COVENANT HOSPICE FOUNDATION INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
COVENANT HOSPICE FOUNDATION INC (EIN 59-3060139)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-11-13
IRS object ID
201543179349301334
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)
Return2015-11-13T09:03:31-06:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN350921680PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CROWE HORWATH LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1225 West Wacker DriveAddressLine1Txt
Address Line2Suite 2600AddressLine2Txt
CityChicagoCityNm
State AbbreviationILStateAbbreviationCd
ZIP606061224ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN593060139EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Covenant Hospice Foundation IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOVEBusinessNameControlTxt
Phone8504332155PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15041 N 12th AvenueAddressLine1Txt
CityPensacolaCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32504ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonODIN BERGPersonNm
Person TitleCFOPersonTitleTxt
Signature2015-11-13SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonNicole BencikPreparerPersonNm
PTINP00756195PTIN
Phone3128997000PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-04-25 22:37:26ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1JEFF MISLEVYBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line15041 N 12th AvenueAddressLine1Txt
CityPensacolaCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32504ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$2,264,947GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.choosecovenant.org/hospiceWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1991FormationYr
Legal Domicile StateFLLegalDomicileStateCd
Activity Or MissionThe organization's mission is to provide funding to Covenant Hospice, Inc. in order to supplement charity and indigent care.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers9TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$611,970PYContributionsGrantsAmt
CY Contributions Grants$642,137CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$15,356CYProgramServiceRevenueAmt
PY Investment Income$559,751PYInvestmentIncomeAmt
CY Investment Income$207,408CYInvestmentIncomeAmt
PY Other Revenue-$116,718PYOtherRevenueAmt
CY Other Revenue-$106,618CYOtherRevenueAmt
PY Total Revenue$1,055,003PYTotalRevenueAmt
CY Total Revenue$758,283CYTotalRevenueAmt
PY Grants And Similar Paid$458,046PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$558,978CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$13,188PYOtherExpensesAmt
CY Other Expenses$28,886CYOtherExpensesAmt
PY Total Expenses$471,234PYTotalExpensesAmt
CY Total Expenses$587,864CYTotalExpensesAmt
PY Revenues Less Expenses$583,769PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$170,419CYRevenuesLessExpensesAmt
Total Assets BOY$4,283,728TotalAssetsBOYAmt
Total Assets EOY$4,542,810TotalAssetsEOYAmt
Total Liabilities BOY$131,837TotalLiabilitiesBOYAmt
Total Liabilities EOY$203,270TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,151,891NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,339,540NetAssetsOrFundBalancesEOYAmt
MissionThe organization's mission is to provide funding to Covenant Hospice, Inc. in order to supplement charity and indigent care.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$574,737ExpenseAmt
Grant$558,978GrantAmt
Revenue$15,356RevenueAmt
DescTHE PURPOSE OF COVENANT HOSPICE FOUNDATION, INC. IS TO RECEIVE AND MAINTAIN A FUND OR FUNDS OF REAL OR PERSONAL PROPERTY, TO USE PRIMARILY FOR THE FINANCIAL SUPPORT AND ENCOURAGEMENT OF THE HEALTH CARE AND COMMUNITY SUPPORT PROGRAMS OF COVENANT HOSPICE, INC. IN 2014, THE AMOUNT TRANSFERRED HELPED SUPPORT THE COSTS OF UNFUNDED PROGRAMS OF COVENANT HOSPICE, INC. THESE UNFUNDED PROGRAMS INCLUDE SERVICES FROM THE FOLLOWING DEPARTMENTS: CHAPLAINS, BEREAVEMENT, CHILDREN, AND VOLUNTEERS. PALLIATIVE CARE SERVICES ARE ALSO OFFERED TO PATIENTS after life-limiting diagnoses, but before they are ready for hospice.Desc
Total Program Service Expenses$574,737TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesYes (true)GamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Karen YoungBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8504332155PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15041 N 12th AvenueAddressLine1Txt
CityPensacolaCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32504ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
ODIN BERG
CFO/PARTIAL YEAR INTERIM CEO4.0054.00Yes (X)Yes (X)$0$282,698$21,582
HARRIS REYNOLDS
VICE CHAIRMAN4.008.00Yes (X)Yes (X)$0$0$0
JT YOUNG
SECRETARY4.008.00Yes (X)Yes (X)$0$0$0
ROBERT MILLS
TREASURER4.008.00Yes (X)Yes (X)$0$0$0
JAMES S CAMBELL ESQ
CHAIRMAN4.008.00Yes (X)Yes (X)$0$0$0
JEFFREY M MISLEVY
PRESIDENT/CEO - PARTIAL YEAR4.0048.00Yes (X)Yes (X)$0$120,531$6,816
BOB PETERSON
DIRECTOR4.004.00Yes (X)$0$0$0
BOB VAN SLYKE
DIRECTOR4.004.00Yes (X)$0$0$0
ROBIN D HERR
PAST CHAIRMAN4.004.00Yes (X)$0$0$0
BILL GREENHUT
DIRECTOR PARTIAL YEAR4.008.00Yes (X)$0$0$0
JOHN R FOGG
DIRECTOR4.000Yes (X)$0$0$0
STEVE SOUTHERLAND II
DIRECTOR4.000Yes (X)$0$0$0
REBECCA H MCQUEEN
DIRECTOR PARTIAL YEAR4.000Yes (X)$0$0$0
DALE O KNEE PHD
FORMER PRESIDENT/CEO0.000.00$0$282,854$24,271Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$686,083TotReportableCompRltdOrgAmt
Total Other Compensation$52,669TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$530,038FundraisingAmt
All Other Contributions$112,099AllOtherContributionsAmt
Total Contributions$642,137TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPalliative Care ServicesDesc
Business612610BusinessCd
Total Revenue Column$15,356TotalRevenueColumnAmt
Related Or Exempt Func Income$15,356RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$15,356TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$79,663TotalRevenueColumnAmt
Exclusion$79,663ExclusionAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,422,180SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,294,435SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$127,745SecuritiesAmt
Other$0OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$127,745TotalRevenueColumnAmt
Exclusion$127,745ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$88,555FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$530,038ContriRptFundraisingEventAmt
Fundraising Direct Expenses$196,814FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$108,259TotalRevenueColumnAmt
Exclusion-$108,259ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$17,056GamingGrossIncomeAmt
Gaming Direct Expenses$15,415GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,641TotalRevenueColumnAmt
Exclusion$1,641ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$758,283TotalRevenueColumnAmt
Related Or Exempt Func Income$15,356RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$100,790ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$558,978TotalAmt
Program Services$558,978ProgramServicesAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$13,074TotalAmt
Management And General$13,074ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$53TotalAmt
Management And General$53ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
shared employees$13,269$13,269
service charges$1,722$1,722
Admin Support$768$768

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$587,864TotalAmt
Program Services$574,737ProgramServicesAmt
Management And General$13,127ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$291,899BOYAmt
EOY$270,002EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$265,690BOYAmt
EOY$263,522EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$11,618BOYAmt
EOY$34,853EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$0LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$0LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$3,714,521BOYAmt
EOY$3,974,433EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,283,728BOYAmt
EOY$4,542,810EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$131,837BOYAmt
EOY$203,270EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$131,837BOYAmt
EOY$203,270EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,112,475BOYAmt
EOY$4,301,862EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$39,416BOYAmt
EOY$37,678EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,151,891BOYAmt
EOY$4,339,540EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,283,728BOYAmt
EOY$4,542,810EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$170,419ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$23,277NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$6,047OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

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$773,909CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$374,594CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$666,734CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$611,970CurrentTaxYearMinus1YearAmt
Current Tax Year$642,137CurrentTaxYearAmt
Total$3,069,344TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$773,909CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$374,594CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$666,734CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$611,970CurrentTaxYearMinus1YearAmt
Current Tax Year$642,137CurrentTaxYearAmt
Total$3,069,344TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$242,391SubstantialContributorsTotAmt
Public Support Total170$2,826,953PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$61,100CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$85,840CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$81,669CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$43,021CurrentTaxYearMinus1YearAmt
Current Tax Year$79,663CurrentTaxYearAmt
Total$351,293TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$154,735CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$314,721CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$130,299CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$96,756CurrentTaxYearMinus1YearAmt
Current Tax Year$105,611CurrentTaxYearAmt
Total$802,122TotalAmt
FieldValueIRS element (for citing)
Total Support$4,222,759TotalSupportAmt
Gross Receipts Rltd Activities$0GrossReceiptsRltdActivitiesAmt
Public Support CY1700.6695PublicSupportCY170Pct
Public Support PY1700.7112PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule A, Part II, Line 10 Other IncomeFormAndLineReferenceDesc
ExplanationDESCRIPTION - GROSS INCOME FROM FUNDRAISING, COLUMN A - 154735.0, COLUMN B - 314721.0, COLUMN C - 101424.0, COLUMN D - 60579.0, COLUMN E - 88555.0, COLUMN F - 720014.0; DESCRIPTION - GROSS INCOME FROM GAMING EVENTS, COLUMN A - 0.0, COLUMN B - 0.0, COLUMN C - 28875.0, COLUMN D - 36177.0, COLUMN E - 17056.0, COLUMN F - 82108.0;ExplanationTxt

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

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Intercompany Payables$164,720
Gift Annuity Obligation$38,550
FieldValueIRS element (for citing)
Total Liability$203,270TotalLiabilityAmt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1MASK PARADEEvent1Nm
Gross Receipts Event1$139,509GrossReceiptsEvent1Amt
Charitable Contri Event1$120,642CharitableContriEvent1Amt
Gross Revenue Event1$18,867GrossRevenueEvent1Amt
Rent Facility Costs Event1$15,831RentFacilityCostsEvent1Amt
Food And Beverage Event1$23,351FoodAndBeverageEvent1Amt
Entertainment Event1$800EntertainmentEvent1Amt
Other Direct Expenses Event1$5,890OtherDirectExpensesEvent1Amt
Event2LIFE'S A DANCEEvent2Nm
Gross Receipts Event2$111,733GrossReceiptsEvent2Amt
Charitable Contri Event2$66,523CharitableContriEvent2Amt
Gross Revenue Event2$45,210GrossRevenueEvent2Amt
Rent Facility Costs Event2$11,636RentFacilityCostsEvent2Amt
Food And Beverage Event2$0FoodAndBeverageEvent2Amt
Entertainment Event2$32,690EntertainmentEvent2Amt
Other Direct Expenses Event2$3,758OtherDirectExpensesEvent2Amt
Other Events Total17OtherEventsTotalCnt
Gross Receipts Other Events$367,351GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$342,873CharitableContriOtherEventsAmt
Gross Revenue Other Events$24,478GrossRevenueOtherEventsAmt
Rent Fclty Costs Other Events$8,610RentFcltyCostsOtherEventsAmt
Food And Beverage Other Events$39,843FoodAndBeverageOtherEventsAmt
Entertainment Other Events$16,755EntertainmentOtherEventsAmt
Oth Direct Expnss Other Events$37,650OthDirectExpnssOtherEventsAmt
Gross Receipts Total$618,593GrossReceiptsTotalAmt
Charitable Contributions Tot$530,038CharitableContributionsTotAmt
Gross Revenue Total Events$88,555GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$36,077RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$63,194FoodAndBeverageTotalEventsAmt
Entertainment Total Events$50,245EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$47,298OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$196,814DirectExpenseSummaryEventsAmt
Net Income Summary-$108,259NetIncomeSummaryAmt

Gaming Information GamingInformationGrp

FieldValueIRS element (for citing)
Gross Revenue Other Gaming$17,056GrossRevenueOtherGamingAmt
Cash Prizes Other Gaming$0CashPrizesOtherGamingAmt
Non Cash Prizes Other Gaming$15,415NonCashPrizesOtherGamingAmt
Volunteer Labor Other GamingYes (true)VolunteerLaborOtherGamingInd
Volunteer Labor Other Gaming1.0VolunteerLaborOtherGamingPct
Gross Revenue Total Gaming$17,056GrossRevenueTotalGamingAmt
Cash Prizes Total Gaming$0CashPrizesTotalGamingAmt
Non Cash Prizes Total Gaming$15,415NonCashPrizesTotalGamingAmt
FieldValueIRS element (for citing)
States Where Gaming ConductedFLStatesWhereGamingConductedCd
LicensedfalseLicensedInd
Explanation If NoFLORIDA DOES NOT REQUIRE THE ORGANIZATION TO BE LICENSED TO OPERATE GAMING ACTIVITIES.ExplanationIfNoTxt
License Suspended EtcfalseLicenseSuspendedEtcInd
Gaming With NonmembersYes (true)GamingWithNonmembersInd
Member Of Other EntityfalseMemberOfOtherEntityInd
Gaming Own Facility0.9GamingOwnFacilityPct
Gaming Other Facility0.1GamingOtherFacilityPct
Individual With BooksBryan WhetzelIndividualWithBooksNm

Persons With Books US Address PersonsWithBooksUSAddress

FieldValueIRS element (for citing)
Address Line15041 N 12th AvenueAddressLine1Txt
CityPensacolaCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32504ZIPCd
FieldValueIRS element (for citing)
Cntrct With3rd Prty For Game RevfalseCntrctWith3rdPrtyForGameRevInd

Gaming Manager Business Name GamingManagerBusinessName

FieldValueIRS element (for citing)
Business Name Line1SEE STATEMENTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Charitable Distribution RqrfalseCharitableDistributionRqrInd
Distributed$0DistributedAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule G, Part III, Line 16 Gaming Manager InformationFormAndLineReferenceDesc
ExplanationTHE FOLLOWING INDIVIDUALS ORGANIZE THE GAMING ACTIVITIES: Nanisa Anderson Angie Schlosser Jenni Perkins Jennifer Griffin Blythe Newsome THESE INDIVIDUALS ARE ALL VOLUNTEERS FOR COVENANT HOSPICE FOUNDATION, INC. AND ARE NOT COMPENSATED FOR THEIR TIME.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Covenant Hospice IncBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line15041 N 12th AvenueAddressLine1Txt
CityPensacolaCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32504ZIPCd
FieldValueIRS element (for citing)
Recipient EIN592208300RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$558,978CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt
Valuation Method Usedn/AValuationMethodUsedDesc
Non Cash Assistancen/ANonCashAssistanceDesc
Purpose Of GrantTo help support programs of Covenant Hospice, Inc.PurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule I, Part I, Line 2 Description Of Procedure For Monitoring Use Of Grant FundsGrant funds to Covenant Hospice, Inc., a 501(c)(3) organization, are used to help support its unfunded programs. These unfunded programs include: children's Program, Bereavement, Chaplain, and indigent patient care.
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.Grant funds to Covenant Hospice, Inc., a 501(c)(3) organization, are used to help support its unfunded programs. These unfunded programs include: children's Program, Bereavement, Chaplain, and indigent patient care.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ODIN BERG
CFO/PARTIAL YEAR INTERIM CEO$0$255,875$0$15,178$0$11,645$0$2,816$0$18,766$0$304,280$0$0
DALE O KNEE PHD
FORMER PRESIDENT/CEO$0$8,444$0$186,965$0$87,445$0$84$0$24,187$0$307,125$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule J, Part I, Line 3 Arrangement used to establish the top management official's compensationFormAndLineReferenceDesc
ExplanationThe organization's President & CEO is paid by Covenant Hospice, Inc. (a related organization). The compensation of the organization's President & CEO is determined using an independent compensation consultant, compensation surveys or studies and approval by the board.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 15a COMPENSATION OF THE TOP MANAGEMENT OFFICIALTHE ORGANIZATION'S PRESIDENT & CEO IS PAID BY COVENANT HOSPICE, INC., A RELATED ORGANIZATION. COVENANT HOSPICE, INC. PROCURES SALARY COMPARABILITY DATA AND HIRES AN INDEPENDENT FIRM TO DO A SALARY COMPARISON FOR ALL SENIOR ADMINISTRATIVE STAFF. THE SALARY COMPARISON WITH THE INDEPENDENT FIRM IS UNDERTAKEN ANNUALLY. THE CEO'S COMPENSATION IS REVIEWED AND APPROVED BY THE COVENANT HOSPICE BOARD WITH INSIGHT GIVEN FROM THE SALARY COMPARISON OF THE INDEPENDENT FIRM. THIS PROCESS IS DONE ANNUALLY AND IS DOCUMENTED. BECAUSE THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IS NOT COMPENSATED BY THE FILING ORGANIZATION, THIS QUESTION IS MARKED "NO" IN ACCORDANCE WITH FORM 990 INSTRUCTIONS.
Form 990, Part VI, Line 15b COMPENSATION OF OTHER OFFICERSTHE ORGANIZATION DOES NOT HAVE ANY OTHER OFFICERS WHO RECEIVE COMPENSATION. THEREFORE THIS QUESTION HAS BEEN ANSWERED "NO" IN ACCORDANCE WITH FORM 990 INSTRUCTIONS.
Form 990, Part VI, Line 1a Delegate broad authority to a committeePURSUANT TO THE ORGANIZATION'S BYLAWS, SECTION 5.1: THERE SHALL BE A STANDING HOSPICE FOUNDATION EXECUTIVE COMMITTEE CONSISTING OF THE CHAIRPERSON, VICE CHAIRPERSON, SECRETARY, TREASURER, AND THE IMMEDIATE PAST CHAIRPERSON OF THE BOARD, IF SUCH PAST CHAIRPERSON REMAINS A HOSPICE FOUNDATION DIRECTOR. IF THE CHAIRPERSON OF HOSPICE FOUNDATION BOARD IS NOT THE SAME INDIVIDUAL AS THE CHAIRPERSON OF THE HOSPICE BOARD, THEN THE CHAIRPERSON OF THE HOSPICE BOARD SHALL ALSO BE A VOTING MEMBER OF THE HOSPICE FOUNDATION EXECUTIVE COMMITTEE. THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF HOSPICE FOUNDATION SHALL BE A VOTING MEMBER OF THE HOSPICE FOUNDATION EXECUTIVE COMMITTEE AND ALL OTHER COMMITTEES. THE CHAIRPERSON OF THE FOUNDATION BOARD SHALL BE THE CHAIRPERSON OF THE HOSPICE FOUNDATION EXECUTIVE COMMITTEE. THE HOSPICE FOUNDATION EXECUTIVE COMMITTEE SHALL MEET TO REVIEW POLICY AND PROCEDURES OF HOSPICE FOUNDATION AND MAKE RECOMMENDATIONS RELATIVE THERETO TO THE HOSPICE FOUNDATION BOARD OR TO THE HOSPICE BOARD, AND SHALL HAVE SUCH FURTHER RESPONSIBILITIES AS DESIGNATED BY THE HOSPICE FOUNDATION BOARD BY RESOLUTION, BUT ONLY AS ALSO AUTHORIZED BY THE HOSPICE BOARD.
Form 990, Part VI, Line 6 Classes of members or stockholdersThe organization's sole member is Covenant Hospice, Inc. Covenant Hospice, Inc. elects the board members of Covenant Hospice Foundation, Inc.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyCovenant Hospice, Inc. elects the board members of Covenant Hospice Foundation, Inc.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersThe following actions require approval from Covenant Hospice, Inc.: -purchase, sale, conveyance, lease, sublease, mortgage, or encumbrances of securities, real estate, tangible and intangible personal property, and other property if the total cumulative consideration is greater than $10,000; -amend the articles of incorporation or bylaws; -appoint or remove officers or directors; -approve the incurrence of indebtedness by the Corporation or obligate the Corporation to incur any indebtedness; -approve the formation of any entity in which Covenant Hospice Foundation, Inc. would acquire an economic interest, or the sale, transfer, or substantial change in use of all or substantially all of the assets of the Corporation, or the divestiture, dissolution, closure, merger, consolidation or change in membership of the Corporation; -approve the operating budget and capital plan for the corporation; -approve the investment firm retained by the corporation to manage the corporation's assets; and -approve the appointment or termination of any administrator of the corporation.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyThe Form 990 is reviewed by staff with the assistance of and review by an independent accounting firm before it is signed and submitted.
Form 990, Part VI, Line 12c Conflict of interest policyConflict of Interest statements are sent annually to members of the Board of Directors, and all key staff members reportable on the Form 990. The forms are reviewed for responses indicating a possible conflict of interest. In addition, the Director of Accounting reviews transactions with vendors with which the Board may be affiliated to determine that all transactions are made at arm's length. If a possible conflict is identified, the person with a conflict is prohibited from participating in the Board of Directors deliberations and decisions in the transaction.
Form 990, Part VI, Line 19 Required documents available to the publicGoverning documents, financial statements and the organization's conflict of interest policy are available on written request.
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesCHANGES IN SPLIT INTEREST - -6047;

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1COVENANT PALLIATIVE CARE SERVICES LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line15041 NORTH 12TH AVEAddressLine1Txt
CityPENSACOLACityNm
State AbbreviationFLStateAbbreviationCd
ZIP32504ZIPCd
FieldValueIRS element (for citing)
EIN464822066EIN
Primary ActivitiesPALLIATIVE SERVICESPrimaryActivitiesTxt
Legal Domicile StateFLLegalDomicileStateCd
Total Income$0TotalIncomeAmt
End Of Year Assets$0EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1COVENANT HOSPICE FOUNDATIONBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
COVENANT HOSPICE INC
5041 N 12TH AVENUEPENSACOLAFL32504592208300PROVIDES CARE TO TERMINALLY ILL PATIENTSFL501(c)(37NAfalse
ALZHEIMERS FAMILY SERVICES INC
5041 N 12TH AVENUEPENSACOLAFL32504593394242SUPPORT TO ALZHEIMERS PATIENTS AND FAMILIESFL501(c)(37COVENANT HOSPICE INCfalse

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.