2013-11-14T14:54:50-06:00 2012-12-31 CROWE HORWATH LLP 70 West Madison Street Suite 700 Chicago IL 606024903 990 2012-01-01 593060139 COVENANT HOSPICE FOUNDATION INC COVE 8504332155 5041 N 12th Avenue Pensacola FL 32504 DALE O KNEE 2013-11-05 true Nicole Bencik P00756195 3128997000 2012 2016-02-24 21:20:13Z DALE O KNEE 5041 N 12th Avenue Pensacola FL 32504 2139208 false X WWW.COVENANTHOSPICE.ORG X 1991 FL THE ORGANIZATION'S MISSION IS TO PROVIDE FUNDING TO COVENANT HOSPICE, INC. IN ORDER TO SUPPLEMENT CHARITY AND INDIGENT CARE. 12 12 0 12 0 0 374594 666734 0 0 91552 227094 314725 -93791 780871 800037 0 526622 0 0 0 0 0 0 0 718095 28872 718095 555494 62776 244543 3512474 3846398 262693 224186 3249781 3622212 THE ORGANIZATION'S MISSION IS TO PROVIDE FUNDING TO COVENANT HOSPICE, INC. IN ORDER TO SUPPLEMENT CHARITY AND INDIGENT CARE. false false 541139 526622 0 THE 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 2012, 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. 541139 true true false false false false false false false false false false false true true false true false false false false false false true true false true false true false false false false false false false false false false false false false true false false false false true 0 0 0 false false false false false true true false false false false X 12 12 false false false false true true true true true false false false true true true true true false false false X Karen Young 8504332155 5041 N 12th Avenue Pensacola FL 32504 ADRIAN P REMKE 4.00 4.00 X X 0 0 0 BOB VAN SLYKE 4.00 8.00 X X 0 0 0 JAMES S CAMPBELL ESP 4.00 4.00 X X 0 0 0 ROBIN D HERR 4.00 4.00 X X 0 0 0 BILL GREENHUT 4.00 0.00 X 0 0 0 CHRISTINA DOSS 4.00 0.00 X 0 0 0 JOHN R FOGG 4.00 0.00 X 0 0 0 PATRICK SCHLENKER 4.00 4.00 X 0 0 0 REBECCA H MCQUEEN 4.00 0.00 X 0 0 0 ROBERT MILLS 4.00 0.00 X 0 0 0 STEVE SOUTHERLAND II 4.00 0.00 X 0 0 0 TODD O'BRIEN 4.00 4.00 X 0 0 0 DALE O KNEE 4.00 64.00 X 0 744887 53382 0 744887 53382 0 false true false 0 590520 76214 666734 0 0 0 0 0 0 0 0 0 0 81669 81669 0 0 0 0 0 1260506 1115081 145425 0 145425 145425 101424 590520 181764 -80340 -80340 28875 42326 -13451 -13451 0 0 0 0 0 0 0 0 0 800037 0 0 133303 526622 526622 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12035 12035 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 GOLDENBERG PROJECT 14517 14517 SERVICE CHARGES 2320 2320 0 0 0 0 555494 541139 14355 0 0 297849 231653 147635 244947 173572 156294 0 0 0 0 0 0 2893418 3213504 0 0 0 0 0 0 3512474 3846398 0 262693 224186 262693 224186 X 3119530 3475902 130251 146310 3249781 3622212 3512474 3846398 X 244543 133672 -5784 X false true X true false X 149486 881991 773909 374594 666734 2846714 0 0 149486 881991 773909 374594 666734 2846714 169378 2677336 73108 60025 61100 85840 81669 361742 0 638494 53602 154735 314721 130299 1291851 4500307 0 0.59490 0.70160 X OTHER INCOME, SCHEDULE A, PART II, LINE 10, DESCRIPTION - GROSS INCOME FROM FUNDRAISING, COLUMN A - 638494, COLUMN B - 53602, COLUMN C - 154735, COLUMN D - 314721, COLUMN E - 101424, COLUMN F - 1262976; DESCRIPTION - GROSS INCOME FROM GAMING EVENTS, COLUMN A - 0, COLUMN B - 0, COLUMN C - 0, COLUMN D - 0, COLUMN E - 28875, COLUMN F - 28875;, RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 GIFT ANNUITY OBLIGATION 41978 INTERCOMPANY PAYABLES 182208 224186 X FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 HOSPICE, FOUNDATION, AND AFS ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. WITH FEW EXCEPTIONS, HOSPICE AND AFFILIATES ARE NO LONGER SUBJECT TO EXAMINATION BY TAX AUTHORITIES FOR YEARS BEFORE 2009. MASK PARADE 132119 113495 18624 829 32131 2600 7060 LIFE'S A DANCE 72881 23051 49830 2000 3213 40251 412 20 486944 453974 32970 32810 34267 23443 2748 691944 590520 101424 0 0 35639 69611 66294 10220 181764 -80340 28875 270 42056 0 0 true 1 28875 270 42056 0 0 42326 -13451 FL true false true false 0.13 0.87 BRYAN WHETZEL 5041 N 12TH AVENUE PENSACOLA FL 32504 false false GAMING MANAGER INFORMATION SCHEDULE G, PART III, LINE 16 THE FOLLOWING INDIVIDUALS ORGANIZE THE GAMING ACTIVITIES: LILL JENNINGS ANGIE SCHLOSSER ANGELA JACKSON ALICIA HALL DONNA BOYLE THESE INDIVIDUALS ARE ALL VOLUNTEERS FOR COVENANT HOSPICE FOUNDATION, INC. AND ARE NOT COMPENSATED FOR THEIR TIME. true COVENANT HOSPICE INC 5041 N 12TH AVENUE PENSACOLA FL 32504 592208300 501(C)(3) 526622 0 N/A N/A TO HELP SUPPORT PROGRAMS OF COVENANT HOSPICE, INC. 1 0 Procedures for monitoring use of grant funds Schedule I, Part I, Line 2 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. false false false false false false false DALE O KNEE 0 312020 0 418238 0 14629 0 6382 0 47000 0 798269 0 0 Arrangement used to establish the top management official's compensation Schedule J, Part I, Line 3 THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT & CEO IS DETERMINED USING AN INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEYS OR STUDIES AND APPROVAL BY THE BOARD. Delegate broad authority to a committee Form 990, Part VI, Section A, Line 1a PURSUANT 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. Classes of members or stockholders Form 990, Part VI, Section A, Line 6 THE ORGANIZATION'S SOLE MEMBER IS COVENANT HOSPICE, INC. COVENANT HOSPICE, INC. ELECTS THE BOARD MEMBERS OF COVENANT HOSPICE FOUNDATION, INC. Members or stockholders electing members of governing body Form 990, Part VI, Section A, Line 7a COVENANT HOSPICE, INC. ELECTS THE BOARD MEMBERS OF COVENANT HOSPICE FOUNDATION, INC. Decisions requiring approval by members or stockholders Form 990, Part VI, Section A, Line 7b THE 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. Review of form 990 by governing body Form 990, Part VI, Section B, Line 11b THE FORM 990 IS REVIEWED BY STAFF WITH THE ASSISTANCE OF AND REVIEW BY AN INDEPENDENT ACCOUNTING FIRM BEFORE IT IS SIGNED AND SUBMITTED. Conflict of interest policy Form 990, Part VI, Section B, Line 12c CONFLICT 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. COMPENSATION OF THE TOP MANAGEMENT OFFICIAL FORM 990, PART VI, LINE 15A THE 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. COMPENSATION OF OTHER OFFICERS FORM 990, PART VI, LINE 15B THE ORGANIZATION DOES NOT HAVE ANY OTHER OFFICERS WHO RECEIVE COMPENSATION. THEREFORE THIS QUESTION HAS BEEN ANSWERED "NO" IN ACCORDANCE WITH FORM 990 INSTRUCTIONS. Governing documents, conflict of interest policy and financial statements available to the public Form 990, Part VI, Section C, Line 19 GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ARE AVAILABLE ON WRITTEN REQUEST. Other changes in net assets or fund balances Form 990 , Part XI, Line 9 CHANGE IN SPLIT INTEREST AGREEMENT - -5784; COVENANT HOSPICE INC 5041 N 12TH AVENUE PENSACOLA FL 32504 PROVIDES CARE TO TERMINALLY ILL PATIENTS FL 501(C)(3) 7 NA false ALZHEIMERS FAMILY SERVICES INC 5041 N 12TH AVENUE PENSACOLA FL 32504 SUPPORT TO ALZHEIMERS PATIENTS AND FAMILIES FL 501(C)(3) 7 COVENANT HOSPICE INC false STUDER COVENANT ALLIANCE LLC 913 GULF BREEZE PARKWAY SUITE 6 GULF BREEZE FL 32561 260286474 EDUCATION FL NA N/A false true false false false false false false false false false false false true true true false false false