2011-07-18T09:00:34-05:00 2010-12-31 CROWE HORWATH LLP 70 West Madison Street Suite 700 Chicago IL 606024903 990 2010-01-01 205276923 GOOD SHEPHERD HOSPICE INC GOOD 8138718100 12973 TELECOM PARKWAY TEMPLE TERRACE FL 33637 GEORGE H WALLACE 2011-06-30 true 3128997000 2010 2016-02-24 21:20:13Z KATHY FERNANDEZ PRESIDENT & CEO 12973 TELECOM PARKWAY TEMPLE TERRACE FL 33637 49394713 false X WWW.GOODSHEPHERDHOSPICE.ORG X 2006 FL GOOD SHEPHERD HOSPICE, INC. PROVIDES HOSPICE AND PALLIATIVE CARE SERVICES THAT RELIEVE THE SUFFERING OF PERSONS RESIDING IN ITS COMMUNITIES AFFECTED BY LIFE-LIMITING ILLNESSES AND END-OF-LIFE ISSUES SO ALL MAY LIVE AS FULLY AND COMFORTABLY AS POSSIBLE. 10 7 432 530 0 0 111082 0 45993604 49394311 0 0 905 402 46105591 49394713 0 0 0 0 25251956 27153393 0 0 0 20754364 21639602 46006320 48792995 99271 601718 3851059 8298417 1780239 4653517 2070820 3644900 X GOOD SHEPHERD HOSPICE, INC. PROVIDES HOSPICE AND PALLIATIVE CARE SERVICES THAT RELIEVE THE SUFFERING OF PERSONS RESIDING IN ITS COMMUNITIES AFFECTED BY LIFE-LIMITING ILLNESSES AND END-OF-LIFE ISSUES SO ALL MAY LIVE AS FULLY AND COMFORTABLY AS POSSIBLE. THE ORGANIZATION ALSO WORKS TO PROMOTE UNDERSTANDING OF THE NEEDS OF PERSONS WITH SERIOUS OR LIFE-LIMITING ILLNESSES AS WELL AS THE NEEDS OF THEIR FAMILIES. false 39208277 0 49394713 A. PATIENT CARE - AS A NOT-FOR-PROFIT HOSPICE PROGRAM INITIALLY LICENSED BY THE STATE OF FLORIDA IN 1984 AND CERTIFIED BY THE FEDERAL MEDICARE PROGRAM, GOOD SHEPHERD HOSPICE PROVIDES A WIDE RANGE OF PALLIATIVE AND SUPPORTIVE CARE SERVICES TO HELP TERMINALLY ILL PATIENTS, THEIR FAMILIES AND THEIR LOVED ONES. GOOD SHEPHERD HOSPICE PROVIDES THESE SERVICES TO THE RESIDENTS OF POLK, HIGHLANDS, AND HARDEE COUNTIES, FLORIDA. THESE SERVICES ARE PROVIDED BY INTERDISCIPLINARY TEAMS COMPOSED OF QUALIFIED PROFESSIONALS AND TRAINED VOLUNTEERS. GOOD SHEPHERD HOSPICE ALSO HAS DEVELOPED AN EXTENSIVE NETWORK OF PARTNERSHIPS WITH HOSPITALS, ASSISTED LIVING FACILITIES AND NURSING HOMES TO IDENTIFY PATIENTS WHO WOULD BENEFIT FROM THE SERVICES AVAILABLE. THE STAFF AND VOLUNTEERS OF GOOD SHEPHERD HOSPICE ADDRESS THE PHYSICAL, EMOTIONAL, SOCIAL AND SPIRITUAL NEEDS OF HOSPICE PATIENTS AND THEIR FAMILIES BY OFFERING MEDICAL SERVICES, NURSING SERVICES, SOCIAL WORK SERVICES, PASTORAL CARE SERVICES, COUNSELING SERVICES AND BEREAVEMENT SERVICES. (CONTINUED IN SCHEDULE O) 39208277 true false false false false false false false true true false false true true true true true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false false true 0 0 432 true false false false false false false false false false false X 10 7 false false false false true true true true true false false true true true true true true true true false FL X DAVID J O'NEIL 8138718111 12973 TELECOM PARKWAY SUITE 100 TEMPLE TERRACE FL 33637 GEORGE H WALLACE 2 X X 0 296378 163087 H DARRELL WHITE 2 X 0 257086 129757 JANE HANCOCK 2 X 0 0 0 KATHY L FERNANDEZ 2 X X 0 677173 185685 JAMES T JOINER 2 X X 0 0 0 WILLIAM C BREDBENNER 40 X 186184 0 34561 PHIL WEGMAN 2 X 0 0 0 PHILLIP WALKER 2 X 0 0 0 REX YENTES 2 X X 0 0 0 RONALD S SCHONWETTER 2 X X 0 420108 248299 BRIAN HINTON 2 X 0 0 0 STANLEY L PIOTROWSKI 2 X 0 0 0 ANDREW LUTTON 40 X 0 187320 98377 SANDRA REX 40 X 104085 0 28321 290269 1838065 888087 2 false true false HPC HEALTHCARE INC 12973 N TELECOM PARKWAY SUITE 100 TEMPLE TERRACE FL 33637 MGMT & ADMIN EXPENSE; RENT 831020 1 0 PATIENT SERVICE REVENUE 41847737 41847737 ROOM AND BOARD 7546574 7546574 0 0 0 0 49394311 0 0 0 0 0 0 0 0 0 0 0 0 OTHER OPERATING REVENUE 402 402 0 0 0 0 402 49394713 49394713 0 0 0 0 0 0 220745 220745 0 21674316 19009047 2665269 346786 7834 338952 3467639 556 3467083 1443907 1197580 246327 0 91055 91055 66135 66135 0 0 0 8393030 8034561 358469 127619 33689 93930 2062782 1121563 941219 376672 2868 373804 0 2111752 1543378 568374 821272 781016 40256 0 60237 32441 27796 147456 147456 0 877972 877972 0 INPATIENT AND RESPITE 1928440 1928440 DRUGS 1835167 1835167 PATIENT SERVICES 1049872 1049872 CHEMO, RADIATION & THERAPY 602242 602242 OPERATIONAL SUPPORT 342189 342189 745710 660406 85304 0 48792995 39208277 9584718 0 0 1000 1000 3341669 1207480 886535 187609 320945 0 0 3662450 4634803 3851059 8298417 2946052 1780239 1707465 1780239 4653517 X 1108139 3367181 962681 277719 2070820 3644900 3851059 8298417 X 601718 972362 X false true true X false X 111082 111082 27704428 45993604 49394311 123092343 0 0 0 0 0 27704428 46104686 49394311 123203425 0 0 0 0 0 0 0 0 123203425 0 0 0 0 0 0 0 0 0 340 905 402 1647 0 0 27704768 46105591 49394713 123205072 X OTHER INCOME, PART III, LINE 12, 2008 - $340, 2009 - $905, 2010 - $402, 0 0 0 125634 5131 0 0 0 0 130765 125458 176 0 0 0 0 125634 80360 45098 0 0 0 0 125458 1.000 0.000 0.000 false true true 0 0 0 1207480 886535 320945 0 320945 BENEFICIAL INTEREST IN NET ASSETS OF HPC 4634803 4634803 0 AMOUNTS DUE TO RELATED PARTIES 1707465 1707465 49394713 48792995 601718 972362 972362 1574080 50367075 972362 972362 49394713 0 0 49394713 48792995 0 0 48792995 0 0 48792995 Intended uses of endowment funds Schedule D, Part V, Line 4 THE BUILDING ENDOWMENT FUND PROVIDES FUNDS FOR THE NECESSARY MAINTENANCE AND FACILITY UP-KEEP OF ALL HPC HEALTHCARE, INC. FACILITIES; THE CHILDREN'S ENDOWMENT FUND PROVIDES FUNDS FOR SPECIFIC EQUIPMENT AND STAFFING TO MEET THE NEEDS OF PEDIATRIC PATIENTS, GRIEVING CHILDREN AND FAMILIES; THE MEDICAL STUDENT ENDOWMENT PROVIDES FUNDS TO THE MEDICAL STUDENT PROGRAM THAT EDUCATES FUTURE PHYSICIANS ON THE IMPORTANCE OF END-OF-LIFE CARE. THESE ENDOWMENTS ARE HELD BY HPC HEALTHCARE, INC. AND THE PROGRAMS AND FACILITIES OF HPC HEALTHCARE, INC. SUPPORT GOOD SHEPHERD HOSPICE, INC. FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 GOOD SHEPHERD HOSPICE (GSH) HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS A NOT-FOR-PROFIT CORPORATION AND IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND ALSO FROM STATE INCOME TAXES UNDER THE PROVISIONS OF CHAPTER 220.13 OF THE FLORIDA INCOME TAX CODE. THE IRC PROVIDES FOR TAXATION OF UNRELATED BUSINESS INCOME UNDER CERTAIN CIRCUMSTANCES. GSH HAS NO SIGNIFICANT UNRELATED BUSINESS INCOME; HOWEVER SUCH STATUS IS SUBJECT TO FINAL DETERMINATION UPON EXAMINATION OF THE RELATED INCOME TAX RETURNS BY THE APPROPRIATE TAXING AUTHORITIES. Other changes in net assets Schedule D, Part XI, Line 8 CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF HPC - 972362; Other revenues in audited financial statements not in form 990 Schedule D, Part XII, Line 2d CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF HPC - 972362; X X X X false true false false false false false false false GEORGE H WALLACE 0 252151 0 40890 0 3337 0 139251 0 23836 0 459465 0 93916 H DARRELL WHITE 0 226782 0 29167 0 1137 0 101948 0 27809 0 386843 0 56171 KATHY L FERNANDEZ 0 399274 0 104810 0 173089 0 160726 0 24959 0 862858 0 104810 WILLIAM C BREDBENNER 164181 0 21499 0 504 0 30060 0 4501 0 220745 0 37559 0 RONALD S SCHONWETTER 0 359345 0 59617 0 1146 0 216851 0 31448 0 668407 0 140467 ANDREW LUTTON 0 168414 0 18402 0 504 0 89184 0 9193 0 285697 0 0 Supplemental nonqualified retirement plan Schedule J, Part I, Line 4b HPC HEALTHCARE, INC. (A RELATED ORGANIZATION) HAS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN WHICH SOME OF THE INTERESTED PERSONS PARTICIPATE. DURING 2010, THE FOLLOWING PAYMENTS WERE MADE BY HPC INTO THE SERP PLANS OF THE PARTICIPANTS: KATHY FERNANDEZ - $171,141 RONALD SCHONWETTER - $98,138 GEORGE WALLACE - $68,454 H. DARRELL WHITE - $34,005 ANDREW LUTTON - $42,571 WILLIAM BREDBENNER - $5,648 PROCESS OF DETERMINING COMPENSATION SCHEDULE J, PART I, LINE 3 THE PRESIDENT & CEO IS PAID BY HPC HEALTHCARE, INC. (A RELATED ORGANIZATION). HPC USES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO DETERMINE HER COMPENSATION. GOOD SHEPHERD HOSPICE, INC. RELIES ON HPC TO ENSURE COMPENSATION IS REASONABLE. PROGRAM SERVICES FORM 990, PART III, LINE 4A (CONTINUED FROM PART III) THESE HOSPICE SERVICES ARE AVAILABLE 24-HOURS-A-DAY, SEVEN-DAYS-A-WEEK, AND ARE TAILORED TO ADDRESS SPECIFIC PATIENT AND FAMILY NEEDS OR PREFERENCES AT ANY TIME DURING THE LENGTH OF CARE. IN ADDITION, THE ORGANIZATION PROVIDES PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, DIETARY COUNSELING, HOME HEALTH AIDE SERVICES, HOMEMAKER SERVICES AND INFUSION THERAPY AS NEEDED. GOOD SHEPHERD HOSPICE PROVIDES PATIENTS WITH ALL PRESCRIBED MEDICATIONS, MEDICAL SUPPLIES AND DURABLE MEDICAL EQUIPMENT, SUCH AS HOSPITAL BEDS, WALKERS AND OXYGEN EQUIPMENT RELATED TO THE HOSPICE DIAGNOSIS. THESE SERVICES AND EQUIPMENT ARE PROVIDED REGARDLESS OF RACE, COLOR, CREED, AGE, GENDER, SEXUAL ORIENTATION, RELIGION, NATIONAL ORIGIN, DISEASE DIAGNOSIS OR ABILITY TO PAY. IN ACCORDANCE WITH ITS CHARITY CARE POLICY, GOOD SHEPHERD HOSPICE PROVIDED $1,747,000 IN CHARITY CARE DURING THE YEAR ENDED DECEMBER 31, 2010. THIS AMOUNT IS MEASURED BY STANDARD RATES, WHICH ARE NOT BILLED OR COLLECTED BECAUSE THE PATIENT DOES NOT HAVE THE ABILITY TO PAY. THIS AMOUNT DOES NOT INCLUDE ANY CONTRACTUAL ADJUSTMENTS FOR MEDICARE, MEDICAID, OR ANY OTHER THIRD PARTY PAYOR SOURCES. B. HOSPICE IN-PATIENT FACILITIES - GOOD SHEPHERD HOSPICE OPERATES TWO HOSPICE HOUSES WHICH CAN ADMIT PATIENTS 24 HOURS PER DAY, SEVEN DAYS PER WEEK. THIS ALLOWS HOSPICE PATIENTS TO AVOID HOSPITAL EMERGENCY ROOMS AND THE POTENTIAL FOR UNWANTED OR UNNEEDED TESTS AND PROCEDURES. AT TIMES, PATIENTS REQUIRE A HIGHER LEVEL OF CARE THAN WHAT CAN BE PROVIDED AT HOME. THE HOSPICE HOUSES OFFER A "HOME AWAY FROM HOME;" THE FOCUS IS ON SPECIALIZED CARE IN A WARM HOME-LIKE ENVIRONMENT. FAMILY MEMBERS AND LOVED ONES CAN VISIT AND STAY WITH THEIR LOVED ONES IN A SERENE SETTING, AS OFTEN, AND FOR AS LONG AS THEY LIKE. THE HOSPICE HOUSE TEAMS ARE COMPOSED OF PHYSICIANS, NURSES, SOCIAL WORKERS, CHAPLAINS, NURSING ASSISTANTS, PHARMACISTS, DIETICIANS, THERAPISTS, AND TRAINED VOLUNTEERS. C. GRIEF COUNSELING - GOOD SHEPHERD HOSPICE OFFERS GRIEF COUNSELING AND BEREAVEMENT SERVICES TO THE COMMUNITY IN A VARIETY OF FORMATS. FACILITATED GROUP COUNSELING SESSIONS ALLOW GRIEVING INDIVIDUALS TO EXPRESS THEIR GRIEF WHILE RECEIVING SUPPORT FROM OTHERS IN SIMILAR SITUATIONS. THESE SESSIONS ARE OFFERED IN A VARIETY OF DAYS, TIMES, AND LOCATIONS. GRIEVING CHILDREN HAVE SPECIAL NEEDS; THEY ARE OFTEN TOO YOUNG TO UNDERSTAND OR EXPRESS THE PAIN THEY FEEL WITH THE LOSS OF A LOVED ONE. THE GOOD SHEPHERD HOSPICE BETHANY CENTER IS A SAFE PLACE WHERE GRIEVING CHILDREN CAN VISIT AND PARTICIPATE IN A NUMBER OF AGE-APPROPRIATE HANDS-ON ACTIVITIES THAT HELP THEM LEARN TO EXPRESS THEIR GRIEF. EACH YEAR, THE GOOD SHEPHERD HOSPICE CAMP BRAVE HEART GIVES YOUNGSTERS WHO HAVE LOST A LOVED ONE THE OPPORTUNITY TO MEET OTHER CHILDREN IN SIMILAR CIRCUMSTANCES, AND ENJOY THE GREAT OUTDOORS WHILE PARTICIPATING IN INDIVIDUAL AND GROUP ACTIVITIES DESIGNED TO BE OUTLETS FOR THEIR EMOTIONS. ALL OF THESE SERVICES ARE AVAILABLE TO EVERYONE IN THE COMMUNITY, NOT JUST THOSE WHOSE LOVED ONE DIED IN HOSPICE. D. VOLUNTEER SERVICES - GOOD SHEPHERD HOSPICE'S 530 TRAINED VOLUNTEERS PROVIDED $529,060 IN VOLUNTEER HOURS IN 2010. VOLUNTEERS UNDERGO A VIGOROUS TRAINING PROGRAM AND SCREENING PROCESS BEFORE MEETING WITH PATIENTS AND FAMILY MEMBERS. VOLUNTEERS SERVE IN A NUMBER OF ROLES, INCLUDING PATIENT COMPANION, CAREGIVER COMPANION, CAREGIVER RESPITE, OFFICE VOLUNTEER, SPECIAL EVENTS VOLUNTEER AND MANY MORE. E. CAREGIVER PROGRAM - THIS PROGRAM PROVIDES ASSISTANCE IN THE HOME BASED ON THE PATIENT AND FAMILY NEEDS, ON A SLIDING-FEE SCALE BASIS. THIS ENABLES PATIENTS TO STAY IN THEIR HOME AND IS AN INTERIM SUPPORT WHEN A PRIVATE CAREGIVER IS TO BE HIRED OR THE PATIENT IS WAITING FOR NURSING HOME PLACEMENT. F. CLINICAL PASTORAL EDUCATION (CPE) - ACCREDITED BY THE ASSOCIATION FOR CLINICAL PASTORAL EDUCATION, INC. (ACPE) TO OFFER PROGRAMS AT THE LEVEL I AND LEVEL II. THE ASSOCIATION FOR CLINICAL PASTORAL EDUCATION, INC. IS RECOGNIZED BY THE U.S. DEPARTMENT OF EDUCATION AS AN ACCREDITING AGENCY. CLINICAL PASTORAL EDUCATION IS INTERFAITH PROFESSIONAL EDUCATION FOR MINISTRY TO PERSONS WITH SPIRITUAL AND EMOTIONAL NEEDS. ALL CHAPLAINS EMPLOYED BY GOOD SHEPHERD ARE REQUIRED TO HAVE A MINIMUM OF ONE UNIT OF CPE. G. NATIONAL INSTITUTE FOR JEWISH HOSPICE (NIJH) ACCREDITATION - NIJH IS THE RESOURCE CENTER FOR HOSPICE CARE OF JEWISH PATIENTS. GOOD SHEPHERD HOSPICE PARTICIPATES IN ORDER TO EDUCATE STAFF, PHYSICIANS, NURSES, SOCIAL WORKERS, VOLUNTEERS, AND CHAPLAINS INVOLVED IN THE TREATMENT AND CARE OF TERMINALLY ILL JEWISH PATIENTS. GOOD SHEPHERD HOSPICE STAFF RECEIVES ANNUAL EDUCATION ON THE SPIRITUAL NEEDS OF JEWISH PATIENTS AND FAMILIES. HUMANE PALLIATIVE STRATEGIES THAT ARE TAILORED TO THE NEEDS OF JEWISH PATIENTS THAT TAKE INTO ACCOUNT THE CELEBRATION OF THE JEWISH HIGH HOLY DAYS AND OTHER NEEDS AND WISHES HAVE BEEN DEVELOPED. GOOD SHEPHERD HOSPICE STAFF RECEIVES EDUCATION ON JEWISH MEDICAL ETHICS, ADVANCE DIRECTIVES, LIVING WILLS, TREATMENT OF BODY AFTER DEATH, GLOSSARY OF JEWISH TERMS AND HOLY DAYS AND OBSERVANCE. H. HOSPICEHELP24 ® - GOOD SHEPHERD HOSPICE'S SPECIALIZED TRIAGE PROGRAM PROVIDES PATIENTS AND FAMILIES WITH DIRECT ACCESS TO HOSPICE PROFESSIONALS, INSTEAD OF HAVING THEM GO THROUGH AN ANSWERING SERVICE, LIKE MANY HOSPICES USE. GOOD SHEPHERD HOSPICE'S DEDICATED STAFF WORKS TO COORDINATE AND MEET THE NEEDS OF PATIENTS AND FAMILIES INCLUDING ACCESS TO ALL DISCIPLINES. PATIENT INFORMATION IS ACCESSIBLE BY COMPUTER TO ASSIST HOSPICE STAFF IN CARING FOR THE PATIENT AND FAMILY. I. JOINT COMMISSION ACCREDITATION - TO ENSURE THAT PATIENTS AND FAMILIES RECEIVE THE HIGHEST QUALITY OF END-OF-LIFE CARE, GOOD SHEPHERD HOSPICE UNDERGOES JOINT COMMISSION ACCREDITATION. JOINT COMMISSION ACCREDITATION IS NOT REQUIRED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES TO OBTAIN LICENSURE. GOOD SHEPHERD HOSPICE BELIEVES THAT UNDERGOING THIS VOLUNTARY ACCREDITATION PROCESS EVERY THREE YEARS REINFORCES THE COMPANY MISSION TO PROVIDE OUTSTANDING HOSPICE CARE. Classes of members or stockholders Form 990, Part VI, Section A, Line 6 THE ORGANIZATION HAS A SOLE MEMBER, HPC HEALTHCARE, INC. THAT BOTH ELECTS THE MEMBERS OF THE GOVERNING BODY OF GOOD SHEPHERD HOSPICE, INC. AND ALSO APPROVES CERTAIN SIGNIFICANT DECISIONS MADE BY THE GOVERNING BODY OF GOOD SHEPHERD HOSPICE, INC. Members or stockholders electing members of governing body Form 990, Part VI, Section A, Line 7a THE ORGANIZATION'S SOLE MEMBER, HPC HEALTHCARE, INC., NOMINATES AND ELECTS THE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS AND MAY APPOINT REPLACEMENT DIRECTORS WHEN VACANCY OCCURS. Decisions requiring approval by members or stockholders Form 990, Part VI, Section A, Line 7b WITHOUT THE WRITTEN APPROVAL OF THE ORGANIZATION'S SOLE MEMBER, HPC HEALTHCARE, INC., THE ORGANIZATION'S GOVERNING BODY IS NOT PERMITTED TO: (1) SELL, LEASE, OR DISPOSE OF ASSETS, MERGE, COMBINE OR OTHERWISE OR REORGANIZE WITH ANY OTHER ENTITY, CONVERT THE ORGANIZATION'S CORPORATE STRUCTURE TO ANOTHER FORM OR ENTER INTO ANY MANAGEMENT SERVICES AGREEMENT; (2) ENTER INTO ANY LOAN FACILITY, BORROW ANY FUNDS OR PLEDGE OR HYPOTHECATE ANY OR ALL OF ITS ASSETS AS SECURITY FOR ANY BORROWING; (3) CHANGE THE CHARACTER OR NATURE OF THE ORGANIZATION'S BUSINESS TO SOMETHING OTHER THAN THE OPERATION OF A HOSPICE; (4) REMOVE OR APPOINT THE PRESIDENT AND CEO OF THE ORGANIZATION; (5) EXECUTE ANY DEED, MORTGAGE, NOTE OR BOND; (6) ADOPT OR AMEND THE ANNUAL OPERATING AND/OR CAPITAL BUDGETS PROPOSED BY THE PRESIDENT AND CEO AND THE MANAGEMENT OF THE ORGANIZATION; (7) MAKE ANY CONTRIBUTION OR DISTRIBUTION OF ASSETS OR PROPERTY TO ANY PERSON; (8) DISSOLVE, LIQUIDATE OR OTHERWISE CAUSE THE ORGANIZATION TO CEASE TO EXIST AS A FLORIDA NOT-FOR-PROFIT CORPORATION WHICH IS EXEMPT FROM TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; (9) FORM ANY SUBSIDIARY CORPORATION; OR (10) ACQUIRE, ENJOY, UTILIZE, AND DISPOSE OF PATENTS, COPYRIGHTS, AND TRADEMARKS AND ANY LICENSES AND OTHER RIGHTS OR INTERESTS THEREUNDER OR THEREIN. Review of form 990 by governing body Form 990, Part VI, Section B, Line 11b THE ORGANIZATION RETAINS AN INDEPENDENT TAX ADVISOR TO ASSIST MANAGEMENT IN THE PREPARATION AND REVIEW OF ITS IRS FORM 990. PRIOR TO FILING THE RETURN, MANAGEMENT AND THE INDEPENDENT TAX ADVISOR REVIEW THE RETURN AND ALL REQUIRED SCHEDULES WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE IS COMPOSED OF INDEPENDENT DIRECTORS OF THE COMPANY. UPON COMPLETION OF ITS REVIEW, THE COMPENSATION COMMITTEE RECOMMENDS TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS THAT MANAGEMENT BE AUTHORIZED TO SIGN AND FILE THE RETURN. UNDER THE COMPANY'S BY LAWS THE EXECUTIVE COMMITTEE HAS THE AUTHORITY TO TAKE THIS ACTION ON BEHALF OF THE BOARD OF DIRECTORS. A COPY OF THE FORM 990 IS PROVIDED TO THE FULL BOARD PRIOR TO FILING WITH THE IRS AND THE EXECUTIVE COMMITTEE REPORTS ITS ACTIVITIES TO THE BOARD OF DIRECTORS ON A QUARTERLY BASIS. Conflict of interest policy Form 990, Part VI, Section B, Line 12c ANNUALLY, EACH OFFICER, DIRECTOR AND KEY EMPLOYEE SIGNS AN ACKNOWLEDGEMENT AND DISCLOSURE FORM ATTESTING THAT THEY HAVE READ THE CONFLICT OF INTEREST POLICY AND AGREEING TO COMPLY FULLY WITH ITS TERMS AND CONDITIONS DURING THEIR SERVICES WITH HPC HEALTHCARE, INC. AND AFFILIATES. THEY FURTHER AGREE THAT IF, AT ANY TIME SUBSEQUENT TO THE SUBMISSION OF THE DISCLOSURE FORM, THEY BECOME AWARE OF ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST OR THE INFORMATION PREVIOUSLY SUBMITTED BECOMES INACCURATE OR INCOMPLETE, THEY WILL PROMPTLY NOTIFY THE HPC BOARD OF DIRECTORS, THE PRESIDENT AND CEO OF HPC HEALTHCARE, INC., AND THE GOOD SHEPHERD HOSPICE BOARD OF DIRECTORS. DETERMINATION OF AND REMEDIES FOR CONFLICTS OF INTEREST 1. DISCLOSURE. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS (AND MEMBERS OF COMMITTEES) CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THE DISCLOSURE SHALL BE MADE AS SOON AS PRACTICABLE FOLLOWING THE REALIZATION BY THE INTERESTED PERSON THAT AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST EXISTS. ORDINARILY, DISCLOSURES BY INTERESTED PERSONS SHOULD BE TO THE CHAIRPERSON OF THE BOARD. WHEN AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST BECOMES APPARENT IN THE COURSE OF A BOARD MEETING (OR COMMITTEE MEETING), THE INTERESTED PERSON SHALL IMMEDIATELY DISCLOSE HIS OR HER FINANCIAL INTEREST AND RELATED MATERIAL FACTS TO THE PRESIDING DIRECTOR OR OFFICER AT SUCH MEETING. 2. DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, THE INTERESTED PERSON SHALL LEAVE THE BOARD (OR COMMITTEE) MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD (OR COMMITTEE) MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. 3. PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST. (A) AN INTERESTED PERSON WHO HAS A CONFLICT OF INTEREST MAY MAKE A PRESENTATION AT THE BOARD (OR COMMITTEE) MEETING, BUT AFTER SUCH PRESENTATION, HE OR SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULT IN THE CONFLICT OF INTEREST. THE INTERESTED PERSON WHO HAS A CONFLICT OF INTEREST WILL NOT BE COUNTED AS PRESENT FOR DETERMINING A MAJORITY WITH RESPECT TO THE VOTE ON THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. (B) THE CHAIRPERSON OF THE BOARD (OR COMMITTEE) SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. (C) AFTER EXERCISING DUE DILIGENCE, THE BOARD (OR COMMITTEE) SHALL DETERMINE WHETHER HPC AND AFFILIATES CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR BUSINESS ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. (D)IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD (OR COMMITTEE) SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS (OR COMMITTEE MEMBERS) WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF HPC AND AFFILIATES AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO HPC AND AFFILIATES AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY (A) IF THE BOARD (OR COMMITTEE) HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE INTERESTED PERSON OF THE BASIS FOR SUCH BELIEF AND AFFORD THE INTERESTED PERSON AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. (B) IF, AFTER HEARING THE RESPONSE OF THE INTERESTED PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED UNDER THE CIRCUMSTANCES, THE BOARD (OR COMMITTEE) DETERMINES THAT THE INTERESTED PERSON HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE SUCH ACTION AS IT DETERMINES TO BE APPROPRIATE, INCLUDING CORRECTIVE AND DISCIPLINARY ACTION. RECORD OF PROCEEDINGS THE MINUTES OF THE BOARD (AND EACH COMMITTEE) SHALL CONTAIN: 1. THE NAME OF EACH PERSON WHO DISCLOSED OR OTHERWISE WAS FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S (OR COMMITTEE'S) DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED. 2. THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORDS OF ANY VOTES TAKEN IN CONNECTION THEREWITH. PERIODIC REVIEWS TO ENSURE THAT HPC AND AFFILIATES OPERATE IN A MANNER CONSISTENT WITH THEIR CHARITABLE PURPOSES AND THAT THEY DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE THEIR STATUS AS ORGANIZATIONS EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEWS SHALL BE CONDUCTED. HPC AND AFFILIATES MAY, BUT NEED NOT, USE AN OUTSIDE ADVISOR TO CONDUCT A PERIODIC REVIEW. THE PERIODIC REVIEW SHALL INCLUDE, AT A MINIMUM, THE FOLLOWING SUBJECTS: 1. WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE AND ARE THE RESULTS OF ARM'S-LENGTH BARGAINING. 2. WHETHER AGREEMENTS TO PROVIDE HEALTH CARE AND AGREEMENTS WITH OTHER HEALTH CARE PROVIDERS, EMPLOYEES AND THIRD PARTY PAYERS FURTHER THE CHARITABLE PURPOSES OF HPC AND AFFILIATES AND DO NOT RESULT IN PRIVATE INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. Process used to establish compensation of top management official Form 990, Part VI, Section B, Line 15a THE ORGANIZATION ENGAGED AN INDEPENDENT COMPENSATION CONSULTANT TO ASSIST IN ESTABLISHING A COMPENSATION CHARTER THAT DETAILS THE ORGANIZATION'S PROCEDURES FOR SETTING COMPENSATION OF THE CEO AND ALL OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. THE COMPENSATION CHARTER ESTABLISHED THE COMPENSATION COMMITTEE, THE INDEPENDENT BODY RESPONSIBLE FOR ESTABLISHING THE COMPENSATION OF THE CEO AND ALL OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. THE COMPENSATION COMMITTEE RELIES ON A RECENT COMPENSATION STUDY PERFORMED BY AN INDEPENDENT COMPENSATION CONSULTANT, WHICH IS DONE ON AN ANNUAL BASIS, THAT PROVIDES COMPENSATION DATA FOR SIMILARLY QUALIFIED PERSONS IN COMPARABLE ORGANIZATIONS TO SUPPORT ITS DECISION-MAKING PROCESS AND REPORTS ITS ACTIVITIES TO THE BOARD OF DIRECTORS AT THE NEXT REGULARLY SCHEDULED MEETING. THE COMPENSATION COMMITTEE ADEQUATELY DOCUMENTS ITS COMPENSATION DETERMINATIONS IN THE MEETING MINUTES ON A TIMELY BASIS. THE CEO OF GOOD SHEPHERD HOSPICE, INC. IS PAID BY HPC HEALTHCARE, INC. Process used to establish compensation of other officers/key employees Form 990, Part VI, Section B, Line 15b SEE NARRATIVE FOR PART VI, LINE 15A Public Disclosure Form 990, Part VI, Section C, Line 19 THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE FILED WITH AND VIEWABLE BY THE PUBLIC AT THE OFFICIAL WEBSITE OF THE FLORIDA DEPARTMENT OF STATE, DIVISION OF CORPORATIONS. THE ORGANIZATION'S BYLAWS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. UNAUDITED FINANCIAL STATEMENTS OF THE ORGANIZATION ARE FILED AND VIEWABLE BY THE PUBLIC AT THE OFFICIAL WEBSITE OF THE STATE OF FLORIDA, DIVISION OF CONSUMER SERVICES. THE ORGANIZATION IS REQUIRED TO FILE ITS AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND OTHER FINANCIAL INFORMATION WITH ITS ANNUAL MEDICARE COST REPORT. THIS INFORMATION IS SUBJECT TO A PUBLIC RECORDS REQUEST. IN ADDITION, THE ORGANIZATION REPORTS ITS FINANCIAL PERFORMANCE EACH YEAR IN ITS ANNUAL REPORT, COPIES OF WHICH ARE AVAILABLE TO THE PUBLIC UPON REQUEST. Other changes in net assets or fund balances Form 990, Part XI, Line 5 CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF HPC - 972362; HPC HEALTHCARE INC 12973 TELECOM PARKWAY STE 100 TEMPLE TERRACE FL 33637 592264957 PARENT FL 501(C)(3) 11 - Type II NA LIFEPATH HOSPICE INC 12973 TELECOM PARKWAY STE 100 TEMPLE TERRACE FL 33637 205276870 HOSPICE CARE FL 501(C)(3) 9 HPC JUDGE ALVA CARVER FOUNDATION INC 12973 TELECOM PARKWAY STE 100 TEMPLE TERRACE FL 33637 200187631 SUPPORT FL 501(C)(3) N/A HPC false false false true false false false false false true false true false true true false false false