2023-11-14T13:41:04-06:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 5001 SPRING VALLEY ROAD SUITE 600W DALLAS TX 75244 990 2022-01-01 751094140 FOREFRONT LIVING HOSPICE FORE 9722395300 12477 MERIT DRIVE DALLAS TX 75251 STEVE AILEY CHIEF FINANCIAL OFFICER 9722395300 2023-11-13 1 STEVE AILEY 999009999 0 RAHIM HABIB P01912003 9723835700 2023-11-13 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z X TIM MALLAD 12467 MERIT DRIVE DALLAS TX 75251 22354189 0 X WWW.FOREFRONTLIVING.ORG X 1962 TX FOREFRONT LIVING HOSPICE, AS A MEMBER OF THE FOREFRONT LIVING FAMILY OF ORGANIZATION HAS A MISSION TO MAKE EACH MOMENT MATTER FOR THOSE IT SERVES. FOREFRONT LIVING HOSPICE PROVIDES HOSPICE AND PALLIATIVE CARE IN AN OUTPATIENT SETTING AND HAS A 36 BED INPATIENT HOSPICE FACILITY. 8 8 234 47 0 0 2069720 2143182 19459798 19906241 -1162 11695 2901565 206447 24429921 22267565 1144001 941415 0 0 12073847 13742736 0 0 0 8863708 8857302 22081556 23541453 2348365 -1273888 46881985 43880298 1736532 1906177 45145453 41974121 FOREFRONT LIVING HOSPICE, AS A MEMBER OF THE FOREFRONT LIVING FAMILY OF NON-PROFIT ORGANIZATIONS, PLEDGES TO MAKE EACH MOMENT MATTER FOR THOSE IT SERVES. 0 0 19071502 941415 19906241 PROVIDED HOSPICE SERVICES IN THE DALLAS-FORT WORTH METROPLEX. 19071502 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 82 0 234 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 1 1 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 X STEVEN AILEY 2144131561 12467 MERIT DRIVE DALLAS TX 75251 WILLIAM DAVIS SECRETARY 1.00 3.00 X 0 0 0 CORNELIUS FOOTE CHAIRMAN 1.00 3.00 X 0 0 0 LAURA WRIGHT TRUSTEE 1.00 3.00 X 0 0 0 DAVID ASHWORTH TRUSTEE 1.00 3.00 X 0 0 0 REBECCA GRUCHELLA MD TRUSTEE 1.00 3.00 X 0 0 0 KEVIN JACKSON TRUSTEE 1.00 3.00 X 0 0 0 BRAD NITSCHKE TRUSTEE 1.00 3.00 X 0 0 0 PHILIP WENTWORTH TRUSTEE 1.00 3.00 X 0 0 0 TIM MALLAD CHIEF EXECUTIVE OFFICER 10.00 30.00 X 0 564008 67192 STEVEN AILEY CHIEF FINANCIAL OFFICER 10.00 30.00 X 0 338749 51903 DANETTE MUZIC EXECUTIVE DIRECTOR - FLH 40.00 0.00 X 61874 0 241 SCOTT POLZIN CHIEF OPERATING OFFICER 10.00 30.00 X 0 322593 17545 ADRIANA MAUBOUSSIN COMMUNITY LIAISON 40.00 0.00 X 165901 0 23885 CHRISTOPHER SONGER DIRECTOR OF PROJECT DEVELO 0.00 40.00 X 0 173300 18489 KIM HARDEN ASSOCIATE EXECUTIVE DIRECTOR 0.00 40.00 X 0 166966 13560 MONIKA PEARCE RESIDENTIAL SALES COUNSELOR 0.00 40.00 X 0 161142 22899 BARBARA MATAMOROS CORPORATE DIRECTOR OF SALES AND MARKETING 10.00 30.00 X 0 160844 20002 227775 1887602 235716 1 0 1 0 DELTA CARE RX 4249 SUNSET BLVD STEUBENVILLE OH 43952 PHARMACY SERVICES 900351 HOSPICE SOURCE LLC PO BOX 219168 KANSAS CITY MO 64121 DME SERVICES 483591 MEDLINE INDUSTRIES INC PO BOX 121080 DALLAS TX 25312 MEDICAL SUPPLIES 442859 MICHAEL BOND MD 7100 TWIN KNOLL LANE PLANO TX 75024 MEDICAL SERVICES 163483 BEN E KEITH PO BOX 2607 FT WORTH TX 76113 FOOD 162727 8 1954554 188628 2143182 RESIDENT REVENUE 623000 19906241 19906241 19906241 11695 11695 156756 86624 70132 70132 70132 EMPLOYEE & GUEST MEALS 900099 81429 81429 PROVIDER RELIEF FUNDS 900099 54886 54886 136315 22267565 19906241 0 218142 941415 941415 62115 62115 11034383 8712534 2321849 217345 171866 45479 1559010 1232743 326267 869883 687863 182020 1201009 1201009 34997 34997 18699 18699 3827 3827 1135791 890612 245179 102533 102533 78670 61688 16982 467174 467174 212593 166701 45892 375401 294365 81036 16119 12639 3480 1539088 1206851 332237 182289 182289 MEDICAL / THERAPY EXPEN 2593423 2593423 BAD DEBT 183201 183201 OTHER EXPENSES 181255 142128 39127 SUPPLIES 157949 123853 34096 373284 204207 169077 23541453 19071502 4469951 0 7064322 3951072 108441 53556 1935940 2179533 39406 75578 31646541 9893524 23128082 21753017 0 3008767 14605794 12858775 46881985 43880298 1376560 1439255 108441 53556 251531 413366 1736532 1906177 X 31201085 29939248 13944368 12034873 45145453 41974121 46881985 43880298 X -1273888 12051 -1909495 X X 0 1 X 1 0 X 8168246 2480922 2092301 2069720 2143182 16954371 19999268 15676018 17630756 19459798 19906241 92672081 28167514 18156940 19723057 21529518 22049423 109626452 0 0 0 109626452 242065 160283 113941 113072 168451 797812 242065 160283 113941 113072 168451 797812 128342 67939 447427 2787331 136314 3567353 28537921 18385162 20284425 24429921 22354188 113991617 0.96170 0.96470 0.00700 0.00500 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2018 AMOUNT: $ 51,510. RESIDENT SERVICES - 2018 AMOUNT: $ 5,299. BEAUTY SHOP - 2018 AMOUNT: $ 20,063. CHARGEABLE SUPPLIES - 2018 AMOUNT: $ 10,084. EMPLOYEE GUEST MEALS - 2018 AMOUNT: $ 34,053. 2019 AMOUNT: $ 67,939. 2020 AMOUNT: $ 29,356. 2021 AMOUNT: $ 50,306. 2022 AMOUNT: $ 81,428. WELLNESS CENTER - 2018 AMOUNT: $ 5,190. VILLAGE STORE INCOME - 2018 AMOUNT: $ 2,143. INSURANCE PROCEEDS - 2020 AMOUNT: $ 72,413. PROVIDER RELIEF FUNDS - 2020 AMOUNT: $ 345,658. 2021 AMOUNT: $ 2,737,025. 2022 AMOUNT: $ 54,886. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 17682243 3464540 14217703 4480393 1169017 3311376 4906550 2433451 2473099 4577355 2826516 1750839 21753017 INTEREST IN NET ASSETS OF FOUNDATION 12034873 CONSTRUCTION IN PROGRESS 128350 INTERCOMPANY 695552 12858775 RELATED PARTY PAYABLE 413366 413366 X 22362413 12051 12051 22350362 3827 -86624 -82797 22267565 23624250 0 23624250 3827 -86624 -82797 23541453 PART X, LINE 2: THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE ORGANIZATION REPORTS ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES AND FILES ALL PROPER RETURNS RELATED TO THESE ACTIVITIES. PART XI, LINE 4B - OTHER ADJUSTMENTS: RELATED PARTY RENT EXPENSE -86,624. PART XII, LINE 4B - OTHER ADJUSTMENTS: RELATED PARTY RENT EXPENSE -86,624. 1 SUPPLEMENTAL ASSISTANCE 115 941414 PART I, LINE 2: THE ORGANIZATION PROVIDES ASSISTANCE TO PATIENTS WHO ARE UNDERGOING FINANCIAL HARDSHIP AND ARE UNABLE TO PAY A PORTION OF THEIR FEES. AN APPLICATION FOR ASSISTANCE IS COMPLETED AND SUBMITTED TO THE EXECUTIVE DIRECTOR FOR REVIEW AND APPROVAL PRIOR TO PROVIDING ASSISTANCE. THE PATIENT'S FINANCIAL CIRCUMSTANCES ARE REVIEWED TO DETERMINE IF THE PATIENT STILL QUALIFIES FOR ASSISTANCE. X X X X 0 1 0 0 0 0 0 0 0 TIM MALLAD CHIEF EXECUTIVE OFFICER 0 384261 0 176715 0 3032 0 28618 0 38574 0 631200 0 0 STEVEN AILEY CHIEF FINANCIAL OFFICER 0 234195 0 98018 0 6536 0 15730 0 36173 0 390652 0 0 SCOTT POLZIN CHIEF OPERATING OFFICER 0 224469 0 91401 0 6723 0 17545 0 0 0 340138 0 0 CHRISTOPHER SONGER DIRECTOR OF PROJECT DEVELO 0 169759 0 2250 0 1291 0 4456 0 14033 0 191789 0 0 ADRIANA MAUBOUSSIN COMMUNITY LIAISON 116801 0 49100 0 0 0 2429 0 21456 0 189786 0 0 0 MONIKA PEARCE RESIDENTIAL SALES COUNSELOR 0 69192 0 91950 0 0 0 4167 0 18732 0 184041 0 0 BARBARA MATAMOROS CORPORATE DIRECTOR OF SALES AND MARK 0 157825 0 500 0 2519 0 4200 0 15802 0 180846 0 0 KIM HARDEN ASSOCIATE EXECUTIVE DIRECTOR 0 155254 0 11712 0 0 0 2184 0 11376 0 180526 0 0 PART I, LINE 4B FOREFRONT LIVING MAINTAINS A 457(F) NONQUALIFIED DEFERRED COMPENSATION RETIREMENT PLAN. DURING 2022 TIM MALLAD CONTRIBUTED $14,460, STEVE AILEY CONTRIBUTED $9,033, AND SCOTT POLZIN CONTRIBUTED $8,399, RESPECTIVELY. FORM 990, PART VI, SECTION A, LINE 3 ON 5/1/2008,FOREFRONT LIVING WAS FORMED TO PROVIDE MANAGEMENT AND SHARED SERVICES TO FOREFRONT LIVING HOSPICE AND OTHER AFFILIATED ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 4 EFFECTIVE 2022, GRACE PRESBYTERIAN MINISTRIES CHANGED ITS NAME TO FOREFRONT LIVING HOSPICE. FORM 990, PART VI, SECTION A, LINE 8B NO COMMITTEES HAVE AUTHORITY TO ACT ON BEHALF OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE CFO WILL REVIEW THE DRAFT REPORT. THE DRAFT REPORT WILL BE REVIEWED AND APPROVED BY THE AUDIT COMMITTEE AND A COPY OF THE REPORT WILL BE PROVIDED TO ALL BOARD MEMBERS FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A COMPLIANCE OFFICER (CO) WHO REVIEWS ALL TRANSACTIONS OF THE ORGANIZATION THAT MAY RESULT IN A CONFLICT OF INTEREST. THE CO DETERMINES IF THE TRANSACTION WOULD RESULT IN UNDUE INFLUENCE AS A RESULT OF THE RELATIONSHIP AND NOT BE PURSUED. THE CO REPORTS ALL CONFLICTS OF INTEREST TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD HAS A COMPENSATION COMMITTEE THAT REVIEWS THE CURRENT COMPENSATION WITH AN OUTSIDE CONSULTANT WHICH INCLUDES COMPARISONS TO LIKE ENTITIES AND SALARY SURVEYS. THE COMPENSATION COMMITTEE RECOMMENDS CHANGES TO THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON WRITTEN REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN NET ASSETS OF FOUNDATION -2,140,528. CHANGE IN NET ASSETS WITH DONOR RESTRICTIONS 231,033. FORM 990, PART XII, LINE 2C: THE ORGANIZATION DOES HAVE A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT. NEITHER THE OVERSIGHT PROCESS NOR THE SELECTION PROCESS HAS CHANGED DURING THE FILING YEAR. FOREFRONT LIVING 12467 MERIT DRIVE DALLAS TX 75251 261459224 SHARED SERVICES/MANAGEMENT TX 501(C)(3) LINE 12B, II N/A 0 FOREFRONT LIVING FOUNDATION 12467 MERIT DRIVE DALLAS TX 75251 751910084 FOUNDATION FOR AFFILIATES TX 501(C)(3) LINE 7 FOREFRONT LIVING 0 FAITH PRESBYTERIAN PROVIDERS INC 12477 MERIT DRIVE DALLAS TX 75251 383800779 PALLATIVE/HOSPICE SERVICES TX 501(C)(3) LINE 10 FOREFRONT LIVING 0 PRESBYTERIAN VILLAGE NORTH FOREFRONT LIVING 8600 SKYLINE DRIVE DALLAS TX 75243 510190369 CCRC TX 501(C)(3) LINE 10 FOREFRONT LIVING 0 THE OUTLOOK AT WINDHAVEN FOREFRONT LIVING 12477 MERIT DRIVE DALLAS TX 75251 851339418 CCRC TX 501(C)(3) LINE 10 FOREFRONT LIVING 0 FOREFRONT LIVING SAN ANTONIO 12477 MERIT DRIVE DALLAS TX 75251 872465887 FUTURE EXPANSION TX 501(C)(3) LINE 10 FOREFRONT LIVING 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0