2023-08-15T12:01:56-05:00 2022-09-30 593070669 MSL PA 500 E BROWARD BLVD SUITE 1550 FORT LAUDERDALE FL 33394 990 2021-10-01 591911861 TIDEWELL HOSPICE INC TIDE 7275864432 5595 RAND BLVD SARASOTA FL 34238 SAIDA BOUHAMID CFO 7275864432 2023-08-15 1 SAIDA BOUHAMID 999009999 VICKI L HINZ CPA P00356696 9548578910 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z JONATHAN FLEECE 5595 RAND BLVD SARASOTA FL 34238 113594422 0 X WWW.EMPATHHEALTH.ORG X 1979 FL TIDEWELL HOSPICE'S MISSION IS HELPING PEOPLE LIVE WELL BY PROVIDING CARE, COMFORT AND COMPASSION. 13 13 978 535 91326 0 6809037 9979799 103332999 103482962 758992 39898 -44284 91326 110856744 113593985 91834 55825 0 0 0 0 0 0 94894 108991445 113165864 109083279 113221689 1773465 372296 30737381 29135309 7992221 7723779 22745160 21411530 X TIDEWELL HOSPICE'S MISSION IS HELPING PEOPLE LIVE WELL BY PROVIDING CARE, COMFORT AND COMPASSION. WHILE HONORING HUMAN DIGNITY AND PERSONAL CHOICE, TIDEWELL TREATS THE WHOLE PERSON THROUGH QUALITY EN-OF-LIFE PROGRAMS THAT FULFILL PHYSICAL, EMOTIONAL AND SPIRITUAL NEEDS. 0 0 92012764 42330 86521454 PATIENT CARETIDEWELL PROVIDE A FULL SPECTRUM OF PROGRAMS AND SERVICES DESIGNED TO RESPOND TO THE NEEDS OF PATIENTS AND FAMILIES WHO ARE LIVING WITH ADVANCED ILLNESS. FROM MEDICAL TO PSYCHOSOCIAL AND SPIRITUAL SERVICES, TIDEWELL CARES FOR THE WHOLE PERSON. TIDEWELL ALSO GOES BEYOND TYPICAL HOSPICE SERVICES BY PROVIDING A LARGE VARIETY OF ALTERNATIVE SERVICES - PET, HORTICULTURE, ART, MUSIC, AROMATHERAPIES, REIKI, THERAPEUTIC MASSAGE AND MORE.TIDEWELL PROVIDED 428,335 PATIENT DAYS OF HOSPICE CARE TO PATIENTS AND THEIR FAMILIES THROUGHOUT SARASOTA, MANATEE, CHARLOTTE, AND DESOTO COUNTIES. DURING FY22, TIDEWELL HOSPICE PROVIDED $4,513,823 IN UNREIMBURSED SERVICES AND COMMUNITY BENEFITS, FULFILLING A KEY PART OF TIDEWELL'S MISSION TO SERVE ALL THOSE IN NEED, REGARDLESS OF THEIR ABILITY TO PAY.RATHER THAN A PLACE, HOSPICE IS A PHILOSOPHY - A PROGRAM OF CARE AND SUPPORT WHEREVER PATIENTS NEED US. TIDEWELL'S SERVICES EXTEND TO ANY LOCATION - A HOME, THE HOSPITAL, AN ASSISTED LIVING FACILITY (ALF), A NURSING HOME OR ANY OF TIDEWELL'S EIGHT HOSPICE HOUSES. PATIENTS WITH CHRONIC OR LIFE-LIMITING ILLNESS AND THEIR FAMILIES WILL NEVER BE ALONE AS TIDEWELL HOSPICE REACHES OUT TO ANY SETTING TO PROVIDE FULL SUPPORT. 16963284 16961508 HOSPICE HOUSESSINCE THEIR INCEPTION, TIDEWELL'S HOSPICE HOUSES HAVE BEEN THE SITE OF RESIDENTIAL CARE FOR THOSE AT THE END OF LIFE WHO HAVE NO CAREGIVER OR WHOSE CAREGIVER IS NO LONGER ABLE TO CARE FOR THEM AT HOME. TIDEWELL'S EIGHT HOSPICE HOUSES ARE ALSO LICENSED AS INPATIENT CARE FACILITIES, ALLOWING FOR THE SKILLED NURSING CARE OF PATIENTS WHOSE NEEDS PREVIOUSLY COULD ONLY BE MET IN THE HOSPITAL SETTING. PATIENTS IN NEED OF CONTINUOUS SYMPTOM CONTROL CAN BE ADMITTED FOR AROUND-THE-CLOCK CARE WHILE THEIR CONDITION IS STABILIZED. TIDEWELL PROVIDED 20,770 PATIENT DAYS OF HOSPICE HOUSE CARE TO PATIENTS AND THEIR FAMILIES IN FY22. 1621547 13495 GRIEF SUPPORTTIDEWELL OFFERS A WIDE VARIETY OF BEREAVEMENT SERVICES, INCLUDING INDIVIDUAL COUNSELING SESSIONS AND ONGOING GRIEF AND LOSS SUPPORT GROUPS. THERE ARE SUPPORT GROUPS FOR ADULTS, AS WELL AS CHILDREN AND TEENS - AND A VARIETY OF GRIEF-SPECIFIC GROUPS FOR SURVIVORS OR SUICIDE, LOVED ONES OF MILITARY VETERANS, PARENTS WHO ARE GRIEVING THE LOSS OF A CHILD AND MORE. ALL BEREAVEMENT SERVICES ARE OFFERED AT NO COST. SERVICES ARE PROVIDED TO ANYONE WHO HAS EXPERIENCED THE DEATH OF A LOVED ONE, NOT JUST THOSE WHO HAVE HAD A LOVED ONE WHO RECEIVED TIDEWELL SERVICES. 472977 COMPLEMENTARY SERVICESUSED TOGETHER WITH CONVENTIONAL MEDICINE, THESE THERAPIES REDUCE STRESS, RELIEVE PAIN AND CREATE DISTRACTION AND OPPORTUNITIES FOR JOY. PROGRAMS INCLUDE: EXPRESSIVE ART, A TYPE OF ART THAT IS NOT CONCERNED WITH THE END RESULT, BUT RATHER WITH THE CREATIVE PROCESS. IT DIVERTS THE PATIENT'S ATTENTION FROM STRESSFUL SYMPTOMS. MUSIC THERAPY BRINGS THE BODY INTO HARMONY AND ENCOURAGES A RELEASE OF ENDORPHINS WHICH HELP STOP PAIN. HORTICULTURAL ACTIVITIES USES PLANTS AND GARDENING ACTIVITIES TO REDUCE STRESS AND DISCOMFORT, ALLEVIATE DEPRESSION AND FEELINGS OF BOREDOM AND LONELINESS. PET THERAPY BRINGS BACK MEMORIES OF FAVORITE PETS AND TRIGGERS DISCUSSION. TIDEWELL'S CLOWNS VISIT AREA NURSING HOMES AND ASSISTED LIVING FACILITIES TO BRING CHEER AND LAUGHTER. AROMATHERAPY USES ESSENTIAL OILS TO BENEFIT THE MIND, BODY AND SPIRIT. THEY CAN BE CALMING, ANTISEPTIC, STIMULATING AND MEDITATIVE. THERAPEUTIC MASSAGE, REIKI AND CARING TOUCH CONTRIBUTE TO PAIN AND STRESS MANAGEMENT AND EVOKE RELAXATION. 472977 111070572 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 1 978 1 1 1 0 0 0 0 0 0 0 0 0 X 13 13 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 FL X SAIDA BOUHAMID 7275864432 5595 RAND BLVD SARASOTA FL 34238 JONATHAN FLEECE PRESIDENT 1.00 46.00 X 0 910629 52399 RAFAEL J SCIULLO CHIEF EXECUTIVE OFFICER 1.00 46.00 X 0 909978 59885 SAIDA BOUHAMID CHIEF FINANCIAL OFFICER 1.00 46.00 X 0 426247 44537 JAMES VALENTI ASSOC. MEDICAL DIRECTOR 40.00 X 324272 0 44868 KAREN RAY ASSOC. MEDICAL DIRECTOR 40.00 X 218582 0 36689 KIMBERLY MARSTERS ASSOC. MEDICAL DIRECTOR 40.00 X 205116 0 43144 BRADEN VANDERWALL ASSOC. MEDICAL DIRECTOR 32.00 X 194596 0 43863 RICHARD DEIBERT COMMUNITY RESOURCE PHYSICIAN 40.00 X 176835 0 28487 ESTHER WYLEN ASSOC. MEDICAL DIRECTOR 40.00 X 173343 0 17755 DONNA JOLLY VP PHARMACY 40.00 X 154458 0 43163 ROBERT KLEIN RESOURCE PHYSICIAN 32.00 X 106756 0 941 KEVIN LOGAN CHAIR 1.00 X X 0 0 0 MATTHEW MAYPER VICE CHAIR 1.00 X X 0 0 0 RENEE EPPARD SECRETARY 1.00 X X 0 0 0 KIMBERLIE BUCHANAN TREASURER 1.00 X X 0 0 0 JAMES FIORICA MD BOARD MEMBER 1.00 X 0 0 0 KAREN FORDHAM BOARD MEMBER 1.00 X 0 0 0 STEVE HALL BOARD MEMBER 1.00 X 0 0 0 A JILL C MCCRORY BOARD MEMBER 1.00 X 0 0 0 FERMIN JJ MIRANDA BOARD MEMBER 1.00 X 0 0 0 STEVE ROSKAMP BOARD MEMBER 1.00 X 0 0 0 MINDY RYALS BOARD MEMBER 1.00 X 0 0 0 JAKE SORG BOARD MEMBER 1.00 X 0 0 0 DANIEL DEEMS BOARD MEMBER 1.00 X 0 0 0 1553958 2246854 415731 32 0 1 0 CORE MEDICAL GROUP 655 SOUTH WILLOW STREET SUITE 128 MANCHESTER NH 03103 MEDICAL AND HEALTH CARE 1478617 STATESERV MEDICAL OF FLORIDA LLC 2130 E UNIVERSITY DRIVE TEMPE AZ 85281 MEDICAL AND HEALTH CARE 1014286 LABORATORY CORPORATION OF AMERICA PO BOX 12140 BURLINGTON NC 27126 MEDICAL LABORATORY SERVICES 947359 SOUTHWEST FLORIDA RETIREMENT CENTER INC 920 TAMIAMI TRAIL SOUTH VENICE FL 34285 MEDICAL AND HEALTH CARE 697214 FUSION MEDICAL STAFFING LLC PO BOX 82674 LINCOLN NE 68501 MEDICAL STAFF SERVICES 624243 57 6776034 2873749 330016 71404 9979799 MEDICARE/MEDICAID PAYMENTS 623000 100770701 100770701 PRIVATE INSURANCE 623000 2419352 2419352 PRIVATE PAYMENTS 623000 292909 292909 103482962 40335 40335 437 -437 -437 -437 OTHER INVESTMENT LOSS - K-1 91326 91326 91326 113593985 103482962 91326 39898 X 55825 55825 18103651 17570164 533487 22507 22507 61407187 60586224 820842 121 1088 538 550 516814 471014 45554 246 3653940 3315683 245258 92999 1302 1302 31956 31956 785159 654258 130901 173956 25837 148119 THERAPY CARE & OTHER PA 21293463 21292748 715 MEDICAL SUPPLIES & PHAR 4529301 4529301 MEDICAL EQUIPMENT 2202886 2201606 1280 MISCELLANEOUS 442654 334116 108275 263 113221689 111070572 2056223 94894 3649 3501 7167057 1502762 154300 1700 6241244 6322877 8535 58983 69582 9197111 5160344 2437897 4036767 226984 226984 14447267 16962601 30737381 29135309 7992221 7723779 7992221 7723779 X 14412508 15134395 8332652 6277135 22745160 21411530 30737381 29135309 X 372296 -1705926 X X 0 1 X 1 0 X 6175741 9324936 5954305 6799862 9979799 38234643 6175741 9324936 5954305 6799862 9979799 38234643 38234643 571215 655444 642871 50753 40335 1960618 33277 323060 59980 416317 40611578 103482962 0.94150 0.92070 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3588 3588 0 PART II-B, LINE 1: TIDEWELL HOSPICE PAID DUES TO AN ORGANIZATION WHICH USED A PORTION OF THOSE DUES FOR LOBBYING. 63474 25125 38349 9133637 5135219 3998418 4036767 DEPOSITS 27188 BEQUESTS RECEIVABLE 555250 BENEFICIAL INTEREST - COMMUNITY FOUNDATION 6238319 WORK IN PROCESS 545160 DUE FROM RELATED ENTITIES 9596684 16962601 X 111865552 -1614600 -1614600 113480152 22507 91326 113833 113593985 113199182 0 113199182 22507 22507 113221689 PART X, LINE 2: HOSPICE HAS RECEIVED A DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE ("IRS") THAT IT IS EXEMPT FROM FEDERAL INCOME TAX AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("IRC"). IT IS ALSO EXEMPT FROM STATE INCOME TAX PURSUANT TO FLORIDA LAW. FURTHER, HOSPICE IS NOT A PRIVATE FOUNDATION FOR FEDERAL TAX PURPOSES AND QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER IRC SECTION 170 AS WELL AS TAX DEDUCTIBLE BEQUESTS, DEVICES, TRANSFERS OR GIFTS UNDER SECTIONS 2055, 2106, OR 2522. HOSPICE IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, HOSPICE IS POTENTIALLY SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSES, IF ANY. HOSPICE HAD NO UNRELATED BUSINESS TAXABLE INCOME DURING THE YEARS ENDED SEPTEMBER 30, 2022 OR 2021. ACCORDINGLY, THESE FINANCIAL STATEMENTS INCLUDE NO PRO-VISION OR LIABILITY FOR INCOME TAXES. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN ASSETS HELD BY OTHERS -1,614,600. PART XI, LINE 4B - OTHER ADJUSTMENTS: SCHEDULE K-1 INCOME/LOSS 91,326. 1 VARIOUS 50 55825 X X X X X 0 0 0 0 0 0 0 0 0 JONATHAN FLEECE PRESIDENT 0 698800 0 0 0 211829 0 26000 0 26399 0 963028 0 0 RAFAEL J SCIULLO CHIEF EXECUTIVE OFFICER 0 819429 0 0 0 90549 0 26000 0 33885 0 969863 0 0 SAIDA BOUHAMID CHIEF FINANCIAL OFFICER 0 388899 0 0 0 37348 0 26000 0 18537 0 470784 0 0 JAMES VALENTI ASSOC. MEDICAL DIRECTOR 324272 0 0 0 0 0 22702 0 22166 0 369140 0 0 0 KAREN RAY ASSOC. MEDICAL DIRECTOR 218582 0 0 0 0 0 19500 0 17189 0 255271 0 0 0 KIMBERLY MARSTERS ASSOC. MEDICAL DIRECTOR 205116 0 0 0 0 0 18307 0 24837 0 248260 0 0 0 BRADEN VANDERWALL ASSOC. MEDICAL DIRECTOR 194596 0 0 0 0 0 19500 0 24363 0 238459 0 0 0 RICHARD DEIBERT COMMUNITY RESOURCE PHYSICIAN 176835 0 0 0 0 0 21394 0 7093 0 205322 0 0 0 ESTHER WYLEN ASSOC. MEDICAL DIRECTOR 173343 0 0 0 0 0 8353 0 9402 0 191098 0 0 0 DONNA JOLLY VP PHARMACY 154458 0 0 0 0 0 25370 0 17793 0 197621 0 0 0 PART I, LINE 3 THE COMPENSATION OF THE PRESIDENT AND CEO IS DETERMINED BY EMPATH HEALTH, INC. ("EHI"). EHI USES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, THE FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEYS OR STUDIES, AND APPROVAL BY THE BOARD OF DIRECTORS OR COMPENSATION COMMITTEE TO DETERMINE HIS COMPENSATION. X 1 67499 LAND LEASE VALUATION 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 SANDY BUCHANAN, STRATUM HEALTH SYSTEM TRUSTEE AND KIMBERLIE BUCHANAN, TIDEWELL HOSPICE TRUSTEE AS SISTER IN-LAWS. STEVE HALL, STRATUM HEALTH SYSTEM AND TIDEWELL HOSPICE TRUSTEE IS THE NEPHEW OF LORI DENGLER, TIDEWELL HOSPICE ARNP (NOT KEY EMPLOYEE). FORM 990, PART VI, SECTION B, LINE 11B UPON COMPLETION AND BEFORE SUBMISSION, THE FORM 990 IS PROVIDED TO EACH BOARD MEMBER ALONG WITH A SUMMARY OF IMPORTANT HIGHLIGHTS, NOTING THE PAGE NUMBERS AND LINES FOR ITEMS OF PARTICULAR IMPORTANCE TO REVIEW. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD OF TRUSTEES AND KEY EMPLOYEES SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT. BOARD MEMBERS SIGN A STATEMENT ANNUALLY. POSSIBLE CONFLICTS ARE REVIEWED OR RESOLVED BY NON-INTERESTED PARTIES OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 15 EACH YEAR A MARKET ANALYSIS IS PERFORMED. ANALYSIS IS CROSS REFERENCED WITH NATIONAL COMPENSATION PUBLICATION FOR VALIDATION. THE INFORMATION DERIVED FROM THIS PROCESS IS PRESENTED TO THE PERSONNEL COMMITTEE, A SUBCOMMITTEE OF THE BOARD OF TRUSTEES. FULL BOARD OF TRUSTEES' APPROVAL IS REQUIRED IN ORDER TO ADJUST COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 TIDEWELL HOSPICE MAKES ITS FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. EACH REQUEST IS EVALUATED BY THE CFO AND A COPY OF THE REQUESTED DOCUMENT IS MADE AND MAILED TO THE REQUESTER. FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 234,896. MANAGEMENT AND GENERAL EXPENSES 43,553. FUNDRAISING EXPENSES 121. TOTAL EXPENSES 278,570. MEDICAL TRANSPORTATION: PROGRAM SERVICE EXPENSES 745,437. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 745,437. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 926,450. MANAGEMENT AND GENERAL EXPENSES 5,853. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 932,303. SALARIES AND BENEFITS ALLOCATION: PROGRAM SERVICE EXPENSES 58,679,441. MANAGEMENT AND GENERAL EXPENSES 771,436. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 59,450,877. FORM 990, PART XI, LINE 9: SCHEDULE K-1 INCOME/LOSS -91,326. CHANGE IN ASSETS HELD BY OTHERS -1,614,600. FORM 990, PART XII, LINE 2C: THE ORGANIZATION'S SOLE MEMBER, STRATUM HEALTH SYSTEMS INC., IS RESPONSIBLE FOR THE OVERSIGHT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THERE WAS NO CHANGE IN THIS PROCESS FROM THE PRIOR YEAR. STRATUM HEALTH SYSTEM INC 5955 RAND BLVD SARASOTA FL 34238 472508009 PROVIDE A COMPREHENSIVE CONTINUUM OF SERVICES FL 501(C)(3) LINE 12A, I EMPATH-STRATUM INC 0 TIDEWELL FOUNDATION INC 5955 RAND BLVD SARASOTA FL 34238 850729071 PROVIDE FUNDS TO SUPPORT THE MISSION AND PROGRAMS OF TIDEWELL HOSPICE FL 501(C)(3) LINE 7 STRATUM HEALTH SYSTEM INC 0 EMPATH HEALTH INC 5771 ROOSEVELT BLVD CLEARWATER FL 33760 263605761 PROVIDE A COMPREHENSIVE CONTINUUM OF SERVICES FL 501(C)(3) LINE 12B, II EMPATH-STRATUM INC 0 THE HOSPICE OF THE FLORIDA SUNCOAST INC 5771 ROOSEVELT BLVD CLEARWATER FL 33760 591744006 HOSPICE FL 501(C)(3) LINE 10 EMPATH HEALTH INC 0 THE HOSPICE INSTITUTE OF THE FLORIDA SUNCOAST INC 5771 ROOSEVELT BLVD CLEARWATER FL 33760 593176721 INACTIVE FL 501(C)(3) LINE 7 EMPATH HEALTH INC 0 THE HOSPICE FOUNDATION OF THE FLORIDA SUNCOAST INC 5771 ROOSEVELT BLVD CLEARWATER FL 33760 592252045 FUNDRAISING FL 501(C)(3) LINE 7 EMPATH HEALTH INC 0 SUNCOAST PACE INC 5771 ROOSEVELT BLVD CLEARWATER FL 33760 452980257 PACE PROGRAM FL 501(C)(3) LINE 10 EMPATH HEALTH INC 0 AIDS SERVICE ASSOCIATION OF PINELLAS INC DBA EMPATH PARTNERS IN CARE (EPIC 5771 ROOSEVELT BLVD CLEARWATER FL 33760 592862537 AIDS PREVENTION FL 501(C)(3) LINE 7 EMPATH HEALTH INC 0 EMPATH-STRATUM INC 5771 ROOSEVELT BLVD CLEARWATER FL 33760 851356625 PROVIDE A COMPREHENSIVE CONTINUUM OF SERVICES FL 501(C)(3) LINE 12A, I 0 HOSPICE SYSTEMS INC 5771 ROOSEVELT BLVD CLEARWATER FL 33760 593502780 INACTIVE FL EMPATH HEALTH INC C 0 0 0 1 0 0 0 0 0 0 0 1 0 1 0 1 1 1 1 1