2023-09-06T07:20:49-05:00 2022-12-31 561031342 WILLIAMS OVERMAN PIERCE LLP 2501 ATRIUM DRIVE SUITE 500 RALEIGH NC 27607 990 2022-01-01 581453827 HOSPICE OF THE PIEDMONT INC HOSP 3368787428 1801 WESTCHESTER DRIVE HIGH POINT NC 27262 WILLIAM T COCKERHAM PRESIDENT & CEO 3368787428 2023-08-29 1 WILLIAM COCKERHAM XXX-XX-XXXX 0 BRIAN SCHEPPERLEY CPA P01332750 9197823444 2023-08-29 X 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z WILLIAM T COCKERHAM 1801 WESTCHESTER DRIVE HIGH POINT NC 27262 34314640 0 X WWW.HOSPICEOFTHEPIEDMONT.ORG X 1981 NC TO PROVIDE PALLIATIVE CARE TO PATIENTS WITH A PROGNOSIS OF SIX MONTHS OR LESS. 21 21 256 123 0 0 2095887 5400123 22301421 22980454 896853 473358 9587 36437 25303748 28890372 0 0 0 0 15297134 15604170 0 0 525851 8543266 10574839 23840400 26179009 1463348 2711363 40332450 40427930 2190622 2893918 38141828 37534012 X TO PROVIDE COMPASSIONATE INTERDISCIPLINARY PALLIATIVE CARE TO PATIENTS WITH A PROGNOSIS OF SIX MONTHS OR LESS. THIS CARE IS PROVIDED IN THE PATIENT'S HOME, NURSING AND ASSISTED LIVING FACILITIES IN THE PIEDMONT TRIAD OF NORTH CAROLINA, 18-BED HOSPITAL FACILITY IN HIGH POINT, OR IN THE ORGANIZATION'S 16-BED FACILITY IN ASHEBORO. 0 0 6850914 17793777 HOSPICE HOMECARE: AN INTERDISCIPLINARY TEAM APPROACH TO END-OF-LIFE CARE THAT ADDRESSES THE PHYSICAL, EMOTIONAL, AND SPIRITUAL NEEDS OF INDIVIDUALS FACING A LIFE-LIMITING ILLNESS AND PROGNOSIS OF SIX MONTHS OR LESS. CARE IS PALLIATIVE IN NATURE, SEEKING COMFORT RATHER THAN CURE. 13626642 5177380 HOSPICE FACILITY CARE: HOSPICE HOME AT HIGH POINT AND THE RANDOLPH HOSPICE HOUSE PROVIDE CARE IN A HOME-LIKE SETTING FOR THOSE WHO NEED MORE SKILLED CARE FOR SYMPTOM MANAGEMENT, WHO MAY NOT HAVE A CAREGIVER AT HOME, OR WHOSE PRIMARY CAREGIVER NEEDS A BRIEF RESPITE. 792611 9297 PIEDMONT PALLIATIVE CARE SERVICES (PPCS): PHYSICIANS AND NURSE PRACTITIONERS CERTIFIED IN PALLIATIVE MEDICINE PROVIDE SYMPTOM MANAGEMENT CONSULTATIONS TO PATIENTS. PPCS ALSO DEVELOPS A HOME-BASED INTERDISCIPLINARY PALLIATIVE CARE VISITING PROGRAM (CARE CONNECTION). 223207 GRIEF COUNSELING CENTER: PROVIDES SPIRITUAL CARE, COUNSELING AND SPECIALIZED GRIEF SUPPORT TO PATIENTS, FAMILY MEMBERS AND CAREGIVERS. THIS SERVICE IS PROVIDED THROUGH MAILINGS, PHONE CALLS, INDIVIDUAL SESSIONS AND SUPPORT GROUPS FOR 13 MONTHS FOLLOWING THE DEATH OF A HOSPICE PATIENT. THE GRIEF COUNSELING CENTER IS ALSO AVAILABLE TO MEMBERS OF THE COMMUNITY WHO HAVE EXPERIENCED A LOSS BY DEATH. 143465 KIDSPATH: THIS IS A SPECIALIZED PEDIATRIC PROGRAM OFFERING HOSPICE CARE AND COUNSELING SERVICES TO CHILDREN AND TEENS FACING A LIFE LIMITING ILLNESS WHICH WILL MOST LIKELY PREVENT THEM FROM REACHING THE AGE OF 18. KIDSPATH COUNSELING SERVICES ARE ALSO AVAILABLE TO CHILDREN AND TEENS WHO ARE DEALING WITH THE LOSS OF A LOVED ONE THROUGH DEATH. 366672 21636839 1 1 0 0 0 0 0 0 0 0 1 1 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 70 0 1 256 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 21 21 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 NC X BARRY LEONARD CFO 3368898446 1801 WESTCHESTER DRIVE HIGH POINT NC 27262 VICKIE GALLIMORE BOARD MEMBER 1.00 X 0 0 0 STEVE HEADLEE BOARD MEMBER 1.00 X 0 0 0 MATT JOBE BOARD MEMBER 1.00 X 0 0 0 STEPHANIE JOHNSON BOARD MEMBER 1.00 X 0 0 0 CONNIE LINEBERRY BOARD MEMBER 1.00 X 0 0 0 DUDLEY MOORE BOARD MEMBER 1.00 X 0 0 0 DEAN SEXTON BOARD MEMBER 1.00 X 0 0 0 RHONDA TROLLINGER BOARD MEMBER 1.00 X 0 0 0 JIM WEHRLEY BOARD MEMBER 1.00 X 0 0 0 STAN BECK BOARD MEMBER 1.00 X 0 0 0 ANGELA JIMENEZ BOARD MEMBER 1.00 X 0 0 0 JEFF MILLER BOARD MEMBER 1.00 X 0 0 0 JOEY MILLIKAN BOARD MEMBER 1.00 X 0 0 0 CARLOS OLVERA BOARD MEMBER 1.00 X 0 0 0 SUSAN MORRIS WOOD BOARD MEMBER 1.00 X 0 0 0 BONNIE FAUST BOARD MEMBER 1.00 X 0 0 0 COURTNEY BEST BOARD MEMBER 1.00 X 0 0 0 JENNIFER CONRAD BOARD MEMBER 1.00 X 0 0 0 PAULA CORREA BOARD MEMBER 1.00 X 0 0 0 MARY POWELL DELILLE BOARD MEMBER 1.00 X 0 0 0 ANGELA MCGILL BOARD MEMBER 1.00 X 0 0 0 SUSAN COX CHIEF NURSING OFFICER 40.00 X 145411 0 19652 WILLIAM COCKERHAM PRESIDENT & CEO 40.00 X 229581 0 14714 BARRY LEONARD CFO 40.00 X 160914 0 12098 AMY BARUCH HOSPICE & PALLIATIVE SPECIALIST 40.00 X 253753 0 46712 HOMA MAGSI CHIEF MEDICAL OFFICER 40.00 X 261012 0 25438 SCOTT MURKIN ASSOCIATE MEDICAL DIRECTOR 40.00 X 228349 0 30972 PATRICIA SHELVIN MD ASSOCIATE MEDICAL DIRECTOR 40.00 X 215344 0 31684 KAREN CROSS HOSPICE & PALLIATIVE SPECIALIST 40.00 X 195913 0 31801 1690277 0 213071 8 0 1 0 WESLEYAN ARMS INC 1795 WESTCHESTER DR HIGH POINT NC 27262 NURSING FACILITY SERVICES 996080 OPTUM HOSPICE PHARMACY SERVICE 9900 BREN RD E MINNETONKA MN 55343 HOSPICE PHARMACY SERVICES 666584 PALMETTO OXYGEN PO BOX 749055 LOS ANGELES CA 90074 DURABLE MEDICAL EQUIPMENT SERVICES 536020 GRAYBRIER NURSING & RETIREMENT CENTER 116 LANE DR TRINITY NC 27370 NURSING FACILITY SERVICES 426242 NC HEALTHCARE ARCHDALE INC 625 ASHLAND ST ARCHDALE NC 27263 NURSING FACILITY SERVICES 418466 5 91048 146150 4500357 662568 5400123 OTHER THIRD PARTY PROVIDER PAYMEN 900099 22980454 22980454 22980454 610686 610686 5265810 5403138 -137328 -137328 -137328 57567 146150 21130 36437 36437 28890372 22980454 0 509795 1903347 1608987 256151 38209 10687529 9028107 1444489 214933 2136602 1816558 277758 42286 876692 745188 113970 17534 6733 443 6276 14 78830 5187 73484 159 40768 40768 832165 54751 775734 1680 207460 165744 41716 139587 15470 101235 22882 413519 334354 77172 1993 354185 303217 50968 714053 378448 228497 107108 277854 131424 144755 1675 PARTICIPANT SERVICES & 6106090 6106090 CLEANING & MAINTENANCE 791013 564536 215615 10862 UNCOLLECTIBLE ACCOUNTS 337082 337082 CONTRACTED STAFF 105958 105958 169542 101039 43703 24800 26179009 21636839 4016319 525851 8436093 6651709 5266896 5230567 50905 24966 2195786 6663663 176510 85918 18213881 8996685 9628475 9217196 14347326 12121299 230459 432612 40332450 40427930 2190622 2625007 0 268911 2190622 2893918 X 37663492 37166820 478336 367192 38141828 37534012 40332450 40427930 X 2711363 -3270017 -49162 X X 0 1 X 1 1 1 X 775378 2820360 3757521 2095887 5400123 14849269 11928778 15250311 24542842 22301421 22980454 97003806 12704156 18070671 28300363 24397308 28380577 111853075 10690 2095674 11355 30922 16065 2164706 0 10690 2095674 11355 30922 16065 2164706 109688369 218792 259419 292417 466166 610686 1847480 218792 259419 292417 466166 610686 1847480 -2243 968 -1275 12920705 18331058 28592780 24863474 28991263 113699280 0.96470 0.96300 0.01620 0.01460 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME/MISCELLANEOUS RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 931199 931199 12102860 5105541 6997319 4101488 2964114 1137374 1078334 927030 151304 9217196 INVESTMENTS 12121299 F 12121299 OPERATING LEASE LIABILITIES 155026 FINANCING LEASE LIABILITIES 113885 268911 X 25530425 -3270017 -49162 -3319179 28849604 40768 40768 28890372 26138241 0 26138241 40768 40768 26179009 PART X, LINE 2: MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE ORGANIZATION, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2022 AND 2021, THERE WERE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR TAX YEARS PRIOR TO 2019. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUST -49,162. X X TASTE OF THE TOWN 108855 95150 13705 2860 5652 RANDOLPH AUCTION & BARBEQUE 71062 44250 26812 2286 7186 1 23800 6750 17050 2555 591 203717 146150 57567 2860 4841 13429 21130 36437 X X X 0 0 0 0 0 0 0 0 0 AMY BARUCH HOSPICE & PALLIATIVE SPECIALIST 253753 0 0 0 0 0 31494 0 15218 0 300465 0 0 0 HOMA MAGSI CHIEF MEDICAL OFFICER 261012 0 0 0 0 0 20488 0 4950 0 286450 0 0 0 SCOTT MURKIN ASSOCIATE MEDICAL DIRECTOR 228349 0 0 0 0 0 26988 0 3984 0 259321 0 0 0 PATRICIA SHELVIN MD ASSOCIATE MEDICAL DIRECTOR 215344 0 0 0 0 0 27000 0 4684 0 247028 0 0 0 WILLIAM COCKERHAM PRESIDENT & CEO 229581 0 0 0 0 0 10959 0 3755 0 244295 0 0 0 KAREN CROSS HOSPICE & PALLIATIVE SPECIALIST 195913 0 0 0 0 0 27000 0 4801 0 227714 0 0 0 BARRY LEONARD CFO 160914 0 0 0 0 0 6420 0 5678 0 173012 0 0 0 SUSAN COX CHIEF NURSING OFFICER 145411 0 0 0 0 0 16446 0 3206 0 165063 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B AT THE FIRST PRACTICAL OPPORTUNITY, THE ANNUAL FORM 990 IS PRESENTED TO AND REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD. AN ANNUAL INSERVICE TRAINING IS OFFERED TO ALL BOARD MEMBERS WHICH EXPLAINS THE PURPOSE OF THE FORM 990 AND ALL DISCLOSURES INCLUDED. FORM 990, PART VI, SECTION B, LINE 12C THE AGENCY'S CONFLICT OF INTEREST POLICIES ARE REVIEWED AS A PART OF ANNUAL INSERVICES AND THE ORIENTATION OF THE NEW BOARD. ALL BOARD MEMBERS SIGN OFF ON THEIR UNDERSTANDING AND ACCEPTANCE OF THESE POLICIES. FORM 990, PART VI, SECTION B, LINE 15 THE PERSONNEL AND EXECUTIVE COMMITTEES OF THE BOARD UTILIZE A DOCUMENTED PROCESS IN DETERMINING THE COMPENSATION OF OFFICERS AND KEY EMPLOYEES. THIS PROCESS TAKES INTO ACCOUNT REASONABLENESS TESTS AND CONTEMPORANEOUSLY SURVEYS THE COMPENSATION OF EXECUTIVES IN SIMILAR INDUSTRIES. FORM 990, PART VI, SECTION C, LINE 19 ALL OR PART OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE THROUGH WWW.GUIDESTAR.ORG, WWW.SOSNC.COM, OR BY REQUEST AT 1801 WESTCHESTER DRIVE, HIGH POINT, NC 27262. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF BENEFICIAL INTEREST -49,162. FORM 990, PART XII, LINE 2C: PROCESS HAS NOT CHANGED FROM PRIOR YEAR.