2025-08-15T18:34:43-05:00 2024-09-30 941239084 ATHERTON & ASSOCIATES LLP PO BOX 4339 MODESTO CA 953524339 990 2023-10-01 770562224 COMMUNITY HOSPICE FOUNDATION STANISLAUS COUNTY COMM 2095786300 4368 SPYRES WAY MODESTO CA 95356 MATHEW FRANCIS CEO 2095786300 2025-08-13 1 1 JACQUELYN HOWELL P01327223 2095774800 2025-08-05 X 2023 2025-03-06 01:10:19Z MATHEW FRANCIS 4368 SPYRES WAY MODESTO CA 95356 6245844 0 X WWW.HOSPICEHEART.ORG X 2002 CA SUPPORT OF COMMUNITY HOSPICE, INC. 19 19 7 67 0 0 1381449 5901220 0 0 150316 194093 -112604 -130821 1419161 5964492 1768143 3006247 0 0 241522 358432 0 0 182738 273942 691460 2283607 4056139 -864446 1908353 7948075 11859351 354192 1353769 7593883 10505582 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 3820136 3006247 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. 3820136 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 3 0 7 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 19 19 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X TOBY BENGUEREL 2095786300 4368 SPYRES WAY MODESTO CA 95356 TRACEY KERR CHAIRMAN 1.00 1.00 X X 0 0 0 JOY MASTACHE VICE CHAIR 1.00 X X 0 0 0 CATHY MENDOZA SECRETARY 1.00 X X 0 0 0 MELISSA WILLIAMS TREASURER 1.00 X X 0 0 0 MELVIN BRADLEY PAST CHAIR 1.00 X X 0 0 0 LORRAINE CARDOZA DIRECTOR 1.00 X 0 0 0 PAM DIFRANCIA DIRECTOR 1.00 X 0 0 0 TRAVIS GUZMAN DIRECTOR 1.00 X 0 0 0 JANICE LUCERO 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 TERESA SCOTT DIRECTOR 1.00 X 0 0 0 STEVEN PINEDO DIRECTOR 1.00 X 0 0 0 DEBORAH KIDWELL-GRAYSON DIRECTOR 1.00 X 0 0 0 MERYL SNIDER DIRECTOR 1.00 X 0 0 0 SHARON JACKSON 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 JEFF PETERSEN DIRECTOR 1.00 X 0 0 0 MARK MALTUN CHIEF FINANCIAL OFFICER THRU 5/19/24 1.00 41.00 X 0 160125 12716 ALISA BETTIS CHIEF EXECUTIVE OFFICER 1.00 41.00 X 0 245373 23551 MONICA OJCIUS CHF INTERIM EXECUTIVE DIRECTOR 1.00 41.00 X 0 157783 23968 TOBY BENGUEREL CHIEF FINANCIAL OFFICER AS OF 5/20/24 1.00 41.00 X 0 0 0 MANINDERDEEP KAHLON NURSE PRACTITIONER 1.00 41.00 X 0 195877 0 PETER LAI MEDICAL DIRECTOR 1.00 41.00 X 0 328576 0 SOVICHEA MONY MEAS TRIAGE RN 1.00 41.00 X 0 162436 0 RAJVINDER KAUR NURSE PRACTITIONER 1.00 41.00 X 0 193254 0 KARIE CROUCH TRIAGE RN 1.00 41.00 X 0 165956 0 0 1609380 60235 0 0 1 0 0 396464 5504756 76689 5901220 194093 194093 150531 396464 281352 -130821 -130821 5964492 0 0 63272 X 3006247 3006247 333921 166961 166960 2891 1446 1445 21620 10810 10810 53265 53265 30076 30076 42995 42995 18000 18000 708 708 5182 5182 9117 8716 401 ALLOWANCE FOR BAD DEBT 396319 396319 BANK, CREDIT CARD & PAY 69349 69349 COMPUTER MAINTENANCE 30929 30929 OTHER PROGRAM EXPENSES 20279 20279 15241 12119 3122 4056139 3820136 53265 182738 563384 1787524 163483 163496 131241 2332791 9066 9066 21397 16623 45570 45570 0 0 5737377 4119164 1322127 3430687 7948075 11859351 65046 108093 46108 39829 243038 1205847 354192 1353769 X 6412647 6621206 1181236 3884376 7593883 10505582 7948075 11859351 1908353 1003346 0 X X 0 1 X 1 0 X X 1 COMMUNITY HOSPICE INC 942638213 10 1 3006247 0 1 3006247 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 1293195 553 280453 9576 1564625 1133925 348 158922 1293195 1409600 1339 -201492 1133925 1204287 1767 225932 1409600 1142324 1640 60323 1204287 0.38560 0.61440 0.00000 0 0 17989 17989 0 27581 27581 0 0 INVESTMENT PROPERTY 4000 ENDOWMENT INVESTMENTS 1556659 EMPLOYEE RETENTION CREDIT RECEIVABLE 49070 OTHER CURRENT ASSETS 21200 RELATED PARTY RECEIVABLES 369549 NOTE RECEIVABLE, RELATED PARTY 1430209 3430687 RELATED PARTY PAYABLE 1205847 1205847 X 6967964 1003346 126 1003472 5964492 0 5964492 1050018 126 126 1049892 3006247 3006247 4056139 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, 2020 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 307644 231472 76172 49142 26107 85514 GOLF FORE HOSPICE 98690 52140 46550 36822 2953 10725 4 140661 112852 27809 1090 19571 49428 546995 396464 150531 87054 48631 145667 281352 -130821 0 1 0.95000 CA 1 0 0 0 1.00000 MARK MALTUN AND TOBY BENGUEREL 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) 3006247 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 328576 0 0 0 0 0 0 0 0 0 328576 0 0 ALISA BETTIS CHIEF EXECUTIVE OFFICER 0 245373 0 0 0 0 0 0 0 23551 0 268924 0 0 MANINDERDEEP KAHLON NURSE PRACTITIONER 0 195877 0 0 0 0 0 0 0 0 0 195877 0 0 RAJVINDER KAUR NURSE PRACTITIONER 0 193254 0 0 0 0 0 0 0 0 0 193254 0 0 MONICA OJCIUS CHF INTERIM EXECUTIVE DIRECTOR 0 157783 0 0 0 0 0 8267 0 15701 0 181751 0 0 MARK MALTUN CHIEF FINANCIAL OFFICER THRU 5/19/24 0 160125 0 0 0 0 0 4839 0 7877 0 172841 0 0 KARIE CROUCH TRIAGE RN 0 165956 0 0 0 0 0 0 0 0 0 165956 0 0 SOVICHEA MONY MEAS TRIAGE RN 0 162436 0 0 0 0 0 0 0 0 0 162436 0 0 X CONSUMABLE GOODS 26 42500 DONOR REPRESENTATION X PRIZES 210 34189 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 8,213. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,213. REPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 3,122. TOTAL EXPENSES 3,122. MEMBERSHIP, DUES, AND SUBSCRIPTIONS: PROGRAM SERVICE EXPENSES 2,144. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,144. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 1,762. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,762. 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