2014-05-13T13:00:39-05:00 2013-06-30 470757164 ALEGENT CREIGHTON HEALTH 12809 W DODGE ROAD OMAHA NE 68154 990 2012-07-01 364003095 HARBOR HOUSE HARB 4023434413 12809 W DODGE ROAD OMAHA NE 68154 THERESA FRANCO 2014-05-08 true Angela Lea P01051055 4023434413 2012 2015-11-30 17:44:51Z GARY GEORGE 7415 CEDAR STREET OMAHA NE 68124 3612258 false X WWW.HOSPICEHOUSE.ORG X 1994 NE TO PROVIDE CARE IN A HOMELIKE ENVIRONMENT TO THE TERMINALLY ILL. 21 21 0 362 0 0 688961 1561667 1971043 1980848 2369 3889 87221 50965 2749594 3597369 9993 46254 0 0 0 0 0 0 0 2366894 2886276 2376887 2932530 372707 664839 3926632 4655576 105035 280116 3821597 4375460 TO EMBRACE RESIDENTS LIVING WITH TERMINAL ILLNESSES AND THEIR FAMILIES AND FRIENDS WITH COMPASSIONATE CARE AND COMFORT, AND TO PROVIDE END-OF-LIFE EDUCATION IN THE COMMUNITY. false false 2779961 46254 1980848 HARBOR HOUSE, DOING BUSINESS AS HOSPICE HOUSE-THE JOSIE HARPER RESIDENCE, OPERATES A LICENSED 26-BED RESIDENTIAL FACILITY WHICH PROVIDES 24-HOUR PROFESSIONAL CARE AND SUPERVISION TO SERVE THE SPIRITUAL, EMOTIONAL, AND PHYSICAL NEEDS OF TERMINALLY ILL RESIDENTS AND THEIR FAMILIES IN A HOME-LIKE SETTING. IN ADDITION TO RESIDENTIAL LIVING SPACE, THE BUILDING ALSO INCLUDES CLASSROOMS, STORAGE, SHOWER FACILITIES FOR FAMILIES AND GUESTS, AND A RESOURCE LIBRARY. 2779961 true true false false false false false false true true false false false true true true false false false false false false false true false false false true true false false false false false false false false false false false false false false false false false false true X 4 0 true 0 false false false false false false false false false false X 21 21 true true false false true true true true true false false true true true true true true false false false X Neil Fortkamp 4023438600 7415 CEDAR STREET OMAHA NE 68124 JAMES SUMMERFELT 1.00 0 X X 0 0 0 NEIL FORTKAMP 1.00 0 X X 0 0 0 THERESA FRANCO 1.00 0 X X 0 0 0 BARBARA FITZGERALD 1.00 0 X 0 0 0 CARL GREINER MD 1.00 0 X 0 0 0 CAROLYN HARPER 1.00 0 X 0 0 0 CINDY ALLOWAY 1.00 58.00 X 0 0 0 DIANE RANDOLPH 1.00 0 X 0 0 0 DIANE ROMBERGER MD 1.00 0 X 0 0 0 HEATHER MORGAN MD 1.00 0 X 0 0 0 JACKIE THIELEN 1.00 0 X 0 0 0 JANE CARMODY 1.00 56.00 X 0 0 0 JOANIE KUSH 1.00 0 X 0 0 0 RICHARD II HACHTEN 1.00 64.00 X 0 0 0 ROBERT LANGDON MD 1.00 0 X 0 0 0 ROSEANNE GOLLAN 1.00 0 X 0 0 0 ROSEMARY LEBEDA 1.00 0 X 0 0 0 STEVE GOESER 1.00 0 X 0 0 0 SUZY SHRIER 1.00 0 X 0 0 0 WILLIAM SUTTON 1.00 0 X 0 0 0 YUNGPO BERNARD SU MD 1.00 0 X 0 0 0 GARY GEORGE 40.00 0 X 96501 0 11960 96501 0 11960 0 false false true ALEGENT CREIGHTON HEALTH 12809 WEST DODGE ROAD OMAHA NE 68154 MANAGEMENT SERVICES 2093552 1 1561667 1561667 NET DAILY RESIDENT SVC 621500 1980848 1980848 0 0 0 0 0 0 0 0 1980848 3889 3889 0 0 0 0 0 0 0 0 65854 41290 14889 50965 50965 0 0 0 0 0 0 0 0 0 0 3597369 1980848 0 54854 0 46254 46254 0 0 0 0 0 0 0 0 2104552 1957233 147319 0 10500 5250 5250 0 0 0 0 0 0 0 2328 2328 244356 244356 0 0 38201 38201 2165 2165 0 0 0 0 143515 143515 23852 23852 OUTSIDE SERVICES 316598 316598 209 209 0 0 2932530 2779961 152569 0 0 100705 594914 181910 181787 80750 0 470062 421923 0 0 26685 26017 3481467 1977682 1539351 1503785 1527169 1927150 0 0 0 0 3926632 4655576 32324 25960 0 72711 254156 105035 280116 X 3660162 4349506 120135 10954 41300 15000 3821597 4375460 3926632 4655576 X 664839 -110976 X false true X true false X 358244 316819 399337 688961 1561667 3325028 1773674 1607804 1798743 2058264 1980848 9219333 0 0 0 0 65854 65854 0 0 2131918 1924623 2198080 2747225 3608369 12610215 10000 0 5000 185000 500000 700000 0 0 0 0 0 0 10000 0 5000 185000 500000 700000 11910215 27115 4958 2186 2369 3889 40517 0 0 0 0 0 0 27115 4958 2186 2369 3889 40517 0 0 0 0 0 0 0 2159033 1929581 2200266 2749594 3612258 12650732 0.94140 0.97000 0.00320 0.00920 X OTHER INCOME, SCHEDULE A, PART III, LINE 12, DESCRIPTION - , COLUMN A - , COLUMN B - , COLUMN C - , COLUMN D - , COLUMN E - , COLUMN F - 0; RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 161435 1796 137277 25954 33345 137875 9785 161435 21000 12345 33345 26507 5507 21000 58080 14420 0 45993 26507 1.00000 false false 320000 320000 2301108 1323065 978043 0 835637 640690 194947 24722 13927 10795 1503785 0 0 DUE TO MEMBER 254156 254156 X 3564208 -46254 -46254 3610462 -13093 -13093 3597369 2901165 14889 14889 2886276 46254 46254 2932530 Intended uses of endowment funds Schedule D, Part V, Line 4 ENDOWMENT FUNDS ARE INTENDED TO HELP WITH THE ORGANIZATIONAL OPERATIONS OF HARBOR HOUSE. FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND HAS RECEIVED A DETERMINATION LETTER THAT IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO THE SECTION 501(A) OF THE CODE. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN THE ORGANIZATION'S TAX EXEMPT STATUS. IN GENERAL, SUCH STANDARDS REQUIRE THE ORGANIZATION TO MEET A COMMUNITY BENEFITS STANDARD AND COMPLY WITH VARIOUS LAWS AND REGULATIONS. THE ORGANIZATION ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. THE ORGANIZATION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT JUNE 30, 2013 AND 2012, THE ORGANIZATION HAD NO UNCERTAIN INCOME TAX POSITIONS ACCRUED. WITH FEW EXCEPTIONS, THE ORGANIZATION IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE US FEDERAL, STATE OR LOCAL AUTHORITIES FOR YEARS ENDED PRIOR TO JUNE 30, 2010. Other revenues in audited financial statements not in form 990 Schedule D, Part XI, Line 2d CHARITY CARE EXPENSE RECLASS - -46254; Other revenues in form 990 not in audited financial statements Schedule D, Part XI, Line 4b SPECIAL EVENT EXPENSE RECLASS - -14889; RESTRICTED CONTRIBUTIONS - 1796; Other expenses in audited financial statements not in form 990 Schedule D, Part XII, Line 2d SPECIAL EVENT EXPENSE RECLASS - 14889; Other expenses in form 990 not in audited financial statements Schedule D, Part XII, Line 4b CHARITY CARE EXPENSE RECLASS - 46254; ANNUAL MAIL APPEALS 107144 41290 65854 14889 0 0 107144 41290 65854 0 0 0 0 0 14889 14889 50965 true CHARITY CARE 90 46254 BOOK REDUCTION OR WRITE OFF OF PATIENT SERVICES SCHEDULE I. PART I, LINE 1 SCHEDULE I, PART I, LINE 1 HARBOR HOUSE RECOGNIZES THE RIGHT TO QUALITY HEALTHCARE REGARDLESS OF AGE, SEX, RACE, RELIGION, NATIONAL ORIGIN, OR ABILITY TO PAY. HARBOR HOUSE PROVIDES CHARITY CARE TO PATIENTS WITH DEMONSTRATED INABILITY TO PAY FOR MEDICALLY NECESSARY SERVICES Procedures for monitoring use of grant funds Schedule I, Part I, Line 2 THESE FUNDS ARE DIRECTLY USED TO OFFSET THE PATIENTS ACCOUNTS RECEIVABLE. false false false false false false false false false Arrangement used to establish the top management official's compensation Schedule J, Part I, Line 3 GARY GEORGE IS THE EXECUTIVE DIRECTOR OF HARBOR HOUSE. HE IS PAID BY ALEGENT CREIGHTON HEALTH, WHICH ACTS AS A MANAGEMENT COMPANY THROUGH A COORDINATION OF SERVICES AGREEMENT. THE AMOUNT PAID TO GARY WAS $96,501, WHICH WAS REPORTED ON FORM 990, PART VII. FORM 990, PART V, LINE 1A FORM 990, PART V, LINE 1A AS PART OF THECOORDINATION OF SERVICES AGREEMENT WITH ALEGENT CREIGHTON HEALTH, ALEGENT CREIGHTON HEALTH PERFORMS THE ACCOUNTS PAYABLE FUNCTION FOR HARBOR HOUSE. HARBOR HOUSE REIMBURSES ALEGENT CREIGHTON HEALTH FOR VENDOR PAYMENTS, THEREFORE NO FORM 1099'S ARE ISSUED BY HARBOR HOUSE. ALEGENT CREIGHTON HEALTH ISSUES THE FORM 1099 AND COMPLIES WITH BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAMING WINNINGS. FORM 990, PART I, LINE 5 AND PART V, LINE 2A FORM 990, PART V, LINE 2A HARBOR HOUSE DOES NOT HAVE ANY EMPLOYEES. INDIVIDUALS PROVIDING SERVICES TO PATIENTS OF HARBOR HOUSE ARE LEASED FROM ALEGENT CREIGHTON HEALTH. Family/business relationships amongst interested persons Form 990, Part VI, Section A, Line 2 RICHARD HACHTEN, JANE CARMODY AND CINDY ALLOWAY - BUSINESS RELATIONSHIP, STEVE GOESER, DIANE RANDOLPH AND JACKIE THIELEN - BUSINESS RELATIONSHIP, JOANIE KUSH AND JAMES SUMMERFELT - BUSINESS RELATIONSHIP, NEIL FORTKAMP, THERESA FRANCO AND JAMES SUMMERFELT - BUSINESS RELATIONSHIP Delegation of management duties Form 990, Part VI, Section A, Line 3 HARBOR HOUSE ENTERED INTO A COORDINATION OF SERVICES AGREEMENT WITH ALEGENT CREIGHTON HEALTH TO PERFORM AND MANAGE FINANCIAL SERVICES FOR A MONTHLY FEE. SERVICES INCLUDE BUT ARE NOT LIMITED TO FINANCIAL REPORTING, BUDGETING, BILLING AND COLLECTIONS, FIXED ASSET MANAGEMENT AND TAX RETURN PREPARATION. IN ADDITION TO FINANCIAL SERVICES, ALEGENT HEALTH PROVIDES INFORMATION SYSTEMS SUPPORT, SECURITY, RISK MANAGEMENT AND CORPORATE COMPLIANCE, PURCHASING, MAINTENANCE AND VARIOUS OTHER SUPPORT SERVICES. Classes of members or stockholders Form 990, Part VI, Section A, Line 6 THE CORPORATE MEMBERS OF HARBOR HOUSE ARE ALEGENT CREIGHTON HEALTH, THE VISITING NURSE ASSOCIATION OF THE MIDLANDS, NEBRASKA METHODIST HOSPITAL AND THE NEBRASKA MEDICAL CENTER. Members or stockholders electing members of governing body Form 990, Part VI, Section A, Line 7a EACH CORPORATE MEMBER WILL BE EQUALLY REPRESENTED ON THE BOARD OF DIRECTORS. THE NUMBER OF VOTING DIRECTORS SHALL BE NO LESS THAN FOUR (4), THE EXACT NUMBER TO BE DETERMINED FROM TIME TO TIME BY DECISION OF THE CORPORATE MEMBERS. CURRENTLY, EACH MEMBER APPOINTS SIX (6) DIRECTORS, FOR A TOTAL OF TWENTY-FOUR (24) DIRECTORS. Decisions requiring approval by members or stockholders Form 990, Part VI, Section A, Line 7b SUBJECT TO THE NEBRASKA NONPROFIT CORPORATION ACT AND OTHER APPLICABLE LAW, THE CORPORATE MEMBERS, BY UNANIMOUS AGREEMENT, SHALL HAVE THE POWER TO: A. FIX THE NUMBER OF DIRECTORS OF THE CORPORATION B. APPROVE, AMEND, OR REPEAL THE BYLAWS OR ARTICLES OF INCORPORATION OF THE CORPORATION C. APPROVE THE MERGER, DISSOLUTION OR CONSOLIDATION OR REORGANIZATION OF THE CORPORATION. D. APPROVE THE FORMATION OF OTHER ENTITIES BY THE CORPORATION. E. APPROVE THE ACQUISITION, SALE, LEASE, TRANSFER OR OTHER ALIENATION OF SUBSTANTIALLY ALL OF THE PROPERTY OF THE CORPORATION, OTHER THAN IN THE USUAL AND REGULAR COURSE OF THE CORPORATIONS BUSINESS. F. APPROVE DEBT INCURRED BY THE CORPORATION IN EXCESS OF $25,000. G. APPROVE THE LONG-RANGE FINANCIAL AND STRATEGIC PLAN FOR THE CORPORATION. H. APPROVE ASSESSMENT UPON, OR REQUIRE CAPITAL CONTRIBUTIONS BY, THE CORPORATE MEMBERS. I. APPROVE ANY DISTRIBUTIONS OF CAPITAL OR NET EARNINGS OF THE CORPORATION. UPON EXERCISE OF ANY POWER DESCRIBED ABOVE, EACH CORPORATE MEMBER SHALL PROMPTLY DELIVER TO THE CORPORATION A DULY EXECUTED CERTIFICATE OR OTHER DOCUMENT EVIDENCING THE APPROVAL OF THAT EXERCISE OF POWER BY SUCH CORPORATE MEMBER. Review of form 990 by governing body Form 990, Part VI, Section B, Line 11b HARBOR HOUSE AND ALEGENT CREIGHTON HEALTH HAVE A COORDINATION OF SERVICE AGREEMENT IN WHICH ALEGENT PROVIDES THE ACCOUNTING AND FINANCE FUNCTIONS FOR HARBOR HOUSE FOR A MONTHLY FEE. THE TAX DEPARTMENT OF ALEGENT CREIGHTON HEALTH PREPARES THE FORM 990 FOR HARBOR HOUSE. FOLLOWING THE PREPARATION OF FORM 990 BY ALEGENT CREIGHTON HEALTH INTERNAL TAX STAFF, THE RETURN IS REVIEWED BY THE ALEGENT CREIGHTON HEALTH TAX DIRECTOR AND HARBOR HOUSE'S FINANCE COMMITTEE. ADDITIONALLY, THE BOARD OF DIRECTORS ARE PROVIDED THE FORM 990 AND REQUIRED SCHEDULES ELECTRONICALLY TO REVIEW AND ASK QUESTIONS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. QUESTIONS ARE REFERRED TO THE ALEGENT CREIGHTON HEALTH TAX DIRECTOR AND THE BOARD IS NOTIFIED OF THE DATE THE TAX RETURN WILL BE FILED. Conflict of interest policy Form 990, Part VI, Section B, Line 12c WRITTEN CONFLICT OF INTEREST POLICY - HARBOR HOUSE HAS ADOPTED THE CONFLICT INVESTIGATION PROCESS OF ALEGENT CREIGHTON HEALTH. ANNUAL COMPLETION OF THE DISCLOSURE STATEMENT IS REQUIRED BY THE BOARD OF DIRECTORS. STATED DISCLOSURES ARE INVESTIGATED BY AN APPOINTED DISINTERESTED PERSON OR COMMITTEE THAT IS SELECTED BY THE CHAIRMAN OF THE BOARD. AFTER EXERCISING DUE DILIGENCE, THE BOARD SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION. FINALLY, THE BOARD MAKES ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGMENT IN CONFORMITY WITH SUCH DETERMINATION. AT ANY TIME A BOARD MEMBER MAY DECLARE A CONFLICT OF INTEREST AND RECUSE HIM/HERSELF FROM THE DISCUSSION. THE INDIVIDUAL IS ALSO REQUIRED TO DISCLOSE ANY KNOWN OR POSSIBLE CONFLICTS OF INTEREST THAT ARISE DURING THE CALENDAR YEAR. Governing documents, conflict of interest policy and financial statements available to the public Form 990, Part VI, Section C, Line 19 HARBOR HOUSE HAS ADOPTED THE CONFLICT OF INTERES POLICY OF ALEGENT CREIGHTON HEALTH, WHICH IS AVAILABLE TO THE PUBLIC AT WWW.ALEGENTCREIGHTON.COM. HARBOR HOUSE DOES NOT MAKE THE GOVERNING DOCUMENTS OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. HOWEVER, THE ARTICLES OF INCORPORATION ARE AVAILABLE AT WWW.SOS.STATE.NE.US Other changes in net assets or fund balances Form 990 , Part XI, Line 9 RELEASED FROM RESTRICTIONS - -110976;