2023-11-14T07:38:52-06:00 2022-12-31 882730877 CHERRY BEKAERT ADVISORY LLC 1111 METROPOLITAN AVE STE 900 CHARLOTTE NC 28204 990 2022-01-01 570843527 HOSPICE OF LAURENS COUNTY HOSP 8648336287 PO BOX 470408 CHARLOTTE NC 28247 PETER A BRUNNICK PRESIDENT & CEO 8648336287 2023-11-13 1 PETER BRUNNICK XXX-XX-XXXX 0 PAULA WENDLING P00536805 7043771678 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z PETER A BRUNNICK PO BOX 470408 CHARLOTTE NC 28247 5810389 0 X WWW.HOSPICEOFLAURENSCOUNTY.COM X 1987 SC OPERATING SINCE 1987, HOSPICE OF LAURENS COUNTY (HOLC) PROVIDES EXPERT END OF LIFE CARE, INCLUDING HOSPICE, GRIEF SUPPORT AND COMMUNITY EDUCATION. HOLC IS COMMITTED TO OFFERING QUALITY OF LIFE TO PATIENTS AND FAMILIES IN OUR COMMUNITY WHO ARE COPING WITH TERMINAL ILLNESS. 19 19 92 14 0 0 187508 574438 2846730 4914011 29 937 299560 -18954 3333827 5470432 0 0 0 0 3118024 4832868 0 0 272751 1403896 2112911 4521920 6945779 -1188093 -1475347 5063411 5602238 5409685 7423859 -346274 -1821621 TO PROVIDE PHYSICAL, SPIRITUAL, AND EMOTIONAL COMFORT TO PATIENTS AND THEIR FAMILIES DEALING WITH A TERMINAL ILLNESS. 0 0 6173961 4914011 ADULT HOSPICE CARE SERVICES - HOSPICE CARE IS PROVIDED TO PATIENTS WHO ARE FACING ILLNESSES THAT NO LONGER RESPOND TO CURE-ORIENTED TREATMENT AND WHO HAVE A LIFE EXPECTANCY OF SIX MONTHS OR LESS. CARE IS PROVIDED IN MULTIPLE SETTINGS, INCLUDING THE PATIENT'S PRIVATE RESIDENCE, NURSING FACILITIES, OR OUR OWN HOSPICE HOUSE. AS A NOT-FOR-PROFIT ORGANIZATION, HOSPICE OF LAURENS COUNTY PROVIDES SERVICES WITHOUT REGARD TO A PATIENT'S INSURANCE STATUS OR ABILITY TO PAY. THESE SERVICES INCLUDE NURSING CARE, PHYSICIAN VISITS, SOCIAL WORK, AND CHAPLAIN SERVICES. IN ADDITION, ANCILLARY SERVICES AND BEREAVEMENT SUPPORT ARE PROVIDED AFTER THE PATIENT'S DEATH. 6173961 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 46 0 1 92 1 0 0 0 0 0 0 0 0 0 0 0 0 X 19 19 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 SC X PETER A BRUNNICK 7043750100 PO BOX 470408 CHARLOTTE NC 28247 LAURA ENGEL CHAIR 1.00 2.00 X X 0 0 0 JEFFREY G GORE VICE-CHAIR 1.00 2.00 X X 0 0 0 GREGORY R KILPATRICK VICE-CHAIR 1.00 2.00 X X 0 0 0 JOHN A MORRICE SECRETARY 1.00 2.00 X X 0 0 0 MICHAEL A MCNAMARA TREASURER 1.00 2.00 X X 0 0 0 JANE B NEESE IMMEDIATE PAST BOARD CHAIR 1.00 2.00 X X 0 0 0 LARRY BREHMER DIRECTOR 1.00 2.00 X 0 0 0 HEATHER G CARSON DIRECTOR 1.00 2.00 X 0 0 0 PATRICK FLETCHER DIRECTOR 1.00 2.00 X 0 0 0 GREGORY GRIER DIRECTOR 1.00 2.00 X 0 0 0 DAVID H JONES DIRECTOR 1.00 2.00 X 0 0 0 COLLIE LEHN DIRECTOR 1.00 2.00 X 0 0 0 BRYAN R MIDURA DIRECTOR 1.00 2.00 X 0 0 0 MEREDITH PINSON DIRECTOR 1.00 2.00 X 0 0 0 KENNETH W POE DIRECTOR 1.00 2.00 X 0 0 0 ALAN R THALINGER DIRECTOR 1.00 2.00 X 0 0 0 JOSEPH TYSINGER DIRECTOR 1.00 2.00 X 0 0 0 ASHLEY LOVE SUMRALL DIRECTOR 1.00 2.00 X 0 0 0 JONATHAN WEATHERS DIRECTOR 1.00 2.00 X 0 0 0 PETER BRUNNICK PRESIDENT & CEO 1.00 41.00 X 0 661401 15182 TODD FONTENOT CHIEF FINANCIAL OFFICER 1.00 41.00 X 0 382275 27891 MICHAEL BOLEWITZ CHIEF OPERATING OFFICER 1.00 41.00 X 0 398019 0 PETE DAVIES CHIEF INFORMATION OFFICER 1.00 41.00 X 0 221694 26861 JESSICA FOX CHIEF MEDICAL OFFICER 1.00 41.00 X 0 205476 6379 ROBERT SMITH MEDICAL OFFICER 1.00 41.00 X 0 287090 0 ANGELA BRON CLINICAL DIRECTOR 40.00 0.00 X 108505 0 23283 JESSICA LAWSON AFTER HOURS RN 40.00 0.00 X 111839 0 12 JASON WILLIS AVP OF OPERATIONS 40.00 0.00 X 117510 0 17779 KARLA FERNANDEZ AVP OF OPERATIONS 40.00 0.00 X 138964 0 0 PATRICIA SADLER MEDICAL DIRECTOR 40.00 0.00 X 132504 0 14863 609322 2155955 132250 7 0 1 0 0 44757 529681 337872 574438 PATIENT FEES 623000 4914011 4914011 4914011 937 937 0 44757 27008 -27008 -27008 312949 312949 0 8054 8054 8054 5470432 4914011 0 -18017 4043468 3576553 305168 161747 23803 20854 1450 1499 472964 433616 22548 16800 292633 260404 20844 11385 324665 273298 46585 4782 16565 16565 85525 60889 21215 3421 2570 2570 279003 229707 3423 45873 170397 154695 15131 571 209586 196582 3281 9723 41908 15644 15230 11034 PATIENT ANCILLARY EXP 861256 861256 BAD DEBT 34666 34666 86770 53227 27627 5916 6945779 6173961 499067 272751 1043307 1241486 187045 187064 4088 375632 733216 26096 32363 28982 18762 6572851 3393354 3346761 3179497 51500 51500 0 158350 5063411 5602238 223470 435709 5186215 6988150 5409685 7423859 X -354914 -1830261 8640 8640 -346274 -1821621 5063411 5602238 -1475347 0 X 0 1 X 1 0 X 40204 165905 325694 187508 574438 1293749 40204 165905 325694 187508 574438 1293749 122745 1171004 60 1810 349 29 937 3185 2357 2357 1299291 13458328 0.90130 0.90110 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2018 AMOUNT: $ 2,357. SCHEDULE A, PART II, COLUMN (E): THE AMOUNTS SHOWN IN THE 2018 COLUMN ARE FOR THE SHORT PERIOD 10/1/18 - 12/31/18. ALL OTHER COLUMNS REPRESENT AMOUNTS FOR FULL 12 MONTH PERIODS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 63607 63607 5492749 2467804 3024945 863876 772931 90945 152619 152619 0 3179497 DUE TO HOSPICE AND PALLIATIVE CARE CHARLOTTE REGION 6866166 OPERATING LEASE LIABILITY, NET OF CURRENT PORTION 121984 6988150 X PART X, LINE 2: MANAGEMENT HAS EVALUATED THE EFFECT OF FASB GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES IN AN ENTITY'S CONSOLIDATED FINANCIAL STATEMENTS BY PRESCRIBING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE ORGANIZATION'S POLICY IS TO RECORD A LIABILITY FOR ANY TAX POSITION TAKEN THAT IS BENEFICIAL TO THE ORGANIZATION, INCLUDING ANY RELATED INTEREST AND PENALTIES, WHEN IT IS MORE LIKELY THAN NOT THE POSITION TAKEN BY MANAGEMENT WITH RESPECT TO A TRANSACTION OR CLASS OF TRANSACTIONS WILL BE OVERTURNED BY A TAXING AUTHORITY UPON EXAMINATION. FLIGHT OF A DOVE 39667 39667 4836 20560 BUTTERFLY RELEASE 5090 5090 1612 44757 44757 4836 22172 27008 -27008 0 0 0 0 0 0 0 0 0 PETER BRUNNICK PRESIDENT & CEO 0 498812 0 160981 0 1608 0 0 0 15182 0 676583 0 0 TODD FONTENOT CHIEF FINANCIAL OFFICER 0 292554 0 88119 0 1602 0 0 0 27891 0 410166 0 0 MICHAEL BOLEWITZ CHIEF OPERATING OFFICER 0 306346 0 90068 0 1605 0 0 0 0 0 398019 0 0 ROBERT SMITH MEDICAL OFFICER 0 279846 0 6265 0 979 0 0 0 0 0 287090 0 0 PETE DAVIES CHIEF INFORMATION OFFICER 0 175236 0 45483 0 975 0 0 0 26861 0 248555 0 0 JESSICA FOX CHIEF MEDICAL OFFICER 0 179861 0 24900 0 715 0 0 0 6379 0 211855 0 0 X 312949 SALES PROCEEDS X 460 20562 FMV X PROGRAM SUPPLIES 14 4361 COST 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S SOLE MEMBER IS HOSPICE & PALLIATIVE CARE CHARLOTTE REGION. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS OF THE ORGANIZATION SHALL AT ALL TIMES BE COMPRISED ONLY OF THE INDIVIDUALS THEN SERVING AS MEMBERS OF THE BOARD OF DIRECTORS OF THE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B AMENDMENTS TO THE BYLAWS MAY ONLY BE MADE BY A MAJORITY VOTE OF THE BOARD OF DIRECTORS OF THE MEMBER. NO LOANS SHALL BE CONTRACTED ON BEHALF OF THE ORGANIZATION AND NO INDEBTEDNESS SHALL BE ISSUED IN ITS NAME UNLESS AUTHORIZED BY A RESOLUTION OF THE BOARD OF DIRECTORS OF THE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B BEFORE SUBMITTING THE FORM 990 TO THE IRS, THE ORGANIZATION EMAILS THE FINAL COPY OF THE FORM 990, INCLUDING ALL REQUIRED SCHEDULES, TO ALL VOTING MEMBERS OF THE GOVERNING BODY. THE FINANCE COMMITTEE MAKES A FULL REVIEW OF THE PREPARED RETURN. ANY COMMENTS OR QUESTIONS REGARDING THE RETURN ARE DISCUSSED AT THE NEXT SCHEDULED MEETING OF THE FULL BOARD. THE BOARD CHAIR, OR DESIGNEE, IS RESPONSIBLE FOR FACILITATING THE REVIEW. FORM 990, PART VI, SECTION B, LINE 12C WHEN A POTENTIAL CONFLICT OF INTEREST IS IDENTIFIED, THE CONFLICT WILL BE RESOLVED BY EITHER THE BOARD OF DIRECTORS' EXECUTIVE COMMITTEE, WHEN A BOARD MEMBER IS INVOLVED, OR BY THE CEO AND THE VICE PRESIDENT OF HUMAN RESOURCES WHEN THE CONFLICT INVOLVES AN EMPLOYEE. IN EACH CASE, A MEETING WILL BE CALLED WITH THE INDIVIDUAL WITH THE POTENTIAL CONFLICT AND THE PARTIES WILL REACH A MUTUALLY AGREED UPON RESOLUTION. IF A CONFLICT OF INTEREST CANNOT BE RESOLVED TO THE SATISFACTION OF BOTH PARTIES, OR IF THERE IS A FAILURE TO COMPLY WITH THE CONFLICT OF INTEREST POLICY, THEN ACTIONS NECESSARY TO ELIMINATE THE CONFLICT OF INTEREST WILL BE TAKEN, UP TO AND INCLUDING THE RESIGNATION OF EITHER THE BOARD MEMBER OR EMPLOYEE. NO BOARD MEMBER OR COMMITTEE MEMBER WILL BE PERMITTED TO BE PRESENT FOR DISCUSSION OF OR BE PERMITTED TO VOTE ON ANY SPECIFIC ISSUE IN WHICH HE OR SHE HAS A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 KEY PERSONNEL IN SUPPORT OF THE FOUNDATION ARE EMPLOYEES OF A RELATED ORGANIZATION, HOSPICE & PALLIATIVE CARE CHARLOTTE REGION, AND ARE SUBJECT TO COMPENSATION, CLASSIFICATION AND ALL OTHER PERSONNEL POLICIES OF THAT ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC ON A REQUEST BASIS. HOSPICE & PALLIATIVE CARE CHARLOTTE REGION PO BOX 470408 CHARLOTTE NC 28247 561219017 HOSPICE CARE NC 501(C)(3) LINE 7 0 HOSPICE OF CLEVELAND COUNTY 951 WENDOVER HEIGHTS DRIVE SHELBY NC 28150 561452373 HOSPICE CARE NC 501(C)(3) LINE 7 HOSPICE & PALLIATIVE CARE CHARLOTTE REGION 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 1 0 1 1