,586ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$155NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$299,770CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$111,169CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$140,949CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$119,678CurrentTaxYearMinus1YearAmt
Current Tax Year$248,735CurrentTaxYearAmt
Total$920,301TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$299,770CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$111,169CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$140,949CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$119,678CurrentTaxYearMinus1YearAmt
Current Tax Year$248,735CurrentTaxYearAmt
Total$920,301TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$130,195SubstantialContributorsTotAmt
Public Support Total170$790,106PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$23,975CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,797CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,245CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$23,553CurrentTaxYearMinus1YearAmt
Current Tax Year$3,398CurrentTaxYearAmt
Total$69,968TotalAmt
FieldValueIRS element (for citing)
Total Support$990,269TotalSupportAmt
Gross Receipts Rltd Activities$30,136,249GrossReceiptsRltdActivitiesAmt
Public Support CY1700.79790PublicSupportCY170Pct
Public Support PY1700.64900PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Art Public Exhibition Amounts ArtPublicExhibitionAmountsGrp

FieldValueIRS element (for citing)
Assets Included$42,964AssetsIncludedAmt
FieldValueIRS element (for citing)
Collection Used Pub ExhibitionYes (X)CollectionUsedPubExhibitionInd
Solicited Assets Sale0SolicitedAssetsSaleInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$500,797OtherCostOrOtherBasisAmt
Book Value$500,797BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,205,828OtherCostOrOtherBasisAmt
Depreciation$1,348,552DepreciationAmt
Book Value$3,857,276BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,245,512OtherCostOrOtherBasisAmt
Depreciation$974,700DepreciationAmt
Book Value$270,812BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$4,628,885TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$6,889,780TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$150NetUnrealizedGainsInvstAmt
Other Revenue$27,880OtherRevenueAmt
Revenue Not Reported$27,730RevenueNotReportedAmt
Revenue Subtotal$6,862,050RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$6,862,050TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$6,880,350TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$27,886OtherExpensesIncludedAmt
Expenses Not Reported$27,886ExpensesNotReportedAmt
Expenses Subtotal$6,852,464ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$6,852,464TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART III, LINE 4:THE ORGANIZATION HAS VARIOUS WORKS OF ART LOCATED AT ITS TWO LOCATIONS ON VISION DRIVE. THE ADMINISTRATIVE BUILDING HOUSES A FRAMED INK PRINT DONATED TO THE ORGANIZATION, AND ITS VALUE IS STATED AT $22,000 (WHICH WAS THE FAIR MARKET VALUE AT THE TIME OF THE DONATION). IN ADDITION, THE NEW INPATIENT FACILITY HOUSES SUCH PURCHASED WORKS OF ART AS FRAMED ORIGINAL PAINTINGS AND PHOTOGRAPHY, LARGE DECORATIVE POTTERY PIECES, MOUNTED MUSEUM-QUALITY HOMEMADE QUILTS, A METAL SCULPTURE, AND AN ORIGINAL HAND-PAINTED WALL MURAL. IN THE AGGREGATE, THESE PARTICULAR ITEMS ARE STATED AT THE $20,964 PRICE PAID BASED ON ARMS-LENGTH TRANSACTIONS.
PART X, LINE 2:THE ORGANIZATION IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND, THEREFORE, HAS NO PROVISION FOR INCOME TAXES. THE ORGANIZATION ACCOUNTS FOR UNCERTAIN INCOME TAX POSITIONS BY PRESCRIBING A MINIMUM PROBABILITY THRESHOLD A TAX POSITION MUST MEET BEFORE A FINANCIAL STATEMENT INCOME TAX BENEFIT IS RECOGNIZED. THE MINIMUM THRESHOLD IS DEFINED AS A TAX POSITION, BASED SOLELY ON ITS TECHNICAL MERITS, THAT WOULD MORE LIKELY THAN NOT BE SUSTAINED UPON EXAMINATION BY THE RELEVANT TAX AUTHORITY WITH KNOWLEDGE OF THE SAME FACTS. THE TAX BENEFIT TO BE RECOGNIZED IS MEASURED AS THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED UPON ULTIMATE RESOLUTION. BASED ON ALL KNOWN FACTS AND CIRCUMSTANCES AND CURRENT TAX LAW, THE ORGANIZATION BELIEVES THE TOTAL AMOUNT OF UNCERTAIN INCOME TAX POSITION LIABILITIES AND RELATED ACCRUED INTEREST ARE NOT MATERIAL TO ITS FINANCIAL POSITION.
PART XI, LINE 2D - OTHER ADJUSTMENTS:FUNDRAISING EXPENSES NETTED WITH REVENUE ON TAX RETURN ROUNDING
PART XII, LINE 2D - OTHER ADJUSTMENTS:FUNDRAISING EXPENSES NETTED WITH REVENUE ON TAX RETURN

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1ANNUAL AUCTION BBQEvent1Nm
Gross Receipts Event1$54,797GrossReceiptsEvent1Amt
Gross Revenue Event1$54,797GrossRevenueEvent1Amt
Other Direct Expenses Event1$6,888OtherDirectExpensesEvent1Amt
Event2FRIENDS WHO CAREEvent2Nm
Gross Receipts Event2$12,790GrossReceiptsEvent2Amt
Gross Revenue Event2$12,790GrossRevenueEvent2Amt
Other Direct Expenses Event2$7,185OtherDirectExpensesEvent2Amt
Other Events Total3OtherEventsTotalCnt
Gross Receipts Other Events$32,269GrossReceiptsOtherEventsAmt
Gross Revenue Other Events$32,269GrossRevenueOtherEventsAmt
Oth Direct Expnss Other Events$3,780OthDirectExpnssOtherEventsAmt
Gross Receipts Total$99,856GrossReceiptsTotalAmt
Gross Revenue Total Events$99,856GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events$17,853OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$17,853DirectExpenseSummaryEventsAmt
Net Income Summary$82,003NetIncomeSummaryAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonSCOTT A MURKIN MDPersonNm
TitleMEDICAL DIRECTORTitleTxt
Base Compensation Filing Org$177,534BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$22,932NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$200,466TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationCEO/DIRECTOR COMPENSATION IS REVIEWED AND APPROVED ANNUALLY BY THE ASSESSMENT COMMITTEE WHICH CONSISTS OF THREE BOARD MEMBERS APPOINTED BY THE BOARD CHAIR. FOR DETERMINATION OF THESE EMPLOYEES' COMPENSATION AMOUNTS, HRC REFERS TO THE HOSPICE & HOME HEALTH SALARY & BENEFITS REPORT THAT IS PUBLISHED EVERY TWO YEARS BY THE HOSPITAL & HEALTHCARE COMPENSATION SERVICE (IN COOPERATION WITH THE NATIONAL ASSOCIATION FOR HOME CARE & HOSPICE). IN ADDITION, A REVIEW IS MADE OF BENCHMARKING DATA FROM MULTI-VIEW INC.'S HOSPICE COMPENSATION SURVEY AS WELL AS COMPARABLE SALARIES ON PUBLICLY-ACCESSIBLE FORM 990S SUBMITTED BY HOSPICES OF OUR SIMILAR SIZE AND SCOPE.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1RANDOLPH HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionBOARD MEMBER STEVEN E. EBLIN IS THE CEO OF RANDOLPH HOSPITALRelationshipDescriptionTxt
Transaction$70,308TransactionAmt
TransactionHOSPICE OF RANDOLPH COUNTY PAID RANDOLPH HOSPITAL FOR INPATIENT ACUTE AND RESPITE CARE FOR HOSPICE PATIENTS.TransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2SEVERAL OF THE BOARD MEMBERS DO BUSINESS WITH HOSPICE OF RANDOLPH COUNTY AND WITH EACH OTHER. FOR EXAMPLE, THERE IS ONE DOCTOR ON THE BOARD WHO MAY REFER HER PATIENTS FOR HOSPICE CARE WHEN APPROPRIATE. BOARD MEMBERS ARE PROHIBITED FROM VOTING ON ANY ISSUES WHERE A POTENTIAL CONFLICT EXISTS.
FORM 990, PART VI, SECTION B, LINE 11BOARD MEMBERS REVIEW A DRAFT FORM OF THE 990 PRIOR TO FILING. THE REVIEW EITHER OCCURS DURING A BOARD MEETING OR THE RETURN IS SENT TO THE BOARD MEMBERS INDIVIDUALLY. FILING DOES NOT OCCUR UNTIL ALL BOARD MEMBERS HAVE INDICATED THEIR APPROVAL.
FORM 990, PART VI, SECTION B, LINE 12CINDIVIDUALS IN CERTAIN SENSITIVE POSITIONS WHO MAKE SUBSTANTIAL AND FREQUENT DECISIONS AFFECTING THE INTERESTS OF HRC ARE REQUIRED TO COMPLETE AND SIGN AN ANNUAL CONFLICT OF INTEREST DISCLOSURE FORM. THE FORMS ARE DISTRIBUTED AND COLLECTED BY THE CORPORATE COMPLIANCE OFFICER (CCO). THE CCO REVIEWS WITH THE CEO/PRESIDENT ANY DISCLOSED CONFLICTS TO DETERMINE WHETHER DISQUALIFICATION FROM CERTAIN DECISIONS IS APPROPRIATE.
FORM 990, PART VI, SECTION B, LINE 15CEO/DIRECTOR COMPENSATION IS REVIEWED AND APPROVED ANNUALLY BY THE ASSESSMENT COMMITTEE WHICH CONSISTS OF THREE BOARD MEMBERS APPOINTED BY THE BOARD CHAIR. FOR DETERMINATION OF THESE EMPLOYEES' COMPENSATION AMOUNTS, HRC REFERS TO THE HOSPICE & HOME HEALTH SALARY & BENEFITS REPORT THAT IS PUBLISHED EVERY TWO YEARS BY THE HOSPITAL & HEALTHCARE COMPENSATION SERVICE (IN COOPERATION WITH THE NATIONAL ASSOCIATION FOR HOME CARE & HOSPICE). IN ADDITION, A REVIEW IS MADE OF BENCHMARKING DATA FROM MULTI-VIEW INC.'S HOSPICE COMPENSATION SURVEY AS WELL AS COMPARABLE SALARIES ON PUBLICLY-ACCESSIBLE FORM 990S SUBMITTED BY HOSPICES OF OUR SIMILAR SIZE AND SCOPE.
FORM 990, PART VI, SECTION C, LINE 19CFO HAS A COPY OF THE AGENCY'S 990 TAX RETURN, COPY OF AUDITED FINANCIAL STATEMENTS, COPY OF CONFLICT OF INTEREST POLICY AT THE AGENCY'S OFFICE FOR ANYONE TO REVIEW PLUS THE 990 TAX RETURN CAN BE ACCESSED VIA GUIDESTAR AND THE FEDERAL GOVERNMENT'S WEBSITE.
FORM 990, PART XII, LINE 2C:THE PROCESS FOR REVIEWING THE AUDIT AND SELECTING AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED.

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