2012-03-01T15:30:22-06:00 2011-09-30 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2010-10-01 591940256 COMMUNITY HOSPICE OF NORTHEAST FLORIDA COMM 9042685200 4266 SUNBEAM RD JACKSONVILLE FL 32257 CARLOS BOSQUE 9042685200 2012-03-01 AMY BIBBY 8282542254 2010 2016-02-24 21:20:13Z CARLOS BOSQUE 4266 SUNBEAM RD JACKSONVILLE FL 32257 93394376 0 X WWW.COMMUNITYHOSPICE.COM X 1984 FL HOSPICE IN HOME CARE OF TERMINALLY ILL PATIENTS AND COMPREHENSIVE GUIDANCE AND SUPPORT FOR PATIENTS AND THEIR FAMILIES. 28 29 898 6505 0 0 4143926 2249082 74775457 90291974 258718 682645 106823 98837 79284924 93322538 100000 0 0 0 36984864 45252581 0 0 0 32969783 38472922 70054647 83725503 9230277 9597035 56343866 64411887 6555376 5963608 49788490 58448279 TO IMPROVE THE QUALITY OF LIFE FOR PATIENTS AND FAMILIES AND BE THE COMPASSIONATE GUIDE FOR END-OF-LIFE CARE IN OUR COMMUNITY. 0 0 72094567 90287048 THE COMMUNITY HOSPICE OF NORTHEAST FLORIDA PROVIDED MEDICAL AND PALLIATIVE CARE, PSYCHOLOGICAL, PHYSICAL AND SPIRITUAL SERVICES TO TERMINALLY ILL PATIENTS AND THEIR FAMILIES REGARDLESS OF THEIR ABILITY TO PAY. EDUCATION AND TRAINING IS PROVIDED TO EXPAND AND ENHANCE KNOWLEDGE OF DEATH AND DYING CARE TO PATIENTS, FAMILY MEMBERS AND THE COMMUNITY. DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2011, 7,111 PATIENTS AND THEIR FAMILIES WERE SERVED TOTALING 421,996 DAYS OF CARE. NUMEROUS COMMUNITY EVENTS WERE HOSTED TO ALLOW ALL MEMBERS OF THE 5 COUNTY AREA THE OPPORTUNITY TO GET A BETTER UNDERSTANDING OF HOSPICE AND PALLIATIVE CARE. DURING THE YEAR, THE HOSPICE BEGAN A PALLIATIVE CARE PROGRAM WITHIN LOCAL HOSPITALS. 72094567 1 1 0 1 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 1 132 0 898 1 0 0 0 0 0 0 0 0 0 0 X 28 29 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X CARLOS BOSQUE CPA CFO 9042685200 4266 SUNBEAM ROAD JACKSONVILLE FL 32257 JAMES R BURKHART 3.00 X X 0 0 0 JOE MITRICK 2.00 X X 0 0 0 SCOTT C CAIRNS 2.00 X 0 0 0 BARBARA CONE 2.00 X X 0 0 0 JOHN W LOGUE 2.00 X X 0 0 0 FERNANDO ACOSTA-RUA 1.00 X 0 0 0 JILL BUIE 1.00 X 0 0 0 LAWRENCE A SOLBERG JR MD 1.00 X 0 0 0 YANK D COBLE JR MD 1.00 X 0 0 0 PAULA RINGHAVER 1.00 X 0 0 0 REV ROBERT L MORRIS 1.00 X 0 0 0 ROB BRADLEY 1.00 X 0 0 0 CHRISTOPHER EMANS 1.00 X 0 0 0 LARRY J FREEMAN 1.00 X 0 0 0 CAROLE GARDNER 1.00 X 0 0 0 JOE GORDY 1.00 X 0 0 0 JOHN HAYT 1.00 X 0 0 0 HON MARCIA M HOWARD 1.00 X 0 0 0 CAL JACKSON 1.00 X 0 0 0 JOY KORMAN 1.00 X 0 0 0 JOHN J DIAMOND 1.00 X 0 0 0 RABBI JOSHUA LIEF 1.00 X 0 0 0 HILARY MATHEWS 1.00 X 0 0 0 JOSH MCGRAW 1.00 X 0 0 0 ESTELLE MCKISSICK 1.00 X 0 0 0 TEALA MILTON JOHNSON 1.00 X 0 0 0 SCOTT WITT 1.00 X 0 0 0 RAY MATUZA 1.00 X 0 0 0 AMBASSADOR MARILYN MCAFEE 1.00 X 0 0 0 MARCIA MORALES 1.00 X 0 0 0 SUSAN PONDER-STANSEL 40.00 X 414855 0 50020 PHIL WARD 40.00 X 248363 0 49947 CARLOS BOSQUE 30.00 X 215177 0 41763 KATHY JOHNSON 40.00 X 204831 0 40409 JOHN MCILVAINE 40.00 X 200861 0 13377 ANDREA FRITZ 40.00 X 182829 0 44886 STEPHEN CLARK 40.00 X 232614 0 18171 KATHRYN MCILVAINE 40.00 X 162523 0 28552 MARY MCELROY 40.00 X 179201 0 11236 ELLEN SORRESSO 40.00 X 166088 0 6284 DAVID YARIAN 40.00 X 177759 0 6378 REUBEN SMITH 40.00 X 177265 0 12304 PAUL BORGMAN 40.00 X 192665 0 22078 DONALD TWIGGS 40.00 X 193074 0 16867 2948105 0 362272 19 0 1 0 NEWELL TERRY & DOUGLAS PA 817 N GADSDEN ST TALLAHASSEE FL 32303 LEGAL SERVICES 270661 1 2068622 180460 2249082 PATIENT SERVICE REVENU 623000 73822660 73822660 NURSING HOME SUPPORT 623000 16469314 16469314 90291974 412451 412451 342032 71838 342032 -71838 270194 270194 CAFE REVENUE 722210 51957 51957 MISCELLANOUS REVENUE 623000 46880 46880 98837 93322538 90291974 0 781482 2024730 479335 1545395 34058943 27742395 6316548 952163 629915 322248 5395050 4687667 707383 2821695 2376763 444932 69405 69405 163692 163692 51974 51974 21273 21273 3091749 3023912 67837 470354 150953 319401 26675384 26125171 550213 304226 304226 1920434 1920434 988065 801443 186622 234037 128523 105514 9602 9602 2012526 2012526 758499 758499 CHARITY CARE EXPENSES 986053 986053 BAD DEBT 607755 607755 MISCELLANEOUS 107894 107894 83725503 72094567 11630936 0 13090169 13140531 7914965 8252634 54583 19745 526072 527999 1802745 1969431 41825284 12050971 28556981 29774313 4290746 10637891 107605 89343 56343866 64411887 6434130 4927734 121246 365810 0 670064 6555376 5963608 X 49788490 58448279 49788490 58448279 56343866 64411887 X 9597035 -937246 X 0 1 1 X 0 X 2660445 2928342 2181745 4143926 3553298 15467756 67749281 63536122 66686742 74775457 90287048 363034650 70409726 66464464 68868487 78919383 93840346 378502406 0 0 0 378502406 303545 114564 129706 279251 386772 1213838 303545 114564 129706 279251 386772 1213838 70713271 66579028 68998193 79198634 94227118 379716244 0.99680 0.99650 0.00320 0.00350 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 76401 0 0 76401 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: THE ORGANIZATION INCURRED EXPENSES BY CALLING ON MEMBERS OF NORTH FLORIDA DELEGATION REGARDING VOLUNTEER BACKGROUND SCREENING BILL, FUNDING FOR "MONEY FOLLOWS THE PERSON" GRANT FOR FLORIDA, PARTNERS IN CARE-MEDICAID, MEDICAID MANAGED CARE CONCERNS, CERTIFICATE OF NEED SUPPORT FOR HOSPICE AND PILL MILL LEGISLATION AND SPECIFIC PROTECTIONS FOR HOSPICE. 886925 886925 31016360 6807327 24209033 9820247 5243644 4576603 101752 101752 29774313 DEFERRED COMP LIABILITY 670064 670064 93322538 83725503 9597035 -948675 11429 -937246 8659789 92373863 -948675 -948675 93322538 0 93322538 83725503 0 83725503 0 83725503 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: INCOME TAXES- COMMUNITY HOSPICE OF NORTHEAST FLORIDA, INC. AND ITS AFFILIATE ARE NOT-FOR-PROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. EFFECTIVE OCTOBER 1, 2009, THE HOSPICE ADOPTED THE FINANCIAL ACCOUNTING STANDARDS BOARD'S ("FASB") AUTHORITATIVE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR THE RECOGNITION AND MEASUREMENT OF THE BENEFITS OF INDIVIDUAL TAX POSITIONS IN THE CONSOLIDATED FINANCIAL STATEMENTS. TAX POSITIONS MUST BE A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT IN ORDER FOR THE BENFIT OF THOSE TAX POSITIONS TO BE RECOGNIZED IN THE HOSPICE'S CONSOLIDATED FINANCIAL STATEMENTS. THE HOSPICE HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2011 AND THE ADOPTION OF THE GUIDANCE DID NOT HAVE A MATERIAL EFFECT ON THE HOSPICE'S FINANCIAL POSITION OR RESULTS OF OPERATIONS. X X X 0 0 0 0 0 0 0 0 0 SUSAN PONDER-STANSEL 273516 0 72744 0 68595 0 29730 0 20290 0 464875 0 68595 0 PHIL WARD 211683 0 36680 0 0 0 29730 0 20217 0 298310 0 0 0 CARLOS BOSQUE 177598 0 27025 0 10554 0 28175 0 13588 0 256940 0 10554 0 KATHY JOHNSON 174136 0 26702 0 3993 0 27035 0 13374 0 245240 0 3993 0 JOHN MCILVAINE 174885 0 25976 0 0 0 6013 0 7364 0 214238 0 0 0 ANDREA FRITZ 158487 0 24342 0 0 0 24431 0 20455 0 227715 0 0 0 STEPHEN CLARK 207154 0 25460 0 0 0 4311 0 13860 0 250785 0 0 0 KATHRYN MCILVAINE 143987 0 18536 0 0 0 21128 0 7424 0 191075 0 0 0 MARY MCELROY 157046 0 22155 0 0 0 4607 0 6629 0 190437 0 0 0 ELLEN SORRESSO 165988 0 100 0 0 0 4995 0 1289 0 172372 0 0 0 DAVID YARIAN 177659 0 100 0 0 0 5333 0 1045 0 184137 0 0 0 REUBEN SMITH 177165 0 100 0 0 0 5385 0 6919 0 189569 0 0 0 PAUL BORGMAN 192565 0 100 0 0 0 5873 0 16205 0 214743 0 0 0 DONALD TWIGGS 192974 0 100 0 0 0 5944 0 10923 0 209941 0 0 0 SHANDS CEO OF SHANDS IS OUR BOARD CHAIRMAN 139500 RENT-MORRIS INPATIENT FACILITY 0 SHANDS CEO OF SHANDS IS OUR BOARD CHAIRMAN 585 RENT-COMMUNITY PALLIATIVE CARE 0 FORM 990, PART VI, SECTION A, LINE 2 JOHN MCILAINE AND KATHY MCILVAINE ARE BOTH KEY EMPLOYEES AND ARE HUSBAND AND WIFE. FORM 990, PART VI, SECTION B, LINE 11 THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTANT WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. UPON COMPLETION, THE RETURN WAS REVIEWED IN ITS ENTIRETY BY THE BUDGET FINANCE COMMITTEE OF THE BOARD, FOLLOWED BY A PRESENTATION TO THE FULL BOARD FOR APPROVAL. FOLLOWING APPROVAL, THE RETURN WAS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS OF THE BOARD OF DIRECTORS ARE REQUIRED ANNUALLY TO COMPLETE AND SIGN A CONFLICT OF INTEREST POLICY IDENTIFYING RELATIONSHIPS THAT MAY GIVE RISE TO CONFLICT. OFFICERS AND KEY MANAGEMENT PERSONNEL ALSO COMPLETE A SURVEY REGARDING POTENTIAL BUSINESS RELATIONSHIPS WITH OTHER OFFICERS, DIRECTORS, AND KEY PERSONNEL. FORM 990, PART VI, SECTION B, LINE 15 USING CURRENT JOB DESCRIPTIONS FOR THE EXECUTIVE POSITIONS, COMPETITIVE COMPENSATION DATA IS COLLECTED FROM PUBLISHED SALARY SURVEYS, THE FORM 990 OF SIMILAR HOSPICES, AND THROUGH DATA SUPPLIED BY EXTERNAL COMPENSATION CONSULTANTS. THIS INFORMATION IS ORGANIZED AND PRESENTED TO THE EXECUTIVE COMMITTEE OF THE BOARD BY THE DIRECTOR OF HUMAN RESOURCES. THE EXECUTIVE COMMITTEE IN TURN DETERMINES AND APPROVES INDIVIDUAL SALARY ADJUSTMENTS IT BELIEVES ARE WARRANTED. THE EXECUTIVE COMMITTEE REVIEWS COMPENSATION FOR THE CEO, COO, CFO, DEPUTY CFO, CMO, CNO, VP OF WORKFORCE DEVELOPMENT, VP OF MARKETING DEVELOPMENT, VP OF MARKETING & COMMUNICATIONS, VP OF BUSINESS DEVELOPMENT, AND THE EXECUTIVE DIRECTOR OF THE RELATED FOUNDATION. FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION WILL PROVIDE ANY GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS UPON REQUEST. THIS CAN BE DONE IN PERSON, BY PHONE, VIA OUR WEBSITE OR ON WWW.GUIDESTAR.COM. THE ORGANIZATION PUBLISHES A COMMUNITY REPORT IN THE LOCAL SUNDAY NEWSPAPER THAT PROVIDES SUMMARY INFORMATION OF THE PREVIOUS YEAR. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -948,675. TRANSFER OF NET ASSETS FROM AFFILIATE 11,429. TOTAL TO FORM 990, PART XI, LINE 5: -937,246. COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION FOR CARING 4266 SUNBEAM ROAD JACKSONVILLE FL 32257 593583920 FUNDRAISING FOR COMMUNITY HOSPICE OF NORTHEAST FLORIDA FL 501(C)(3) 13, TYPE I N/A 1 1 0 1 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION A 100828 COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION C 2068622 COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION L 263740 COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION N 157404