2023-11-15T10:03:27-06:00 2022-12-31 113266576 GRASSI & CO CPA'S PC 750 THIRD AVENUE 28TH FLOOR NEW YORK NY 10017 990 2022-01-01 843797085 CAPITAL CARING STAY AT HOME SERVICES IN CAPI 7035311108 3180 FAIRVIEW PARK DRIVE FALLS CHURCH VA 22042 JOSEPH MURRAY CFO 7035311108 2023-11-14 1 JOSEPH MURRAY 999009999 0 JAIME RAPPS P01426990 2126616166 2023-11-14 0 AAL1 IAL1 2022 2023-04-26 12:10:37Z JOSEPH MURRAY 3180 FAIRVIEW PARK DRIVE 500 FALLS CHURCH VA 22042 658554 0 X WWW.CAPITALCARING.ORG X 2019 VA CAPITAL CARING STAY AT HOME SERVICES, INC. PROVIDES SERVICES THAT SEEK TO IMPROVE PATIENTS SOCIAL AND PHYSICAL ENVIRONMENTS AS A MEANS OF BETTERING THEIR CARE AND QUALITY OF LIFE SO THAT THEY CAN ULTIMATELY STAY AT HOME, WHERE THE VAST MAJORITY OF FAMILIES WOULD WANT TO RECEIVE CARE AS THEY AGE AND THEIR MEDICAL AND FUNCTIONAL CONDITION DETERIORATES. 10 9 11 9 0 0 351210 1250 609922 657304 0 0 41800 0 1002932 658554 0 0 0 0 984594 1011348 0 0 59650 216056 146949 1200650 1158297 -197718 -499743 54340 270391 607084 1322878 -552744 -1052487 X CAPITAL CARING STAY AT HOME SERVICES, INC. PROVIDES SERVICES THAT SEEK TO IMPROVE PATIENTS SOCIAL AND PHYSICAL ENVIRONMENTS AS A MEANS OF BETTERING THEIR CARE AND QUALITY OF LIFE SO THAT THEY CAN ULTIMATELY STAY AT HOME, WHERE THE VAST MAJORITY OF FAMILIES WOULD WANT TO RECEIVE CARE AS THEY AGE AND THEIR MEDICAL AND FUNCTIONAL CONDITION DETERIORATES. 0 0 341863 357304 CAPITAL CARING STAY AT HOME SERVICES (CCSHS) PROVIDES CONTRACTED MEDICAL SERVICES TO ORGANIZATIONS NEEDING SUCH SERVICES. CAPITAL CARING STAY AT HOME SERVICES PROVIDED 1,643 HOURS OF MEDICAL SERVICES SUPPORT FOR THE YEAR ENDING DECEMBER 31, 2022. 183418 300000 CCSHS PROVIDES PATIENT MANGEMENT SERVICES TO THE RENAL ADVANCED ILLNESS NETWORK (RAIN) PROGRAM FOR DAVITA HEALTHCARE FOR PATIENTS WITH ADVANCED RENAL DISEASE. DURING THE YEAR ENDED DECEMBER 31, 2022, CCSHS PROVIDED APPROXIMATELY 1,219 HOURS OF MEDICAL DIRECTOR SERVICE TO THE PROGRAM. 191804 CCSHS PROVIDES SUPPORT TO IMPROVE PATIENTS SOCIAL AND PHYSICAL ENVIROMENTS ALLOWING THE PATIENT TO STAY AT HOME TO RECEIVE CARE. AS PART OF THIS SUPPORT, CCSHS PROVIDES MEALS TO PATIENTS IN NEED OF ASSISTANCE TO INSURE THAT PATIENTS HAVE PROPER NUTRITION WHILE RECEIVING CARE. FOR THE YEAR ENDED DECEMBER 31, 2022 CCSHS PROVIDED 2,457 MEALS TO PATIENTS IN NEED OF ASSISTANCE. 717085 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 11 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 DC MD VA X THE ORGANIZATION 7035316231 3180 FAIRVIEW PARK DRIVE SUITE 500 FALLS CHURCH VA 22042 TOM KOTSOUMPAS PRESIDENT AND CEO 5.00 35.00 X X 0 496429 13544 LYNN MENTO CEO 1.00 3.00 X X 0 0 0 REV DR TYRONE PITTS VICE CHAIR 1.00 3.00 X X 0 0 0 ANGELA WEBB INTERIM TREASURER 1.00 3.00 X X 0 0 0 JOHN ADAMS BOARD MEMBER 1.00 3.00 X 0 0 0 CLIFFORD BARNES BOARD MEMBER 1.00 3.00 X 0 0 0 JEANINE ENGLISH BOARD MEMBER 1.00 3.00 X 0 0 0 BILL NOVELLI BOARD MEMBER 1.00 3.00 X 0 0 0 DIANE TY BOARD MEMBER 1.00 3.00 X 0 0 0 CLIFFORD E BARNES BOARD MEMBER 1.00 3.00 X 0 0 0 DR J CAMERON MUIR CHIEF INNOVATIONS OFFICER 35.00 5.00 X 322452 0 9723 322452 496429 23267 1 0 1 0 0 1250 1250 PATIENT SERVICES 621610 657304 657304 657304 658554 657304 0 0 332175 209359 122816 477089 300694 176395 336 212 124 143926 90712 53214 57822 36443 21379 4918 4918 516 516 -1523 -1523 10000 6303 3697 48591 48591 BAD DEBT 59650 59650 MEALS FOR PATIENTS 14270 14270 OTHER EXPENSES 10527 9985 542 1158297 717085 381562 59650 22262 5622 26958 81241 5120 183528 54340 270391 607084 1322878 607084 1322878 X -837711 -1200251 284967 147764 -552744 -1052487 54340 270391 -499743 0 X X 0 1 X 1 0 X 300314 351210 1250 652774 300314 351210 1250 652774 652774 142 142 41800 41800 694716 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2021 AMOUNT: $ 41,800. 2022 AMOUNT: $ 0. 0 ACCOUNTS RECEIVABLE RELATED ENTITIES - CAPITAL CARING HEALTH, INC 183528 183528 ACCOUNTS PAYABLE RELATED ENTITIES - CAPITAL HEALTH 1322242 ACCOUNTS PAYABLE RELATED ENTITIES - CAPITAL CARING ADVANCED ILLNESS SERVICES 636 1322878 X PART V, LINE 4: ENDOWMENT FUNDS CAN BE USED TO SUPPORT THE GENERAL OPERATIONS AND PROGRAM SERVICES OF CAPITAL CARING STAY AT HOME SERVICES. THE ENDOWMENT FUNDS ARE HELD BY CAPITAL HOSPICE, A RELATED TAX EXEMPT ENTITY. PART X, LINE 2: THE CONSOLIDATED GROUP HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE CONSOLIDATED GROUP IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE CONSOLIDATED GROUP BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS PRIOR TO 2019. 0 1 0 0 0 0 0 1 0 TOM KOTSOUMPAS PRESIDENT AND CEO 0 496429 0 0 0 0 0 11548 0 1996 0 509973 0 0 DR J CAMERON MUIR CHIEF INNOVATIONS OFFICER 297984 0 0 0 24468 0 0 0 9723 0 332175 0 0 0 PART I, LINE 4B DURING THE 2022 CALENDAR YEAR, CAPITAL HOSPICE MAINTAINED A SUPPLEMENTAL NON-QUALIFIED 457(F) DEFERRED COMPENSATION PLAN. THE FOLLOWING REPORTABLE INDIVIDUALS WERE ELIGIBLE TO PARTICIPATE IN THAT PLAN: -JAMES CAMERON MUIR MD DURING 2022, THE THERE WERE NO CONTRIBUTIONS MADE BY CAPITAL HOSPICE TO THE PLAN. DURING 2022, THE FOLLOWING DISTRIBUTIONS WERE MADE BY CAPITAL HOSPICE FROM THE PLAN: -JAMES CAMERON MUIR MD - $24,468 DURING THE 2022 CALENDAR YEAR, THE COMPANY MAINTAINED A NON QUALIFIED 457(B) DEFERRED COMPENSATION PLAN FOR THE FOLLOWING EMPLOYEE: JOHN T. KOUTSOUMPAS DURING 2022, THE COMPANY MADE CONTRIBUTIONS TO THE PLAN TOTALING $10,400. IN 2022, THERE WERE NO DISBURSEMENTS FROM THE PLAN. PART I, LINE 5 COMPENSATION OF THE ORGANIZATION'S PRESIDENT AND CEO IS PAID BY CAPITAL HOSPICE, A RELATED TAX-EXEMPT ORGANIZATION. CAPITAL HOSPICE USES THE FOLLOWING METHODS TO DETERMINE THE PRESIDENT AND CEO'S COMPENSATION: COMPENSATION COMMITTEE-INDEPENDENT COMPENSATION CONSULTANT-FORM 990 OF OTHER ORGANIZATIONS-COMPENSATION SURVEY OR STUDY-APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 7 IF THE ORGANIZATION REACHES ITS BUDGETED AMOUNT OF NET INCOME FROM OPERATIONS FOR THE YEAR THEN EMPLOYEES ARE ELIGIBLE FOR A BONUS, WHICH IS BASED UPON KEY METRICS THAT ARE UNRELATED TO NET INCOME. FORM 990, PART VI, SECTION A, LINE 1A THERE SHALL BE AN EXECUTIVE COMMITTEE COMPOSED OF MEMBERS ELECTED FROM AMONG THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL HAVE POWERS AND DUTIES AS DELEGATED BY THE BOARD OF DIRECTORS AND CONSISTENT WITH THESE BYLAWS AND THE ACT. FORM 990, PART VI, SECTION A, LINE 6 CAPITAL CARING HEALTH, A VIRGINIA NOT FOR PROFIT CORPORATION ("MEMBER"), IS THE SOLE MEMBER OF THE CORPORATION. THE SOLE MEMBER SHALL HAVE AND EXERCISE CERTAIN RIGHTS AND CERTAIN POWERS RELATED TOTHE CORPORATION SET FORTH IN THE CORPORATION'S BYLAWS. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THE CORPORATION, CAPITAL CARING HEALTH, SHALL HAVE THE RIGHT TO APPOINT THE DIRECTORS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER, THROUGH ITS CHAIR OR CEO, OR THROUGH ANY OTHER OFFICER OF THE MEMBER WHO IS AUTHORIZED BY THE BOARD OF DIRECTORS OF THE MEMBER (THE "MEMBER BOARD"), SHALL EXERCISE ALL AUTHORITY AT MEETINGS OF THE CORPORATION AS MEMBERS ARE AUTHORIZED TO EXERCISE. FORM 990, PART VI, SECTION B, LINE 11B THE 990 FOR CAPITAL CARING STAY AT HOME SERVICES, INC. IS REVIEWED BY THE CONTROLLER . NEXT, THE 990 IS SENT TO ALL OF THE MEMBERS OF THE BOARD OF TRUSTEES INCLUDING THE PRESIDENT OF CAPITAL CARING STAY AT HOME, INC. FOR THEIR REVIEW AND TO SOLICIT ANY COMMENTS OR QUESTIONS. THE FINANCE AUDIT INVESTMENT COMMITTEE (FAIC) OF THE BOARD MEETS TO REVIEW AND DISCUSS THE FORM 990 IN DETAIL. THIS MEETING IS OPEN TO ALL BOARD MEMBERS AFTER THE FORM 990 HAS BEEN REVIEWED BY THE BOARD AND ANY COMMENTS OR QUESTIONS FROM BOARD MEMBERS HAVE BEEN RESPONDED TO, THE FORM 990 WILL BE FINALIZED, SIGNED BY THE PRESIDENT/CEO AND SUBSEQUENTLY FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMEBERS, OFFICERS AND KEY MANAGERS ARE REQUIRED TO REPORT ANY REAL OR POTENTIAL OR PERCEIVED CONFLICT OF INTEREST INVOLVING THEM OR ANOTHER PERSON BY PROMPTLY FILING A WRITTEN DISCLOSURE STATEMENT WITH THE PRESIDENT OR CHAIR OF THE BOARD OF TRUSTEES. THE PRESIDENT WILL REVIEW ALL SUCH STATEMENTS AND THE ANNUAL DISCLOSURE STATEMENTS AND DISCUSS WITH THE CHAIR OF THE BOARD ANY POTENTIAL CONFLICTS OF INTEREST. IF THE PRESIDENT AND THE CHAIR OF THE BOARD DETERMINE THAT A POTENTIAL CONFLICT EXISTS, THEN THE BOARD SHALL INFORM THE PERSON OF THE BASIS FOR SUCH BELIEF AND ALLOW THE PERSON TO EXPLAIN AND DISCLOSE. FOR ANY TRANSACTION/ARRANGEMENT DISCUSSED DURING A BOARD MEETING FOR WHICH A CONFLICT OF INTEREST IS DEEMED TO EXIST, THE AFFECTED BOARD MEMBER SHALL NOT BE COUNTED IN DETERMINING THE QUOROM FOR THE MEETING BUT SHALL BE PERMITTED TO BRIEFLY STATE HIS POSITION ON THE MATTER AND ANSWER PERTINENT QUESTIONS OF OTHER BOARD MEMBERS BEFORE VACATING THE GOVERNING BOARD. THE BOARD MEMBER SHALL LEAVE THE GOVERNING BOARD AND A MAJORITY OF THE REMAINING BOARD MEMBERS SHALL DETERMINE WHETHER TO UNDERTAKE SUCH TRANSACTION/ARRANGEMENT. IF THE BOARD DECIDES THAT A PERSON HAS FAILED TO DISCLOSE A CONFLICT OF INTEREST, THE BOARD SHALL TAKE CORRECTIVE ACTION. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR THE ORGANIZATION'S CHIEF EXECUTIVE OFFICE IS PAID BY CAPITAL HOSPICE, A RELATED TAX EXEMPT ORGANIZATION. IN 2019 THE EXECUTIVE COMMITTEE OF THE BOARD HAS ENGAGED QUATT AND ASSOCIATES, AN INDEPENDENT CONSULTING GROUP, TO PREPARE A REPORT TO ASSIST WITH ESTABLISHING COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL AND OTHER KEY PERSONNEL. THE REPORT WAS REVIEWED AND APPROVED BY THE EXECUTIVE COMMITTEE AFTER THOROUGH DISCUSSION OF THE DATA, ITS SOURCES AND THE FINDINGS. THE ORGANIZATION AS SUBJECT TO INTERMEDIATE SANCTIONS UNDER INTERNAL REVENUE CODE (IRC) SECTION 4958, CONSIDERS THAT THE INTERMEDIATE SANCTIONS MARKET BENCHMARKING METHODOLOGY FOR DISQUALIFIED INDIVIDUALS, CONDUCTED BY QUATT AND ASSOCIATES, HAS PROVIDED A VALID AND ROBUST MEANS OF DETERMINING MARKET BASED COMPENSATION COMPETITIVENESS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGE FROM THE PRIOR YEAR. CAPITAL HOSPICE 3180 FAIRVIEW PARK DRIVE FALLS CHURCH VA 220421206 541920770 DIRECT SUPPORT OF PATIENTS AND THEIR PUBLIC EDUCATION AND ADVOCACY. VA 501(C)(3) 10 CAPITAL CARING HEALTH 0 CAPITAL CARING HEALTH 3180 FAIRVIEW PARK DRIVE FALLS CHURCH VA 220421206 843773372 MEDICAL SUPPORT SERVICES VA 501(C)(3) TYPE III-FI N/A 0 CAPITAL CARING ADVANCED ILLNESS SERVICES INC 3180 FAIRVIEW PARK DRIVE FALLS CHURCH VA 220421206 843787656 ILLNESS, PALLATIVE, AND PRIMARY VA 501(C)(3) 7 CAPITAL CARING HEALTH 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 1