2013-11-15T16:06:59-06:00 2012-12-31 410746749 CLIFTONLARSONALLEN LLP 420 SOUTH ORANGE AVENUE SUITE 500 ORLANDO FL 32801 990 2012-01-01 592935928 HOSPICE OF THE COMFORTER INC HOSP 4076820808 480 W CENTRAL PARKWAY ALTAMONTE SPRINGS FL 32714 ERNESTO LOPEZ 4078622643 2013-11-15 1 AMY CHAPMAN P00843460 4078021200 2013-11-15 2012 2016-03-07 17:11:31Z ERNESTO LOPEZ 480 W CENTRAL PARKWAY ALTAMONTE SPRINGS FL 32714 34089002 0 X WWW.HOSPICEOFTHECOMFORTER.ORG X 1990 FL TO PROVIDE COMPASSIONATE & EXPERT CARE TO HOSPICE PATIENTS. 9 8 495 505 0 0 1223974 700579 37387983 30472041 417558 62349 58137 10000 39087652 31244969 20000 0 0 0 22688539 19887259 3950 0 0 16695141 11059987 39407630 30947246 -319978 297723 28558251 19033609 12724444 5902079 15833807 13131530 X HOSPICE OF COMFORTER IS COMPASSIONATE PEOPLE PROVIDING COMPASSIONATE AND EXPERT END OF LIFE CARE. HOSPICE IS GUIDED BY THE HIGHEST ETHICAL PRINCIPLES WHILE CARING FOR THE PHYSICAL, EMOTIONAL AND SPIRITUAL NEEDS OF PATIENTS AND THEIR FAMILIES FACING AN INCURABLE ILLNESS. 0 0 24713625 29670374 HOSPICE SERVICES IN ORANGE, SEMINOLE, AND OSCEOLA COUNTIES - WE WERE PRIVILEGED IN 2012 TO PROVIDE END-OF-LIFE COMPASSIONATE CARE TO 2,908 ADULTS AND CHILDREN LIVING IN ORANGE, SEMINOLE AND OSCEOLA COUNTY AND ALSO AT HOSPICE HOUSE OR ROBISON RESIDENCE ON OUR CAMPUS. WE KEEP OUR PROMISE THAT NO PATIENT WILL BE TURNED AWAY DUE TO AN INABILITY TO PAY AND THE GENEROSITY OF DONORS IN OUR COMMUNITY PROVIDED $435,501.00 IN CHARITY CARE. IN 2012, 312 STAFF MEMBERS AND 291 ACTIVE VOLUNTEERS JOINED TOGETHER BELIEVING IN ONE MISSION. AS THE LEADER IN INNOVATIVE, COMPASSIONATE AND EXPERT CARE RECOGNIZED THROUGHOUT CENTRAL FLORIDA WE COOPERATED WITH COMMUNITY PARTNERS TO PROVIDE 230 INTERNAL AND EXTERNAL PRESENTATIONS. WE WERE RECOGNIZED BY THE ORLANDO SENTINEL IN THE TOP 100 COMPANIES FOR WORKING FAMILIES FOR THE 8TH YEAR IN A ROW. OUR PATIENTS AND FAMILIES BELIEVE IN OUR WORK AND WE ARE PRIVILEGED TO BELIEVE IN OUR MISSION FIRST. MORE INFORMATION CAN BE FOUND ON OUR WEBSITE: WWW.HOSPICEOFTHECOMFORTER.ORG OR ON OUR FOUNDATION WEBSITE AT WWW.COMFORTERFOUNDATION.ORG. 534116 0 431563 HOSPICE HOUSE - "I DON'T KNOW WHAT I WOULD HAVE DONE WITHOUT HOSPICE HOUSE WHEN MY HUSBAND NEEDED AROUND THE CLOCK CARE - THEY WERE THERE FOR HIM AND FOR ME AND I WILL NEVER FORGET THEM..." MARGIE IN 2012, 934 PATIENTS WERE CARED FOR AT HOSPICE HOUSE WITH AN AVERAGE LENGTH OF STAY OF 5.5 DAYS. AS THE ONLY FREE-STANDING HOSPICE FACILITY IN THE TRI-COUNTY SERVICE COMMUNITY, 16 PRIVATE SUITES WITH A PRIVATE LANAII WELCOME PATIENTS AND FAMILIES 24 HOURS A DAY WITH A CHILDREN'S AREA, CHAPEL AND CAFETERIA. "ROBISON RESIDENCE WHEN THERE IS NO ONE OR NO ABLE CAREGIVER."ON A QUIET WOODED LOT IS A RENOVATED BEAUTIFUL HOME WITH SIX PRIVATE BEDROOMS FOR HOSPICE RESIDENTS GREETED BY STAFF AND VOLUNTEERS EVERY DAY IT'S THEIR HOME. DURING 2012, 46 HOSPICE PATIENTS CALLED ROBISON RESIDENCE HOME - THE AVERAGE LENGTH OF STAY WAS 37.4 DAYS. 0 370104 HORIZONS BEREAVMENT CENTER - WE ARE THE EXPERTS IN GRIEF AND CARE FOR FAMILIES OF OUR PATIENTS FOR 13 MONTHS AFTER A DEATH. THIS COMMITMENT IS SEEN AT OUR HORIZON'S LOSS PROGRAM FOR ADULTS IN 2012 PROVIDING 1,082 INDIVIDUAL COUNSELING SESSIONS IN ADDITION TO 236 GROUP SESSIONS OFFERED AT NO COST TO ADULTS REGARDLESS OF WHETHER THEIR LOVED ONE WAS SERVED BY OUR ORGANIZATION. CHILDREN ARE THE "FORGOTTEN GRIEVERS" AND OUR LICENSED COUNSELORS SAW 427 CHILDREN IN 71 PUBLIC SCHOOLS DURING THEIR SCHOOL DAY. BEREAVEMENT SUPPORT IS NOT REIMBURSED AND IS PROVIDED AT NO COST THROUGH THE GENEROSITY OF OUR COMMUNITY. 25247741 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 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 43 0 495 1 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 FL X X JAY OH 4076820808 480 W CENTRAL PARKWAY ALTAMONTE SPRINGS FL 32714 ROBERT G WILSON 40.00 0.70 X X 330935 0 13990 JACK D CADDEN 0.30 0.00 X X 0 0 0 DWAN M MCANDREWS 0.30 0.00 X 0 0 0 JO C SIMONINI 0.30 0.30 X X 0 0 0 BONNIE J HANNAH 0.30 0.00 X 0 0 0 ROBERT J WATSON 0.30 0.70 X X 0 0 0 SUZAN CHICK 0.30 0.00 X 0 0 0 SANDRA RANDOLPH 0.30 0.00 X X 0 0 0 FARLEN HALIKMAN 0.30 0.00 X 0 0 0 ERIC MOORE 40.00 0.00 X 199926 0 27638 SHERRY BROOKS 40.00 0.00 X 114470 0 18304 RYAN RONALD 40.00 0.00 X 173401 0 26069 JULIUS GARNER 40.00 0.00 X 142095 0 468 JEFFREY WHITE 40.00 0.00 X 104474 0 8188 1065301 0 94657 6 0 1 0 FOWLER WHITE BOGGS PA 501 E KENNEDY BLVD STE 1700 TAMPA FL 33602 LEGAL SERVICES 129426 1 550000 150579 8043 700579 HOSPICE SERVICES 623000 30472041 30472041 30472041 77 77 2906305 2844033 62272 62272 62272 PROFESSIONAL SERVICES 541900 10000 10000 10000 31244969 30472041 0 72349 217463 217463 14319784 11897577 2422207 4128525 3335772 792753 1221487 1015987 205500 684322 684322 143173 143173 164001 164001 618982 260064 358918 21068 21068 1475341 1416507 58834 649882 456929 192953 74779 74779 37310 37310 140015 140015 243010 121505 121505 NURSING HOME ROOM AND B 3317516 3317516 MEDICAL COSTS, SUPPLIES 1886851 1886851 OUTPATIENT SERVICES 768342 768342 CONTRACT LABOR 560469 474697 85772 274926 274926 30947246 25247741 5699505 0 1143416 1449 200996 119878 1276009 2235697 495648 567730 615978 278479 2197228 1573876 18724964 623352 5757903 15 223459 0 15326887 28558251 19033609 3911031 2582982 8275000 538413 3319097 12724444 5902079 X 15713929 13011652 119878 119878 15833807 13131530 28558251 19033609 X 297723 -3000000 X X 0 1 X 1 0 X 1835307 1480041 1724982 1223974 700579 6964883 37383851 45157978 45397275 37387983 30525878 195852965 39219158 46638019 47122257 38611957 31226457 202817848 0 0 0 202817848 111174 115831 298216 417558 62349 1005128 111174 115831 298216 417558 62349 1005128 167720 10000 177720 39498052 46753850 47420473 39029515 31298806 204000696 0.99420 0.99230 0.00490 0.00660 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7687 7687 0 964298 790561 173737 1225243 775628 449615 623352 DUE FROM AFFILIATES 15326887 15326887 QUI TAM 3000000 DUE TO THIRD PARTIES 164449 DUE TO AFFILIATES 154648 3319097 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. THE TAX RETURNS FOR THE FISCAL YEARS ENDED 2008 TO 2011 ARE OPEN TO EXAMINATION BY FEDERAL AND STATE AUTHORITIES. X 1 1 X 0 1 0 0 0 0 0 0 0 ROBERT G WILSON 113472 0 196873 0 20590 0 13990 0 0 0 344925 0 0 0 ERIC MOORE 196176 0 3750 0 0 0 23888 0 3750 0 227564 0 0 0 RYAN RONALD 171614 0 1787 0 0 0 24282 0 1787 0 199470 0 0 0 PART I, LINE 1A A PASTORAL HOUSING ALLOWANCE WAS INCLUDED IN THE W-2 FOR ROBERT WILSON. THIS WAS STRICTLY A REPORTING ITEM ON FORM W-2. THIS ALLOWANCE WAS NOT TAXABLE COMPENSATION TO ROBERT WILSON; NO ADDITIONAL COMPENSATION PROVIDED. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS REVIEWED BY THE VICE PRESIDENT OF FINANCE, THE FINANCE COMMITTEE, AND THEN REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS WITH CONFLICTS OF INTEREST ARE EXCLUDED FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15 THE 2012 COMPENSATION FOR THE ORGANIZATION'S CEO, COO, CFO, CIO, CHIEF MEDICAL OFFICER, ASSOCIATE MEDICAL DIRECTORS, AND PHYSICIANS WERE SET BY MEMBERS OF THE BOARD OF DIRECTORS, NONE OF WHOM HAVE A CONFLICT OF INTEREST WITH RESPECT TO THE COMPENSATION ARRANGEMENT BEING CONSIDERED. THE CEO PROVIDES GUIDANCE AND RECOMMENDATIONS TO THE EXECUTIVE COMMITTEE FOR EACH OF THE POSITIONS OTHER THAN THEIR OWN. THE CEO IS NOT PRESENT AS THE BOARD DELIBERATES AND DETERMINES THE FINAL RECOMMENDATIONS FOR ALL COMPONENTS OF EXECTUTIVE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 INDIVIDUALS MAY LOCATE THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ON THE ORGANIZATION'S WEBSITE OR THE INFORMATION MAY BE FAXED UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: QUI TAM LIABILITY -3,000,000. FORM 990, PART XII, LINE 2C: THE ORGANIZATION DID NOT CHANGE EITHER ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR. FORM 990, PART XI, LINE 9: IN 2012 THE QUI TAM LIABILITY WAS RECORDED TO ESTIMATE THE AMOUNT OF FUNDS HOSPICE WOULD HAVE TO PAY BACK TO MEDICARE. TIME DEVOTED TO HOSPICE OF THE COMFORTER FOUNDATION, INC. - EIN# 27-1858033 FORM 990, PART VII: SECTION A, COLUMN B NAME TITLE HRS/WK DEVOTED ROBERT WILSON CEO/DIRECTOR 0.30 ROBERT J. WATSON DIRECTOR 0.30 TIME DEVOTED TO THE COMFORTER HEALTH CARE GROUP, INC. - EIN# 27-18579940 FORM 990, PART VII: SECTION A, COLUMN B NAME TITLE HRS/WK DEVOTED ROBERT WILSON PRESIDENT/CEO 0.30 JO C. SIMONINI SECRETARY 0.30 ROBERT J. WATSON TREASURER 0.30 THE COMFORTER HEALTH CARE GROUP INC 480 W CENTRAL PARKWAY ALTAMONTE SPRINGS FL 32714 271857940 HOSPICE SERVICES FL 501(C)(3) LINE 11D, III-O 0 HOSPICE OF THE COMFORTER FOUNDATION INC 480 W CENTRAL PARKWAY ALTAMONTE SPRINGS FL 32714 271858033 SUPPORTING ORGANIZATION FL 501(C)(3) LINE 7 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0