2024-08-08T19:46:10-05:00 2023-09-30 440160260 FORVIS LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2022-10-01 593583920 COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION FOR CARING INC COMM 9042685200 4266 SUNBEAM ROAD JACKSONVILLE FL 32257 ANDREA FRITZ SR. VP OF FINANCE 9042685200 2024-08-08 1 1 AMY BIBBY P00445891 8282542254 2024-08-08 2022 2024-08-08 14:25:15Z SEE SCH O DISCLOSURE SUSAN PONDER-STANSEL 4266 SUNBEAM ROAD JACKSONVILLE FL 32257 7187676 0 X N/A X 1984 FL ADVANCING PHILANTHROPY TO ENABLE COMMUNITY HOSPICE OF NORTHEAST FLORIDA TO FULFILL ITS MISSION AND VISION OF CARE, RESEARCH AND EDUCATION. 24 23 16 41 0 0 2306989 5465443 0 0 985229 1540228 215033 -72452 3507251 6933219 1186800 2337536 0 0 1314597 1251833 0 0 55065 517380 505956 3018777 4095325 488474 2837894 20627818 22851102 1426250 645389 19201568 22205713 THE ORGANIZATION WAS ORGANIZED AND EXISTS FOR THE PURPOSE OF SOLICITING AND MANAGING THE CHARITABLE CONTRIBUTIONS SOLEY FOR THE USE IN FUNDING THE OPERATIONS, CAPITAL EXPENDITURES AND SPECIAL PROGRAMS OF COMMUNITY HOSPICE OF NORTHEAST FLORIDA, INC. 0 0 3498549 2337536 THE COMMUNITY HOSPICE & PALLIATIVE CARE FOUNDATION IS DEDICATED TO ENABLING COMMUNITY HOSPICE & PALLIATIVE CARE TO FULFILL ITS MISSION AND VISION. FUNDS RAISED THROUGH THE FOUNDATION ENHANCE THE QUALITY OF LIFE FOR PATIENTS AND FAMILIES AND SUPPORT UNFUNDED AND UNDER-FUNDED PATIENT CARE, OUTREACH PROGRAMS, AND SERVICES FOR THOSE FACING ADVANCED ILLNESS AND GRIEF. DONOR SUPPORT PROVIDES COMMUNITY PROGRAMS AND COMPASSIONATE CARE TO ALL WHO NEED IT, REGARDLESS OF ABILITY TO PAY. 3498549 1 1 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 13 0 1 16 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 24 23 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 FL X X ANDREA FRITZ 9042685200 4266 SUNBEAM ROAD JACKSONVILLE FL 32257 JASON OSBORNE CHAIR 2.00 X X 0 0 0 FONTAINE LEMAISTRE IV VICE CHAIR 2.00 X X 0 0 0 MARK BAILEY TREASURER 2.00 X X 0 0 0 SUSAN MONAHAN OD FAAO SECRETARY 2.00 X 0 0 0 CHARLIE ARNOLD DIRECTOR 1.00 X 0 0 0 MICHAEL ASSAF DIRECTOR 1.00 X 0 0 0 LOU CALDROPOLI DIRECTOR 1.00 X 0 0 0 BRET CATTO DIRECTOR 1.00 X 0 0 0 JENNIFER CLEEK DIRECTOR 1.00 X 0 0 0 BRIAN COUGHLIN DIRECTOR 1.00 X 0 0 0 WILL COURTNEY DIRECTOR 1.00 X 0 0 0 MAT HUGO DIRECTOR 1.00 X 0 0 0 NANCY LANTINBERG DIRECTOR 1.00 X 0 0 0 NEILL LASHER DIRECTOR 1.00 X 0 0 0 TREY MILLS DIRECTOR 1.00 X 0 0 0 MARCIA MORALES EMERITUS 1.00 X 0 0 0 SUSAN PONDER-STANSEL PRESIDENT & CEO ALIVIA CARE, INC., EX-OFFICIO 3.00 37.00 X X 0 541122 45853 SHEILA RICE DIRECTOR 1.00 X 0 0 0 KEVIN ROBBINS EX-OFFICIO 1.00 2.00 X 0 0 0 MICHAEL RUBLE DIRECTOR 1.00 X 0 0 0 REBECCA SCHWAM DIRECTOR 1.00 X 0 0 0 PAMELA STEITZ DIRECTOR 1.00 X 0 0 0 UNNI THOMAS MD DIRECTOR 1.00 X 0 0 0 CRAIG WALKER DIRECTOR 1.00 X 0 0 0 PHILLIP WARD CEO 2.00 38.00 X 0 420018 37179 GREGORY DIXON FORMER CFO ALIVIA CARE 0.00 0.00 X 0 329722 18213 0 1290862 101245 0 1 1 0 0 4394 411409 5049640 73715 5465443 455664 455664 1084564 0 1084564 1084564 1084564 177935 411409 177935 0 76522 -76522 -76522 MISCELLANEOUS INCOME 900099 4070 4070 4070 6933219 0 0 1467776 2337536 2337536 95108 47554 47554 1035105 748495 286610 11543 7644 3413 486 62489 41384 18476 2629 47588 31516 14070 2002 7570 7570 25508 25508 138510 138510 34015 34015 80498 80498 117414 115020 2394 406 406 9972 9972 239 239 12516 12516 6835 6835 BAD DEBT EXPENSE 48500 48500 MISCELLANEOUS EXPENSE 23973 23973 4095325 3498549 541711 55065 500 500 2078496 1482289 1627614 2739751 267114 291024 84143 10905547 12602358 5735633 5497625 12914 153412 20627818 22851102 1174289 89512 251961 555877 1426250 645389 X 11776352 13242647 7425216 8963066 19201568 22205713 20627818 22851102 X 2837894 716801 -550550 X X 0 1 X 1 0 X X 1 COMMUNITY HOSPICE OF NORTHEAST FLORIDA INC 591940256 10 1 2337536 0 1 2337536 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5060507 3789 546058 238331 5372023 6388990 -1001 -1090151 237331 5060507 5599617 112375 903037 226039 6388990 5284291 43029 473834 201537 5599617 5373183 44481 252037 385410 5284291 0.86000 0.14000 0 0 0 ENDOWMENT-RELATED INVESTMENTS 5253098 F SPLIT-INTEREST AGREEMENT 244527 F 5497625 DUE TO AFFILIATE 419494 LEASE LIABILITY 136383 555877 X 7037456 716801 -550550 166251 6871205 138510 -76496 62014 6933219 4033311 0 4033311 138510 -76496 62014 4095325 PART V, LINE 4: THE ORGANIZATION'S PATIENT CARE ENDOWMENT IS USED FOR ASSISTING WITH PATIENT CARE NEEDS OF THE COMMUNITY HOSPICE OF NORTHEAST FLORIDA, A RELATED ORGANIZATION. THE ORGANIZATION'S PEDIATRIC CARE ENDOWMENT IS USED TO FUND THE PEDIATRIC PROGRAM. PART X, LINE 2: COMMUNITY HOSPICE OF NORTHEAST FLORIDA AND ITS AFFILIATES ARE NOT-FOR-PROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPICE FOLLOWS THE FINANCIAL ACCOUNTING STANDARDS BOARD'S 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 MEET A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT IN ORDER FOR THE BENEFIT 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, 2023. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN SPLIT INTEREST AGREEMENT -550,550. PART XI, LINE 4B - OTHER ADJUSTMENTS: THRIFT STORE EXPENSES -76,496. PART XII, LINE 4B - OTHER ADJUSTMENTS: THRIFT STORE EXPENSES -76,496. HALLOWEEN DOORS & MORE 304115 246729 57386 57386 DERBY RUN REVENUE 78884 46922 31962 31962 9 206345 117758 88587 88587 589344 411409 177935 177935 177935 0 1 COMMUNITY HOSPICE OF NORTHEAST FLORIDA INC 4266 SUNBEAM ROAD JACKSONVILLE FL 32257 591940256 501(C)(3) 2337536 0 ASSISTANCE WITH OPERATIONS, CAPITAL EXPENDITURES AND SPECIAL PROGRAMS 1 0 PART I, LINE 2: THE COMMUNITY HOSPICE OF NORTHEAST FLORIDA FOUNDATION IS A SUPPORTING ORGANIZATION OF THE COMMUNITY HOSPICE OF NORTHEAST FLORIDA (ITS SOLE MEMBER). MONITORING OF FUNDS IS MAINTAINED THROUGH HIGH OVERLAP OF THE TWO ORGANIZATIONS' MANAGEMENT AND GOVERNING BODIES. 1 0 0 0 0 0 0 0 0 SUSAN PONDER-STANSEL PRESIDENT & CEO ALIVIA CARE, INC., E 0 500000 0 28030 0 13092 0 16470 0 29383 0 586975 0 0 PHILLIP WARD CEO 0 385445 0 13138 0 21435 0 16470 0 20709 0 457197 0 0 GREGORY DIXON FORMER CFO ALIVIA CARE 0 198568 0 0 0 131154 0 4062 0 14151 0 347935 0 0 PART I, LINE 3 THE PROCESS USED TO ESTABLISH COMPENSATION FOR THE PRESIDENT/CEO WAS UNDERTAKEN BY A RELATED ORGANIZATION. THIS PROCESS INCLUDED THE USE OF A COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, FORM 990S OF OTHER ORGANIZATIONS, COMPENSATION STUDIES/SURVEY, AND THE APPROVAL BY THE BOARD/COMMITTEE. PART I, LINE 4A GREGORY DIXON RECEIVED A SEVERANCE PAYMENT DURING THE FISCAL YEAR OF $131,154. X CHRISTMAS GIFTS AND CARDS 2 25250 FMV X CONTRUCTION SUPPLIES 1 11032 FMV X PATIO RENTAL, BAR PACKAGE, BARTENDER/TI 1 10433 FMV X MULTIPLE DME ITEMS 1 9000 FMV X USE OF BARN 1 7000 FMV X PASTA STATION FOR 400 GUESTS 1 6000 FMV X MARKETING SERVICES 1 5000 FMV 0 1 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S SOLE MEMBER IS THE COMMUNITY HOSPICE OF NORTHEAST FLORIDA, INC., A 501(C)(3) ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A AT LARGE DIRECTORS SHALL BE ELECTED BY THE BOARD OF DIRECTORS OF COMMUNITY HOSPICE OF NORTHEAST FLORIDA, INC. (THE SOLE MEMBER) AT ANY MEETING OF THE BOARD OF DIRECTORS OF THAT ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B 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 AUDIT 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. ANY PERSON DETERMINED TO HAVE A CONFLICT OF INTEREST IS REQUIRED TO RECUSE THEMSELVES FROM ANY VOTE RELATED TO THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMMITTEE OF THE BOARD REVIEWS AND MAKES DECISIONS ANNUALLY REGARDING COMPENSATION FOR EXECUTIVE STAFF. THE EXECUTIVE COMMITTEE RETAINED AN INDEPENDENT CONSULTANT TO CONDUCT A COMPREHENSIVE REVIEW OF THE COMPETITIVENESS AND REASONABLENESS OF THE COMPENSATION AND BENEFITS PROVIDED TO THE FOLLOWING POSITIONS: CEO, CFO, VICE PRESIDENT AND EXECUTIVE DIRECTOR OF PHILANTHROPY. A REVIEW OF COMPETITIVENESS AND REASONABLENESS FOR LIKE ORGANIZATIONS TO INCLUDE NOT-FOR-PROFIT POST ACUTE CARE PROVIDERS AND HOSPITALS OF COMPARABLE SIZE, REGARDLESS OF GEOGRAPHY WAS CONDUCTED. TARGET MARKET AT MEDIAN. 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. FORM 990, PART XI, LINE 9: NET ASSET TRANSFER TO PARENT CHANGE IN SPLIT INTEREST AGREEMENT -550,550. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. FORM 990, SECTION B: THE ORGANIZATION IS DOING BUSINESS AS COMMUNITY HOSPICE & PALLIATIVE CARE FOUNDATION. COMMUNITY HOSPICE OF NORTHEAST FLORIDA 4266 SUNBEAM RD JACKSONVILLE FL 32257 591940256 HOSPICE & PALLIATIVE CARE FL 501(C)(3) LINE 10 ALIVIA CARE INC 0 HOSPICE OF GOLDEN ISLES INC 1692 GLYNCO PKWY BRUNSWICK GA 31525 581428562 HOSPICE & PALLIATIVE CARE GA 501(C)(3) LINE 7 ALIVIA CARE OF GEORGIA INC 0 HOSPICE SATILLA 808 EVERGREEN WAY WAYCROSS GA 31501 581741612 HOSPICE & PALLIATIVE CARE GA 501(C)(3) LINE 3 ALIVIA CARE OF GEORGIA INC 0 ALIVIA CARE INC 4266 SUNBEAM RD JACKSONVILLE FL 32257 844695341 LEADERSHIP SUPPORT FOR HOSPICE & PALLIATIVE CARE FL 501(C)(3) LINE 10 N/A 0 ALIVIA CARE OF GEORGIA INC 4266 SUNBEAM RD JACKSONVILLE FL 32257 850842222 LEADERSHIP SUPPORT FOR HOSPICE & PALLIATIVE CARE FL 501(C)(3) LINE 10 ALIVIA CARE INC 0 ALIVIA CARE SOLUTIONS INC 4266 SUNBEAM RD JACKSONVILLE FL 32257 852777461 HOSPICE & PALLIATIVE CARE FL 501(C)(3) LINE 10 ALIVIA CARE INC 0 PACE PARTNERS FOR NORTHEAST FLORIDA INC 4266 SUNBEAM RD JACKSONVILLE FL 32257 364861283 PROGRAM FOR NURSING HOME PATIENTS FL 501(C)(3) LINE 12A, I COMMUNITY HOSPICE OF NORTHEAST FLORIDA 0 0 1 0 1 0 0 0 0 1 0 1 1 0 1 1 1 0 1 1 SCHEDULE R, PART VII THE COMMUNITY MANAGEMENT COMPANY OF NORTHEAST FLORIDA, INC. WAS ESTABLISHED IN DECEMBER 2012 AND IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE AND EDUCATIONAL PURPOSES, INCLUDING THE PROVISION OF PALLIATIVE CARE SERVICES AND OTHER HEALTH SERVICES TO IMPROVE THE HEALTH SERVICES OF THE PEOPLE IN THE COMMUNITY IT SERVES. AS OF SEPTEMBER 30, 2019, COMMUNITY MANAGEMENT COMPANY OF NORTHEAST FLORIDA, INC. HAD NOT ENGAGED IN ANY FINANCIAL TRANSACTIONS AND THEIR APPLICATION FOR EXEMPTION WAS STILL IN THE PROCESS.