HOSPICE OF RANDOLPH COUNTY INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- HOSPICE OF RANDOLPH COUNTY INC (EIN 56-1376378)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-13
- IRS object ID
- 201403179349302560
- Schema version
- 2013v3.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-13T10:03:52-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 560570567 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | D M J & CO PLLC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 703 GREEN VALLEY ROAD SUITE 201 | AddressLine1 |
| City | GREENSBORO | City |
| State | NC | State |
| ZIP Code | 27408 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561376378 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE OF RANDOLPH COUNTY INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HOSP | BusinessNameControlTxt |
| Phone | 3366729300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 416 VISION DRIVE | AddressLine1 |
| City | ASHEBORO | City |
| State | NC | State |
| ZIP Code | 27203 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RHONDA BURCH MOFFITT | PersonNm |
| Person Title | CEO/PRESIDENT | PersonTitleTxt |
| Phone | 3366729300 | PhoneNum |
| Signature | 2014-11-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ERIC DUTTON CPA | PreparerPersonNm |
| PTIN | P01218304 | PTIN |
| Phone | 3362759886 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | RHONDA BURCH MOFFITT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 416 VISION DRIVE | AddressLine1 |
| City | ASHEBORO | City |
| State | NC | State |
| ZIP Code | 27203 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $6,418,640 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HOSPICEOFRANDOLPH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1981 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | MISSION: 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 Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 115 | TotalEmployeeCnt |
| Total Volunteers | 60 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $140,949 | PYContributionsGrantsAmt |
| CY Contributions Grants | $139,678 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,624,359 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,172,840 | CYProgramServiceRevenueAmt |
| PY Investment Income | $7,245 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,739 | CYInvestmentIncomeAmt |
| PY Other Revenue | $67,061 | PYOtherRevenueAmt |
| CY Other Revenue | $83,633 | CYOtherRevenueAmt |
| PY Total Revenue | $6,839,614 | PYTotalRevenueAmt |
| CY Total Revenue | $6,399,890 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,489,249 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,579,927 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $66,334 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,004,552 | PYOtherExpensesAmt |
| CY Other Expenses | $1,977,683 | CYOtherExpensesAmt |
| PY Total Expenses | $6,493,801 | PYTotalExpensesAmt |
| CY Total Expenses | $6,557,610 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $345,813 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$157,720 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $8,682,420 | TotalAssetsBOYAmt |
| Total Assets EOY | $8,545,202 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,585,170 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,605,858 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $7,097,250 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,939,344 | NetAssetsOrFundBalancesEOYAmt |
| Mission | HOSPICE 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 Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $4,453,729 | ExpenseAmt |
| Revenue | $6,172,963 | RevenueAmt |
| Desc | PROVIDE 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 2013, HOSPICE OF RANDOLPH COUNTY PROVIDED 46,839 DAYS OF PATIENT CARE FOR ITS 730 HOSPICE, HOME HEALTH, AND KIDS PATH PATIENTS. | Desc |
| Total Program Service Expenses | $4,453,729 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | Yes (1) | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 28 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 115 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NC | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAREY DURHAM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3366729300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 416 VISION DRIVE | AddressLine1 |
| City | ASHEBORO | City |
| State | NC | State |
| ZIP Code | 27203 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|
| W EDWARD BUNCH | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RICK CRAWFORD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| NEAL GRIFFIN | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CRANFORD KNOTT | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CANDICE GARRETT | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DR MALKIAT DHATT | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| STEVE EBLIN | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GLENN M PUGH | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ROXANNE TAYLOR | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RHONDA BURCH MOFFITT | |||||||
| CEO/PRESIDENT | 40.00 | $123,091 | $0 | $12,486 | Yes (X) | ||
| CAREY M DURHAM | |||||||
| CFO | 40.00 | $87,151 | $0 | $12,321 | Yes (X) | ||
| JOHN S ROGERS | |||||||
| SECRETARY | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| STUART FOUNTAIN | |||||||
| TREASURER | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| CHRISTINE MCCARTY MD | |||||||
| BOARD CHAIR | 1.00 | $5,800 | $0 | $0 | Yes (X) | ||
| SCOTT A MURKIN MD | |||||||
| MEDICAL DIRECTOR | 40.00 | $172,469 | $0 | $23,016 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $388,511 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $47,823 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HOSPICE PHARMACIA | |||||
| 1601 CHERRY ST SUITE 1700 | PHILADELPHIA | PA | 19102 | PATIENT MEDICATIONS | $390,318 |
| ADVANCED HOMECARE | |||||
| PO BOX 18049 | GREENSBORO | NC | 27419 | MEDICAL SUPPLIES | $175,830 |
| GRAYBRIER NURSING & RET CTR | |||||
| 116 LANE DRIVE | TRINITY | NC | 27370 | PATIENT CARE FACILITY | $173,437 |
| RANDOLPH HEALTH & REHAB CENTER | |||||
| 230 E PRESNELL ST | ASHEBORO | NC | 27204 | PATIENT CARE FACILITY | $158,867 |
| WOODLAND HILL CARE & REHAB | |||||
| 400 VISION DRIVE | ASHEBORO | NC | 27203 | PATIENT CARE FACILITY | $153,596 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $7,150 | FederatedCampaignsAmt |
| All Other Contributions | $132,528 | AllOtherContributionsAmt |
| Noncash Contributions | $20,000 | NoncashContributionsAmt |
| Total Contributions | $139,678 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICARE PAYMENTS | 621610 | $5,641,518 | $5,641,518 |
| MEDICAID PAYMENTS | 621610 | $274,184 | $274,184 |
| PRIVATE INSURANCE | 621610 | $257,138 | $257,138 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,172,840 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,739 | TotalRevenueColumnAmt |
| Exclusion | $3,739 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $102,260 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $18,750 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $83,510 | TotalRevenueColumnAmt |
| Exclusion | $83,510 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $123 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $123 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $123 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,399,890 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,172,963 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $87,249 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $436,334 | TotalAmt |
| Management And General | $436,334 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,364,602 | TotalAmt |
| Program Services | $2,718,991 | ProgramServicesAmt |
| Management And General | $591,206 | ManagementAndGeneralAmt |
| Fundraising | $54,405 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,359 | TotalAmt |
| Program Services | $43,424 | ProgramServicesAmt |
| Management And General | $5,066 | ManagementAndGeneralAmt |
| Fundraising | $869 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $464,456 | TotalAmt |
| Program Services | $353,962 | ProgramServicesAmt |
| Management And General | $103,723 | ManagementAndGeneralAmt |
| Fundraising | $6,771 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $265,176 | TotalAmt |
| Program Services | $182,332 | ProgramServicesAmt |
| Management And General | $78,555 | ManagementAndGeneralAmt |
| Fundraising | $4,289 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,680 | TotalAmt |
| Management And General | $27,680 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,746 | TotalAmt |
| Management And General | $56,746 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $167,594 | TotalAmt |
| Program Services | $152,246 | ProgramServicesAmt |
| Management And General | $15,348 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,985 | TotalAmt |
| Management And General | $65,985 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $254,179 | TotalAmt |
| Management And General | $254,179 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,347 | TotalAmt |
| Management And General | $40,347 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICINES AND DRUGS | $399,139 | $399,139 | |
| DURABLE MEDICAL EQUIPME | $185,038 | $185,038 | |
| MEDICAL AND OFFICE SUPP | $152,700 | $127,275 | $25,425 |
| CATERING SERVICES | $82,712 | $82,712 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $545,563 | TotalAmt |
| Program Services | $208,610 | ProgramServicesAmt |
| Management And General | $336,953 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,557,610 | TotalAmt |
| Program Services | $4,453,729 | ProgramServicesAmt |
| Management And General | $2,037,547 | ManagementAndGeneralAmt |
| Fundraising | $66,334 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $807,371 | BOYAmt |
| EOY | $1,014,492 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,709,589 | BOYAmt |
| EOY | $1,676,915 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,663 | BOYAmt |
| EOY | $10,413 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $934,989 | BOYAmt |
| EOY | $763,034 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $86,832 | BOYAmt |
| EOY | $98,884 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $6,935,435 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,078,655 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,076,792 | BOYAmt |
| EOY | $4,856,780 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,184 | BOYAmt |
| EOY | $124,684 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,682,420 | BOYAmt |
| EOY | $8,545,202 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $383,609 | BOYAmt |
| EOY | $438,112 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,201,561 | BOYAmt |
| EOY | $1,167,746 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,585,170 | BOYAmt |
| EOY | $1,605,858 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,097,250 | BOYAmt |
| EOY | $6,939,344 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,097,250 | BOYAmt |
| EOY | $6,939,344 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,682,420 | BOYAmt |
| EOY | $8,545,202 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$157,720 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$186 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $299,520 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $299,770 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $111,169 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $140,949 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $119,678 | CurrentTaxYearAmt |
| Total | $971,086 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $299,520 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $299,770 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $111,169 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $140,949 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $119,678 | CurrentTaxYearAmt |
| Total | $971,086 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $265,776 | SubstantialContributorsTotAmt |
| Public Support Total170 | $705,310 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $48,575 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $23,975 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,797 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,245 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $23,553 | CurrentTaxYearAmt |
| Total | $115,145 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $507 | CurrentTaxYearMinus4YearsAmt |
| Total | $507 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $1,086,738 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $28,695,373 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.64900 | PublicSupportCY170Pct |
| Public Support PY170 | 0.54310 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Art Public Exhibition Amounts ArtPublicExhibitionAmountsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Assets Included | $42,964 | AssetsIncludedAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Collection Used Pub Exhibition | Yes (X) | CollectionUsedPubExhibitionInd |
| Solicited Assets Sale | 0 | SolicitedAssetsSaleInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $500,797 | OtherCostOrOtherBasisAmt |
| Book Value | $500,797 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,204,779 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,207,683 | DepreciationAmt |
| Book Value | $3,997,096 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,229,859 | OtherCostOrOtherBasisAmt |
| Depreciation | $870,972 | DepreciationAmt |
| Book Value | $358,887 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,856,780 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $6,418,454 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$186 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $18,750 | OtherRevenueAmt |
| Revenue Not Reported | $18,564 | RevenueNotReportedAmt |
| Revenue Subtotal | $6,399,890 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $6,399,890 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,576,360 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $18,750 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $18,750 | ExpensesNotReportedAmt |
| Expenses Subtotal | $6,557,610 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $6,557,610 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES NETTED WITH REVENUE ON TAX RETURN |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | ANNUAL AUCTION BBQ | NameOfEvent1Amt |
| Gross Receipts Event1 | $44,822 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $44,822 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $5,675 | OtherDirectExpensesEvent1Amt |
| Name Of Event2 | HUMAN RACE | NameOfEvent2Amt |
| Gross Receipts Event2 | $11,595 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $11,595 | GrossRevenueEvent2Amt |
| Other Events Total | 3 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $23,397 | GrossReceiptsOtherEventsAmt |
| Gross Revenue Other Events | $23,397 | GrossRevenueOtherEventsAmt |
| Oth Direct Expnss Other Events | $3,065 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $79,814 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $79,814 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $8,740 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $8,740 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $71,074 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SCOTT A MURKIN MD | PersonNm |
| Title | MEDICAL DIRECTOR | TitleTxt |
| Base Compensation Filing Org | $172,469 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $23,016 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $195,485 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | CEO/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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RANDOLPH HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | BOARD MEMBER STEVEN E. EBLIN IS THE CEO OF RANDOLPH HOSPITAL | RelationshipDescriptionTxt |
| Transaction | $56,050 | TransactionAmt |
| Transaction | HOSPICE OF RANDOLPH COUNTY PAID RANDOLPH HOSPITAL FOR INPATIENT ACUTE AND RESPITE CARE FOR HOSPICE PATIENTS. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | SEVERAL OF THE BOARD MEMBERS DO BUSINESS WITH HOSPICE OF RANDOLPH COUNTY AND WITH EACH OTHER. FOR EXAMPLE, THERE ARE SEVERAL DOCTORS ON THE BOARD WHO MAY REFER THEIR 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 11 | BOARD 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 12C | INDIVIDUALS 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 15 | CEO/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 19 | CFO 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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