2021-11-08T08:08:19-06:00 2020-12-31 621199757 LBMC PC PO BOX 1869 BRENTWOOD TN 370241869 990 2020-01-01 620983550 ALIVE HOSPICE INC ALIV 6153271085 1718 PATTERSON STREET NASHVILLE TN 37203 JOSEPH HAMPE CHIEF OPERATING OFFICER 6153271085 2021-11-01 1 JOSEPH HAMPE XXX-XX-XXXX JULIE BARTLETT P00742923 6153774600 2021-11-01 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z KIMBERLY GOESSELE 1718 PATTERSON STREET NASHVILLE TN 37203 38139201 0 X WWW.ALIVEHOSPICE.ORG X 1975 TN ALIVE HOSPICE, INC. PROVIDES LOVING CARE TO PEOPLE WITH LIFE-THREATENING ILLNESSES, SUPPORT TO THEIR FAMILIES AND SERVICE TO THE COMMUNITY IN A SPIRIT OF ENRICHING LIVES. DURING 2020, THE ORGANIZATION INCURRED EXPENSES OF $1,330,000 FOR FINANCIAL ASSISTANCE TO PATIENTS WHO WERE OTHERWISE UNABLE TO PAY. 23 23 440 446 0 0 2654028 4355968 31155175 32940979 115747 74976 95073 75524 34020023 37447447 0 0 0 0 22641310 23988720 0 0 596925 10962241 11483539 33603551 35472259 416472 1975188 36036332 38033196 4657715 4413542 31378617 33619654 X SEE SCHEDULE O 0 0 26721062 33016503 ALIVE HOSPICE SERVES THOSE WHO HAVE A LIMITED LIFE EXPECTANCY (REGARDLESS OF ILLNESS OR AGE) AND LIVE WITHIN THE AGENCY'S 12-COUNTY SERVICE AREA. ALIVE HOSPICE PROVIDED END-OF-LIFE CARE TO 4,418 PATIENTS DURING 2020.ONLY ALIVE HOSPICE PROVIDES THIS UNPARALLELED SCOPE OF SERVICES: IN-HOME HOSPICE SERVICES; INPATIENT RESIDENTIAL CARE AT ITS 30-BED ALIVE HOSPICE RESIDENCE NASHVILLE FACILITY; INPATIENT RESIDENTIAL CARE AT ITS 10-BED ALIVE HOSPICE MURFREESBORO FACILITY; INPATIENT HOSPICE CARE AT OTHER HOSPITALS THROUGHOUT MIDDLE TENNESSEE; FULL-TIME MEDICAL DIRECTORS (PHYSICIANS) ON STAFF; ALIVE GRIEF SUPPORT SERVICES, COUNSELING AND SUPPORT FOR THOSE WHO HAVE EXPERIENCED LOSS; INDIVIDUALIZED, INTERDISCIPLINARY CARE TEAMS - 24 HOUR, 7 DAYS-A-WEEK; AND ACCESSIBILITY TO HIGHLY SKILLED CLINICAL STAFF.HOME CARE SERVICES:THE MAJORITY OF ALIVE HOSPICE'S PATIENTS ARE SERVED IN THEIR HOMES. HOME HOSPICE CARE SERVICES ARE DESIGNED TO EASE PAIN, ALLEVIATE SYMPTOMS, AND PROVIDE SUPPORT TO THE PATIENTS AND THEIR CAREGIVERS. IN ADDITION TO THESE SERVICES PROVIDED BY OUR SKILLED TEAM, WE PROVIDE MEDICAL EQUIPMENT AND SUPPLIES, MEDICATION AND CAREGIVER TRAINING. ALIVE HOSPICE SERVED 3,149 PATIENTS IN THEIR HOMES DURING 2020.INPATIENT HOSPICE CARE:OUR INPATIENT FACILITIES ALLOW CARE TO BE PROVIDED FOR PATIENTS WHO ARE UNABLE TO BE CARED FOR AT HOME OR MAY BE EXPERIENCING A MEDICAL CRISIS.- ALIVE HOSPICE RESIDENCE NASHVILLE (1,230 PATIENTS WERE SERVED IN 2020)- INPATIENT CARE PROVIDED BY ALIVE HOSPICE AT YOUR LOCAL HOSPITALS - ALIVE HOSPICE RESIDENCE MURFREESBORO (522 PATIENTS WERE SERVED IN 2020).ALIVE MONARCHS:ALIVE HOSPICE HAS A LONG TRADITION OF SERVING PATIENTS OF ALL AGES WHO FACE LIFE THREATENING ILLNESSES. ALIVE MONARCHS IS ONE OF THE FEW HOSPICE CARE PROVIDERS FOR PERINATAL AND PEDIATRIC PATIENTS IN THE NATION. THE BEAUTIFUL MONARCH BUTTERFLY INSPIRED THE NAME OF ALIVE HOSPICE'S PEDIATRIC PROGRAM. BUTTERFLIES, WHICH ARE CLOSELY ASSOCIATED WITH HOSPICE CARE, SIGNIFY HOPE, THE BEAUTY OF LIFE AND THE CELEBRATION OF THOSE WE LOVE. A TOTAL OF 10 PEDIATRIC PATIENTS AND THEIR FAMILIES RECEIVED CARE IN 2020.PALLIATIVE CARE:ALIVE HOSPICE PROVIDED HOSPITAL BASED PALLIATIVE CARE SERVICES FOR THOSE WHO ARE NOT IN NEED OF HOSPICE CARE, BUT WHO DO HAVE INCURABLE AND PROGRESSIVE DISEASES. PALLIATIVE CARE ADDRESSES THE SYMPTOMS OF A DISEASE REGARDLESS OF LIFE EXPECTANCY, WHILE HOSPICE CARE ADDRESSES THOSE SYMPTOMS WHEN THE PATIENT'S LIFE EXPECTANCY CAN BE THOUGHT OF IN MONTHS RATHER THAN YEARS. A TOTAL OF 6,285 PALLIATIVE PATIENTS WERE CARED FOR IN 2020.ALIVE GRIEF SUPPORT SERVICES:GRIEF IS A NATURAL PROCESS AND ALIVE GRIEF SUPPORT SERVICES IS A COMPREHENSIVE PROGRAM THAT ADDRESSES THE NEEDS THAT ARISE FOLLOWING THE DEATH OF A LOVED ONE. ALIVE GRIEF SUPPORT SERVICES PROVIDES BEREAVEMENT CARE FOR PATIENTS' FAMILY MEMBERS AND THE COMMUNITY AT LARGE. OUR SERVICES ARE DESIGNED TO MEET THE BEREAVEMENT NEEDS OF CHILDREN AND ADULTS WHO HAVE EXPERIENCED THE RECENT DEATH OF SOMEONE SIGNIFICANT.ALIVE GRIEF SUPPORT SERVICES UTILIZE PROFESSIONAL GRIEF COUNSELORS AND TRAINED VOLUNTEERS TO GUIDE INDIVIDUALS THROUGH THE PROCESS OF MOURNING. THIS ASSISTANCE IS AVAILABLE IN BOTH INDIVIDUAL COUNSELING SESSIONS AND GROUP SETTINGS FOR ANY BEREAVED PERSON, REGARDLESS OF THE NATURE OF THE DEATH. GRIEF COUNSELING HELPS ADULTS, CHILDREN, AND FAMILIES COPE WITH DEATH AND GRIEF AS THEY FACE THE LOSS OF LOVED ONES.DURING 2020, WE PROVIDED 1,979 ADULTS AND CHILDREN VARIOUS TYPES OF GRIEF SUPPORT. THIS SUPPORT WAS ACROSS ALL PROGRAMS INCLUDING: MEMORIAL EVENTS, SUPPORT GROUPS, INDIVIDUAL COUNSELING SESSIONS, ONE VIRTUAL CAMP FOR CHILDREN, ONE VIRTUAL FAMILY RETREAT, AND SPECIAL WORKSHOPS. OUR CAMPS WERE HELD VIRTUALLY IN 2020 DUE TO THE COVID-19 PANDEMIC. -ADDITIONAL, THERE WERE 1,258 CALLS TO THE GRIEF LINE AND 24,828 BEREAVEMENT MAILINGS IN 2020. CHARITY CARE:IN ADDITION, ALIVE HOSPICE HAS A POLICY OF PROVIDING CHARITY CARE TO PATIENTS WHO ARE UNABLE TO PAY. CHARITY CARE EXPENSES WERE $1,330,000 FOR THE YEAR ENDED DECEMBER 31, 2020. 26721062 1 1 0 1 0 0 0 1 0 1 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 76 0 1 440 1 0 0 0 0 0 0 0 0 0 0 0 0 X 23 23 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 TN X JOSEPH HAMPE 6153271085 1718 PATTERSON STREET NASHVILLE TN 37203 ANGIE MULDER BOARD MEMBER 1.00 X 0 0 0 BETH WORKMAN TREASURER & CHAIR ELECT 1.00 X X 0 0 0 BRIAN MARGER BOARD MEMBER 1.00 X 0 0 0 CLARK BAKER CHAIR 1.00 X X 0 0 0 GEORGE HUDDLESTON JR BOARD MEMBER 1.00 X 0 0 0 GINA ZYLSTRA BOARD MEMBER 1.00 X 0 0 0 JANE SIEGEL MD BOARD MEMBER 1.00 X 0 0 0 JEFF LANDMAN MD BOARD MEMBER 1.00 X 0 0 0 JOSEPH DORKO BOARD MEMBER 1.00 X 0 0 0 KIMBERLY CANNON BOARD MEMBER 1.00 X 0 0 0 LYNN LIEN BOARD MEMBER 1.00 X 0 0 0 MARY FLIPSE BOARD MEMBER 1.00 X 0 0 0 MICHAEL PAYNE BOARD MEMBER 1.00 X 0 0 0 MIKE EDGEWORTH MD BOARD MEMBER 1.00 X 0 0 0 PHILIP RANSDELL BOARD MEMBER 1.00 X 0 0 0 REV KELLY MILLER SMITH BOARD MEMBER 1.00 X 0 0 0 ROBERT TAYLOR MD BOARD MEMBER 1.00 X 0 0 0 ROBYN FULWIDER BOARD MEMBER 1.00 X 0 0 0 SARA FINLEY SECRETARY 1.00 X X 0 0 0 STEPHEN HEYMAN MD BOARD MEMBER 1.00 X 0 0 0 THERESE BRUMFIELD BOARD MEMBER 1.00 X 0 0 0 VERONICA MARABLE JOHNSON BOARD MEMBER 1.00 X 0 0 0 VICKI ESTRIN BOARD MEMBER 1.00 X 0 0 0 DAVID MCRAY CHIEF MEDICAL OFFICER 40.00 X 264130 0 43441 FRAN DOEHRING CHIEF NURSING OFFICER 40.00 X 211788 0 21482 JOSEPH HAMPE CHIEF OPERATING OFFICER 40.00 X 277371 0 39403 KIMBERLY GOESSELE PRESIDENT/CEO 40.00 X 301798 0 33842 LAURA THARPE TEAM MEDICAL DIRECTOR 40.00 X 225390 0 15191 ANH MEADOWS TEAM MEDICAL DIRECTOR 40.00 X 239371 0 15579 CORRINNE ELHERT FORMER VICE PRESIDENT ORGANIZATIONAL IMPROVEMENT 40.00 X 169652 0 22167 SASHA BOWERS TEAM MEDICAL DIRECTOR 40.00 X 217043 0 21662 TERESA COSGROVE VICE PRESIDENT OF FINANCE 40.00 X 149846 0 43218 2056389 0 255985 32 0 1 0 MECHANICAL RESOURCE GROUP 750 MELROSE AVE NASHVILLE TN 37211 HVAC 357327 FRANTZ BUILDING SERVICES INC PO BOX 2001 OWENSBORO KY 42302 JANITORIAL SERVICES & SUPPLIES 210348 ALLIED UNIVERSAL SECURITY SERVICES PO BOX 828854 PHILADELPHIA PA 19182 SECURITY 116637 CONSOLIDATED MEDICAL STAFFING PO BOX 17983 MEMPHIS TN 38187 STAFFING 107931 MILEK MEDIA LLC 2021 21ST AVENUE S STE C-110 NASHVILLE TN 37212 MARKETING 106704 5 88389 1361750 2905829 24745 4355968 PATIENT SERVICE REVENUE 623000 32940979 32940979 32940979 92282 92282 674448 691754 -17306 -17306 -17306 MISCELLANEOUS REVENUE 900099 74204 74204 REBATES/DISCOUNTS 900099 1320 1320 75524 37447447 33016503 0 74976 2312374 1724998 547157 40219 17745525 13392350 4049568 303607 110419 63271 45782 1366 2409512 1851407 502359 55746 1410890 1072980 313701 24209 118101 118101 61550 61550 19235 14137 5098 590135 92508 481627 16000 212363 212228 135 443216 164797 148246 130173 2577074 1938801 626773 11500 983 62 906 15 49164 34604 14099 461 86266 5884 80382 1263995 985503 272733 5759 383641 300417 76685 6539 DIRECT PATIENT CARE 3346369 3346369 MEDICAL SUPPLIES 753238 753238 MISCELLANEOUS 578971 578971 FLEET MANAGEMENT 461782 442280 18306 1196 537456 537456 35472259 26721062 8154272 596925 303844 579262 6371027 8643340 854972 495880 4375565 4656050 84138 87452 286752 280590 32974147 12647688 20984410 20326459 2129595 2304974 1000 1000 554293 554293 90736 103896 36036332 38033196 2715545 3025623 1879086 1366435 63084 21484 4657715 4413542 X 29247039 31466478 2131578 2153176 31378617 33619654 36036332 38033196 1975188 233413 32436 0 X X 0 1 X 1 0 X 7635727 2422453 3770252 2665413 4388404 20882249 29358848 29151634 29644922 31155175 32940979 152251558 8294 3523 2077 1889 1320 17103 37002869 31577610 33417251 33822477 37330703 173150910 142500 5000 5280 63305 59392 275477 0 142500 5000 5280 63305 59392 275477 172875433 99148 111769 104756 144877 92282 552832 99148 111769 104756 144877 92282 552832 38622 85856 80557 93184 74204 372423 37140639 31775235 33602564 34060538 37497189 174076165 0.99310 0.99200 0.00320 0.00340 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 751 751 0 PART II-B, LINE 1: THE ORGANIZATION INDIRECTLY INFLUENCED LEGISLATION THROUGH ITS DUES TO THE NATIONAL HOSPICE AND PALLIATIVE CARE ORGANIZATION (NHPCO) FOR CALENDAR YEAR 2020. APPROXIMTELY 2.5% OF THE ORGANIZATION'S MEMBERSHIP DUES PAYMENT GOES TOWARDS LOBBYING EFFORTS. X DISPLAYED ON PREMISES 0 1772308 3000 78521 1853829 1645579 3000 123729 1772308 1812493 3000 -169914 1645579 1714911 5000 92582 1812493 1649298 5066 60547 1714911 0.00000 0.64420 0.35580 0 0 6543933 6543933 19264132 7473865 11790267 1660501 1115114 545387 5376996 4058709 1318287 128585 128585 20326459 LEASE INCENTIVE OBLIGATION LT - HENDERSONVILLE 10417 LEASE INCENTIVE OBLIGATION LT - LEBANON 11067 21484 X 37339011 233413 32436 -355050 -89201 37428212 19235 19235 37447447 35097974 -355050 -355050 35453024 19235 19235 35472259 PART III, LINE 4: THE ORGANIZATION MAINTAINS A COLLECTION OF ART THAT IS DISPLAYED IN THE HOSPICE PATIENTS' ROOMS AND ON THE ORGANIZATION'S PROPERTY TO ADD A PEACEFUL NATURE TO THE ENVIORNMENT. PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM INCOME TAXES UNDER THE PROVISIONS OF INTERNAL REVENUE CODE SECTION 501(C)(3), AND, ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS INCLUDED IN THE FINANCIAL STATEMENTS. AS OF DECEMBER 31, 2020 AND 2019, THE ORGANIZATION HAS ACCRUED NO INTEREST AND NO PENALTIES RELATED TO UNCERTAIN TAX POSITIONS. IT IS THE ORGANIZATION'S POLICY TO RECOGNIZE INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE. THE ORGANIZATION FILES A U.S. FEDERAL INFORMATION TAX RETURN. PART XI, LINE 2D - OTHER ADJUSTMENTS: ADJUSTMENT FOR BAD DEBT EXPENSE -304,283. ADJUSTMENT FOR NEGATIVE EXPENSE -50,767. PART XII, LINE 2D - OTHER ADJUSTMENTS: ADJUSTMENT FOR BAD DEBT EXPENSE -304,283. ADJUSTMENT FOR NEGATIVE EXPENSE -50,767. X X X X 0 0 0 0 0 0 0 0 0 KIMBERLY GOESSELE PRESIDENT/CEO 291519 0 10279 0 0 0 11128 0 22714 0 335640 0 0 0 JOSEPH HAMPE CHIEF OPERATING OFFICER 267092 0 10279 0 0 0 26286 0 13117 0 316774 0 0 0 DAVID MCRAY CHIEF MEDICAL OFFICER 262071 0 2059 0 0 0 20860 0 22581 0 307571 0 0 0 ANH MEADOWS TEAM MEDICAL DIRECTOR 238660 0 711 0 0 0 3504 0 12075 0 254950 0 0 0 LAURA THARPE TEAM MEDICAL DIRECTOR 221836 0 3554 0 0 0 3133 0 12058 0 240581 0 0 0 SASHA BOWERS TEAM MEDICAL DIRECTOR 213489 0 3554 0 0 0 0 0 21662 0 238705 0 0 0 FRAN DOEHRING CHIEF NURSING OFFICER 201509 0 10279 0 0 0 11484 0 9998 0 233270 0 0 0 TERESA COSGROVE VICE PRESIDENT OF FINANCE 139567 0 10279 0 0 0 16613 0 26605 0 193064 0 0 0 CORRINNE ELHERT FORMER VICE PRESIDENT ORGANIZATIONAL 159373 0 10279 0 0 0 11150 0 11017 0 191819 0 0 0 FORM 990, PART III, LINE 1: OUR MISSION ALIVE HOSPICE, INC PROVIDES LOVING CARE TO PEOPLE WITH LIFE-THREATENING ILLNESSES, SUPPORT TO THEIR FAMILIES, AND SERVICE TO THE COMMUNITY IN A SPIRIT OF ENRICHING LIVES. OUR VISION - TO BE RECOGNIZED AS EXPERT PROVIDERS OF HOSPICE CARE, PALLIATIVE CARE, MANAGEMENT OF ADVANCED DISEASE, AND GRIEF SUPPORT, AND TO BE THE AGENCY OF CHOICE FOR THE PROVISION OF THESE SERVICES - TO BE RECOGNIZED AS INNOVATORS AND LEADERS IN ALL ASPECTS OF END-OF-LIFE RESOURCES - TO INFLUENCE THE PERCEPTIONS WITHIN THE COMMUNITY AND AMONG MEDICAL PROFESSIONALS SO THAT THE END OF LIFE IS ACCEPTED AS A MEANINGFUL COMPONENT OF THE HUMAN EXPERIENCE. OUR VALUES - WE BELIEVE DEATH TO BE A NATURAL PART OF LIFES JOURNEY - WE BELIEVE IN HONESTY AND INTEGRITY IN ALL WE SAY AND DO - WE BELIEVE IN COMPASSION TO THOSE WE SERVE AND TO EACH OTHER - WE BELIEVE IN RESPECT AND DIGNITY FOR ALL - WE VALUE COMPETENT, KNOWLEDGEABLE STAFF MOTIVATED TO ACHIEVE PERSONAL AND PROFESSIONAL GROWTH - WE BELIEVE IN ACCOUNTABILITY TO SOCIETY, OUR COMMUNITY, AND EACH OTHER - WE BELIEVE IN RESPONSIBLE STEWARDSHIP OF THE RESOURCES WITH WHICH WE HAVE BEEN ENTRUSTED - WE BELIEVE IN THE CONTINUOUS PURSUIT OF ORGANIZATIONAL EXCELLENCE - WE BELIEVE IN TEAMWORK TO ACHIEVE OUR VISION, MISSION, AND TO SUPPORT OUR VALUES. FORM 990, PART VI, SECTION A, LINE 1 THE CORPORATION SHALL HAVE AN EXECUTIVE COMMITTEE CONSISTING OF THE OFFICERS OF THE CORPORATION AND SUCH MEMBERS AS RECOMMENDED BY THE CHAIR AND VOTED UPON BY THE BOARD. AS PER CORPORATE BY-LAWS, THE EXECUTIVE COMMITTEE SHALL MEET AT ANY TIME WHEN THE DIRECTORS ARE NOT IN SESSION AND SHALL HAVE THE FULL AUTHORITY OF THE BOARD OF DIRECTORS TO MANAGE THE AFFAIRS OF THE CORPORATION PROVIDED THAT NO ACTION TAKEN BY THE EXECUTIVE COMMITTEE SHALL BE IN CONFLICT WITH ANY ACTION TAKEN BY THE BOARD OF THE DIRECTORS, AND THE EXECUTIVE COMMITTEE MAY NOT TAKE ANY ACTION PROHIBITED BY THE TENNESSEE CODE ANNOTATED SECTION 48-58-206. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FULL FORM 990 WAS PROVIDED TO EVERY BOARD MEMBER FOR REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C FOR THE DECEMBER 31, 2020 YEAR-END, THE BOARD MEMBERS SIGNED THE CONFLICT OF INTEREST POLICY STATING THAT THEY HAVE READ AND UNDERSTOOD THE POLICY. EACH FORM IS REVIEWED BY THE EXECUTIVE OFFICE MANAGER FOR COMPLETION AND TO DETERMINE IF ANY POTENTIAL CONFLICTS OF INTEREST EXIST. IF A POTENTIAL CONFLICT OF INTEREST IS DETERMINED TO EXIST, THE CEO AND BOARD CHAIR ARE NOTIFIED, AND IT IS THEN REPORTED TO THE EXECUTIVE COMMITTEE. IF A CONFLICT EXISTS WITH A VOTING BOARD MEMBER, THEN THAT BOARD MEMBER MUST RECUSE THEMSELVES FROM VOTING ON THAT PARTICULAR BUSINESS TRANSACTION. ALSO, THERE IS AN AGENDA ITEM AT EVERY BOARD MEETING ON DECLARATIONS OF CONFLICT OF INTEREST. THE BOARD CHAIR WOULD ASK BOARD MEMBERS PRESENT IF THERE IS A POTENTIAL CONFLICT OF INTEREST, AND THIS IS DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE 2020 ANNUAL REPORT, WHICH INCLUDES THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS, IS AVAILABLE ON THE ALIVE HOSPICE WEBSITE. THE ORGANIZATION'S GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC AND NOT REQUIRED TO BE MADE AVAILABLE PURSUANT TO IRC 6104. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PREVIOUS YEAR. ALIVE PCM HOLDINGS LLC 1718 PATTERSON STREET NASHVILLE TN 37203 800938306 PALLIATIVE CARE SERVICES TN ALIVE HOSPICE INC C -7491 13266 1.00000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 ALIVE PCM HOLDINGS LLC S CASH ALIVE PCM HOLDINGS LLC Q CASH