2012-03-07T12:05:39-06:00 2011-09-30 GILLIAM COBLE & MOSER LLP P O BOX 41196 GREENSBORO NC 274041196 990 2010-10-01 561249146 HOSPICE AT GREENSBORO INC HOSP 3366212500 2500 SUMMIT AVENUE GREENSBORO NC 27405 PATRICIA A SOENKSEN 3366212500 2012-03-02 1 BERT DAVIS JR 3362300350 2010 2016-02-24 21:20:13Z HOSPICE & PALLIATIVE CARE OF GREENSB PATRICIA A SOENKSEN 2500 SUMMIT AVENUE GREENSBORO NC 27405 22342715 0 X WWW.HOSPICEGSO.ORG X 1979 NC THE ORGANIZATION PROVIDES NURSING AND SUPPORT TO THE TERMINALLY ILL AND THEIR FAMILIES. 16 16 246 226 0 0 1524383 1545560 18543147 20181851 276192 418039 239715 121434 20583437 22266884 0 0 0 0 11204092 12195256 0 0 357948 7370853 7954227 18574945 20149483 2008492 2117401 20888106 22287334 1808104 1703837 19080002 20583497 X THE MISSION OF HOSPICE AND PALLIATIVE CARE OF GREENSBORO IS TO ENHANCE THE QUALITY OF LIFE BY PROVIDING EXPERT INTERDISCIPLINARY CARE, CONSULTATION, SUPPORT AND EDUCATION FOR THOSE AFFECTED BY SERIOUS ILLNESS, DEATH OR GRIEF. 0 0 15574739 18995932 HOSPICE IS A COMPREHENSIVE, TEAM-ORIENTED PROGRAM OF MEDICAL CARE, PAIN MANAGEMENT, EMOTIONAL AND SPIRITUAL SUPPORT PROVIDED FOR TERMINALLY ILL PATIENTS AND THEIR FAMILIES. 556321 594358 PALLIATIVE CARE SERVICES IS A HOSPITAL-BASED CONSULTATION TEAM (PHYSICIAN, NURSE PRACTITIONER, NURSE LIAISON, SOCIAL WORKER AND CHAPLAIN) THAT ADDRESSES PALLIATIVE CARE NEEDS SUCH AS SYMPTOM AND PAIN MANAGEMENT, ASSISTANCE IN DETERMINING GOALS OF CARE, EMOTIONAL AND/OR SPIRITUAL SUPPORT. 693436 436421 KIDS PATH PROVIDES HOME CARE FOR MEDICALLY FRAGILE AND TERMINALLY ILL CHILDREN; COUNSELING AND SUPPORT FOR CHILDREN EXPERIENCING SERIOUS ILLNESS OR LOSS; AND CONSULTATION FOR ADULTS WHO CARE FOR CHILDREN EXPERIENCING GRIEF AND LOSS. 117499 132884 COUNSELING AND EDUCATION CENTER (CEC) PROVIDES INDIVIDUAL AND GROUP COUNSELING FOR GRIEF AND LOSS FOR FAMILIES OF HOSPICE PATIENTS AND THE COMMUNITY. 117499 132884 16941995 1 1 0 0 0 0 0 0 1 1 1 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 43 0 1 246 1 0 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NC X X PATRICIA A SOENKSEN 3366212500 2500 SUMMIT AVENUE GREENSBORO NC 27405 BOB NEWTON 1.00 X 0 0 0 DR PATRICT WRIGHT 1.00 X 0 0 0 SUSAN SHUMAKER 1.00 X 0 0 0 TERRY AKIN 1.00 X 0 0 0 NOEL BURT 1.00 X 0 0 0 DR HOWARD CHUBBS 1.00 X 0 0 0 ROSS HARRIS 1.00 X 0 0 0 KARIN HENDERSON 1.00 X 0 0 0 RON JOHNSON 1.00 X 0 0 0 ANN LINEWEAVER 1.00 X 0 0 0 MARY MAGRINAT 1.00 X 0 0 0 DAVID MARKER 1.00 X 0 0 0 EVERETTE MILLS 1.00 X 0 0 0 DR MOHAMED MOHAMED 1.00 X 0 0 0 CAROLYNN RICE 1.00 X 0 0 0 RALPH SHELTON 1.00 X 0 0 0 PATRICIA A SOENKSEN 40.00 X 139895 0 15495 JAMES T HAIGLER 40.00 X 105008 0 13114 JUAN C MONGUILOD 40.00 X 177240 0 21923 NIMISH C GOSRANI 40.00 X 140936 0 16527 DONALD E HERTWECK 40.00 X 137020 0 16594 SUSAN COX 40.00 X 85323 0 16178 PATRICIA GIBBONS 40.00 X 92100 0 12216 700099 0 83653 5 0 1 0 BLUE CROSSBLUE SHIELD OF NORTH CAROLINA PO BOX 580017 CHARLOTTE NC 28258 HEALTH INSURANCE 1471708 PROCARE PBM 3090 PREMIERE PARKWAY DULUTH GA 30097 PHARMACY BENEFITS MANAGER 910685 CONE HEALTH 1200 NORTH ELM STREET GREENSBORO NC 27401 HEALTH SERVICES 802886 ADVANCED HOME CARE INC PO BOX 65081 CHARLOTTE NC 28265 DME AND IV THERAPY PROVIDER 638080 CAMDEN PLACE 1 MARITHE COURT GREENSBORO NC 27407 LONG-TERM CARE FACILITY 620503 17 6765 1538795 79543 1545560 PER DIEM REIMBURSEMENT 623000 16262773 16262773 PASS-THROUGH REVENUES( 623000 3023100 3023100 PER VISIT REIMBURSEMEN 623000 895978 895978 20181851 452521 452521 34482 -34482 -34482 -34482 150557 6765 41349 109208 109208 MISCELLANEOUS REVENUE 900099 12226 12226 12226 22266884 20159595 0 561729 482824 205468 277356 8267810 6834714 1231954 201142 2715618 2184807 468390 62421 729004 586508 125739 16757 13250 13250 37138 37138 29367 29367 23383 23383 332297 170588 149087 12622 586149 391482 194667 277219 270051 6844 324 469748 469748 257162 172706 83624 832 PATIENT SERVICES AND SU 5612234 5608735 3499 CONTINUING EDUCATION AN 223987 47188 175905 894 FUNDRAISING PROJECT COS 62956 62956 DUES AND SUBSCRIPTIONS 29337 29337 20149483 16941995 2849540 357948 750 748 2952259 3252279 562297 555562 1627988 1940239 2186426 2076502 27588 0 74649 266654 8667346 4675393 3962792 3991953 9493357 10203397 20888106 22287334 1808104 1703837 1808104 1703837 X 15448491 16626256 565471 590265 3066040 3366976 19080002 20583497 20888106 22287334 X 2117401 -613906 X 0 1 1 X 0 X 1567136 3622341 1202440 1524383 1545560 9461860 1567136 3622341 1202440 1524383 1545560 9461860 6851 9455009 407086 637329 217879 277432 452521 1992247 128299 248870 32585 172149 121434 703337 12157444 84810632 0.77770 0.78450 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: REVENUE FROM SPECIAL EVENTS MISCELLANEOUS REVENUE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 9485857 809168 -74170 -7222 -17736 10195897 6842247 1827015 875408 -40325 -18488 9485857 5736575 592288 538420 -13951 -11085 6842247 0.61540 0.31480 0.06980 1 0 323250 323250 5027781 2198676 2829105 2720407 2175855 544552 595908 300862 295046 3991953 LONG TERM INVESTMENTS 9232929 F BENEFICIAL INTERESTS IN ENDOWMENT FUND 970468 F 10203397 22266884 20149483 2117401 -534363 -79543 -613906 1503495 18519331 -534363 -534363 19053694 3213190 3213190 22266884 17015836 0 17015836 3133647 3133647 20149483 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ENDOWMENT FUNDS ARE USED TO FUND CONTINUING OPERATIONS AND SPECIAL PROJECTS OF THE ORGANIZATION. PART XI, LINE 8 - OTHER ADJUSTMENTS: NONCASH CONTRIBUTIONS RECORDED ON TAX RETURN NOT ON FINANCIAL STATEMENTS -79,543. PART XII, LINE 2D - OTHER ADJUSTMENTS: UNREALIZED LOSSES ON INVESTMENT -493,625. CHANGE IN BENEFICIAL INTEREST IN ENDOWMENT FUNDS -40,738. PART XII, LINE 4B - OTHER ADJUSTMENTS: NONCASH CONTRIBUTIONS 79,543. INPATIENT AND CONSULTING CHARGES, NETTED WITH REVENUE ON FINANCIAL STATEMENT 3,133,647. PART XIII, LINE 4B - OTHER ADJUSTMENTS: INPATIENT AND CONSULTING CHARGES, NETTED WITH REVENUE ON FINANCIAL STATEMENT 3,133,647. CORKS FOR KIDS PATH 92623 6765 85858 31678 LIGHT UP A LIFE 64699 64699 9671 157322 6765 150557 41349 41349 109208 X X 0 1 0 0 0 1 0 0 0 PATRICIA A SOENKSEN 124895 0 15000 0 0 0 6312 0 9183 0 155390 0 0 0 JUAN C MONGUILOD 177240 0 0 0 0 0 13359 0 8564 0 199163 0 0 0 NIMISH C GOSRANI 140936 0 0 0 0 0 12689 0 3837 0 157462 0 0 0 DONALD E HERTWECK 137020 0 0 0 0 0 12525 0 4069 0 153614 0 0 0 X 20740 SELLING PRICE X 32 13735 SELLING PRICE X 16 2015 SELLING PRICE X ART & CRAFT SUPPLIES 15 6991 SELLING PRICE X GIFT CARDS 51 18894 SELLING PRICE X MISCELLANEOUS GIFTS & TOYS 77 12678 SELLING PRICE X MISCELLANEOUS SERVICE 8 4490 SELLING PRICE 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE FINANCE COMMITTEE AND, ONCE APPROVED, IS REVIEWED WITH THE FULL BOARD OF DIRECTORS BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C ALL NEW EMPLOYEES SIGN A CONFLICT OF INTEREST POLICY. IN ADDITION, THE BOARD OF DIRECTORS REVIEW AND UPDATE THE CONFLICT OF INTEREST POLICY ANNUALLY BEFORE SIGNING THEMSELVES. FORM 990, PART VI, SECTION B, LINE 15 THE CEO'S SALARY IS EVALUATED BY THE BOARD OF DIRECTORS ANNUALLY. THE CEO'S BASE SALARY IS DETERMINED USING BENCHMARK MARKET DATA OBTAINED FROM THE HOSPICE SALARY AND BENEFITS REPORT PUBLISHED BY HOSPITAL AND HEALTHCARE COMPENSATION SERVICE IN COOPERATION WITH THE NATIONAL ASSOCIATION FOR HOMECARE & HOSPICE (NAHC). THIS IS THE MOST COMPREHENSIVE SURVEY DONE BY HOSPICE ORGANIZATIONS AND IT IS WIDELY USED. AT THE BEGINNING OF EVERY FISCAL YEAR, THE BOARD CHAIR AND THE CEO JOINTLY DEVELOP QUANTIFIABLE OBJECTIVES TO MEASURE AND EVALUATE THE CEO'S PERFORMANCE. THESE INCLUDE INDICATORS SUCH AS: VOLUME (AVERAGE DAILY CENSUS) TARGETS; NET MARGIN; MEDICATION COST PER DAY; EMPLOYEE TURNOVER RATES; AND EMPLOYEE SATISFACTION. THE ORGANIZATION MAINTAINS A SALARY SCHEDULE FOR ALL EXEMPT POSITIONS AND A PAY SCALE FOR ALL NON-EXEMPT POSITIONS. COMPENSATION FOR OFFICERS AND KEY EMPLOYEES IS DETERMINED THROUGH THE USE OF THIS SCHEDULE. EACH IS REVIEWED ANNUALLY BY COMPARING TO BENCHMARK POSITION WITHIN THE HOSPICE MARKET AND RELATED SALARY AND WAGE DATA. WHERE NEEDED, APPROPRIATE AND FEASIBLE, PAY RANGES MAY BE MODIFIED, WITH BOARD APPROVAL, TO MORE CLOSELY REFLECT THE MARKET. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S TAX FORMS ARE ALL AVAILABLE ON THE WEBSITE WWW.GUIDESTAR.ORG. THEY ARE ALSO AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -534,363. NONCASH CONTRIBUTIONS RECORDED ON TAX RETURN NOT ON FINANCIAL STATEMENTS -79,543. TOTAL TO FORM 990, PART XI, LINE 5: -613,906.