2024-05-01T12:07:01-05:00 2023-09-30 941239084 ATHERTON & ASSOCIATES LLP PO BOX 4339 MODESTO CA 953524339 990 2022-10-01 770562224 COMMUNITY HOSPICE FOUNDATION STANISLAUS COUNTY COMM 2095786300 4368 SPYRES WAY MODESTO CA 95356 ALISA BETTIS CEO 2095786300 2024-04-11 1 ALISA BETTIS 999009999 1 JACQUELYN HOWELL P01327223 2095774800 2024-04-10 X 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ALISA BETTIS 4368 SPYRES WAY MODESTO CA 95356 1696738 0 X WWW.HOSPICEHEART.ORG X 2002 CA SUPPORT OF COMMUNITY HOSPICE, INC. 18 18 6 67 0 0 1100178 1381449 0 0 162239 150316 19604 -112604 1282021 1419161 780048 1768143 0 0 321833 241522 0 0 122781 251276 273942 1353157 2283607 -71136 -864446 7852730 7948075 110959 354192 7741771 7593883 THE FOUNDATION EXISTS TO RAISE FUNDS AND AWARENESS OF THE COMMUNITY HOSPICE MISSION. COMMUNITY HOSPICE PROVIDES COMPASSIONATE END-OF-LIFE CARE AND BEREAVEMENT SUPPORT TO PATIENTS AND THEIR FAMILIES REGARDLESS OF ABILITY TO PAY. 0 0 2123223 1768143 0 TO RAISE FUNDS TO SUPPORT THE OPERATIONS OF COMMUNITY HOSPICE, INC., A RELATED NOT-FOR-PROFIT CORPORATION. COMMUNITY HOSPICE, INC. USES THESE FUNDS TO PROVIDE SERVICES AND SUPPORT TO THE TERMINALLY ILL AND THEIR FAMILIES. 2123223 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 0 0 1 1 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 2 0 6 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 18 18 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X MARK MALTUN 2095786300 4368 SPYRES WAY MODESTO CA 95356 MELVIN BRADLEY CHAIRMAN 1.00 1.00 X X 0 0 0 TRACEY KERR VICE CHAIR 1.00 X X 0 0 0 CLAUDIA KRAUSNICK SECRETARY 1.00 X X 0 0 0 JOY MASTACHE TREASURER 1.00 X X 0 0 0 CHUCK MITTEN PAST CHAIR 1.00 X X 0 0 0 PAM DIFRANCIA DIRECTOR 1.00 X 0 0 0 DON GAEKLE DIRECTOR 1.00 X 0 0 0 NANCY HOUGHTON DIRECTOR 1.00 X 0 0 0 SHARON JACKSON DIRECTOR 1.00 X 0 0 0 DEBORAH KIDWELL-GRAYSON DIRECTOR 1.00 X 0 0 0 CATHY MENDOZA DIRECTOR 1.00 X 0 0 0 ERIKA MENDOZA DIRECTOR 1.00 X 0 0 0 VERONICA NAPIER DIRECTOR 1.00 X 0 0 0 JEFF PETERSON DIRECTOR 1.00 X 0 0 0 STEVEN PINEDO DIRECTOR 1.00 X 0 0 0 TERESA SCOTT DIRECTOR 1.00 X 0 0 0 MERYL SNIDER DIRECTOR 1.00 X 0 0 0 MELISSA WILLIAMS DIRECTOR 1.00 X 0 0 0 MARK MALTUN CHIEF FINANCIAL OFFICER 1.00 41.00 X 0 161885 10990 ALISA BETTIS CHIEF EXECUTIVE OFFICER 1.00 41.00 X 0 74187 1605 MONICA OJCIUS INTERIM CHF EXECUTIVE DIRECTOR 1.00 41.00 X 0 136491 21107 MANINDERDEEP KAHLON NURSE PRACTITIONER 1.00 41.00 X 0 192681 15713 PETER LAI MEDICAL DIRECTOR 1.00 41.00 X 0 312156 28202 SOVICHEA MONY MEAS TRIAGE RN 1.00 41.00 X 0 212855 19294 RAJVINDER KAUR NURSE PRACTITIONER 1.00 41.00 X 0 193947 14153 JATINDERJIT HUNDAL ACHH ADMINISTRATOR 1.00 41.00 X 0 191698 7728 JOHN RENNER FORMER INTERIM CEO 1.00 41.00 X 0 177562 0 0 1653462 118792 0 1 1 0 0 398611 49070 933768 141508 1381449 150316 150316 164973 398611 277577 -112604 -112604 1419161 0 0 37712 X 1768143 1768143 222547 111274 111273 4739 2370 2369 14236 7118 7118 37603 37603 26013 26013 34338 34338 18000 18000 218 218 929 929 13932 11911 2021 BANK, CREDIT CARD & PAY 77090 77090 COMPUTER MAINTENANCE 28307 28307 OTHER PROGRAM EXPENSES 21343 21343 MISCELLANEOUS 9783 9783 6386 6386 2283607 2123223 37603 122781 377631 563384 167892 163483 131241 3264 0 16806 9066 23943 21397 45570 45570 0 0 6154885 5737377 1108309 1322127 7852730 7948075 65811 65046 18919 46108 26229 243038 110959 354192 X 6566056 6412647 1175715 1181236 7741771 7593883 7852730 7948075 -864446 716558 0 X X 0 1 X 1 0 X X 1 COMMUNITY HOSPICE INC 942638213 10 1 1768143 0 1 1768143 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1133925 348 158922 1293195 1409600 1339 -201492 1133925 1204287 1767 225932 1409600 1142324 1640 60323 1204287 1058448 114384 -30508 1142324 0.25710 0.74290 0.00000 0 0 17989 17989 0 27581 27581 0 0 INVESTMENT PROPERTY 4000 ENDOWMENT INVESTMENTS 1269057 EMPLOYEE RETENTION CREDIT RECEIVABLE 49070 1322127 RELATED PARTY PAYABLE 243038 243038 X 2145686 716558 9967 726525 1419161 0 1419161 525431 9967 9967 515464 1768143 1768143 2283607 PART V, LINE 4: THE INTENDED USE OF THE ENDOWMENT FUNDS ARE TO FUND FUTURE OPERATING EXPENSES OF COMMUNITY HOSPICE, INC. PART X, LINE 2: MANAGEMENT HAS EVALUATED THE FOUNDATION'S TAX POSITIONS AND CONCLUDED THAT THE FOUNDATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS. THE FOUNDATION IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE, OR LOCAL TAX AUTHORITIES FOR TAX YEARS ENDING SEPTEMBER 30, 2019 AND PRIOR. PART XI, LINE 2D - OTHER ADJUSTMENTS: EVENT EXPENSES INCLUDED IN PART VIII LINE 8B PART XII, LINE 2D - OTHER ADJUSTMENTS: EVENT EXPENSES INCLUDED IN PART VIII LINE 8B PART XII, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTION TO COMMUNITY HOSPICE NOT INCLUDED AS FINANCIAL STATEMENT EXP. ANNUAL GALA 268569 202657 65912 39239 51369 63340 GOLF FORE HOSPICE 103678 66276 37402 11550 25970 24043 6 191337 129678 61659 8069 53997 563584 398611 164973 50789 85408 141380 277577 -112604 0 1 0.95000 CA 1 0 0 0 1.00000 MARK MALTUN 4368 SPYRES WAY MODESTO CA 95356 0 MONICA OJCIUS 0 REGISTRATION AND OPERATION OF RAFFLES. X 0 1 COMMUNITY HOSPICE INC 4368 SPYRES WAY MODESTO CA 95356 942638213 501(C)(3) 1768143 0 FUNDS RAISED AND REIMBURSED EXPENSES FOR COMMUNITY HOSPICE INC 1 PART I, LINE 2: ALL FUNDS ARE DISTRIBUTED TO COMMUNITY HOSPICE, INC. WHICH IS A RELATED ENTITY. X X X X X 0 0 0 0 0 0 0 0 0 PETER LAI MEDICAL DIRECTOR 0 312156 0 0 0 0 0 14078 0 14124 0 340358 0 0 SOVICHEA MONY MEAS TRIAGE RN 0 212855 0 0 0 0 0 6992 0 12302 0 232149 0 0 MANINDERDEEP KAHLON NURSE PRACTITIONER 0 192681 0 0 0 0 0 9562 0 6151 0 208394 0 0 RAJVINDER KAUR NURSE PRACTITIONER 0 193947 0 0 0 0 0 7733 0 6420 0 208100 0 0 JATINDERJIT HUNDAL ACHH ADMINISTRATOR 0 191698 0 0 0 0 0 1577 0 6151 0 199426 0 0 JOHN RENNER FORMER INTERIM CEO 0 177562 0 0 0 0 0 0 0 0 0 177562 0 0 MARK MALTUN CHIEF FINANCIAL OFFICER 0 161885 0 0 0 0 0 4839 0 6151 0 172875 0 0 MONICA OJCIUS INTERIM CHF EXECUTIVE DIRECTOR 0 136491 0 0 0 0 0 8267 0 12840 0 157598 0 0 X PRIZES 210 92937 DONOR REPRESENTATION X CONSUMABLE GOODS 26 48571 DONOR REPRESENTATION 0 0 1 0 FORM 990, PART VI, SECTION A, LINE 3 MANAGEMENT DUTIES ARE PERFORMED BY CHI MANAGEMENT, INC. WHICH IS A RELATED PARTY EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6 COMMUNITY HOSPICE INC. IS THE MEMBER OF COMMUNITY HOSPICE FOUNDATION AND IS A RELATED ENTITY. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION HAS ONE MEMBER WITH THE POWER TO ELECT OR APPOINT ONE OR MORE MEMBERS OF THE GOVERNING BODY. THE MEMBER IS COMMUNITY HOSPICE, INC., A RELATED ENTITY. FORM 990, PART VI, SECTION A, LINE 7B GOVERNANCE DECISIONS BY THE ORGANIZATION MAY BE SUBJECT TO APPROVAL BY COMMUNITY HOSPICE, INC. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS REVIEWS THE FORM 990 AND IS PROVIDED WITH AN OPPORTUNITY TO COMMENT ON THE TAX RETURN PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C ALL EMPLOYEES, VOLUNTEERS, AND MEMBERS OF THE BOARD OF DIRECTORS AND ADVISORY COMMITTEES WILL SIGN A CONFLICT OF INTEREST DOCUMENT UPON EMPLOYMENT, APPOINTMENT, OR REAPPOINTMENT AT LEAST ANNUALLY AND MONITORED BY THE CORPORATE COMPLIANCE OFFICER, INDICATING THAT THEY HAVE READ AND UNDERSTOOD THE RELEVANT POLICIES AND THAT THEY WILL OBSERVE THEM. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS APPROVED BY THE INDEPENDENT BOARD OF DIRECTORS WHERE THE VOTE OF EACH MEMBER IS COUNTED. COMPENSATION ANALYSIS OF SIMILARLY SITUATED ORGANIZATIONS (TAXABLE AND TAX-EXEMPT) WITH RESPECT TO SIZE AND RESPONSIBILITIES OF EACH POSITION ARE COMPARED. THIS ANALYSIS IS PREPARED ANNUALLY. THE PROCESS OF ARRIVING AT EACH INDIVIDUAL'S COMPENSATION ARRANGEMENT IS DOCUMENTED IN BOARD MINUTES, PERSONAL ACTION FORMS, AND THE EMPLOYEE'S PERSONNEL FILE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES AVAILABLE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND ANNUAL REPORT TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 24E STAFF RECRUITMENT, TRAINING & EDUCATION: PROGRAM SERVICE EXPENSES 6,303. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,303. MEMBERSHIP, DUES, AND SUBSCRIPTIONS: PROGRAM SERVICE EXPENSES 83. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 83. FORM 990, PART XII, LINE 2C MEMBERS OF THE BOARD OF DIRECTORS FROM COMMUNITY HOSPICE, INC., CHI MANAGEMENT, INC. AND COMMUNITY HOSPICE FOUNDATION MAKE UP THE AUDIT COMMITTEE CHARGED WITH THE RESPONSIBILITY OF OVERSIGHT IN CONNECTION TO THE AUDITED FINANCIAL STATEMENTS AND SELECTION OF INDEPENDENT AUDITORS. COMMUNITY HOSPICE INC 4368 SPYRES WAY MODESTO CA 95356 942638213 HOSPICE CARE FOR THE TERMINALLY ILL CA 501(C)(3) 509(A)(2) N/A 0 CHI MANAGEMENT INC 4368 SPYRES WAY MODESTO CA 95356 200178425 PROVIDE PROFESSIONAL SERVICES FOR CHI INC., CHI FOUNDATION AND HOPE CHEST CA 501(C)(3) 509(A)(2) N/A 0 0 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0