2011-05-16T07:37:27-05:00 2010-12-31 LARSONALLEN LLP 101 N TRYON STREET SUITE 1000 CHARLOTTE NC 28246 990 2010-01-01 561452373 HOSPICE OF CLEVELAND COUNTY INC HOSP 7044874677 951 WENDOVER HEIGHTS DRIVE SHELBY NC 28150 MYRA MCGINNIS 7044874677 2011-05-11 1 7049985200 2010 2016-02-24 21:20:13Z HOSPICE CLEVELAND COUNTY MYRA MCGINNIS 951 WENDOVER HEIGHTS DRIVE SHELBY NC 28150 11180096 0 X WWW.HOSPICECARES.CC X 1984 NC HOSPICE OF CLEVELAND COUNTY PROVIDES CARE AND SUPPORT TO PATIENTS WITH A LIFE-LIMITING ILLNESS. 21 21 153 244 -395 0 923415 791144 9754830 10320132 85611 40682 12958 14979 10776814 11166937 0 0 0 0 4218629 5343213 0 0 0 4411428 4325138 8630057 9668351 2146757 1498586 15307862 16424316 1671624 1289492 13636238 15134824 HOSPICE OF CLEVELAND COUNTY, INC. EXISTS TO PROVIDE HIGH QUALITY SKILLED COMPASSIONATE CARE AND SUPPORT FOR INDIVIDUALS WITH A LIFE-LIMITING ILLNESS, THEIR FAMILIES, AND THE COMMUNITY, REGARDLESS OF THEIR ABILITY TO PAY. 0 0 6259421 7518492 HOSPICE CLEVELAND COUNTY PROVIDES COMPREHENSIVE END OF LIFE HEALTHCARE FOR TERMINALLY ILL PATIENTS AND THEIR FAMILIES DURING THE FINAL STAGES OF ILLNESS. DURING 2010, HOSPICE CLEVELAND COUNTY PROVIDED 44,036 DAYS OF HOMECARE INCLUDING 11,576 DAYS OF NURSING HOME AND HOSPITAL INPATIENT CARE. HOSPICE CLEVELAND COUNTY SERVED 673 HOMECARE PATIENTS IN 2010. HOSPICE CLEVELAND COUNTY'S INTERDISCIPLINARY TEAMS CONSISTING OF PHYSICIANS, NURSES, HOSPICE AIDES, SOCIAL WORKERS, AND OTHER SUPPORTIVE PERSONNEL PROVIDED OVER 31,000 VISITS DURING 2010. 1858340 2583692 HOSPICE CLEVELAND COUNTY OWNS AND OPERATES TWO HOSPICE HOUSES THAT PROVIDE HOSPICE INPATIENT AND RESIDENTIAL CARE FOR TERMINALLY ILL PATIENTS DURING THE FINAL STAGES OF ILLNESS. THE WENDOVER HOSPICE HOUSE HAS 14 BEDS. THE KINGS MOUNTAIN HOSPICE HOUSE HAS 8 BEDS AND OPENED IN MAY 2010. DURING 2010, HOSPICE CLEVELAND COUNTY PROVIDED 6,911 DAYS OF CARE IN THESE FACILITIES. HOSPICE CLEVELAND COUNTY SERVED 293 PATIENTS IN THE HOSPICE HOUSES IN 2010. 332523 217948 PALLIATIVE CARE CLEVELAND COUNTY PROVIDES A PROGRAM OF PAIN CONTROL, SYMPTOM MANAGEMENT AND ASSISTANCE WITH DIFFICULT DECISION MAKING. DURING 2010, PALLIATIVE CARE CLEVELAND COUNTY SERVED 642 PATIENTS. 8450284 1 1 0 1 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 39 0 153 1 0 0 0 0 0 0 0 0 0 0 X 21 21 0 1 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NC X PAM BENFIELD 7044874677 951 WENDOVER HEIGHTS DRIVE SHELBY NC 28150 LALLAGE CAROUTHERS 1.00 X 0 0 0 EDDIE HOLBROOK 1.00 X 0 0 0 EARL LUTZ 1.00 X 0 0 0 JEFF LEDFORD 1.00 X 0 0 0 DR BECKY LOVE 1.00 X 0 0 0 DOUG SATTERFIELD 1.00 X 0 0 0 JOSEPH TYSINGER 1.00 X 0 0 0 ROSLYN CRUMP 1.00 X 0 0 0 DR ROBERT GOSSETT 1.00 X 0 0 0 KARLA HAYNES-ELMORE 1.00 X 0 0 0 DR FORREST THOMPSON 1.00 X 0 0 0 ADRIAN CAMP 1.00 X 0 0 0 CHARLES WEBBER 1.00 X 0 0 0 JT SCRUGGS 1.00 X 0 0 0 DR JEFF CARLEY 1.00 X 0 0 0 TIM MATHIS 1.00 X 0 0 0 KATHY WILSON 1.00 X 0 0 0 ANDREA LESLIE-FITE 1.00 X 0 0 0 LARRY FOX 1.00 X 0 0 0 JENNIE LAMBERT 1.00 X 0 0 0 STEVE PADGETT 1.00 X 0 0 0 MYRA MCGINNIS 49.00 X 0 125117 38911 DR DAVID BARKER 44.50 X 159986 0 32957 DR JAMES POTTS 51.30 X 139108 0 28656 DR SANGYA PATEL 44.40 X 139314 0 28699 438408 125117 129223 3 0 1 0 MORRISON CONSTRUCTION COMPANY PO BOX 1488 SHELBY NC 28151 CONSTRUCTION SERVICES 1592114 CLEVELAND COUNTY HEALTHCARE SYSTEM 201 E GROVER STREET SHELBY NC 28150 MANAGEMENT SERVICES 274264 2 78153 712991 791144 PATIENT REVENUE 621610 10320132 10320132 10320132 40682 40682 34553 13159 21394 21394 UNRELATED BUSINESS INC 452000 -395 -395 DISPOSAL OF ASSET 900099 -6020 -6020 -6415 11166937 10320132 -395 56056 4430021 3907004 523017 90189 79541 10648 503570 444118 59452 319433 281720 37713 34416 34416 260857 17427 243430 27995 27995 106913 45622 61291 66073 25253 40820 208114 91581 116533 154498 147799 6699 22477 13189 9288 507804 507804 45778 45778 PURCHASED SERVICES 1775241 1775241 SUPPLIES 778180 778180 BAD DEBT EXPENSES 182949 182949 PROFESSIONAL FEES 32228 32228 121615 92633 28982 9668351 8450284 1218067 0 4246022 6075486 2396788 833526 804114 726953 1094028 1080466 3271 5328 58301 62382 9729167 2101844 6659919 7627323 45419 12852 15307862 16424316 1437696 952477 233928 337015 1671624 1289492 X 12832124 14407871 804114 726953 13636238 15134824 15307862 16424316 1498586 X X 0 1 1 X 0 X 393628 366454 1180647 923415 791778 3655922 393628 366454 1180647 923415 791778 3655922 307491 3348431 209278 284653 187882 85611 40682 808106 -70 -395 -465 18296 -2761 10608 13028 -6019 33152 4496715 42268351 0.74460 0.56020 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 410 410 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: THE ORGANIZATION BELONGS TO THE NATIONAL HOSPICE AND PALLIATIVE CARE ORGANIZATION WHICH DETERMINED THAT 8.10% OF ITS PROVIDER DUES WERE USED FOR SPECIFIC LOBBYING PURPOSES. 295737 295737 7354906 1279948 6074958 1445570 656104 789466 632954 165792 467162 7627323 ESTIMATED THIRD PARTY LIABILITY 337015 337015 11166937 9668351 1498586 0 1498586 11244098 644915 644915 10599183 567754 567754 11166937 9668351 0 9668351 0 9668351 PART XII, LINE 2D - OTHER ADJUSTMENTS: RELEASE FROM RESTRICTION 644,915. PART XII, LINE 4B - OTHER ADJUSTMENTS: RESTRICTED PLEDGES RECEIVED 546,995. CHANGE IN DISCOUNT ON PLEDGES RECEIVABLE 20,759. VARIOUS 34553 34553 13159 34553 34553 13159 13159 21394 X 1 1 X X X 0 0 0 0 0 0 0 0 0 MYRA MCGINNIS 0 110363 0 14754 0 0 0 0 0 38911 0 164028 0 0 DR DAVID BARKER 158520 0 0 0 1466 0 0 0 32957 0 192943 0 0 0 DR JAMES POTTS 138096 0 0 0 1012 0 0 0 28656 0 167764 0 0 0 DR SANGYA PATEL 138456 0 0 0 858 0 0 0 28699 0 168013 0 0 0 PART I, LINE 1A HOSPICE OF CLEVELAND COUNTY, INC. PAYS ALL OR A PORTION OF MONTHLY DUES FOR EMPLOYEES WHO CHOOSE TO JOIN THE LOCAL YMCA PROGRAM. THIS IS REPORTED AS TAXABLE FRINGE IN THE EMPLOYEES PAYROLL EARNINGS AND TAXED APPROPRIATELY. FORM 990, PART VI, SECTION A, LINE 3 HOSPICE OF CLEVELAND COUNTY, INC. HAS AN AGREEMENT WITH CLEVELAND REGIONAL MEDICAL CENTER TO PROVIDE MANAGEMENT SERVICES FOR DAY-TO-DAY OPERATIONS. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OF THE ORGANIZATION HAVE VOTING RIGHTS IN ELECTION OF THE BOARD MEMBERS AT THE ANNUAL MEETING HELD IN MARCH OF EACH YEAR. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S EXECUTIVE DIRECTOR WILL REVIEW AND APPROVE FORM 990 AND WILL PRESENT IT TO THE FINANCE COMMITTEE BEFORE IT IS FILED. THE FINANCE COMMITTEE WILL THEN PRESENT THE PREPARED FORM 990 TO THE BOARD OF DIRECTORS FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MAINTAINS A CONFLICT OF INTEREST POLICY THAT COVERS ALL EMPLOYEES AND BOARD MEMBERS. EACH YEAR THE CONFLICT OF INTEREST POLICY IS REVIEWED AT ONE OF THE MONTHLY STAFF MEETINGS WITH ALL EMPLOYEES. SENIOR LEADERSHIP AND ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE, SIGN AND DATE AN ANNUAL CONFLICT OF INTEREST DISCLOSURE FORM. ALL DISCLOSURES BY BOARD MEMBERS ARE REVIEWED AND APPROVED BY THE CLEVELAND COUNTY HEATHCARE SYSTEM COMPLIANCE DIRECTOR. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION OF THE EXECUTIVE DIRECTOR AND SENIOR LEADERSHIP WAS LAST REVIEWED IN 2010. FORM 990, PART VI, SECTION C, LINE 19 REQUESTS FOR REVIEW OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS MUST BE SUBMITTED TO HOSPICE OF CLEVELAND COUNTY, INC. IN WRITING AND MUST INCLUDE THE NAME, ADDRESS, AND TELEPHONE NUMBER OF THE INDIVIDUAL OR ENTITY MAKING THE REQUEST. ALL REQUESTS ARE SUBMITTED TO THE EXECUTIVE DIRECTOR FOR APPROVAL. UPON APPROVAL, THE DOCUMENTS ARE MADE AVAILABLE WITHIN TWO WEEKS OF RECEIPT OF THE WRITTEN REQUEST. THE DOCUMENTS ARE AVAILABLE FOR REVIEW AT THE HOSPICE OF CLEVELAND COUNTY, INC. ADMINISTRATIVE OFFICE BUILDING. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. CLEVELAND REGIONAL MEDICAL CENTER 201 E GROVER ST SHELBY NC 28150 560654386 GOVERNMENTAL HOSPITAL NC 501(C)(3) 170(B)(1)(A)(III) N/A 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 CLEVELAND REGIONAL MEDICAL CENTER O 61933 CLEVELAND REGIONAL MEDICAL CENTER L 274264