2023-03-29T12:27:00-05:00 2022-12-31 550621482 GRAY GRIFFITH & MAYS AC 707 VIRGINIA STREETEASTSUITE 400 CHARLESTON WV 253012711 990 2022-01-01 222432409 CHAUTAUQUA HOSPICE AND PALLIATIVE CARE CHAU 7163380033 20 W FAIRMOUNT AVE LAKEWOOD NY 14750 MIKE TESTA PRESIDENT/CEO 7163380033 2023-03-27 1 MIKE TESTA 999009999 0 J RYAN LINDSAY P01835061 3043459400 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MIKE TESTA 20 W FAIRMOUNT AVE LAKEWOOD NY 14750 6272329 0 X WWW.CHPC.CARE X 1981 NY CHPC'S MISSION IS TO PROVIDE COMPREHENSIVE PALLIATIVE/END-OF-LIFE CARE AND EDUCATION. 12 12 89 0 0 0 1318345 358750 5654480 4588846 31492 138980 594 -27381 7004911 5059195 0 0 0 0 3654283 3747443 0 0 57043 2114006 1859180 5768289 5606623 1236622 -547428 7044722 6102644 548545 483291 6496177 5619353 CHPC'S MISSION IS TO PROVIDE COMPREHENSIVE PALLIATIVE/END-OF-LIFE CARE AND EDUCATION. 0 0 3505078 4436136 HOSPICE PROGRAM: CHPC PROVIDES COMPASSIONATE, EXPERT END-OF-LIFE CARE TO RESIDENTS OF CHAUTAUQUA COUNTY, NEW YORK. HOSPICE SERVICES ARE AVAILABLE TO PATIENTS WHEREVER THEY CALL HOME, INCLUDING THEIR OWN HOME, AN ASSISTED LIVING FACILITY, A NURSING HOME, OR HOSPITAL 56528 0 BEREAVEMENT SERVICES: CHPC PROVIDES BEREAVEMENT SERVICES THROUGH HOSPICE BEREAVEMENT SUPPORT, COMMUNITY BEREAVEMENT SUPPORT, AND GRIEF SUPPORT GROUPS. 398414 154430 PALLIATIVE CARE: CHPC OFFERS COMMUNITY BASED PALLIATIVE CARE TO INDIVIDUALS WITH SERIOUS ILLNESS FOCUSING ON PAIN MANAGEMENT AND SYMPTOM CONTROL. THE FOCUS IS TO KEEP THE PATIENT COMFORTABLE, AT HOME AND IN CONTROL WHILE REDUCING HOSPITALIZATIONS AND EMERGENCY DEPARTMENT VISITS. 3960020 1 1 0 1 0 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 0 0 0 0 1 21 0 1 89 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X THE ORGANIZATION 7163380033 20 W FAIRMOUNT AVE LAKEWOOD NY 14750 CHARLES RICE CHAIRMAN 2.00 X X 0 0 0 DAVID DENGLER VICE CHAIRMAN 2.00 X X 0 0 0 ELLEN LUCZKOWIAK TREASURER 2.00 X X 0 0 0 CARMEN HLOSTA SECRETARY 2.00 X X 0 0 0 KATHIE CRACIUM-WRIGHT DIRECTOR 2.00 X 0 0 0 JOY BILHARZ DIRECTOR 2.00 X 0 0 0 JANESE BERKHOUSE DIRECTOR 2.00 X 0 0 0 SHAM BAHGAT DIRECTOR 2.00 X 0 0 0 MICHAEL WHITE DIRECTOR 2.00 X 0 0 0 DR MATTHEW WEHR DIRECTOR 2.00 X 0 0 0 LORI THIERFELDT DIRECTOR 2.00 X 0 0 0 ANN ECKMAN DIRECTOR 2.00 X 0 0 0 RENEE MOULTON VP FINANCE TERM. 11/2022 37.50 X 85321 0 10958 SHAUNA ANDERSON PRES/CEO TERM. 6/2022 37.50 X 68995 0 0 MICHAEL TESTA PRES/CEO EFF. 7/2022 37.50 X 64631 0 7168 DR THOMAS PUTNAM MEDICAL DIRECTOR 37.50 X 193739 0 4320 412686 0 22446 1 0 1 0 0 86506 32295 239949 358750 HOSPICE / HOME CARE 621610 3912638 3912638 ROOM AND BOARD 621610 521778 521778 PALLIATIVE CARE 621610 154430 154430 4588846 25305 25305 1259016 1145341 113675 113675 113675 38692 86506 67793 -29101 -29101 MISCELLANEOUS 900099 1720 1720 1720 5059195 4590566 0 109879 412686 139481 273205 2696072 1819721 828740 47611 327424 225761 97452 4211 311261 185191 120849 5221 12036 12036 244457 221819 22638 137751 86840 50911 117356 73982 43374 67302 42428 24874 29400 18534 10866 140576 122828 17748 24961 15427 9534 20 13 7 71780 45251 26529 27147 17114 10033 NURSING HOME CONTRACT 553479 553479 DRUGS 160492 160492 MEDICAL EQUIPMENT AND S 120325 120325 TELEPHONE 51194 30979 20215 100904 80355 20549 5606623 3960020 1589560 57043 2084618 1085582 6178 6181 435442 195852 417283 444693 32449 27167 3315051 339222 2589690 2975829 1460397 1257720 18665 109620 7044722 6102644 548545 389005 0 94286 548545 483291 X 6356177 5619353 140000 0 6496177 5619353 7044722 6102644 -547428 -329396 0 X X 0 1 X 0 0 X 203196 429529 1734382 1326334 329649 4023090 5038853 5397283 5969343 5654480 4588846 26648805 5242049 5826812 7703725 6980814 4918495 30671895 0 0 0 30671895 150696 38610 73382 31492 138980 433160 150696 38610 73382 31492 138980 433160 1615 594 1720 3929 5392745 5865422 7778722 7012900 5059195 31108984 0.98590 0.98910 0.01390 0.01090 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 741 741 0 PART II-B, LINE 1: THE ORGANIZATION PAYS DUES TO HOSPICE & PALLIATIVE CARE ASSOCIATION OF NYS. HPCANYS PARTICIPATES IN LOBBYING ACTIVITIES AND THE AMOUNT REPORTED ABOVE REPRESENTS THE PORTION OF DUES ALLOCATED FOR LOBBYING ACTIVITIES 160036 160036 3013001 246746 2766255 142014 92476 49538 2975829 LEASE LIABILITY 94286 94286 X 4785556 -329396 67793 -261603 5047159 12036 12036 5059195 5662380 67793 67793 5594587 12036 12036 5606623 PART X, LINE 2: THE AGENCY IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND FORM NEW YORK STATE INCOME TAXES UNDER ARTICLE 7-A OF THE EXECUTIVE LAW. THEREFORE, NO PROVISION HAS BEEN MADE FOR FEDERAL OR NEW YORK STATE INCOME TAXES IN THE FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: DIRECT COST OF FUNDRAISING EVENTS NETTED AGAINST REVENUE ON 990 67,793. PART XII, LINE 2D - OTHER ADJUSTMENTS: DIRECT COST OF FUNDRAISING EVENTS NETTED AGAINST REVENUE ON 990 67,793. AUCTION 26396 21671 4725 22464 GALA 28617 20085 8532 28781 13 70185 44750 25435 16548 125198 86506 38692 67793 67793 -29101 X X X 0 0 0 0 0 0 0 0 0 DR THOMAS PUTNAM MEDICAL DIRECTOR 193739 0 0 0 0 0 0 0 4320 0 198059 0 0 0 PART I, LINE 3 THE COMPENSATION COMMITTEE IS MADE UP OF THE EXECUTIVE COMMITTEE MEMBERS OF THE BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE UTILIZES A WRITTEN ANALYSIS WHICH INCLUDES DATA ON SALARY RANGES AND AVERAGE PERFORMANCE INCREASES OF SIMILARLY QUALIFIED PERSONS IN COMPARABLE POSITIONS AT SIMILAR ORGANIZATIONS. FORM 990, PART VI, SECTION B, LINE 11B A DRAFT COPY OF THE 990 IS DISTRIBUTED AND PRESENTED TO THE BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C INDIVIDUALS ARE TO COMMUNICATE CONFLICTS AS THEY OCCUR AND ABSTAIN FROM VOTES AS APPROPRIATE FORM 990, PART VI, SECTION B, LINE 15 THE WAGE AND COMPENSATION SUB COMMITTEE SHALL CONSIST OF BOARD REPRESENTATION, THE PRESIDENT/CEO, VP OF CLINICAL SERVICES, VP OF FINANCE AND HUMAN RESOURCES. THIS COMMITTEE WILL MEET BIANNUALLY OR AS INDICATED TO REVIEW WAGES AND COMPENSATION. THE COMMITTEE WILL REPORT RECOMMENDATIONS TO THE FINANCE COMMITTEE, EXECUTIVE COMMITTEE, AND BOARD FOR REVIEW AND FOLLOW UP. FORM 990, PART VI, SECTION C, LINE 18 THE IRS FORM 990 IS MADE AVAILABLE UPON REQUEST FORM 990, PART VI, SECTION C, LINE 19 THE DOCUMENTS ARE MADE AVAILABLE UPON REQUEST AT THE MAIN OFFICE OF THE ORGANIZATION. FORM 990, PART XII, LINE 2C: THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR SELECTION AND OVERSIGHT OF THE INDEPENDENT AUDITOR. THIS PROCESS HAS NOT CHANGED.