2023-09-11T09:37:38-05:00 2022-10-31 FORVIS LLP 111 South Tejon Suite 800 Colorado Springs CO 809039848 990 2021-11-01 840831843 MOUNT EVANS HOSPICE INC % BRANDI HOSKINS MOUN 3036746400 3081 BERGEN PEAK DRIVE EVERGREEN CO 80439 KERI SCHROEDER-JAEGER PRESIDENT/CEO 3036746400 2023-09-08 true KERI SHROEDER-JAEGER 999009999 Adam R Smith CPA P00958966 7194714290 2023-08-31 2 2021 2023-04-26 12:10:37Z MOUNT EVANS HOME HEALTH CARE & HOSPI KERI SCHROEDER-JAEGER 3081 BERGEN PEAK DRIVE EVERGREEN CO 80439 9725430 false X WWW.MTEVANS.ORG X 1980 CO PROVIDING COMPASSIONATE AND EXPERIENCED CARE DURING CHALLENGING TIMES. 16 16 100 300 0 1804982 3322380 6834941 5905808 193564 213730 -2493 4864 8830994 9446782 0 0 0 0 4897341 4906900 0 0 215403 2290842 2445134 7188183 7352034 1642811 2094748 7027978 8828699 620446 693072 6407532 8135627 WE SUPPORT OUR MOUNTAIN COMMUNITY BY PROVIDING COMPASSIONATE AND EXPERIENCED CARE DURING CHALLENGING TIMES false false 3408527 3011962 MOUNT EVANS HOME HEALTH CARE SERVICES PROVIDE HOMEBOUND INDIVIDUALS AND THEIR FAMILIES WITH NURSING, THERAPIES, AND SUPPORT SERVICES AS THEY RECOVER FROM AN ILLNESS OR INJURY. HOME HEALTH CARE ALLOWS PEOPLE TO RECOVER IN THE COMFORT OF THEIR OWN HOME UNTIL THEY ARE ABLE TO TRANSFER TO OUTPATIENT SERVICES. MOUNT EVANS PALLIATIVE CARE SERVICES PROVIDE SUPPORTIVE CARE TO THOSE LIVING WITH A CHRONIC OR PROGRESSIVE ILLNESS. PALLIATIVE CARE FOCUSES ON PROVIDING RELIEF FROM A PATIENT'S SYMPTOMS AND THE STRESS OF THEIR ILLNESS WITH THE GOAL OF IMPROVING THEIR QUALITY OF LIFE. IN FISCAL YEAR 2022 OUR HOME HEALTH AND PALLIATIVE CARE PROGRAMS MADE 15,232 VISITS TO 1,165 PEOPLE. 2253094 2893846 MOUNT EVANS HOSPICE SERVICES PROVIDE COMFORT CARE AND SUPPORT TO THOSE NEARING THE END OF THEIR LIVES IN FISCAL YEAR 2022 MOUNT EVANS HOSPICE TEAM PROVIDED 19,095 DAYS TO 214 PEOPLE TO PROVIDE END-OF-LIFE CARE. HOSPICE CARE IS PROVIDED IN PATIENT'S HOMES AND IN LOCAL LONG-TERM CARE AND ASSISTED CARE FACILITIES. 115543 0 MOUNT EVANS SUPPORT SERVICES PROGRAM PROVIDES INDIVIDUAL AND FAMILY BEREAVEMENT COUNSELING AND SUPPORT GROUPS INCLUDING: CAREGIVER SUPPORT, GRIEVING THE DEATH OF A SPOUSE/PARTNER, ADULT GRIEF SUPPORT, BEREAVED PARENT SUPPORT, SURVIVING THE HOLIDAYS, AND SOLSTICE MEMORIALS. IN FISCAL YEAR 2022, Mount Evans held over 150 individual and group bereavement counseling sessions and over 45 caregiver and bereavement support groups. MOUNT EVANS ALSO OFFERED FREE FOOT CARE AND BLOOD PRESSURE CLINICS, INFORMATION AND REFERRAL, AND COORDINATED WITH SAINT JOSEPH'S HOSPITAL TO HOST A MOBILE MAMMOGRAPHY UNIT 5777164 true true false false false false false false false true true false false false true true true false false false false false false false true false false false false true false false false false false false false false true false false false false false false false true 8 0 100 true false false false false false true true false false false false false false X 16 16 false false false false false false false true false false false true true true true true true true false false X BRANDI HOSKINS 3036746400 3081 BERGEN PEAK DR EVERGREEN CO 80439 KERI SCHROEDER-JAEGER PRESIDENT/CEO 40.0 0.0 X 197113 0 24062 JULIE NELSON RN 40.0 0.0 X 117770 0 26704 DOUGLAS LINN DIRECTOR OF FINANCE 40.0 0.0 X 90755 0 28556 ISABELLE COMINA THERAPY MANAGER 40.0 0.0 X 106305 0 10699 KRISTIN SCHULD RN 40.0 0.0 X 107413 0 8913 SUZANNE FEROLDI DIRECTOR OF OPERATIONS 40.0 0.0 X 105106 0 11150 TERRY RITTER NURSING MANAGER 40.0 0.0 X 101976 0 12424 DOUG SPENCER CHAIR 1.0 0.0 X X 0 0 0 DAN TUTEUR BOARD MEMBER 1.0 0.0 X 0 0 0 JIM CHIDDIX BOARD MEMBER 1.0 0.0 X 0 0 0 VALERIE GLUTH BOARD MEMBER 1.0 0.0 X 0 0 0 ALAN HOROWITZ BOARD MEMBER 1.0 0.0 X 0 0 0 BARRY SCHROEDER CHAIR-ELECT 1.0 0.0 X X 0 0 0 TODD WISSER MD BOARD MEMBER 1.0 0.0 X 0 0 0 ROD HOCK TREASURER 1.0 0.0 X X 0 0 0 MARK GRAYBILL BOARD MEMBER 1.0 0.0 X 0 0 0 LEONOR MCCALL-RODRIGUEZ BOARD MEMBER 1.0 0.0 X 0 0 0 BILL SLAUGHTER SECRETARY 1.0 0.0 X X 0 0 0 JAMIE ARNOLD BOARD MEMBER 1.0 0.0 X 0 0 0 DAVIS LINDEN BOARD MEMBER 1.0 0.0 X 0 0 0 ROBERT LOEFFLER BOARD MEMBER 1.0 0.0 X 0 0 0 TED NING MD BOARD MEMBER 1.0 0.0 X 0 0 0 BARB SCRIPPS BOARD MEMBER 1.0 0.0 X 0 0 0 826438 0 122508 13 false true false Life Care Center of Evergreen 2987 Bergen Peak Drive EVERGREEN CO 80439 Patient Care Service 352452 Core Medical Group PO Box 306478 NASHVILLE TN 372306478 CONTRACT CLINICIANS 179173 EIDE BAILEY CONSULTING 7001 E BELLEVIEW AVE SUITE 700 DENVER CO 80237 IT SUPPORT 128337 DELTA CARE RX PO BOX 2340 WINTERSVILLE OH 43953 PHARMACY SERVICES 110605 4 390076 1863952 1068352 286044 3322380 MEDICARE/MEDICAID 621610 4620668 4620668 PATIENT SERVICE REVENUE 621610 1279230 1279230 MISCELLANEOUS REVENUE 900099 5910 5910 5905808 213510 213510 0 0 1670 1670 0 1670 1670 131372 131152 220 220 220 150690 390076 147496 3194 3194 0 0 0 0 0 0 0 9446782 5905808 218594 0 0 0 0 393203 393203 0 4125485 3934448 41108 149929 80602 47880 31972 750 132810 121300 11510 174800 161130 6800 6870 0 0 34740 34740 0 0 0 769620 591170 178450 58650 58650 275836 62496 177800 35540 364930 314400 50530 0 178450 178240 210 194410 187530 6880 0 18330 18330 0 0 126298 126298 58900 12790 46110 MEDICAL SUPPLIES 285990 285990 BAD DEBT EXPENSE 58030 58030 FUNDRAISING 10594 10594 MISCELLANEOUS EXPENSE 10356 10356 7352034 5777164 1359467 215403 2340 6580 1024987 748154 0 1320 1814707 3792337 0 0 0 0 0 0 20852 20850 103622 105435 3246884 1830438 1328387 1416446 2529083 2532577 0 0 0 0 0 0 204000 205000 7027978 8828699 528885 601512 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91561 91560 620446 693072 X 5449792 7096721 957740 1038906 6407532 8135627 7027978 8828699 2094748 -366653 X X false true X true false X 1235742 925010 1189213 1804982 3322380 8477327 4218230 4824383 5914168 6834941 5905808 27697530 0 0 0 5453972 5749393 7103381 8639923 9228188 36174857 92835 103411 111003 49429 62120 418798 5726 95625 101351 92835 109137 111003 49429 157745 520149 35654708 107269 99082 115795 158394 215180 695720 0 107269 99082 115795 158394 215180 695720 145622 101461 58375 3194 308652 0 5706863 5949936 7277551 8798317 9446562 37179229 0.95900 0.97010 0.01871 0.01674 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 728693 63500 -152923 639270 539730 20102 168861 728693 515913 6620 17197 539730 463553 14850 37510 515913 431205 27335 5013 463553 0.07620 0.61660 0.30720 false false 394000 394000 2394474 1372028 1022446 458410 458410 0 1416446 0 Rental Property Use Allocation 91560 91560 9021525 -366653 -366653 9388178 58604 58604 9446782 7293430 7293430 58604 58604 7352034 SCHEDULE D, PART V, LINE 4 MOUNT EVANS' ENDOWMENT CONSISTS OF TWO INDIVIDUAL FUNDS ESTABLISHED BY DONORS TO PROVIDE ANNUAL FUNDING FOR MOUNT EVANS ACTIVITIES. THE ENDOWMENT ALSO INCLUDES CERTAIN UNRESTRICTED NET ASSETS DESIGNATED FOR ENDOWMENT BY BOARD OF DIRECTORS. NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS ARE CLASSIFIED AND REPORTED BASED ON EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. SCHEDULE D, PART X, LINE 2 MOUNT EVANS IS A COLORADO NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. MOUNT EVANS HAS RECEIVED A DETERMINATION LETTER THAT IT IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME IN PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A)(VIII), AND HAS BEEN CLASSIFIED AS AN ORGANIZATION OTHER THAN A PRIVATE FOUNDATION UNDER SECTION 509(A)(2). THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN TAX-EXEMPT STATUS. IN GENERAL, SUCH STANDARDS REQUIRE MOUNT EVANS TO MEET A COMMUNITY BENEFIT STANDARD AND COMPLY WITH VARIOUS LAWS AND REGULATIONS. UNRELATED BUSINESS INCOME TO MOUNT EVANS' TAX-EXEMPT STATUS IS REPORTED ACCORDINGLY AND A PROVISION FOR INCOME TAX IS PROVIDED FOR THOSE ACTIVITIES THAT CREATE TAXABLE INCOME. MOUNT EVANS ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ASC TOPIC 740. MOUNT EVANS RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT OCTOBER 31, 2022 AND 2021. MOUNT EVANS HAD NO UNCERTAIN TAX POSITIONS ACCRUED. SCHEDULE D, PART XI, LINE 4B REVENUE ON RETURN, NOT INCLUDED ON BOOKS: SPECIAL EVENT EXPENSE 58,064 SCHEDULE D, PART XII, LINE 4B EXPENSE ON RETURN, NOT INCLUDED ON BOOKS: SPECIAL EVENT EXPENSE 58,064 GALA 203983 142595 61388 1200 11655 11506 37892 MOONLIGHT SOIRE 174250 148133 26117 3215 22145 3766 4170 1 158542 99348 59194 699 9040 477 5520 36211 536775 390076 146699 699 13455 34277 20792 78273 147496 -797 X X X true false false false false false false true false KERI SCHROEDER-JAEGER PRESIDENT/CEO 178013 0 19100 0 0 0 0 0 24062 0 221175 0 SCHEDULE J, PART I, LINE 4a DESCRIPTION OF SEVERANCE OR CHANGE OF CONTROL PAYMENT: DOUGLAS LINN, DIRECTOR OF FINANCE, RECEIVED A QUALIFYING PAYMENT IN THE AMOUNT OF $50,000. SCHEDULE J, PART I, LINE 7 THE ORGANIZATION'S EXECUTIVE COMMITTEE ANNUALLY REVIEWS THE PERFORMANCE OF THE PRESIDENT/CEO TO DETERMINE IF ADDITIONAL COMPENSATION IN THE FORM OF A BONUS WILL BE PAID. DURING CALENDAR YEAR ENDED DECEMBER 31, 2021, THE EXECUTIVE COMMITTEE AWARDED THE PRESIDENT/CEO A BONUS BASED ON REVIEW OF HER PERFORMANCE AND SERVICE TO THE ORGANIZAITON. X 3 286044 FAIR MARKET VALUE false true true SCHEDULE M, PART I, COLUMN (B) THE NUMBER REPORTED ON SCHEDULE M. PART I, COLUMN (B) REPRESENTS THE TOTAL NUMBER OF CONTIRUBUTIONS RECEIVED. SCHEDULE M, LINE 32B MOUNT EVANS HOSPICE USES CARE HELPING CHARITIES, INC. (CHC). A TAX-EXEMPT VEHICLE DONATION CORPORATION THAT ALLOWS INDIVIDUALS INTERESTED IN DONATING A VEHICLE TO PROCESS AUTO DONATIONS. DONORS SUBMIT INFORMATION TO CHC ON THE DONATION OF THE VEHICLE. CHC PICKS UP THE VEHICLE, SELLS IT, AND THEN PROVIDES THE PROCEEDS TO MOUNT EVANS. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE COMPLETED FORM 990 IS EMAILED IN PDF FORMAT TO ALL BOARD MEMBERS AND MEMBERS OF THE FINANCE COMMITTEE FOR THEIR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND OFFICERS ARE REQUIRED TO ANNUALLY DISCLOSE ANY TRANSACTIONS WITH THE ORGANIZATION THAT WOULD RESULT IN ANY BENEFIT TO THEMSELVES. THEIR IMMEDIATE FAMILIES OR ANY ENTITY IN WHICH THEY HOLD A SIGNIFICANT FINANCIAL OWNERSHIP OR OTHER INTERESTS. BOARD MEMBERS WILL REFRAIN FROM PARTICIPATION IN ANY ACTION ON SUCH MATTERS. DISCLOSURE OF A POTENTIAL CONFLICT AND THE GOVERNING BODY'S DECISION REGARDING VOTING WILL BE NOTED IN THE MINUTES OF THE MEETING. FORM 990, PART VI, SECTION B, LINE 15A THE PRESIDENT OF THE BOARD OF DIRECTORS COMPLETES A PERFORMANCE EVALUATION OF THE PRESIDENT/CHIEF EXECUTIVE OFFICER BASED ON PREVIOUS GOALS SET FOR THE PRIOR YEAR. THE PRESIDENT'S EVALUATION AND RECOMMENDATION FOR COMPENSATION IS TAKEN TO THE EXECUTIVE COMMITTEE FOR THEIR REVIEW AND APPROVAL. SALARY SURVEYS ARE REVIEWED AND DISCUSSED DURING THE EXECUTIVE COMMITTEE'S APPROVAL PROCESS. ONCE THE EXECUTIVE COMMITTEE HAS COMPLETED THEIR REVIEW, THE RECOMMENDATION FOR COMPENSATION, INCLUDING SALARY SURVEYS AND THE PERFORMANCE EVALUATION, IS TAKEN TO THE BOARD OF DIRECTORS FOR THEIR FINAL REVIEW AND APPROVAL. THE DELIBERATION AND DOCUEMNTION IS DOCUMENTED IN THE BOARD MEETING MINUTES AND THE PERSONELL FILE. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MAINTAINED IN THE AGENCY ADMINISTRATIVE OFFICES AND ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PAGE 11, PART XI, LINE 2C THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS SELECTS THE INDEPENDENT ACCOUNTANT AND HAS THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT. UPON CONCLUSION OF THE AUDIT, THE AUDITING FIRM PRESENTS THE RESULTS AND FINIDINGS TO THE FINANCE COMMITTEE. THERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM THE PRIOR YEAR. FORM 990 PART IX LINE 11G DESCRIPTION:NURSING SERVICE FEES TOTAL FEES:517690 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICAL THERAPISTS TOTAL FEES:73480 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTANTS TOTAL FEES:110070 FORM 990 PART IX LINE 11G DESCRIPTION:HUMAN RESOURCE SERVICES TOTAL FEES:68380