HOSPICE & PALLIATIVE CARECENTER: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- HOSPICE & PALLIATIVE CARECENTER (EIN 58-1343313)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-14
- IRS object ID
- 201213199349302256
- 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 G
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-14T09:56:29-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420714325 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCGLADREY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 230 N ELM ST STE 1100 | AddressLine1 |
| City | GREENSBORO | City |
| State | NC | State |
| ZIP Code | 27401 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581343313 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE & PALLIATIVE CARECENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HOSP | NameControl |
| Phone | 3367683972 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 HOSPICE LANE | AddressLine1 |
| City | WINSTONSALEM | City |
| State | NC | State |
| ZIP Code | 27103 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRIAN K PAYNE | Name |
| Title | PRESIDENT & CEO | Title |
| Phone | 3367683972 | Phone |
| Date Signed | 2012-11-12 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ADRIENNE MCKINNEY | Name |
| PTIN | P00819656 | PTIN |
| Phone | 3362724551 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | BRIAN K PAYNE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 HOSPICE LANE | AddressLine1 |
| City | WINSTONSALEM | City |
| State | NC | State |
| ZIP Code | 27103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 32435168 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.HOSPICECARECENTER.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1978 | YearFormation |
| State Legal Domicile | NC | StateLegalDomicile |
| Activity Or Mission Description | HOSPICE & PALLIATIVE CARECENTER PROVIDES IN-HOME AND INPATIENT MEDICAL CARE FOR THE TERMINALLY ILL, TRAINS VOLUNTEERS TO ASSIST WITH FAMILIES OF PATIENTS, AND CONDUCTS EDUCATIONAL GRIEF SEMINARS FOR THE COMMUNITY. IN 2011, HOSPICE & PALLIATIVE CARECENTER CARED FOR 3,428 PATIENTS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 25 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 25 | NbrIndependentVotingMembers |
| Total Nbr Employees | 465 | TotalNbrEmployees |
| Total Nbr Volunteers | 630 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2350063 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 2399398 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 29557634 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 29737776 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 34873 | InvestmentIncomePriorYear |
| Investment Income Current Year | -10417 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 145704 | OtherRevenuePriorYear |
| Other Revenue Current Year | 178941 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 32088274 | TotalRevenuePriorYear |
| Total Revenue Current Year | 32305698 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 156000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 16997329 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 18827426 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 5000 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 1323655 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 11656752 | OtherExpensePriorYear |
| Other Expenses Current Year | 12012499 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 28659081 | TotalExpensesPriorYear |
| Total Expenses Current Year | 30995925 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3429193 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1309773 | RevenuesLessExpensesCY |
| Total Assets BOY | 26409553 | TotalAssetsBOY |
| Total Assets EOY | 25011137 | TotalAssetsEOY |
| Total Liabilities BOY | 5267875 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2524743 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 21141678 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 22486394 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | HOSPICE & PALLIATIVE CARECENTER PROVIDES COMPASSIONATE CARE FOR THOSE INDIVIDUALS LIVING WITH A LIFE-LIMITING ILLNESS AND THEIR FAMILIES, THROUGH QUALITY MEDICAL, EMOTIONAL, SPIRITUAL, AND SOCIAL SUPPORT. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 16797114 | Expense |
| Revenue | 22447084 | Revenue |
| Description | HOSPICE HOMECARE - PROVIDES MEDICAL CARE FOR TERMINALLY ILL PATIENTS, FOCUSING ON IMPROVING QUALITY OF LIFE, PHYSICAL AND EMOTIONAL COMFORT, DIGNITY AND PEACE OF MIND FOR PATIENTS AND THEIR FAMILIES. SKILLED PROFESSIONALS PROVIDE IN-HOME PATIENT SERVICES, INCLUDING NURSING HOMES, ASSISTED LIVING HOMES, GROUP HOMES, REST HOMES, AND RETIREMENT COMMUNITIES, REGARDLESS OF ABILITY TO PAY.IN 2011, HOSPICE & PALLIATIVE CARECENTER PROVIDED 140,151 DAYS OF CARE TO 2,055 PATIENTS IN THIS CAPACITY. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 7279417 | Expense |
| Revenue | 7106094 | Revenue |
| Description | KATE B. REYNOLDS (KBR) HOSPICE HOME - 40-BED INPATIENT FACILITY THAT PROVIDES HOSPICE PATIENTS STATE OF THE ART CARE IN A BEAUTIFUL, HOME-LIKE SETTING. HOSPICE PATIENTS RECEIVING CARE AT HOME MAY BE ADMITTED TO THE KBR HOSPICE HOME WHEN NECESSARY MEDICAL CARE IS NOT EASILY MANAGED AT HOME, OR WHEN A CAREGIVER IS IN NEED OF RESPITE.IN 2011, KATE B. REYNOLDS HOSPICE HOME PROVIDED 12,298 DAYS OF CARE TO 1,178 INPATIENTS. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 259805 | Expense |
| Revenue | 94407 | Revenue |
| Description | HOME HEALTH CARE - PROGRAM FOR PATIENTS WITH SERIOUS ILLNESSES IN NEED OF INTERMITTENT SKILLED NURSING CARE. HOME HEALTH CARE PATIENTS MAY BE SEEKING AGGRESSIVE TREATMENT FOR THEIR ILLNESS, YET HAVE A SKILLED NURSING NEED WHICH REQUIRES THE SERVICES OF A REGISTERED NURSE. HOME HEALTH CARE SERVICES INCLUDE CARING FOR THE MEDICAL, SPIRITUAL, SOCIAL, AND EMOTIONAL NEEDS OF PATIENTS AND THEIR FAMILIES.IN 2011, THE HOME HEALTH PROGRAM PROVIDED 5,789 DAYS OF CARE TO 54 PATIENTS. | Description |
Activity Other ActivityOther (6 entries)
| ExpenseExpense | RevenueRevenue | DescriptionDescription | GrantsGrants |
|---|---|---|---|
| 243702 | 226027 | PALLIATIVE CARE SERVICES- A PROGRAM THAT PROVIDES PATIENTS WITH MEDICAL CARE FOCUSED ON THE RELIEF OF PAIN, SYMPTOMS, AND STRESS OF SERIOUS ILLNESS - REGARDLESS OF THE DIAGNOSIS. PALLIATIVE CARE SERVICES ARE PROVIDED SIMULTANEOUSLY WITH ALL OTHER MEDICAL TREATMENTS.IN 2011, THE PALLIATIVE CARE SERVICES PROGRAM PROVIDED 76,412 DAYS OF CARE TO 683 PATIENTS. | |
| 144855 | 0 | COMPLEMENTARY THERAPIES | |
| 176110 | 37952 | COMMUNITY PARTNERSHIP/COMMUNITY EDUCATION | |
| 275742 | 2003 | GRIEF COUNSELING CENTER | |
| 182010 | HOSPICE BEREAVEMENT SERVICES | ||
| 156000 | THE HOSPICE FOUNDATION PROGRAM SERVICES | 156000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 1178419 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 156000 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 265982 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 25514755 | 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 | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | 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 | 1 | 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 | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 1 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 123 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 465 | 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 | 25 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 25 | 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 |
| States Where Copy Of Return Is Filed | NC | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONY CHAMBERS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3367683972 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 HOSPICE LANE | AddressLine1 |
| City | WINSTONSALEM | City |
| State | NC | State |
| ZIP Code | 27103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (34 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| RICHARD V BENNETT | |||||||
| CHAIR | 1.00 | X | X | 0 | 0 | 0 | |
| CHARLES H HAUSER | |||||||
| 1ST VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 | |
| MARGARET ANN HOFLER | |||||||
| 2ND VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 | |
| MICHAEL L ROBINSON | |||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 | |
| R SCOTT BOWEN JR | |||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 | |
| ROBERT COIL | |||||||
| ASSISTANT TREASURER | 1.00 | X | X | 0 | 0 | 0 | |
| DALE E DRISCOLL | |||||||
| PAST CHAIR | 1.00 | X | X | 0 | 0 | 0 | |
| PATRICIA L ADAMS MD | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| ELMS L ALLEN MD | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| ROLAND J BARRETT II MD | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| CANDICE BROWN | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| REV DAVID B HODGES | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| DONNY LAMBETH | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| A THAD LEWALLEN | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| JEFF LINDSAY | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| MARY F LYLES MD | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| WARD MILLER | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| JAMES O'NEILL | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| REV DR CEDRIC S RODNEY | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| AARON SINGLETON | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| JAMES N SMITH | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| DR PEGGY VALENTINE | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| EDWIN L WELCH | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| GORDON WILLIAMS | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| KENNETH P CARLSON MD | |||||||
| EMERITUS DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| JIMMY STRICKLAND | |||||||
| DIRECTOR - FOUNDATION CHAIR | 1.00 | X | 0 | 0 | 0 | ||
| JOANN E DAVIS | |||||||
| PRESIDENT/CEO (RETIRED 12/31/11) | 36.00 | X | 177566 | 0 | 15209 | ||
| BRIAN K PAYNE | |||||||
| PRESIDENT/CEO | 36.00 | X | 145340 | 0 | 5910 | ||
| KATHERINE F CECIL | |||||||
| VP, FINANCE & ADMINISTRATI | 40.00 | X | 78780 | 0 | 8294 | ||
| RICHARD C STEPHENSON | |||||||
| CHIEF MEDICAL OFFICER | 40.00 | 238288 | 0 | 21202 | X | ||
| KAREN L CROSS | |||||||
| ASSISTANT MEDICAL DIRECTOR | 40.00 | 179677 | 0 | 20652 | X | ||
| KIM KINSLEY | |||||||
| ASSISTANT MEDICAL DIRECTOR | 40.00 | 172192 | 0 | 9943 | X | ||
| GENEVIEVE WROBLEWSKI | |||||||
| ASSISTANT MEDICAL DIRECTOR | 40.00 | 167070 | 0 | 11274 | X | ||
| BRENTON SHARPE | |||||||
| PHARMACIST | 40.00 | 152118 | 0 | 7595 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1311031 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 100079 | TotalOtherCompensation |
| Number Individuals GT100 K | 10 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| FORSYTH MEMORIAL HOSPITAL | |||||
| 3333 SILAS CREEK PARKWAY | WINSTONSALEM | NC | 27103 | HOSPITAL SERVICES | 523613 |
| SPRINGWOOD CARE CENTER | |||||
| 5755 SHATTALON DRIVE | WINSTONSALEM | NC | 33336 | SKILLED NURSING FACILITY | 468664 |
| GRACE HEALTHCARE OF WINSTON-SALEM | |||||
| 1900 WEST FIRST STREET | WINSTONSALEM | NC | 27104 | SKILLED NURSING FACILITY | 422260 |
| IL LONG CONSTRUCTION CO INC | |||||
| PO BOX 4186 | WINSTONSALEM | NC | 27115 | CONSTRUCTION | 359287 |
| NC BAPTIST HOSPITALWFUMC | |||||
| MEDICAL CENTER BLVD | WINSTONSALEM | NC | 27157 | HOSPITAL SERVICES | 337525 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 14 | NumberOfContractorsGT100K |
| Federated Campaigns | 342196 | FederatedCampaigns |
| Fundraising Events | 256184 | FundraisingEvents |
| All Other Contributions | 1801018 | AllOtherContributions |
| Noncash Contributions | 87270 | NoncashContributions |
| Total Contributions | 2399398 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICE REVENU | 621610 | 29296523 | 29296523 |
| MANAGEMENT REVENUE | 621610 | 441253 | 441253 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 29737776 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 15922 | TotalRevenueColumn |
| Exclusion | $15,922 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 15376 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 15820 | Securities |
| Other | 25895 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -444 | Securities |
| Other | -25895 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -26339 | TotalRevenueColumn |
| Exclusion | -$26,339 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 90905 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 256184 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 87755 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3150 | TotalRevenueColumn |
| Exclusion | $3,150 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER INCOME | Description |
| Business Code | 621610 | BusinessCode |
| Total Revenue Column | 175791 | TotalRevenueColumn |
| Related Or Exempt Function Income | 175791 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 175791 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 32305698 | TotalRevenueColumn |
| Related Or Exempt Function Income | 29913567 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | -$7,267 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 156000 | Total |
| Program Services | 156000 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 431099 | Total |
| Management And General | 431099 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15029195 | Total |
| Program Services | 13155626 | ProgramServices |
| Management And General | 1252352 | ManagementAndGeneral |
| Fundraising | 621217 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 327423 | Total |
| Program Services | 282550 | ProgramServices |
| Management And General | 28054 | ManagementAndGeneral |
| Fundraising | 16819 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1927949 | Total |
| Program Services | 1369645 | ProgramServices |
| Management And General | 417093 | ManagementAndGeneral |
| Fundraising | 141211 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1111760 | Total |
| Program Services | 933878 | ProgramServices |
| Management And General | 122294 | ManagementAndGeneral |
| Fundraising | 55588 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 154773 | Total |
| Program Services | 97827 | ProgramServices |
| Management And General | 56946 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5904 | Total |
| Management And General | 5904 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 48450 | Total |
| Management And General | 48450 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5129273 | Total |
| Program Services | 4577470 | ProgramServices |
| Management And General | 365270 | ManagementAndGeneral |
| Fundraising | 186533 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 207111 | Total |
| Program Services | 68997 | ProgramServices |
| Fundraising | 138114 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 605818 | Total |
| Program Services | 180281 | ProgramServices |
| Management And General | 294318 | ManagementAndGeneral |
| Fundraising | 131219 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 319887 | Total |
| Program Services | 319887 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 667549 | Total |
| Program Services | 393805 | ProgramServices |
| Management And General | 273744 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 658191 | Total |
| Program Services | 612424 | ProgramServices |
| Management And General | 34479 | ManagementAndGeneral |
| Fundraising | 11288 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71518 | Total |
| Management And General | 71518 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 736590 | Total |
| Program Services | 272723 | ProgramServices |
| Management And General | 463867 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 133455 | Total |
| Management And General | 133455 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| PATIENT MEDICAL SUPPLIE | 2709544 | 2709544 | ||
| EQUIPMENT & MAINTENANCE | 278014 | 178801 | 99213 | |
| EMPLOYEE PROCUREMENT | 126001 | 126001 | ||
| CONTINUING EDUCATION | 88012 | 45767 | 35643 | 6602 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72409 | Total |
| Program Services | 33529 | ProgramServices |
| Management And General | 23816 | ManagementAndGeneral |
| Fundraising | 15064 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30995925 | Total |
| Program Services | 25514755 | ProgramServices |
| Management And General | 4157515 | ManagementAndGeneral |
| Fundraising | 1323655 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8809982 | BOY |
| EOY | 6609524 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42508 | BOY |
| EOY | 42742 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1458075 | BOY |
| EOY | 1011601 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3063202 | BOY |
| EOY | 2948661 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 118673 | BOY |
| EOY | 121446 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 195110 | BOY |
| EOY | 215959 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 18179225 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 4959110 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12502737 | BOY |
| EOY | 13220115 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 381668 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 219266 | BOY |
| EOY | 459421 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26409553 | BOY |
| EOY | 25011137 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1829224 | BOY |
| EOY | 1934763 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3360880 | BOY |
| EOY | 175308 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 77771 | BOY |
| EOY | 414672 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5267875 | BOY |
| EOY | 2524743 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19733493 | BOY |
| EOY | 21163734 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1387185 | BOY |
| EOY | 1301660 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21000 | BOY |
| EOY | 21000 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21141678 | BOY |
| EOY | 22486394 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26409553 | BOY |
| EOY | 25011137 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1309773 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 34943 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1661013 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2128589 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 4748696 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2350063 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2399398 | CurrentTaxYear |
| Total | 13287759 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1661013 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2128589 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 4748696 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2350063 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2399398 | CurrentTaxYear |
| Total | 13287759 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 538184 | AmountsSubstContributorsTotal |
| Public Support Total170 | 12749575 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 65613 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 137589 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 31069 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 34134 | CurrentTaxYearMinus1Year |
| Current Tax Year | 15922 | CurrentTaxYear |
| Total | 284327 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 98571 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 165508 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 177819 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 307198 | CurrentTaxYearMinus1Year |
| Current Tax Year | 266696 | CurrentTaxYear |
| Total | 1015792 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 14587878 | TotalSupport |
| Gross Receipts From Admissions Etc | 133148644 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.87400 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.88960 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
| General Explanation | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME SPECIAL EVENTS INCOME | GeneralExplanation |
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 | 756977 | OtherCostOrOtherBasis |
| Book Value | 756977 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 11778921 | OtherCostOrOtherBasis |
| Depreciation | 2108543 | Depreciation |
| Book Value | 9670378 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3714028 | OtherCostOrOtherBasis |
| Depreciation | 2380478 | Depreciation |
| Book Value | 1333550 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1929299 | OtherCostOrOtherBasis |
| Depreciation | 470089 | Depreciation |
| Book Value | 1459210 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 13220115 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CAPITAL LEASE OBLIGATION | Description |
| Amount | $414,672 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 414672 | TotalOfAmounts |
| Total Revenue | 32305698 | TotalRevenue |
| Total Expenses | 30995925 | TotalExpenses |
| Excess Or Deficit For Year | 1309773 | ExcessOrDeficitForYear |
| Other | $34,943 | OtherAmount |
| Total Adjustments | 34943 | TotalAdjustments |
| Excess Or Deficit Per FS | 1344716 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 32186749 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | -118949 | OtherRevenues |
| Revenue Not Rptd F990 | -118949 | RevenueNotRptdF990 |
| Revenue Subtotal | 32305698 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 32305698 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 30792851 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | -131556 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | -131556 | ExpensesNotRptdF990 |
| Expenses Subtotal | 30924407 | ExpensesSubtotal |
| Other Expenses Not Included | 71518 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 71518 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 30995925 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | MANAGEMENT EVALUATED HOSPICE'S TAX POSITIONS AND CONCLUDED THAT HOSPICE HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE CONSOLIDATED FINANCIAL STATEMENTS. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | EQUITY IN INCOME OF ROWAN HOSPICE AND PALLIATIVE CARE 34,943. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RECLASSIFICATION OF INTEREST EXPENSE -71,518. THE HOSPICE FOUNDATION REVENUE 138,713. ELIMINATIONS -221,087. EQUITY IN INCOME OF ROWAN HOSPICE AND PALLIATIVE CARE 34,943. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | THE HOSPICE FOUNDATION EXPENSES 89,531. ELIMINATIONS -221,087. | |
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: | RECLASSIFICATION OF INTEREST EXPENSE 71,518. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | HOSPICE HOPE RUN | NameOfEvent1 |
| Gross Receipts Event1 | 142754 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 100299 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 42455 | GrossRevenueEvent1 |
| Non Cash Prizes Event1 | 9077 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 2470 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 25 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 500 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 13866 | OtherDirectExpensesEvent1 |
| Name Of Event2 | GOLF TOURNAMENT | NameOfEvent2 |
| Gross Receipts Event2 | 56987 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 42462 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 14525 | GrossRevenueEvent2 |
| Non Cash Prizes Event2 | 2362 | NonCashPrizesEvent2 |
| Food And Beverage Event2 | 5411 | FoodAndBeverageEvent2 |
| Entertainment Event2 | 1610 | EntertainmentEvent2 |
| Other Direct Expenses Event2 | 1145 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 7 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 147348 | GrossReceiptsOtherEvents |
| Charitable Contrib Other Events | 113423 | CharitableContribOtherEvents |
| Gross Revenue Other Events | 33925 | GrossRevenueOtherEvents |
| Non Cash Prizes Other Events | 19450 | NonCashPrizesOtherEvents |
| Rent Facility Costs Other Events | 7585 | RentFacilityCostsOtherEvents |
| Food And Beverage Other Events | 7310 | FoodAndBeverageOtherEvents |
| Other Direct Expenses Other Events | 16944 | OtherDirectExpensesOtherEvents |
| Gross Receipts Total | 347089 | GrossReceiptsTotal |
| Charitable Contributions Total | 256184 | CharitableContributionsTotal |
| Gross Revenue Total Events | 90905 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 30889 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 10055 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 12746 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 2110 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 31955 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 87755 | DirectExpenseSummaryEvents |
| Net Income Summary | 3150 | NetIncomeSummary |
Form990 Schedule G Part IV Form990ScheduleGPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | SCHEDULE G, PART II, COLUMN C, NUMBER OF EVENTS: | ReturnReference |
| Explanation | OTHER EVENTS INCLUDED ON SCHEDULE G REPRESENT ALL FUNDRAISING EVENTS HELD BY HOSPICE & PALLIATIVE CARECENTER. OF THE SEVEN TOTAL EVENTS LISTED IN THE OTHER COLUMN, FIVE EVENTS GENERATED GROSS RECEIPTS GREATER THAN $5,000. | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE HOSPICE FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 HOSPICE LANE | AddressLine1 |
| City | WINSTONSALEM | City |
| State | NC | State |
| ZIP Code | 27103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 561823562 | EINOfRecipient |
| IRC Section | 501(C)3 | IRCSection |
| Amount Of Cash Grant | 156000 | AmountOfCashGrant |
| Purpose Of Grant | ENDOWMENT | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: EXPENDITURE RESPONSIBILITY | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| 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 (7 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOANN E DAVIS | |||||||||||||
| 177566 | 0 | 0 | 0 | 0 | 0 | 8947 | 0 | 6262 | 0 | 192775 | 0 | 0 | 0 |
| BRIAN K PAYNE | |||||||||||||
| 145239 | 0 | 101 | 0 | 0 | 0 | 0 | 0 | 5910 | 0 | 151250 | 0 | 0 | 0 |
| RICHARD C STEPHENSON | |||||||||||||
| 237187 | 0 | 1101 | 0 | 0 | 0 | 10560 | 0 | 10642 | 0 | 259490 | 0 | 0 | 0 |
| KAREN L CROSS | |||||||||||||
| 179451 | 0 | 226 | 0 | 0 | 0 | 7942 | 0 | 12710 | 0 | 200329 | 0 | 0 | 0 |
| KIM KINSLEY | |||||||||||||
| 172091 | 0 | 101 | 0 | 0 | 0 | 0 | 0 | 9943 | 0 | 182135 | 0 | 0 | 0 |
| GENEVIEVE WROBLEWSKI | |||||||||||||
| 166767 | 0 | 303 | 0 | 0 | 0 | 1346 | 0 | 9928 | 0 | 178344 | 0 | 0 | 0 |
| BRENTON SHARPE | |||||||||||||
| 151892 | 0 | 226 | 0 | 0 | 0 | 7595 | 0 | 0 | 0 | 159713 | 0 | 0 | 0 |
Schedule M IRS990ScheduleM
Works Of Art WorksOfArt
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 2 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 625 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | EST. FAIR MARKET VALUE | MethodOfDeterminingRevenues |
Clothing And Household Goods ClothingAndHouseholdGoods
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Noncash Contribs Rptd F990 | 30252 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | EST. FAIR MARKET VALUE | MethodOfDeterminingRevenues |
Securities Publicly Traded SecuritiesPubliclyTraded
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 7 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 15853 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV AT DONATION DATE | MethodOfDeterminingRevenues |
Drugs And Medical Supplies DrugsAndMedicalSupplies
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 1000 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | EST. FAIR MARKET VALUE | MethodOfDeterminingRevenues |
Other Non Cash Contributions Table OtherNonCashContributionsTable (3 entries)
| Non Cash CheckboxNonCashCheckbox | DescriptionDescription | Number Of ContributionsNumberOfContributions | Noncash Contribs Rptd F990NoncashContribsRptdF990 | Method Of Determining RevenuesMethodOfDeterminingRevenues |
|---|---|---|---|---|
| X | GIFT CERTIFICATES | 27 | 1240 | FACE VALUE |
| X | SPORTS TICKETS | 96 | 19150 | EST. FAIR MARKET VALUE |
| X | VACATION STAYS | 14 | 19150 | FACE VALUE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of8283 Received | 0 | NumberOf8283Received |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 1 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Form990 Schedule M Part II Form990ScheduleMPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: | Identifier |
| Return Reference | PART I, COLUMN (B): | ReturnReference |
| Explanation | THE NUMBER OF CONTRIBUTIONS REFERENCED IN PART I, COLUMN B IS REPRESENTATIVE OF THE NUMBER OF CONTRIBUTED ITEMS RECEIVED EXCEPT FOR PUBLICLY TRADED SECURITIES, WHICH SIGNIFIES THE NUMBER OF CONTRIBUTORS | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE PREPARED FORM 990 WILL BE REVIEWED BY THE GOVERNANCE BOARD FINANCE COMMITTEE, THE AGENCY CEO, THE AGENCY VP OF FINANCE & ADMINISTRATION, AND THE AGENCY CONTROLLER FOR ACCURACY AND REASONABLENESS PRIOR TO BEING FILED WITH THE IRS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED AND DISCUSSED WITH ALL EMPLOYEES AT GENERAL ORIENTATION. EMPLOYEES SIGN AN ACKNOWLEDGEMENT INDICATING THEY HAVE READ AND UNDERSTAND THE CONFLICT OF INTEREST POLICIES. IN ADDITION, MANAGERS COMPLETE TRAINING FOR POLICIES REGARDING SOLICITATION, DISTRIBUTION AND ACCESS, GIFTS AND GRATUITIES, REFERRAL OF BUSINESS, PATIENT/FAMILY LEGAL MATTERS, AND WILLS. THE CONFLICT OF INTEREST POLICY IS ALSO INCLUDED IN THE EMPLOYEE HANDBOOK. ANNUALLY, THE BOARD OF DIRECTORS MUST SIGN AN ACKNOWLEDGEMENT INDICATING THEY HAVE READ AND UNDERSTAND THE CONFLICT OF INTEREST POLICY. ALL BOARD MEMBERS WILL BE REQUIRED TO DISCLOSE ANY CONFLICT OF INTEREST AND WILL EXCUSE THEMSELVES FROM DECISION MAKING, INPUT OR VOTING RELATED TO THE CONFLICT. THEY WILL BE REQUIRED TO REPORT ANY CONFLICT TO THE BOARD OR CEO. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE GOVERNING BOARD OF DIRECTORS IS RESPONSIBLE FOR DETERMINING CEO COMPENSATION. THE GOVERNING BOARD CONSULTS MARKET SURVEYS, PUBLISHED INDUSTRY STANDARDS, AND THE "HOSPICE & HOMECARE SALARY & BENEFITS REPORT." THE CEO AND THE HUMAN RESOURCES DEPARTMENT ARE JOINTLY RESPONSIBLE FOR DETERMINING ALL OTHER OFFICERS' COMPENSATION. THE PROCESS AND AIDS USED ARE THE SAME AS USED FOR DETERMINING CEO COMPENSATION. | |
| FORM 990, PART VI, SECTION C, LINE 19 | HOSPICE & PALLIATIVE CARECENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND ITS FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC ONLY ON REQUEST. | |
| FORM 990, PART VII, SECTION A, COLUMN F | THE ORGANIZATION, IN A FULL TRANSPARENCY POSTURE TO REPORTING, IS REPORTING ALL BENEFITS IN FULL IN COLUMN F, PART VII AND IS NOT APPLYING THE $10,000 PER ITEM EXCEPTION FOR CERTAIN BENEFITS. | |
| FORM 990, PART VII, LINE 1A, COLUMN B: | THE CHAIR AND VICE CHAIR OF HOSPICE & PALLIATIVE CARECENTER JOINTLY SERVE ON THE HOSPICE FOUNDATION AND HOSPICE & PALLIATE CARECENTER'S BOARD OF DIRECTORS. BOTH DIRECTORS DEVOTE APPROXIMATELY ONE HOUR PER WEEK TO EACH OF THE ORGANIZATIONS. THE PRESIDENT/CEO SERVES BOTH THE HOSPICE FOUNDATION AND HOSPICE & PALLIATIVE CARECENTER. THE PRESIDENT DEVOTES 40 COMBINED HOURS PER WEEK TO THE ORGANIZATIONS, 4 HOURS PER WEEK SERVING THE FOUNDATION, AND 36 HOURS PER WEEK SERVING HOSPICE & PALLIATIVE CARECENTER. | HOURS DEVOTED TO A RELATED ORGANIZATION |
| FORM 990, PART XI, LINE 5: | EQUITY IN INCOME OF ROWAN HOSPICE AND PALLIATIVE CARE 34,943. TOTAL TO FORM 990, PART XI, LINE 5: 34,943. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XI, LINE 2C: FINANCE COMMITTEE | THE FINANCE COMMITTEE'S PROCESS OF EVALUATION HAS NOT CHANGED SINCE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE HOSPICE FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 HOSPICE LANE | AddressLine1 |
| City | WINSTONSALEM | City |
| State | NC | State |
| ZIP Code | 27103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561823562 | EIN |
| Primary Activities | SUPPORT OF HOSPICE & PALLIATIVE CARECENTER | PrimaryActivities |
| Legal Domicile State | NC | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | LINE 11A, I | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE & PALLIATIVE CARECENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | 1 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| THE HOSPICE FOUNDATION | |
| B | 156000 |
| THE HOSPICE FOUNDATION | |
| C | 38944 |
| THE HOSPICE FOUNDATION | |
| M | 26143 |
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