CALDWELL HOSPICE AND PALLIATIVE CARE INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: CALDWELL HOSPICE AND PALLIATIVE CARE INC (EIN 56-1338470)
Tax period: 2011-07-01 to 2012-06-30
Filed: 2013-01-22
IRS object ID: 201340229349300219
Schema version: 2011v1.2
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule I
Schedule J
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-01-22T11:53:34-06:00	Timestamp
Tax Period End Date	2012-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	561607661	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LOWDERMILK CHURCH & CO LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	121 N STERLING STREET	AddressLine1
City	MORGANTON	City
State	NC	State
ZIP Code	28655	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	561338470	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	CALDWELL HOSPICE AND PALLIATIVE CARE INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	CALD	NameControl
Phone	8287540101	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	902 KIRKWOOD STREET NW	AddressLine1
City	LENOIR	City
State	NC	State
ZIP Code	28645	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	CATHY SWANSON	Name
Title	EXECUTIVE DIRECTOR	Title
Phone	8287540101	Phone
Date Signed	2013-01-08	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	CYNTHIA RANDOLPH	Name
PTIN	P00441502	PTIN
Phone	8284331226	Phone

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	CATHY SWANSON	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	902 KIRKWOOD STREET NW	AddressLine1
City	LENOIR	City
State	NC	State
ZIP Code	28645	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	8777108	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.CALDWELLHOSPICE.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1981	YearFormation
State Legal Domicile	NC	StateLegalDomicile
Activity Or Mission Description	TO PROVIDE CARE FOR THE TERMINALLY ILL AND THEIR FAMILIES	ActivityOrMissionDescription
Nbr Voting Members Governing Body	15	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	15	NbrIndependentVotingMembers
Total Nbr Employees	151	TotalNbrEmployees
Total Nbr Volunteers	392	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	494180	ContributionsGrantsPriorYear
Contributions Grants Current Year	217809	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	7770852	ProgramServiceRevenuePriorYear
Program Service Revenue CY	8548159	ProgramServiceRevenueCY
Investment Income Prior Year	144	InvestmentIncomePriorYear
Investment Income Current Year	6700	InvestmentIncomeCurrentYear
Other Revenue Prior Year	18326	OtherRevenuePriorYear
Other Revenue Current Year	4440	OtherRevenueCurrentYear
Total Revenue Prior Year	8283502	TotalRevenuePriorYear
Total Revenue Current Year	8777108	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	750000	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	5257741	SalariesEtcPriorYear
Salaries Etc Current Year	5861282	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	2528175	OtherExpensePriorYear
Other Expenses Current Year	2572989	OtherExpensesCurrentYear
Total Expenses Prior Year	7785916	TotalExpensesPriorYear
Total Expenses Current Year	9184271	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	497586	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-407163	RevenuesLessExpensesCY
Total Assets BOY	16440040	TotalAssetsBOY
Total Assets EOY	16069519	TotalAssetsEOY
Total Liabilities BOY	853182	TotalLiabilitiesBOY
Total Liabilities EOY	889824	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	15586858	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	15179695	NetAssetsOrFundBalancesEOY
Mission Description	PROVIDE END OF LIFE CARE THROUGH THE HOSPICE PHILOSOPHY	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	8138172	Expense
Revenue	8551268	Revenue
Description	HOSPICE CARE - TO PROVIDE CARE AND SUPPORT TO TERMINALLY ILL PERSONS AND THEIR FAMILIES, BY AN INTERDISCIPLINARY TEAM OF PHYSICIANS, NURSES, SOCIAL WORKERS, AND VOLUNTEERS.	Description
Total Program Service Expense	8138172	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	0	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	1	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	0	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	0	Hospital
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	0	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transaction Related Entity	0	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	21	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	151	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	0	UnrelatedBusinessIncome
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	15	NbrVotingGoverningBodyMembers
Number Independent Voting Members	15	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	0	MembersOrStockholders
Election Of Board Members	0	ElectionOfBoardMembers
Decisions Subject To Approval	0	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
Other Website	X	OtherWebsite
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	TERRY JOHNSON	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	8287540101	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	902 KIRKWOOD STREET NW	AddressLine1
City	LENOIR	City
State	NC	State
ZIP Code	28645	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Highest Compensated EmployeeHighestCompensatedEmployee
ROBERT BELK MD
BOARD MEMBER/MEDICAL DIREC	0.00	X	0	0	0
MARC CARPENTER
BOARD MEMBER	0.00	X	0	0	0
JOSEPH DELK III
BOARD MEMBER	0.00	X	0	0	0
DAVID GRAY
BOARD MEMBER	0.00	X	0	0	0
INEZ JONES
BOARD MEMBER	0.00	X	0	0	0
DEBORAH MURRAY
BOARD MEMBER	0.00	X	0	0	0
TAMRA STARNES
BOARD MEMBER	0.00	X	0	0	0
ROB HINMAN
BOARD MEMBER	0.00	X	0	0	0
CLAUDIA BUJOLD
BOARD MEMBER	0.00	X	0	0	0
LAURA EASTON
BOARD MEMBER	0.00	X	0	0	0
JANET WINKLER
BOARD MEMBER	0.00	X	0	0	0
PARKER WILLIAMSON
PRESIDENT	0.00		0	0	0	X
HOUSTON GROOME
VICE PRESIDENT	0.00		0	0	0	X
PEG BROYHILL
SECRETARY	0.00		0	0	0	X
JAMES C HARPER JR
TREASURER	0.00		0	0	0	X
CATHY SWANSON
CEO	40.00		130824	0	4056		X
THOMAS RAY
PHYSICIAN	40.00		187700	0	16692		X
DENNICE HERMAN
MEDICAL DOCTOR	40.00		113638	0	5677		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	432162	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	26425	TotalOtherCompensation
Number Individuals GT100 K	3	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources
Number Of Contractors GT100 K	0	NumberOfContractorsGT100K
All Other Contributions	217809	AllOtherContributions
Total Contributions	217809	TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICARE/MEDICAID PAYM	623990	7638685	7638685
INSURANCE REIMBURSEMEN	623990	520247	520247
PRIVATE REIMBURSEMENT	623990	389227	389227

Field	Value	IRS element (for citing)
Total Program Service Revenue	8548159	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	6700	TotalRevenueColumn
Exclusion	$6,700	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	1331	GrossIncomeFundraisingEvents
Fundraising Direct Expenses	0	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	1331	TotalRevenueColumn
Exclusion	$1,331	ExclusionAmount

Other Revenue Misc OtherRevenueMisc

Field	Value	IRS element (for citing)
Description	OTHER REVENUE	Description
Business Code	623990	BusinessCode
Total Revenue Column	3109	TotalRevenueColumn
Related Or Exempt Function Income	3109	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Other Revenue	3109	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	8777108	TotalRevenueColumn
Related Or Exempt Function Income	8551268	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$8,031	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	750000	Total
Program Services	750000	ProgramServices

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	4756888	Total
Program Services	4090924	ProgramServices
Management And General	665964	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	180000	Total
Program Services	154800	ProgramServices
Management And General	25200	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	586368	Total
Program Services	504277	ProgramServices
Management And General	82091	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	338026	Total
Program Services	290702	ProgramServices
Management And General	47324	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	1426	Total
Program Services	1226	ProgramServices
Management And General	200	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	13127	Total
Management And General	13127	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	30358	Total
Management And General	30358	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	19226	Total
Program Services	17304	ProgramServices
Management And General	1922	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	61139	Total
Program Services	55025	ProgramServices
Management And General	6114	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	155057	Total
Program Services	147304	ProgramServices
Management And General	7753	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	1826	Total
Management And General	1826	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	412535	Total
Program Services	354780	ProgramServices
Management And General	57755	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	162296	Total
Program Services	142963	ProgramServices
Management And General	19333	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
THERAPIES	537845	537845
PHARMACY	317624	317624
AMBULANCE	257068	257068
MAINTENANCE	103908	93517	10391

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	499554	Total
Program Services	422813	ProgramServices
Management And General	76741	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	9184271	Total
Program Services	8138172	ProgramServices
Management And General	1046099	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
EOY	-2	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	4202784	BOY
EOY	4535203	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	656999	BOY
EOY	345930	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	1376813	BOY
EOY	1376195	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	125991	BOY
EOY	102271	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	12040773	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	2330851	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	10077453	BOY
EOY	9709922	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	16440040	BOY
EOY	16069519	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	134058	BOY
EOY	55348	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	719124	BOY
EOY	834476	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	853182	BOY
EOY	889824	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	13172806	BOY
EOY	14822232	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	2414052	BOY
EOY	357463	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	15586858	BOY
EOY	15179695	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	16440040	BOY
EOY	16069519	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	-407163	ReconcilationRevenueExpenses
Reconcilation Other Changes	0	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Separate	X	FinancialStatementSeparate
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	X	PubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	236016	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	4879394	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	2744031	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	494180	CurrentTaxYearMinus1Year
Current Tax Year	217809	CurrentTaxYear
Total	8571430	Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	4903753	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	5981470	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	6994744	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	7770852	CurrentTaxYearMinus1Year
Current Tax Year	8548159	CurrentTaxYear
Total	34198978	Total

Total509 Total509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	5139769	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	10860864	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	9738775	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	8265032	CurrentTaxYearMinus1Year
Current Tax Year	8765968	CurrentTaxYear
Total	42770408	Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Amts From Subst Contributors AmtsFromSubstContributors

Field	Value	IRS element (for citing)
Total	0	Total

Support From DQ Ps Etc SupportFromDQPsEtc

Field	Value	IRS element (for citing)
Total	0	Total

Field	Value	IRS element (for citing)
Public Support Total509	42770408	PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	156770	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	94194	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	2990	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	144	CurrentTaxYearMinus1Year
Current Tax Year	6700	CurrentTaxYear
Total	260798	Total

Investment Income And UBTI InvestmentIncomeAndUBTI

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	156770	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	94194	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	2990	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	144	CurrentTaxYearMinus1Year
Current Tax Year	6700	CurrentTaxYear
Total	260798	Total

Other Income509 OtherIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	118349	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	128395	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	78753	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	18326	CurrentTaxYearMinus1Year
Current Tax Year	4440	CurrentTaxYear
Total	348263	Total

Total Support Total TotalSupportTotal

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	5414888	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	11083453	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	9820518	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	8283502	CurrentTaxYearMinus1Year
Current Tax Year	8777108	CurrentTaxYear
Total	43379469	Total

Field	Value	IRS element (for citing)
Public Support Percentage509	0.98600	PublicSupportPercentage509
Prior Year Support Percentage	0.98030	PriorYearSupportPercentage
Investment Income Percentage	0.00600	InvestmentIncomePercentage
Prior Yr Invest Income Percentage	0.01000	PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509	X	ThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	716887	OtherCostOrOtherBasis
Book Value	716887	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	9390265	OtherCostOrOtherBasis
Depreciation	1184052	Depreciation
Book Value	8206213	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	525264	OtherCostOrOtherBasis
Depreciation	340085	Depreciation
Book Value	185179	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1408357	OtherCostOrOtherBasis
Depreciation	806714	Depreciation
Book Value	601643	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	9709922	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescription	AmountAmount
DUE TO PHYSICIANS AND NURSING HOMES	$212,097
ACCRUED PAYROLL AND PAYROLL TAXES	$609,707
DEFERRED REVENUE	$12,672

Field	Value	IRS element (for citing)
Total Of Amounts	834476	TotalOfAmounts
Total Revenue	8777108	TotalRevenue
Total Expenses	9184271	TotalExpenses
Excess Or Deficit For Year	-407163	ExcessOrDeficitForYear
Excess Or Deficit Per FS	-407163	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	8777108	TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F990	0	RevenueNotRptdF990
Revenue Subtotal	8777108	RevenueSubtotal
Revenue Not Rptd On Fin Stmt	0	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	8777108	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	9184271	TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F990	0	ExpensesNotRptdF990
Expenses Subtotal	9184271	ExpensesSubtotal
Expenses Not Rptd On Fin Stmt	0	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	9184271	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

Field	Value	IRS element (for citing)
Explanation	FASB ASC 740-10, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS. BASED ON AN EVALUATION OF UNCERTAIN TAX POSITIONS, MANAGERMENT IS REQUIRED TO MEASURE POTENTIAL TAX LIABILITIES THAT COULD HAVE A RISK OF GREATER THAN A 50% LIKELIHOOD OF BEING REALIZED UPON SETTLEMENT. AS OF JUNE 30, 2012 MANAGEMENT HAS DETERMINED THAT THE ORGANIZATION HAS NO SUCH RISK AND THEREFORE NO LIABILITIES HAVE BEEN RECORDED FOR UNCERTAIN TAX POSITIONS.	Explanation

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	0	RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	CALDWELL HOSPICE FOUNDATION	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	PO BOX 1058	AddressLine1
City	LENOIR	City
State	NC	State
ZIP Code	28645	ZIPCode

Field	Value	IRS element (for citing)
EIN Of Recipient	566469396	EINOfRecipient
IRC Section	501(C)(3)	IRCSection
Amount Of Cash Grant	750000	AmountOfCashGrant
Method Of Valuation	COST	MethodOfValuation
Purpose Of Grant	TO REPAY FUNDS ADVANCED TO CHPC FOR THE PURPOSE OF HELPING TO PAY FOR THE NEW FACILITY.	PurposeOfGrant

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	1	TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Explanation	THESE FUNDS WERE TO REPAY FOR THE ADVANCE TO CALDWELL HOSPICE AND PALLIATIVE CARE FOR THE PURPOSE OF HELPING TO PAY FOR THE NEW FACILITY. THESE FUNDS ARE NOT FOR GRANT PURPOSES. THEY ARE BEING REPAID TO CALDWELL HOSPICE FOUNDATION.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	0	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

Field	Value	IRS element (for citing)
Name Person	THOMAS RAY	NamePerson
Base Compensation Filing Org	187700	BaseCompensationFilingOrg
Comp Based On Related Orgs	0	CompBasedOnRelatedOrgs
Bonus Filing Org	0	BonusFilingOrg
Bonus Related Orgs	0	BonusRelatedOrgs
Other Compensation Filing Org	0	OtherCompensationFilingOrg
Other Compensation Related Orgs	0	OtherCompensationRelatedOrgs
Deferred Comp Filing Org	16692	DeferredCompFilingOrg
Deferred Comp Related Orgs	0	DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org	0	NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs	0	NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org	204392	TotalCompensationFilingOrg
Total Compensation Related Orgs	0	TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org	0	CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs	0	CompReportPrior990RelatedOrgs

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

Return ReferenceReturnReference	ExplanationExplanation
FORM 990, PART VI, SECTION B, LINE 11	FORM 990 IS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT IS FILED AND IT IS REVIEWED BY THE BOARD OF DIRECTORS AND MANAGEMENT AT A BOARD MEETING.
FORM 990, PART VI, SECTION B, LINE 12C	ALL BOARD MEMBERS, EMPLOYEES AND VOLUNTEERS MUST SIGN AN ACKNOWLEDGEMENT ON OUR POLICY FOR AN INDIVIDUAL STATEMENT OF CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15	THE ORGANIZATION DETERMINES THE SALARY OF THE EXECUTIVE DIRECTOR BY PERFORMANCE REVIEWS AND SALARY SURVEYS OF SIMILAR POSITIONS. THESE ITEMS ARE REVIEWED BY BOARD PERSONNEL COMMITTEE AND APPROVED BY THE BOARD OF DIRECTORS. THE SALARIES OF OTHER KEY EMPLOYEES IS DONE BY PERFORMANCE REVIEWS, SALARY SURVEYS OF SIMILAR POSITIONS AND APPROVAL BY THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.