2014-08-14T12:36:01-05:00 2013-12-31 521130974 ALBRIGHT CRUMBACKER MOUL & ITELL CPA'S 1110 PROFESSIONAL COURT SUITE 300 HAGERSTOWN MD 21740 990 2013-01-01 541126227 BLUE RIDGE HOSPICE INC BLUE 5405365210 333 WEST CORK STREET NO 405 WINCHESTER VA 22601 ERNEST J CARNEVALE JR PRESIDENT AND CEO 3017395300 2014-08-14 1 R KERT SHIPWAY P00349171 3017395300 2014-08-14 2013 2015-11-30 17:44:51Z ERNEST J CARNEVALE JR 333 WEST CORK STREET SUITE 405 WINCHESTER VA 22601 17025265 0 X WWW.BLUERIDGEHOSPICE.ORG X 1981 VA BLUE RIDGE HOSPICE'S MISSION IS TO MAKE QUALITY END-OF-LIFE CARE AVAILABLE TO INDIVIDUALS AND THEIR FAMILIES FACING SERIOUS ILLNESS AND TO SUPPORT ANYONE IN OUR COMMUNITY AFFECTED BY DEATH, DYING, AND LOSS. BLUE RIDGE HOSPICE PROVIDES PHYSICAL, EMOTIONAL, SOCIAL, AND SPIRITUAL CARE FOR TERMINALLY ILL PATIENTS AND THEIR FAMILIES IN THE REGIONS OF VIRGINIA CONSISTING OF THE CITY OF WINCHESTER AND COUNTIES OF FREDERICK, CLARKE, WARREN, FAUQUIER, SHENANDOAH, PAGE, RAPPAHANNOCK, AND WESTERN LOUDOUN. BLUE RIDGE HOSPICE PROVIDES AN EMPHASIS ON ENHANCING THE LIVES OF TERMINALLY ILL PERSONS. 14 14 249 1311 0 0 2947657 3309900 12955639 12432127 67195 167837 196755 74666 16167246 15984530 0 0 0 0 8579253 8662135 0 0 2354056 7182501 7059713 15761754 15721848 405492 262682 5324411 5663976 1506472 1522272 3817939 4141704 X SEE SCHEDULE "O" FOR MISSION STATEMENT. 0 0 9674993 11675569 THE ORGANIZATION PROVIDES MEDICAL AND OTHER RELATED SERVICES, SUCH AS NURSING CARE, SOCIAL WORK, CERTIFIED NURSING ASSISTANTS AND VOLUNTEER ASSISTANCE, TO THE TERMINALLY ILL AND THEIR FAMILIES WHO LIVE IN THE COUNTIES OF FREDERICK, CLARKE, WARREN, FAUQUIER, SHENANDOAH, WESTERN LOUDOUN, PAGE, RAPPAHANNOCK AND THE CITY OF WINCHESTER, VA. BLUE RIDGE HOSPICE SERVED OVER 1,107 PATIENTS IN 2013. THESE PATIENTS WERE SERVED REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES. 1331569 692006 BLUE RIDGE HOSPICE INPATIENT CARE CENTER SERVED OVER 229 PATIENTS IN 2013 IN THEIR FACILITY. THE PATIENTS STAY AT THE FACILITY FOR GENERAL INPATIENT LEVEL OF CARE OR FOR ASSISTED LIVING ROOM AND BOARD CARE. THESE PATIENTS WERE SERVED REGARDLESS OF THEIR ABILITY TO PAY FOR THEIR STAY AT THE INPATIENT CARE CENTER. THE CENTER PROVIDES ROOM AND BOARD, NURSING, SOCIAL WORK, CERTIFIED NURSING ASSISTANTS, MUSIC THERAPY, CHAPLAIN, AND VOLUNTEER SERVICES TO ITS PATIENTS. 319198 BLUE RIDGE HOSPICE PROVIDED BEREAVEMENT AND OUTREACH SERVICES, SUCH AS MUSIC THERAPY AND CHAPLAIN SERVICES TO THE POPULATION IN THE ENTIRE SERVICE AREA. BEREAVEMENT SERVICES ARE PROVIDED FREE OF CHARGE TO THE RESIDENTS IN THE BLUE RIDGE HOSPICE SERVICE AREA. MUSIC THERAPY AND CHAPLAIN SERVICES ARE PROVIDED AS AN UNREIMBURSED SERVICE TO HOSPICE PATIENTS. 617046 75635 PALLIATIVE MEDICINE CONSULTANTS STRIVE TO RELIEVE PHYSICAL, EMOTIONAL, AND SPIRITUAL PAIN, WHILE IMPROVING THE QUALITY OF LIFE FOR PATIENTS AND THEIR FAMILIES WHO ARE FACING SERIOUS ILLNESS. PALLIATIVE MEDICINE CONSULTANTS SERVED OVER 400 PATIENTS AND MADE 920 VISITS IN 2013 AT THE HOSPITAL AND OUT-PATIENT CLINIC. 617046 75635 11942806 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 106 0 1 249 1 0 0 0 0 0 1 1 1 4 0 0 1 0 0 0 0 X 14 14 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 VA X X CHERYL RINGER 5405365210 333 WEST CORK STREET SUITE 405 WINCHESTER VA 22601 ROBERT MOWERY CPA CHAIRPERSON 1.00 X X 0 0 0 PAUL DELMERICO VICE CHAIRPERSON 1.00 X X 0 0 0 BETHANNE BERMAN SECRETARY 1.00 X X 0 0 0 NANCY PICKLAP CPA TREASURER 1.00 X X 0 0 0 GEORGE CALEY AT-LARGE 1.00 X X 0 0 0 LYNNE SAYLES AT-LARGE 1.00 X X 0 0 0 HELEN ZEBARTH AT-LARGE 1.00 X X 0 0 0 CHRISTOPHER CURRAN DIRECTOR 1.00 X 0 0 0 JOHN HARDESTY DIRECTOR 1.00 X 0 0 0 MARY ANN KAPLAN DIRECTOR 1.00 X 0 0 0 BRENDA MATTHEWS DIRECTOR 1.00 X 0 0 0 SHERRY THOMAS DIRECTOR 1.00 X 0 0 0 JARED TRUBAN DIRECTOR 1.00 X 0 0 0 LEONARD YANG MD DIRECTOR 1.00 X 0 0 0 ERNEST J CARNEVALE JR PRESIDENT AND CEO 40.00 X 194102 0 11412 CHERYL RINGER VP OF FINANCE, CFO 40.00 X 117519 0 15498 PATRICIA BISHOP VP OF CLINICAL SERVICES 40.00 X 125132 0 5452 RICHARD MILLIGAN PHYSICIAN 40.00 X 180134 0 16170 JACK WRIGHT PHYSICIAN 40.00 X 181038 0 11412 PATRICIA GRAY-IRWIN VP OF CLINICAL SERVICES 40.00 X 125197 0 0 ANTHONY CROSEN VP OF DEVELOPMENT AND COMM 40.00 X 108487 0 16170 1031609 0 76114 7 0 1 0 ANTHEM PO BOX 580494 CHARLOTTE NC 282580494 HEATLH INSURANCE PROVIDER 1708899 HOSPISCRIPT LLC PO BOX 933273 ATLANTA GA 311933273 PHARMACY 509744 VALLEY HOME CARE PO BOX 1910 WINCHESTER VA 226048060 DURABLE MEDICAL SUPPLIER 439451 THE HARTFORD PO BOX 98702 CHICAGO IL 061839043 WORKERS COMPENSATION INSURANCE 291587 GULF SOUTH PO BOX 841968 DALLAS TX 752841968 MEDICAL SUPPLIES PROVIDER 246303 11 5142 3304758 3309900 HOSPICE CARE 623990 11664486 11664486 INPATIENT CARE CENTER 623990 692006 692006 PALLIATIVE CARE 623990 75635 75635 12432127 41136 41136 960 0 960 960 960 987224 3500 864023 0 123201 3500 126701 126701 240295 5142 176712 63583 63583 OTHER 900099 10123 10123 10123 15984530 12443210 0 231420 338531 338531 7717270 6749820 698766 268684 45208 35012 8822 1374 561126 470016 71971 19139 13500 10379 3121 62414 27936 34478 7241 70 5373 1798 211713 107344 44000 60369 589270 499384 66238 23648 280360 280360 79521 57410 18860 3251 27031 22190 3694 1147 199462 173631 16722 9109 1294702 1102790 146497 45415 THRIFT SHOP EXPENSES 1861239 1861239 NURSING HOME 668060 668060 PATIENT SERVICES - DRUG 519423 519423 EQUIPMENT RENTAL 492840 492840 752937 726141 2391 24405 15721848 11942806 1424986 2354056 652551 1013684 32391 38427 20819 43118 1403853 1174851 324 271 104368 70861 2763400 1086443 1259566 1676957 1850539 1645807 5324411 5663976 1037300 1130606 469172 391666 1506472 1522272 X 2525119 2840850 1292820 1300854 3817939 4141704 5324411 5663976 262682 73640 -12557 0 X 0 1 X 1 0 X 1823183 2325866 2709704 2947657 3309900 13116310 1823183 2325866 2709704 2947657 3309900 13116310 13116310 36944 45780 61723 59045 42096 245588 5162 7850 3713 5471 14583 36779 13398677 63923563 0.97890 0.97480 X 1134541 41136 41136 1134541 1134541 60928 60928 1134541 1134541 58219 58219 1134541 1134541 43477 43477 1134541 1134541 35300 35300 1134541 1.00000 0 0 93000 93000 704167 42945 661222 703994 168762 535232 1032605 736078 296527 229634 138658 90976 1676957 CORPORATE BONDS 241021 F MUTUAL FUNDS 1385294 F OTHER 19492 F 1645807 X 16195153 73640 149540 223180 15971973 12557 12557 15984530 15871388 149540 149540 15721848 0 15721848 PART V, LINE 4: ENDOWMENT IS DESIGNATED TO FUND FUTURE GROWTH AND CONSTRUCTION PROJECTS. PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION COMPLIES WITH ASC 740-10 (FORMERLY FIN 48), WHICH ESTABLISHES A THRESHOLD FOR DETERMINING WHEN AN INCOME TAX BENEFIT OF A TAX POSITION CAN BE RECOGNIZED. UNDER ASC 740-10, A TAX POSITION INCLUDES, AMONG OTHER THINGS, (A) A DECISION NOT TO FILE A TAX RETURN (B) AN ALLOCATION OR A SHIFT OF INCOME BETWEEN JURISDICTIONS (C) THE CHARACTERIZATION OF INCOME OR A DECISION TO EXCLUDE REPORTING TAXABLE INCOME IN A TAX RETURN (D) A DECISION TO CLASSIFY A TRANSACTION, ENTITY, OR OTHER POSITION IN A TAX RETURN AS TAX EXEMPT AND (E) AN ENTITY'S STATUS, INCLUDING ITS STATUS AS A TAX-EXEMPT NOT-FOR-PROFIT ENTITY. BASED ON ITS INTERPRETATION OF THE REQUIREMENTS OF ASC 740-10, MANAGEMENT BELIEVES THAT THE ORGANIZATION HAS NO UNCERTAIN TAX POSITIONS THAT QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE. ACCORDINGLY, COMPLIANCE WITH THIS STANDARD HAD NO MATERIAL EFFECT ON THE ORGANIZATION'S FINANCIAL STATEMENTS. 5K RUN 29790 29790 11741 DESIGNER SHOWHOUSE 166569 166569 130761 4 49078 5142 43936 34210 245437 5142 240295 176712 176712 63583 X 1 1 X X X 0 0 0 0 0 0 0 0 0 ERNEST J CARNEVALE JR PRESIDENT AND CEO 194102 0 0 0 0 0 0 0 11412 0 205514 0 0 0 RICHARD MILLIGAN PHYSICIAN 180134 0 0 0 0 0 0 0 16170 0 196304 0 0 0 JACK WRIGHT PHYSICIAN 181038 0 0 0 0 0 0 0 11412 0 192450 0 0 0 LYNNE SAYLES INVESTMENT BANKER/BOARD MEMBER NO DIRECT INVOLVEMENT 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 BOARD MEMBERS ARE ENGAGED IN VARIOUS BUSINESS ACTIVITIES THROUGHOUT THE COMMUNITY IN WHICH THEY ENTER INTO VENDOR RELATIONSHIPS. FORM 990, PART VI, SECTION B, LINE 11 BLUE RIDGE HOSPICE SENDS THE FORM 990 TO ALL BOARD MEMBERS VIA EMAIL PRIOR TO THE BOARD MEETING. THE BOARD MEMBERS THEN DISCUSS THE 990 DURING THE FOLLOWING MEETING. ANY BOARD MEMBERS WHO ARE NOT ABLE TO ATTEND THE NEXT MEETING ARE ENCOURAGED TO CALL WITH QUESTIONS OR COMMENTS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY ALL EMPLOYEES AND THE BOARD OF DIRECTORS ARE GIVEN A COPY OF BLUE RIDGE HOSPICE'S WRITTEN CONFLICT OF INTEREST POLICIES AND THEY ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT. EACH CONFLICT OR PERCEIVED CONFLICT ARE REVIEWED TO DETERMINE IF APPROPRIATE CONTROLS ARE IN PLACE TO MAINTAIN ARMS-LENGTH-TRANSACTIONS FOR SUCH RELATIONSHIPS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR THE ORGANIZATION'S CEO IS DETERMINED ON AN ANNUAL BASIS BY THE BOARD OF DIRECTORS DURING HIS ANNUAL EVALUATION PROCESS. THE BOARD UTILIZES VARIOUS SALARY SERVICES AND RESOURCES TO DETERMINE APPROPRIATE SALARIES FOR POSITIONS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.