2012-05-15T17:36:27-05:00 2011-06-30 AKT LLP 312 S JUNIPER STREET SUITE 100 ESCONDIDO CA 92025 990 2010-07-01 953125765 SAN DIEGO HOSPICE CORPORATION SAND 6196881600 4311 THIRD AVENUE SAN DIEGO CA 92103 KATHLEEN JONES 6196881600 2012-05-11 1 ELSA A ROMERO 7607461560 2012-05-11 2010 2016-02-24 21:20:13Z SD HOSPICE & INST PAL MED KATHLEEN JONES 4311 THIRD AVENUE SAN DIEGO CA 92103 82772913 0 X WWW.SDHOSPICE.ORG X 1977 CA PROVIDE SUPPORT, ASSISTANCE AND EDUCATION TO TERMINALLY ILL PERSONS AND THEIR FAMILIES. 23 22 978 718 0 0 6042087 6152248 70521448 76603520 7658 17145 0 0 76571193 82772913 98250 167452 0 0 51034814 56292332 0 0 0 25120255 26847753 76253319 83307537 317874 -534624 23105018 20502216 11851567 9783389 11253451 10718827 X PROVIDE PROFESSIONAL SUPPORT, PRACTICAL ASSISTANCE AND EDUCATION TO TERMINALLY ILL PERSONS, MEMBERS OF THEIR FAMILIES AND SIGNIFICANT OTHERS. 0 0 74877011 167452 76603520 FOUNDED IN 1977, SAN DIEGO HOSPICE AND THE INSTITUTE FOR PALLIATIVE MEDICINE (SDHIPM) WAS THE FIRST HOSPICE PROGRAM ESTABLISHED IN THE SAN DIEGO AREA. OUR MISSION CENTERS ON RELIEVING PAIN AND SUFFERING, INCLUDING PHYSICAL, EMOTIONAL, SOCIAL AND SPIRITUAL PAIN EXPERIENCED DURING SERIOUS ILLNESS OR AT THE END OF LIFE. THROUGH IMPECCABLE QUALITY OF SERVICES TO PATIENTS AND THEIR LOVED ONES, AS WELL AS PROVIDING PROFESSIONAL EDUCATION TO CLINICIANS AT OUR WORLD-RENOWNED INSTITUTE FOR PALLIATIVE MEDICINE, SDHIPM SEEKS TO CHANGE FOR THE BETTER THE WAY PEOPLE FACE DEATH AND DYING.SDHIPM SERVES PEOPLE OF ALL AGES ACROSS THE ENTIRE SAN DIEGO COUNTY REGION. WE CARE FOR NEARLY 1,200 PATIENTS A DAY IN THEIR HOMES, ACUTE-CARE SETTINGS, LONG-TERM CARE FACILITIES AND THROUGH OUR INPATIENT CARE CENTER, THE ONLY FREE-STANDING HOSPICE HOSPITAL IN CALIFORNIA. COMMUNITY EVENTS SPONSORED BY SDHIPM EDUCATE MORE THAN 78,000 PEOPLE EACH YEAR. SDHIPM'S INSTITUTE FOR PALLIATIVE MEDICINE (THE INSTITUTE) IS THE PREEMINENT PROVIDER OF PROFESSIONAL EDUCATION IN PALLIATIVE MEDICINE AND THE WORLD LEADER IN PALLIATIVE MEDICINE RESEARCH. THE INSTITUTE HAS PLAYED A MAJOR ROLE IN ESTABLISHING THE GLOBAL GROUNDWORK FOR EDUCATION AND RESEARCH IN PALLIATIVE MEDICINE, AS WELL AS INTEGRATING PALLIATIVE MEDICINE INTO HEALTHCARE SYSTEMS SUCH AS HOSPITALS AND LONG-TERM-CARE FACILITIES. THE INSTITUTE'S CENTER FOR ADVANCED LEARNING TRAINS MORE THAN 3,400 CLINICIANS (PHYSICIANS, NURSES, SOCIAL WORKERS, PHARMACISTS AND CLERGY) FROM AROUND THE WORLD EACH YEAR IN PALLIATIVE CARE. THE INSTITUTE'S PHYSICIAN FELLOWSHIP PROGRAM IS THE LARGEST IN THE U.S., WITH BOTH U.S. FELLOWS AND FELLOWS FROM DEVELOPING COUNTRIES. THE INSTITUTE'S CENTER FOR RESEARCH COMPLETED 5 STUDIES DURING THE YEAR AND HAS 40 ACTIVE STUDIES FUNDED BY THE NATIONAL INSTITUTE FOR HEALTH OR PRIVATE FOUNDATIONS. SDHIPM'S CENTER FOR GRIEF CARE AND EDUCATION IS A RESOURCE OFFERING EMOTIONAL SUPPORT AND EDUCATION ABOUT GRIEF, LOSS AND CHANGE BEFORE AND AFTER A DEATH. OUR GRIEF AND BEREAVEMENT SERVICES ANNUALLY REACH OVER 9,500 INDIVIDUALS OF ALL AGES. OUR CENTER FOR GRIEF CARE AND EDUCATION EDUCATES AND EMPLOYS HIGHLY TRAINED THERAPISTS THAT OFFER A VARIETY OF INDIVIDUALIZED SERVICES USING VARIOUS THERAPEUTIC MODALITIES, WITH INDIVIDUALS, FAMILIES, GROUPS, AND THROUGH WORKSHOPS AND SPECIALIZED CHILDREN'S PROGRAMS.SDHIPM'S COMPREHENSIVE CASE MANAGEMENT PROGRAMS (CCMP) FOCUS ON HELPING PEOPLE OF ALL AGES WHO ARE LIVING WITH LONG-TERM ILLNESSES. WE BRING THEM EMOTIONAL AND PRACTICAL SUPPORT THAT HELPS THEM MAINTAIN THEIR INDEPENDENCE, MANAGE THEIR LIVES, AND DEAL WITH THE CHALLENGES THEY FACE DAILY. SERVICES PROVIDED BY CCMP ARE MADE POSSIBLE BY STATE AND FEDERAL FUNDS THROUGH STATE WAIVER PROGRAMS, AND THERE ARE NO OUT-OF-POCKET EXPENSES FOR ANY OF OUR CLIENTS. CCMP INCLUDES OUR HIV/AIDS CASE MANAGEMENT PROGRAM WHERE WE COORDINATE DAILY LIVING ISSUES FOR CLIENTS THAT ARE MEDICAL, LEGAL, FINANCIAL, HOUSING AND TRANSPORTATION RELATED, AS WELL AS PROVIDE EDUCATION TO THEM IN MANAGING THEIR DISEASE. CCMP ALSO INCLUDES OUR PARTNERS FOR CHILDREN PROGRAM, A PEDIATRIC PALLIATIVE CARE STATE WAIVER PROGRAM APPROVED IN OCTOBER OF 2009, WHICH OFFERS SERVICES TO CHILDREN IN NEED. THIS PROGRAM PROVIDES PALLIATIVE CASE MANAGEMENT SERVICES TO MEDI-CAL AND CCS (CALIFORNIA CHILD SERVICE) APPROVED CHILDREN WITH LIFE-THREATENING ILLNESSES. THE PROGRAM ALLOWS THESE CHILDREN TO RECEIVE PALLIATIVE SERVICES CONCURRENT WITH CURATIVE TREATMENTS. SERVICES INCLUDE CARE COORDINATION, FAMILY EDUCATION AND TRAINING, EXPRESSIVE THERAPIES, RESPITE CARE AND SUPPORT COUNSELING FOR CHILD AND FAMILY. 74877011 1 1 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 289 0 1 978 1 0 0 0 0 0 0 0 0 0 0 X 23 22 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X SAN DIEGO HOSPICE & THE INSTITUTE FOR PALLIATIVE MEDICINE 6196881600 4311 THIRD STREET SAN DIEGO CA 92103 HOWARD BARNHORST II 1.00 X 0 0 0 MARILYNN BOESKY 1.00 X 0 0 0 KRISTY BREHM 1.00 X 0 0 0 STEPHANIE COUTTS 1.00 X 0 0 0 BERIT DURLER 1.00 X 0 0 0 AMES EARLY 1.00 X 0 0 0 JOHN GILCHRIST JR 1.00 X 0 0 0 DAVID GILL 1.00 X 0 0 0 GORDON GILL 1.00 X 0 0 0 DORIS HOWELL MD 1.00 X 0 0 0 ARTHUR JOHNSON MD 1.00 X 0 0 0 EMANUEL KAUDER MD 1.00 X 0 0 0 CHERYL KENDRICK 1.00 X 0 0 0 SUSAN HARRIS LAUN 1.00 X 0 0 0 ANN NAVARRA 1.00 X 0 0 0 ANDREW NELSON 1.00 X 0 0 0 WILL NEWBERN 1.00 X 0 0 0 GEORGE OLMSTEAD 1.00 X 0 0 0 JOLYN PARKER 1.00 X 0 0 0 MARTY PENDARVIS 1.00 X 0 0 0 DONNA MARIE ROBINSON 1.00 X 0 0 0 WILLIAM STANTON MD 1.00 X 0 0 0 KENNETH UNRUH 1.00 X 0 0 0 KAYE WOLTMAN 1.00 X 0 0 0 RUTH WESTREICH 1.00 X 0 0 0 TRACI BRUCKNER 1.00 X 0 142656 5058 KATHLEEN PACURAR 10.00 X 63749 191246 2488 STEVEN OPPENHEIM MD 40.00 X 209985 0 5707 KATHY JONES 36.00 X 218680 24298 3546 CHARLES VON GUNTEN MD 36.00 X 231018 25669 4629 LAUREL HERBST MD 36.00 X 212672 23630 4542 NANETTE JOHNSON 40.00 X 0 0 0 CAROL LOVCI 40.00 X 0 0 0 BEN MARCANTONIO 40.00 X 0 0 0 HELEN MCNEAL 40.00 X 0 0 0 SHARON O'MARY 40.00 X 0 0 0 FRANK FERRIS 40.00 X 254197 0 4628 ELIZABETH MENKIN 40.00 X 194845 0 2785 SHANNON MOORE 40.00 X 212887 0 1533 CHARLES LEWIS 40.00 X 152685 0 1943 SCOTT IRWIN 40.00 X 153337 0 2215 DEBORAH DUNNE - FORMER OFFICER 40.00 X 222844 0 569 JAN CETTI 20.00 X 64893 64893 1298 2191792 472392 40941 40 1 1 0 DELIVER-IT INC 25108 MARGUERITE PKWY B137 MISSION VIEJO CA 92692 COURIER 976034 HOSPISCRIPT SERVICES LLC PO BOX 933273 ATLANTA GA 31193 PHARMACEUTICALS 868222 ALLSCRIPTS 24630 NETWORK PLACE CHICAGO IL 60673 SOFTWARE PROVIDER 448452 CARE MEDICAL TRANSPORTATION INC 9770 CANDIDA STREET SAN DIEGO CA 92126 PATIENT TRANSPORTATION 304333 BG MEDIA LLC 444 W BEECH STREET SUITE 400 SAN DIEGO CA 92101 MARKETING 250838 12 5779973 305691 66584 6152248 NET PATIENT SERVICES 75185849 75185849 OTHER REVENUE 980620 980620 EDUCATION AND RESEARCH 320003 320003 NURSING HOME HOSPICE 117048 117048 76603520 17145 17145 82772913 76603520 0 17145 4500 4500 162952 162952 1150292 166050 984242 45693606 42398630 3294976 5922456 5159112 763344 3525978 2992361 533617 89144 89144 56425 56425 58363 58363 327602 180485 147117 541728 89861 451867 1445408 766422 678986 582150 2355 579795 1835054 1570132 264922 1627523 1477444 150079 33227 32093 1134 1370710 1370710 207027 207027 MEDICAL SUPPLIES/EQUIP. 13229828 13158210 71618 PATIENT THERAPY 4732888 4648784 84104 FOOD/NUTRITIONAL 161823 161779 44 DUES & SUBSCRIPTIONS 142075 73838 68237 SECURITY 137064 110439 26625 269714 143827 125887 83307537 74877011 8430526 0 3395337 1066480 8462900 9440614 1596609 889629 30372996 22022819 9038325 8350177 611847 755316 23105018 20502216 10697717 8983389 153850 1000000 800000 11851567 9783389 X 11253451 10718827 11253451 10718827 23105018 20502216 -534624 0 X X 0 1 1 X 0 X 10476346 13621898 6042087 6152248 36292579 52669088 58711415 97451345 70521448 76603520 355956816 52669088 69187761 111073243 76563535 82755768 392249395 0 0 0 392249395 13162 16549 19101 7658 17145 73615 13162 16549 19101 7658 17145 73615 115728 121471 237199 52797978 69325781 111092344 76571193 82772913 392560209 0.99920 0.99880 0.00020 0.00020 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3228366 3228366 17163038 13575391 3587647 113164 68051 45113 9868428 8379377 1489051 8350177 NOTE PAYABLE 800000 800000 82772913 83307537 -534624 0 -534624 87352029 10359089 10359089 76992940 5779973 5779973 82772913 84684588 7157024 7157024 77527564 5779973 5779973 83307537 PART XII, LINE 2D - OTHER ADJUSTMENTS: REVENUES FROM RELATED ORGANIZATION PER CONSOLIDATED GAAP STATEMENTS 10,359,089. PART XII, LINE 4B - OTHER ADJUSTMENTS: ELIMINATING ENTRIES - CONSOLIDATED GAAP STATEMENTS 5,779,973. PART XIII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES FROM RELATED ORGANIZATION PER CONSOLIDATED GAAP STATEMENTS 7,157,024. PART XIII, LINE 4B - OTHER ADJUSTMENTS: ELIMINATING ENTRIES - CONSOLIDATED GAAP STATEMENTS 5,779,973. 1 0 0 0 0 0 0 0 0 0 LEADERSHIP DEVELOPMENT INITIATIVE EUROPE (INCLUDING ICELAND & GREENLAND) 7 32798 WIRE LEADERSHIP DEVELOPMENT INITIATIVE SOUTH AMERICA 2 12000 WIRE LEADERSHIP DEVELOPMENT INITIATIVE SUB-SAHARAN AFRICA 10 67154 WIRE/CHECK LEADERSHIP DEVELOPMENT INITIATIVE NORTH AMERICA 1 3000 WIRE LEADERSHIP DEVELOPMENT INITIATIVE MIDDLE EAST AND NORTH AFRICA 1 4000 WIRE LEADERSHIP DEVELOPMENT INITIATIVE RUSSIA & THE NEWLY INDEPENDENT STATES 1 4000 WIRE LEADERSHIP DEVELOPMENT INITIATIVE SOUTH ASIA 3 24000 WIRE LEADERSHIP DEVELOPMENT INITIATIVE EAST ASIA AND THE PACIFIC 3 16000 WIRE 0 0 0 0 0 0 PROCEDURE FOR MONITORING GRANTS OUTSIDE THE U.S.: SCHEDULE F, PART I, LINE 2: SDHIPM RECEIVED A GRANT FOR OUR LEADERSHIP DEVELOPMENT INITIATIVE WHICH ALLOWS EACH PARTICIPANT IN THE PROGRAM A STIPEND TO SPEND ON THEIR OWN ACTIVITIES TO GROW AND DEVELOP AS A LEADER. PRIOR TO RECEIVING EACH STIPEND, EACH PARTICIPANT SUBMITS AN INDIVIDUAL DEVELOPMENT PLAN AND BUDGET THAT OUTLINES HOW THEY WILL BE SPENDING THEIR STIPEND. THEIR PLAN AND BUDGET IS REVIEWED BY THE DIRECTOR OF THE PROGRAM AS WELL AS THE PARTICIPANT'S MENTOR. THE MENTORS ALSO RECEIVE STIPENDS AT INTERVALS THROUGHOUT THE PROGRAM AND MUST REPORT TO THE DIRECTOR OF THE PROGRAM AT REGULAR INTERVALS ABOUT HOW THE FUNDS ARE BEING SPENT AND ANY DEVIATIONS FROM THE ORIGINAL BUDGETED USE OF THE FUNDS. ONE OF THE CO-DIRECTORS OF THE LEADERSHIP DEVELOPMENT INITIATIVE AS WELL AS THE PARTICIPANT'S MENTORS ARE IN CONVERSATIONS WITH THE PARTICIPANTS THROUGHOUT THE PROGRAM ABOUT THE USE OF THEIR STIPEND. EACH PARTICIPANT HAS PREPARED AND SUBMITTED AN INDIVIDUAL DEVELOPMENT PLAN ALONG WITH THEIR BUDGET THAT GUIDES THEIR ACTIVITIES AND THEIR SPENDING OF THE STIPEND. THEY ARE EXPECTED TO MAINTAIN COPIES OF RECEIPTS FOR ANY EXPENDITURES WHICH CAN BE REQUESTED BY THE DIRECTOR OF THE PROGRAM AT ANY TIME. X X 1 0 0 0 0 0 0 0 0 KATHLEEN PACURAR 63749 191246 0 0 0 0 0 0 622 1866 64371 193112 0 0 STEVEN OPPENHEIM MD 209985 0 0 0 0 0 2095 0 3612 0 215692 0 0 0 KATHY JONES 218680 24298 0 0 0 0 2429 0 1005 112 222114 24410 0 0 CHARLES VON GUNTEN MD 231018 25669 0 0 0 0 2450 0 1961 218 235429 25887 0 0 LAUREL HERBST MD 212672 23630 0 0 0 0 2363 0 1961 218 216996 23848 0 0 FRANK FERRIS 254197 0 0 0 0 0 2450 0 2178 0 258825 0 0 0 ELIZABETH MENKIN 194845 0 0 0 0 0 0 0 2785 0 197630 0 0 0 SHANNON MOORE 212887 0 0 0 0 0 1533 0 0 0 214420 0 0 0 CHARLES LEWIS 152685 0 0 0 0 0 1943 0 0 0 154628 0 0 0 SCOTT IRWIN 153337 0 0 0 0 0 1527 0 688 0 155552 0 0 0 DEBORAH DUNNE - FORMER OFFICER 222844 0 0 0 0 0 0 0 569 0 223413 0 0 0 JAN CETTI 64893 64893 0 0 0 0 1298 0 0 0 66191 64893 0 0 PART I, LINE 4A DEBORAH DUNN WHO IS THE FORMER CAO AS OF FEBRUARY 2010 RECEIVED SEVERANCE PAY OF $107,597 DURING THE FISCAL YEAR. LAUREL HERBST WHO IS THE FORMER CHIEF MEDICAL OFFICER AS OF JANUARY 2011 RECEIVED SEVERANCE PAY OF $107,194 DURING THE FISCAL YEAR. SUPPLEMENTAL INFORMATION PART III COMPENSATION SURVEYS ARE REVIEWED ANNUALLY IN ORDER TO DETERMINE COMPENSATION FOR ALL POSITIONS WITHIN THE ORGANIZATION, WITH THE EXCEPTION OF THE CEO WHOSE COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS. THE COMPENSATION SURVEYS INCLUDE COUNTY, STATE, REGIONAL AND NATIONAL DATA PRIMARILY RELATED TO NON-PROFIT, HOSPICE AND OTHER HEALTHCARE AGENCIES. EDUCATION AND YEARS OF RELEVANT EXPERIENCE ARE INCLUDED IN THE COMPENSATION SURVEYS. JOLYN PARKER BOARD MEMBER 59320 CONSULTING 0 KRISTY BREHM BOARD MEMBER 30000 CONSULTING 0 FORM 990, PART VI, SECTION B, LINE 11 THE CFO, CONTROLLER, AND A REPRESENTATIVE FROM THE FINANCE COMMITTEE REVIEWS THE FORM 990 BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES SIGN A CONFLICT OF INTEREST POLICY STATEMENT ANNUALLY AND ARE REQUIRED TO DISCLOSE ANY POSSIBLE CONFLICTS THROUGHOUT THE YEAR. ALL DIRECTORS REFRAIN FROM VOTING ON ANY TRANSACTION OR MATTER BEFORE THE BOARD IN WHICH A CONFLICT OR POSSIBLE CONFLICT EXISTS. THE SIGNED CONFLICT OF INTEREST POLICY STATEMENTS ARE REVIEWED BY THE EXECUTIVE COMMITTEE OF THE BOARD AND HUMAN RESOURCES. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION SURVEYS ARE REVIEWED ANNUALLY IN ORDER TO DETERMINE COMPENSATION FOR ALL POSITIONS WITHIN THE ORGANIZATION, WITH THE EXCEPTION OF THE CEO WHOSE COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS. THE COMPENSATION SURVEYS INCLUDE COUNTY, STATE, REGIONAL AND NATIONAL DATA PRIMARILY RELATED TO NON-PROFIT, HOSPICE AND OTHER HEALTHCARE AGENCIES. EDUCATION AND YEARS OF RELEVANT EXPERIENCE ARE INCLUDED IN THE COMPENSATION SURVEYS. FORM 990, PART VI, SECTION C, LINE 19 THE FOLLOWING ORGANIZATIONAL DOCUMENTS WILL BE AVAILABLE (FOR INSPECTION OR COPYING) AT THE ORGANIZATION'S MAIN OFFICE DURING NORMAL BUSINESS HOURS AT NO CHARGE: TAX EXEMPTION APPLICATION (FORM 1023) INTERNAL REVENUE SERVICE DETERMINATION LETTER ARTICLES OF INCORPORATION BY-LAWS THE PUBLIC INSPECTION COPY OF THE ORGANIZATION'S FORM 990 FROM THE PREVIOUS THREE YEARS WILL BE AVAILABLE (FOR INSPECTION OR COPYING) AT THE ORGANIZATION'S MAIN OFFICE DURING NORMAL BUSINESS HOURS AT NO CHARGE. WHEN RESPONDING TO A PUBLIC INSPECTION REQUEST FOR ANY ORGANIZATIONAL DOCUMENT OR FORM 990 BY ANYONE, THE ORGANIZATION SHALL FULFILL SUCH REQUEST IN A TIMELY MANNER WITHOUT INQUIRING AS TO THE REASON FOR THE PUBLIC INSPECTION REQUEST. THE FOLLOWING OTHER DOCUMENTS (MOST UPDATED VERSIONS) WILL BE AVAILABLE (FOR INSPECTION OR COPYING) AT THE ORGANIZATION'S MAIN OFFICE DURING NORMAL BUSINESS HOURS AT NO CHARGE: MOST RECENT COPY OF THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS CONFLICT OF INTEREST POLICY FORM 990, PART XII LINE 2C NO CHANGE FROM PRIOR YEAR SAN DIEGO HOSPICE FOUNDATION INC 4311 THIRD AVENUE SAN DIEGO CA 92103 956336024 SUPPORT SAN DIEGO HOSPICE CORPORATION CA 501(C)(3) 170(B)(1)(A)(VI) N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0