2024-05-01T12:07:43-05:00 2023-09-30 941239084 ATHERTON & ASSOCIATES LLP PO BOX 4339 MODESTO CA 953524339 990 2022-10-01 942638213 COMMUNITY HOSPICE INC COMM 2095786300 4368 SPYRES WAY MODESTO CA 953569259 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 30867763 0 X WWW.HOSPICEHEART.ORG X 1979 CA HOSPICE CARE FOR THE TERMINALLY ILL 13 13 241 353 0 0 2661008 5126947 23029307 25151245 9429 12828 476881 576743 26176625 30867763 0 0 0 0 15872647 17520900 0 0 0 11939432 13054125 27812079 30575025 -1635454 292738 16005008 16144826 6520658 6367738 9484350 9777088 TO PROVIDE COMPASSIONATE, QUALITY CARE, EDUCATION AND SUPPORT TO TERMINALLY ILL PATIENTS AND THEIR FAMILIES, REGARDLESS OF ABILITY TO PAY. 0 0 25845387 0 25591338 TO PROVIDE AID AND COMFORT TO TERMINALLY ILL PATIENTS AND THEIR FAMILIES ON A PHYSICAL AND SPIRITUAL LEVEL. 25845387 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 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 0 0 1 1 1 0 0 1 42 0 241 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X MARK MALTUN 2095786300 4368 SPYRES WAY MODESTO CA 953569259 CHAD VAN HOUTEN CHAIR 1.00 0.50 X X 0 0 0 FATIMA SEWARD VICE CHAIR 1.00 0.50 X X 0 0 0 MICHAEL GIANELLI SECRETARY 1.00 0.50 X X 0 0 0 CHERYL HARLESS TREASURER 1.00 0.50 X X 0 0 0 SUSAN DONKER PAST CHAIR 1.00 0.50 X X 0 0 0 DAVID BENN BOARD MEMBER 1.00 X 0 0 0 MELVIN BRADLEY BOARD MEMBER 1.00 X 0 0 0 SUE CIPPONERI BOARD MEMBER 1.00 X 0 0 0 GREGORY D FIELDS BOARD MEMBER 1.00 X 0 0 0 EUGENE PATRIZIO BOARD MEMBER 1.00 X 0 0 0 KRISTIN REZA BOARD MEMBER 1.00 X 0 0 0 CHRISTINE SCHWEININGER BOARD MEMBER 1.00 X 0 0 0 PHILIP YU BOARD MEMBER 1.00 1.00 X 0 0 0 MARK MALTUN CHIEF FINANCIAL OFFICER 1.00 41.00 X 0 161885 10990 ALISA BETTIS CHIEF EXECUTIVE OFFICER 40.00 2.00 X 74187 0 1605 MONICA OJCIUS INTERIM CHF EXECUTIVE DIRECTOR 1.00 41.00 X 0 136491 21107 RAJVINDER KAUR NURSE PRACTITIONER 40.00 2.00 X 193947 0 14153 MANINDERDEEP KAHLON NURSE PRACTITIONER 40.00 2.00 X 192681 0 15713 PETER LAI MEDICAL DIRECTOR 40.00 2.00 X 312156 0 28202 SOVICHEA MONY MEAS TRIAGE RN 40.00 2.00 X 212855 0 19294 JATINDERJIT HUNDAL ACHH ADMINISTRATOR 40.00 2.00 X 191698 0 7728 JOHN RENNER FORMER INTERIM CEO 40.00 2.00 X 177562 0 0 1355086 298376 118792 50 1 1 0 MIGUEL HERNANDEZ MD 1448 FLORIDA AVE MODESTO CA 95350 MEDICAL SERVICES 185352 DREW HO MD PO BOX 2386 OAKDALE CA 95361 MEDICAL SERVICES 166793 HUMAYUN ABBAS 1018 S WEDGEWOOD RD SAN RAMON CA 94582 MEDICAL SERVICES 102506 3 3151204 1975743 5126947 PATIENT SERVICES 621610 25151245 25151245 25151245 12828 12828 136650 0 136650 136650 136650 MISCELLANEOUS 900099 440093 440093 440093 30867763 25591338 0 149478 X 232374 232374 15720978 15371211 349767 413217 404231 8986 1154331 1110140 44191 2759708 2759708 617993 183175 434818 17595 17595 225268 191669 33599 393273 169569 223704 496608 496608 226707 226707 358958 58843 300115 691813 600671 91142 DIRECT PATIENT SERVICES 5917410 5917410 EQUIPMENT RENTAL AND MA 538921 405039 133882 PROVISION FOR BAD DEBTS 268175 250850 17325 STAFF RECRUITMENT, TRAI 146879 129355 17524 394817 306647 88170 30575025 25845387 4729638 0 496606 345521 3764675 453790 3202707 4008150 104886 123332 612170 487300 15655413 8041143 7781503 7614270 42461 3112463 16005008 16144826 2697741 2123901 193036 141132 2104843 1911206 41957 24189 1483081 2167310 6520658 6367738 X 9291082 9328982 193268 448106 9484350 9777088 16005008 16144826 292738 0 X X 0 1 X 1 1 1 X 1360230 1753542 3573624 2661008 5126947 14475351 24594271 23975979 23706594 23370588 25591338 121238770 25954501 25729521 27280218 26031596 30718285 135714121 0 0 0 135714121 140565 140194 145276 145029 149478 720542 140565 140194 145276 145029 149478 720542 26095066 25869715 27425494 26176625 30867763 136434663 0.99470 0.99460 0.00530 0.00540 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1133925 348 158922 1293195 1409600 1339 -201492 1133925 1204287 1767 225932 1409600 1142324 1640 60323 1204287 1058448 114384 1142324 0.25710 0.74290 0.00000 0 1 1 1511422 1511422 5839763 2647620 3192143 8304228 5393523 2910705 7614270 BOND CASH COLLATERAL 3317 DEPOSITS 4620 RELATED PARTY RECEIVABLE 924837 OPERATING LEASE RIGHT-OF-USE ASSETS 203946 EMPLOYEE RETENTION CREDIT RECEIVABLE 1975743 3112463 RELATED PARTY PAYABLE 197180 LINE OF CREDIT 1467121 OPERATING LEASE LIABILITIES 206648 SBA LOAN PAYABLE 296361 2167310 X 30767864 -99899 -99899 30867763 0 30867763 30575025 0 30575025 0 30575025 PART V, LINE 4: THE INTENDED USE OF THE ENDOWMENT FUNDS ARE TO FUND FUTURE OPERATING EXPENSES. PART X, LINE 2: MANAGEMENT HAS EVALUATED HOSPICE'S TAX POSITIONS AND CONCLUDED THAT HOSPICE 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. HOSPICE 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. X X X X X 0 0 0 0 0 0 0 0 0 PETER LAI MEDICAL DIRECTOR 312156 0 0 0 0 0 14078 0 14124 0 340358 0 0 0 SOVICHEA MONY MEAS TRIAGE RN 212855 0 0 0 0 0 6992 0 12302 0 232149 0 0 0 MANINDERDEEP KAHLON NURSE PRACTITIONER 192681 0 0 0 0 0 9562 0 6151 0 208394 0 0 0 RAJVINDER KAUR NURSE PRACTITIONER 193947 0 0 0 0 0 7733 0 6420 0 208100 0 0 0 JATINDERJIT HUNDAL ACHH ADMINISTRATOR 191698 0 0 0 0 0 1577 0 6151 0 199426 0 0 0 JOHN RENNER FORMER INTERIM CEO 177562 0 0 0 0 0 0 0 0 0 177562 0 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 A CALIFORNIA ENTERPRISE DEVELOPMENT AUTHORITY 352273601 13067RAD5 2006-11-01 5200000 REFINANCE BUILDING LOAN 0 0 0 A 5200000 129022 2006 0 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 1 0 0 0 0 A 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 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 SIMILAR 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 ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND ANNUAL REPORT AVAILABLE TO THE PUBLIC UPON REQUEST IN PUBLIC BINDERS. FORM 990, PART IX, LINE 24E CONTRACT LABOR: PROGRAM SERVICE EXPENSES 85,802. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 85,802. PROMOTION: PROGRAM SERVICE EXPENSES 71,537. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 71,537. MEMBERSHIP, DUES, AND SUBSCRIPTIONS: PROGRAM SERVICE EXPENSES 51,744. MANAGEMENT AND GENERAL EXPENSES 6,697. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 58,441. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 49,896. MANAGEMENT AND GENERAL EXPENSES 8,087. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 57,983. KITCHEN SUPPLIES: PROGRAM SERVICE EXPENSES 7,390. MANAGEMENT AND GENERAL EXPENSES 43,251. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 50,641. JANITORIAL: PROGRAM SERVICE EXPENSES 21,419. MANAGEMENT AND GENERAL EXPENSES 11,143. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,562. LICENSES: PROGRAM SERVICE EXPENSES 3,282. MANAGEMENT AND GENERAL EXPENSES 16,388. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,670. SUPPLIES & MINOR EQUIPMENT: PROGRAM SERVICE EXPENSES 11,006. MANAGEMENT AND GENERAL EXPENSES 2,604. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,610. PROGRAM SPECIFIC: PROGRAM SERVICE EXPENSES 4,571. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,571. 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. FORM 990, PART VIII, LINE 8 FUNDRAISING INCOME AND EXPENSES DO NOT APPEAR ON THE FORM 990 FOR COMMUNITY HOSPICE, INC. ALL FUNDRAISING ACTIVITIES ARE CONDUCTED AND REPORTED ON THE FORM 990 OF COMMUNITY HOSPICE FOUNDATION, A TYPE 1 SUPPORTING ORGANIZATION. CHI MANAGEMENT INC 4368 SPYRES WAY MODESTO CA 95351 200178425 TO PROVIDE PROFESSIONAL SERVICES FOR NONPROFIT ORGANIZATIONS. CA 501(C)(3) 509(A)(2) N/A 1 COMMUNITY HOSPICE FOUNDATION 4368 SPYRES WAY MODESTO CA 95351 770562224 TO RAISE FUNDS TO SUPPORT THE OPERATION OF COMMUNITY HOSPICE, INC. CA 501(C)(3) 509(A)(3) N/A 1 0 0 1 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 COMMUNITY HOSPICE FOUNDATION C 1768143 FAIR MARKET VALUE CHI MANAGEMENT INC C 1363061 FAIR MARKET VALUE CHI MANAGEMENT INC M 2759708 FAIR MARKET VALUE CHI MANAGEMENT INC J 72000 FAIR MARKET VALUE COMMUNITY HOSPICE FOUNDATION J 18000 FAIR MARKET VALUE