2014-08-11T07:26:15-05:00 2013-12-31 560517823 KOONCE WOOTEN & HAYWOOD LLP P O BOX 17806 RALEIGH NC 276197806 990 2013-01-01 561228779 HOSPICE OF WAKE COUNTY INC HOSP 9198280890 250 HOSPICE CIRCLE RALEIGH NC 27607 JOHN THOMA EXECUTIVE DIRECTOR 9198280890 2014-07-31 1 DAVID BOYCE P01368646 9197829265 2013 2015-11-30 17:44:51Z JOHN THOMA 250 HOSPICE CIRCLE RALEIGH NC 27607 24778868 0 X N/A X 1979 NC EMPOWERING INDIVIDUALS, FAMILIES AND COMMUNITIES TO EMBRACE MEANING AT END OF LIFE. 22 22 387 350 0 0 1461854 1250905 22648413 23520257 6121 7706 0 0 24116388 24778868 0 0 0 0 15441573 16792545 0 0 0 7824082 8167100 23265655 24959645 850733 -180777 18448147 18163272 4669398 4565300 13778749 13597972 EMPOWERING INDIVIDUALS, FAMILIES AND COMMUNITIES TO EMBRACE MEANING AT END OF LIFE. 0 0 22618253 23520257 HOSPICE PROVIDED AT HOME MEDICAL CARE FOR THE TERMINALLY ILL AND COUNSELING FOR OTHER FAMILY MEMBERS. 22618253 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 2 0 387 0 0 0 0 0 0 0 0 0 X 22 22 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X ANTOINETTE MESSLER 9198280890 250 HOSPICE CIRCLE RALEIGH NC 27607 ERICK HAWKINS PRESIDENT 2.00 X 0 0 0 CHARLES HODGES BOARD MEMBER 2.00 X 0 0 0 LINDA JOHNSON BOARD MEMBER 2.00 X 0 0 0 JAMES BURGESS BOARD MEMBER 2.00 X 0 0 0 VICKI ALLEN BOARD MEMBER 2.00 X 0 0 0 BETH BLACK BOARD MEMBER 2.00 X 0 0 0 PHILLIP MARK BLAKE BOARD MEMBER 2.00 X 0 0 0 DAVID MOYE BOARD MEMBER 2.00 X 0 0 0 BART NORMAN BOARD MEMBER 2.00 X 0 0 0 BRENDA GIBSON BOARD MEMBER 2.00 X 0 0 0 JENNIFER DIRIENZO TREASURER 2.00 X 0 0 0 BILLY DUNLAP BOARD MEMBER 2.00 X 0 0 0 DAVID FINCH BOARD MEMBER 2.00 X 0 0 0 FRANKLIN FREEMAN BOARD MEMBER 2.00 X 0 0 0 MONICA LALIBERTE BOARD MEMBER 2.00 X 0 0 0 WEST LAWSON BOARD MEMBER 2.00 X 0 0 0 JOHN MEDINGER SECRETARY 2.00 X 0 0 0 BOBBY SIMPSON VICE PRESIDENT 2.00 X 0 0 0 STEPHEN TREMONT BOARD MEMBER 2.00 X 0 0 0 LINDA JEFFERSON BOARD MEMBER 2.00 X 0 0 0 CASSANDRA SKINNER BOARD MEMBER 2.00 X 0 0 0 JOHN THOMA CHIEF EXECUTIVE OFFICER & 40.00 X 131965 0 12596 ANTOINETTE MESSLER VICE PRESIDENT FINANCE & O 40.00 X 99556 0 12115 COOPER LINTON VICE PRESIDENT MARKETING & 40.00 X 96128 0 11213 LESLIE SUTTON HOSPICE PHYSICIAN 40.00 X 155259 0 13238 DEB BLUE MEDICAL DIRECTOR 40.00 X 137554 0 2532 MARK NICHOLS HOSPICE PHYSICIAN 40.00 X 161352 0 14133 781814 0 65827 4 0 1 0 0 1250905 1250905 PATIENT SERVICE REIMB 900099 23520257 23520257 23520257 7706 7706 24778868 23520257 0 7706 363573 363573 13062820 12458481 604339 356087 343448 12639 1993239 1739554 253685 1016826 907895 108931 112513 91379 21134 12888 12888 30300 30300 282723 282723 853602 581890 271712 472551 272719 199832 735487 727097 8390 65255 65255 519923 259961 259962 75446 37643 37803 PHARMACY 1638844 1638844 DURABLE MEDICAL EQUIPME 1455042 1455042 SKILLED NURSING-ROOM & 1093037 1093037 OUTPATIENT TREATMENTS 584040 584040 235449 144500 90949 24959645 22618253 2341392 0 191476 94952 1597591 986540 2441709 3120746 70136 187324 15965362 2370296 13990655 13595066 156580 178644 18448147 18163272 1627393 1838295 3040560 2725560 1445 1445 4669398 4565300 X 13254151 13073308 524598 524664 13778749 13597972 18448147 18163272 -180777 0 X 0 1 X 0 0 X 706410 11513754 2122443 1461854 1250905 17055366 706410 11513754 2122443 1461854 1250905 17055366 17055366 17133 11886 11273 6121 7640 54053 17109419 98989042 0.99680 0.99560 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1570665 10505 131732 1712902 1742164 76886 -248385 1570665 1667084 161930 -86850 1742164 1563613 81764 21707 1667084 308651 1254962 1563613 0.85000 0.15000 0 1 1 14624193 1452269 13171924 4561 203 4358 1336608 917824 418784 13595066 DUE TO END OF LIFE COALITION 1445 1445 24778868 0 24778868 0 24778868 24959645 0 24959645 0 24959645 X X 0 0 0 0 0 0 0 0 0 LESLIE SUTTON HOSPICE PHYSICIAN 155259 0 0 0 0 0 6585 0 6653 0 168497 0 0 0 MARK NICHOLS HOSPICE PHYSICIAN 161352 0 0 0 0 0 6553 0 7580 0 175485 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE EXECUTIVE AND FINANCE COMMITTEES PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST IS REVIEWED ANNUALLY IN BOARD MEETING AND EACH MEMBER IS REQUIRED TO SIGN THEIR UNDERSTANDING OF THE DOCUMENT. FORM 990, PART VI, SECTION B, LINE 15A FORM 990, PART VI, SECTION B, LINE 15: PRESIDENT OF THE BOARD AND THE EXECUTIVE COMMITTEE REVIEW THE CEO'S PERFORMANCE AND REVIEW COMPARABLE SALARIES IN THE INDUSTRY USING SALARY INFORMATION OBTAINED BY THE HUMAN RESOURCES DEPARTMENT. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON DEMAND. THEY CAN BE EMAILED OR VIEWED HARDCOPY IN THE OFFICE. WE HAVE MAILED HARDCOPY REQUESTS AS WELL. HOSPICE OF WAKE COUNTY FOUNDATION INC 250 HOSPICE CIRCLE RALEIGH NC 27607 561867838 RAISES AND INVESTS FUNDS TO BE USED IN THE FUTURE BY HOSPICE OF WAKE COUNTY NC 501 (C)(3) 509 (A)(3) 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 HOSPICE OF WAKE COUNTY FOUNDATION C 1250905 COST HOSPICE OF WAKE COUNTY FOUNDATION M 163129 FUNDRAISING FOR HOSPICE HOSPICE OF WAKE COUNTY FOUNDATION Q 281700 COST