2013-03-21T12:34:21-05:00 2012-09-30 461497033 EKS&H LLLP 7979 E TUFTS AVENUE SUITE 400 DENVER CO 802372521 990 2011-10-01 841453050 PIKES PEAK HOSPICE FOUNDATION PIKE 7196333400 2550 TENDERFOOT HILL STREET COLORADO SPRINGS CO 80906 MARTHA BARTON 7196333400 2013-03-19 1 DORI J EGGETT P00645252 3037409400 2011 2016-02-25 16:41:14Z MARTHA BARTON 2550 TENDERFOOT HILL STREET COLORADO SPRINGS CO 80906 8083607 0 X WWW.PIKESPEAKHOSPICE.ORG X 1998 CO TO GENERATE AND DISTRIBUTE FUNDS IN SUPPORT OF PIKES PEAK HOSPICE & PALLIATIVE CARE, INC. 14 13 0 524 0 0 1117707 5584768 0 0 388291 197585 -27279 -38844 1478719 5743509 39226 4288721 0 0 196359 232107 0 0 484282 256932 401988 492517 4922816 986202 820693 12168949 14032328 32507 38536 12136442 13993792 THE MISSION OF PIKES PEAK HOSPICE FOUNDATION IS TO GENERATE AND DISTRIBUTE FUNDS IN SUPPORT OF PIKES PEAK HOSPICE & PALLIATIVE CARE, INC., SERVE THE CHARITABLE INTERESTS OF OUR DONORS AND PRUDENTLY MANAGE THEIR GIFTS. 0 0 4344296 4288721 PIKES PEAK HOSPICE FOUNDATION IS A SUPPORTING ORGANIZATION FOR PIKES PEAK HOSPICE & PALLIATIVE CARE, INC. WHICH PROVIDED SERVICES TO 1975 PATIENTS IN FISCAL YEAR 2012. AMOUNT TRANSFERRED TO PPHPC WAS $4,288,721 IN FISCAL YEAR 2012. $1,304,094 OF THE AMOUNT TRANSFERRED WAS RAISED THROUGH THE WE CARE CAPITAL CAMPAIGN AND EARMARKED FOR THE NEW HEADQUARTERS LOCATED AT 2550 TENDERFOOT HILL STREET, COLORADO SPRINGS, COLORADO. 4344296 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 X 14 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X VALERIE HERL 7196333400 2550 TENDERFOOT HILL STREET COLORADO SPRINGS CO 80906 X JEFF ROSACKER 1.00 X X 0 0 0 DORIS BAKER 1.00 X X 0 0 0 DAN WINTER 1.00 X X 0 0 0 PATRICIA MARTIN 1.00 X X 0 0 0 TOM DERMODY 1.00 X 0 0 0 BILL BERENZ 1.00 X 0 0 0 KATHRYN CURRY 1.00 X 0 0 0 SCOTT DAVIS 1.00 X 0 0 0 CARLA HARTSELL 1.00 X 0 0 0 ROGER HILL 1.00 X 0 0 0 GAIL NUTH 1.00 X 0 0 0 STEVE RODEMER 1.00 X 0 0 0 SCOTT ROSS DO 1.00 X 0 0 0 MARTHA BARTON 0.00 X X 0 175429 9347 JOAN SELMAN 40.00 X 0 89326 2607 0 264755 11954 0 0 1 0 0 53810 91230 5439728 1859468 5584768 252639 252639 2246200 2301254 -55054 -55054 -55054 0 91230 38844 -38844 -38844 5743509 0 0 158741 4288721 4288721 94140 94140 105836 1900 103936 3675 142 3533 14315 481 13834 14141 14141 5924 5924 35435 35435 84880 84880 94174 94174 10810 10810 26699 26699 1433 1433 7381 7381 4033 4033 OTHER EXPENSES 75644 75644 DIRECT PATIENT SERVICES 55575 55575 4922816 4344296 94238 484282 300 300 1156244 920038 157600 1623960 1321 1019 78288 56124 12233 22164 9593488 10202020 1247763 1262827 12168949 14032328 16727 23652 15780 14884 32507 38536 X 9029842 8700104 236757 2257583 2869843 3036105 12136442 13993792 12168949 14032328 X 820693 1036657 X 0 1 1 X 0 X X X 0 0 0 PIKES PEAK HOSPICE & PALLIATIVE CARE 840816047 9 1 1 1 4288721 1 4288721 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2106113 203440 344561 2654114 2070890 9333 25890 2106113 1749395 131307 190188 2070890 0.25080 0.68680 0.06240 0 0 66288 56124 10164 12000 12000 22164 BENEFICIAL INTEREST IN PERPETUAL TRUST 1213409 BENEFICIAL INTEREST IN CHARITABLE REMAINDER TRUST 49418 1262827 ANNUITY OBLIGATIONS 14884 14884 5743509 4922816 820693 1102835 47025 -113203 1036657 1857350 6948390 1102835 47025 55021 1204881 5743509 0 5743509 802319 168224 168224 634095 4288721 4288721 4922816 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: PERMANENTLY RESTRICTED ENDOWMENT FUNDS ARE THOSE FOR WHICH DONORS HAVE STIPULATED UNDER TERMS OF THE GIFT INSTRUMENT THAT THE PRINCIPAL OF THE FUND IS NOT EXPENDABLE AND IS TO BE INVESTED FOR THE PURPOSE OF PRODUCING PRESENT AND FUTURE INCOME. THE INCOME GENERATED IS AVAILABLE FOR ANY AND ALL USES REQUIRED BY PIKES PEAK HOSPICE TO FURTHER AND ENHANCE END-OF-LIFE CARE SERVICES OFFERED TO THE COMMUNITY. TEMPORARILY RESTRICTED NET ASSETS ARE $2,257,583 AND ARE RESTRICTED BY THE DONORS FOR VARIOUS PROGRAMS. BOARD DESIGNATED FUNDS ARE UNRESTRICTED FUNDS THAT THE PPHF BOARD OF TRUSTEES HAS DETERMINED WILL BE RETAINED AND INVESTED. THE PRINCIPAL AS WELL AS THE INCOME IS AVAILABLE FOR ANY AND ALL USES REQUIRED BY PPHPC WITH APPROVAL OF THE PPHF BOARD OF TRUSTEES. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION APPLIES A MORE-LIKELY-THAN-NOT MEASUREMENT METHODOLOGY TO REFLECT THE CONSOLIDATED FINANCIAL STATEMENT IMPACT OF UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A RETURN. AFTER EVALUATING THE TAX POSITIONS TAKEN, NONE ARE CONSIDERED TO BE UNCERTAIN. THEREFORE, NO AMOUNTS HAVE BEEN RECOGNIZED AS OF SEPTEMBER 30, 2012 AND 2011. IF INCURRED, INTEREST AND PENALTIES ASSOCIATED WITH TAX POSITIONS ARE RECORDED IN THE PERIOD ASSESSED AS OTHER EXPENSE. NO INTEREST OR PENALTIES HAVE BEEN ASSESSED AS OF SEPTEMBER 30, 2012 AND 2011. TAX YEARS THAT REMAIN SUBJECT TO EXAMINATION INCLUDE 2008 THROUGH THE CURRENT PERIOD FOR THE COLORADO RETURN. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN VALUE OF BENEFICIAL INTEREST IN CHARITABLE REMAINDER TRUST 4,569. CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUST 10,495. CHANGE IN VALUE OF BENEFICIAL INTEREST IN CGA TRUST 1,113. UNCOLLECTIBLE PLEDGES -129,380. TOTAL TO SCHEDULE D, PART XI, LINE 8: -113,203. PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF BENEFICIAL INTEREST IN CHARITABLE REMAINDER TRUST 4,569. CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUST 10,495. CHANGE IN VALUE OF BENEFICIAL INTEREST IN CGA TRUST 1,113. SPECIAL EVENTS EXPENSE 38,844. PART XIII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENTS EXPENSE 38,844. UNCOLLECTIBLE PLEDGES 129,380. PART XIII, LINE 4B - OTHER ADJUSTMENTS: TRANSFERS TO PIKES PEAK HOSPICE AND PALLIATIVE CARE 4,288,721. TREES OF LIFE 91230 91230 38844 91230 91230 38844 38844 -38844 1 PIKES PEAK HOSPICE & PALLIATIVE CARE INC 2550 TENDERFOOT HILL STREET COLORADO SPRINGS CO 80906 840816047 501(C)(3) 4288721 ORGANIZATION SUPPORTS PIKES PEAK HOSPICE & PALLIATIVE CARE, INC. 1 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE ENTITIES ARE RELATED. 0 0 0 0 0 0 0 0 0 MARTHA BARTON 0 172829 0 2600 0 0 0 5433 0 3914 0 184776 0 0 X 7 1812443 FAIR MARKET VALUE X FUNERAL PLOTS 5 8075 DONOR VALUED X MEDICAL EQUIP 1 1750 DONOR VALUED X FURNITURE 2 23000 DONOR VALUED X LABOR & EQUIP 6 14200 DONOR VALUED 0 1 0 METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: PART I, COLUMN (B): THE PUBLICLY TRADED STOCKS, FUNERAL PLOTS AND VAULTS, AND MEDICAL EQUPIMENT ARE SHOWN AS NUMBER OF ITEMS CONTRIBUTED. OFFICE FURNITURE AND MATERIALS AND LABOR FOR NEW HEADQUARTERS ARE SHOWN AS NUMBER OF CONTRIBUTORS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE TREASURER AND VP OF BUSINESS OPERATIONS AND IS THEN PRESENTED TO THE AUDIT COMMITTEE FOR APPROVAL. AN ELECTRONIC COPY OF THE 990 IS FORWARDED TO THE ENTIRE BOARD OF DIRECTORS FOR THEIR INDIVIDUAL REVIEW. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL EDUCATION TO BOARD MEMBERS AND STAFF. ALL CONFLICTS ADDRESSED BY OFFICERS AND CONTRACT LEGAL COUNSEL AS NEEDED. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE AT THE ORGANIZATION'S LOCATION AND ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A: PIKES PEAK HOSPICE & PALLIATIVE CARE, INC. PAYS THE SALARIES FOR THE ORGANIZATION'S EMPLOYEES. THEREFORE, THE ORGANIZATION DOES NOT REPORT ANY COMPENSATION ON W-2S OR 1099-MISCS FOR ITS EMPLOYEES. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 1,102,835. DONATED SERVICES AND USE OF FACILITIES: 47,025. CHANGE IN VALUE OF BENEFICIAL INTEREST IN CHARITABLE REMAINDER TRUST 4,569. CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUST 10,495. CHANGE IN VALUE OF BENEFICIAL INTEREST IN CGA TRUST 1,113. UNCOLLECTIBLE PLEDGES -129,380. TOTAL TO FORM 990, PART XI, LINE 5: 1,036,657. PIKES PEAK HOSPICE & PALLIATIVE CARE INC 2550 TENDERFOOT HILL STREET COLORADO SPRINGS CO 80906 840816047 CARE OF TERMINALLY ILL CO 501(C)(3) LINE 9 N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0