2013-01-22T11:53:34-06:00 2012-06-30 561607661 LOWDERMILK CHURCH & CO LLP 121 N STERLING STREET MORGANTON NC 28655 990 2011-07-01 561338470 CALDWELL HOSPICE AND PALLIATIVE CARE INC CALD 8287540101 902 KIRKWOOD STREET NW LENOIR NC 28645 CATHY SWANSON 8287540101 2013-01-08 1 CYNTHIA RANDOLPH P00441502 8284331226 2011 2016-02-25 16:41:14Z CATHY SWANSON 902 KIRKWOOD STREET NW LENOIR NC 28645 8777108 0 X WWW.CALDWELLHOSPICE.ORG X 1981 NC TO PROVIDE CARE FOR THE TERMINALLY ILL AND THEIR FAMILIES 15 15 151 392 0 0 494180 217809 7770852 8548159 144 6700 18326 4440 8283502 8777108 0 750000 0 0 5257741 5861282 0 0 0 2528175 2572989 7785916 9184271 497586 -407163 16440040 16069519 853182 889824 15586858 15179695 PROVIDE END OF LIFE CARE THROUGH THE HOSPICE PHILOSOPHY 0 0 8138172 8551268 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. 8138172 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 21 0 151 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X TERRY JOHNSON 8287540101 902 KIRKWOOD STREET NW LENOIR NC 28645 ROBERT BELK MD 0.00 X 0 0 0 MARC CARPENTER 0.00 X 0 0 0 JOSEPH DELK III 0.00 X 0 0 0 DAVID GRAY 0.00 X 0 0 0 INEZ JONES 0.00 X 0 0 0 DEBORAH MURRAY 0.00 X 0 0 0 TAMRA STARNES 0.00 X 0 0 0 ROB HINMAN 0.00 X 0 0 0 CLAUDIA BUJOLD 0.00 X 0 0 0 LAURA EASTON 0.00 X 0 0 0 JANET WINKLER 0.00 X 0 0 0 PARKER WILLIAMSON 0.00 X 0 0 0 HOUSTON GROOME 0.00 X 0 0 0 PEG BROYHILL 0.00 X 0 0 0 JAMES C HARPER JR 0.00 X 0 0 0 CATHY SWANSON 40.00 X 130824 0 4056 THOMAS RAY 40.00 X 187700 0 16692 DENNICE HERMAN 40.00 X 113638 0 5677 432162 0 26425 3 0 1 0 0 217809 217809 MEDICARE/MEDICAID PAYM 623990 7638685 7638685 INSURANCE REIMBURSEMEN 623990 520247 520247 PRIVATE REIMBURSEMENT 623990 389227 389227 8548159 6700 6700 1331 0 1331 1331 OTHER REVENUE 623990 3109 3109 3109 8777108 8551268 0 8031 750000 750000 4756888 4090924 665964 180000 154800 25200 586368 504277 82091 338026 290702 47324 1426 1226 200 13127 13127 30358 30358 19226 17304 1922 61139 55025 6114 155057 147304 7753 1826 1826 412535 354780 57755 162296 142963 19333 THERAPIES 537845 537845 PHARMACY 317624 317624 AMBULANCE 257068 257068 MAINTENANCE 103908 93517 10391 499554 422813 76741 9184271 8138172 1046099 0 -2 4202784 4535203 656999 345930 1376813 1376195 125991 102271 12040773 2330851 10077453 9709922 16440040 16069519 134058 55348 719124 834476 853182 889824 X 13172806 14822232 2414052 357463 15586858 15179695 16440040 16069519 -407163 0 X 0 1 1 X 0 X 236016 4879394 2744031 494180 217809 8571430 4903753 5981470 6994744 7770852 8548159 34198978 5139769 10860864 9738775 8265032 8765968 42770408 0 0 0 42770408 156770 94194 2990 144 6700 260798 156770 94194 2990 144 6700 260798 118349 128395 78753 18326 4440 348263 5414888 11083453 9820518 8283502 8777108 43379469 0.98600 0.98030 0.00600 0.01000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 716887 716887 9390265 1184052 8206213 525264 340085 185179 1408357 806714 601643 9709922 DUE TO PHYSICIANS AND NURSING HOMES 212097 ACCRUED PAYROLL AND PAYROLL TAXES 609707 DEFERRED REVENUE 12672 834476 8777108 9184271 -407163 -407163 8777108 0 8777108 0 8777108 9184271 0 9184271 0 9184271 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. 0 CALDWELL HOSPICE FOUNDATION PO BOX 1058 LENOIR NC 28645 566469396 501(C)(3) 750000 COST TO REPAY FUNDS ADVANCED TO CHPC FOR THE PURPOSE OF HELPING TO PAY FOR THE NEW FACILITY. 1 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. X X 0 0 0 0 0 0 0 0 0 THOMAS RAY 187700 0 0 0 0 0 16692 0 0 0 204392 0 0 0 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.