2020-01-24T10:40:02-06:00 2019-05-31 593070669 MOORE STEPHENS LOVELACE PA 255 S ORANGE AVENUE SUITE 600 ORLANDO FL 32801 990 2018-06-01 800730376 MORSELIFE HOSPICE INSTITUTE INC MORS 5614715111 4847 DAVID S MACK DRIVE WEST PALM BEACH FL 33417 HONG CHAE SENIOR VICE PRESIDENT/CFO 5616875753 2020-01-24 1 NORMAN B NEAL CPA P00071411 4077405400 104.178.77.115 2020-01-24 10:35:53 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 7FC0E18F63597829422D687723989F114BEB8769 2018 2020-09-22 18:59:49Z KEITH A MYERS 4847 DAVID S MACK DRIVE WEST PALM BEACH FL 33417 0 0 X WWW.MORSELIFE.ORG X 2011 FL TO PROVIDE HOSPICE SERVICES TO THE RESIDENTS OF JOSEPH L. MORSE HEALTH CENTER AND OTHERS IN THE WEST PALM BEACH AREA. 24 23 6 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195773 0 0 0 0 68977 0 264750 0 -264750 216481 982516 216481 1247266 0 -264750 X TO PROVIDE HOSPICE SERVICES TO THE RESIDENTS OF JOSEPH L. MORSE HEALTH CENTER AND OTHERS IN THE WEST PALM BEACH AREA. 1 1 78118 THE ORGANIZATION IS IN THE PROCESS OF OBTAINING CERTIFICATION TO BECOME A HOSPICE SERVICE PROVIDER. 78118 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 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 0 0 1 6 1 0 0 0 0 0 0 0 0 0 0 0 0 X 24 23 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X X RANDY T WOLAN 5612096108 4847 DAVID S MACK DRIVE WEST PALM BEACH FL 33417 KEITH A MYERS PRESIDENT/CEO 2.00 46.00 X X 0 3143234 27197 TERRI C SRIBERG CHAIRMAN 2.00 14.00 X X 0 0 0 JEFFREY S FARBER MD SECRETARY 2.00 4.00 X X 0 0 0 VICKI LORING TREASURER 2.00 6.00 X X 0 0 0 MARILYN ZELNICK BERMAN DIRECTOR EMERITUS 2.00 8.00 X 0 0 0 LARRY BEYER DIRECTOR EMERITUS 2.00 4.00 X 0 0 0 RICHARD COMITER DIRECTOR 2.00 4.00 X 0 0 0 BONNIE DWARES DIRECTOR 2.00 4.00 X 0 0 0 CYNTHIA HIRSCH DIRECTOR 2.00 4.00 X 0 0 0 MARILYN KATZ DIRECTOR 2.00 8.00 X 0 0 0 STANLEY KATZ DIRECTOR 2.00 12.00 X 0 0 0 FRANCINE KITTREDGE DIRECTOR 2.00 6.00 X 0 0 0 SUZANNE LEVINE DIRECTOR 2.00 8.00 X 0 0 0 ARTHUR S LORING DIRECTOR 2.00 14.00 X 0 0 0 DAVID MOSCOW DIRECTOR 2.00 6.00 X 0 0 0 DEAN ROSENBACH DIRECTOR 2.00 4.00 X 0 0 0 ANDREW SANKIN DIRECTOR 2.00 4.00 X 0 0 0 LARRY SOSNOW DIRECTOR 2.00 4.00 X 0 0 0 HANK STRAUSS DIRECTOR 2.00 4.00 X 0 0 0 ELLEN SUSSMAN DIRECTOR 2.00 6.00 X 0 0 0 BARBARA KAY DIRECTOR 2.00 4.00 X 0 0 0 BETH GOLDBERG DIRECTOR 2.00 6.00 X 0 0 0 ANDREA STARK DIRECTOR 2.00 8.00 X 0 0 0 JANICE WILLINGER DIRECTOR 2.00 2.00 X 0 0 0 HONG CHAE SENIOR VICE PRESIDENT/CFO 1.00 47.00 X 0 1064231 37672 ALAN SADOWSKY SR. VP OF COMMUNITY-BASED SERVICES 1.00 39.00 X 0 459603 37427 0 4667068 102296 0 0 1 0 0 0 0 0 0 181570 52342 129228 1682 1682 696 48 648 11825 4350 7475 5534 3445 2089 18269 18269 10289 113 10176 10380 10380 5175 1303 3872 561 561 14 14 9692 9207 485 6092 5665 427 RECRUITING AND SELECTIO 1309 1309 SUPPLIES 1088 1088 CLAIMS EXPENSE 498 498 MEDICAL WASTE REMOVAL 59 59 17 17 264750 78118 186632 0 1663 36980 200450 767467 190846 12777 14368 178069 216481 982516 0 33901 0 1148964 216481 64401 216481 1247266 X 0 -264750 0 -264750 216481 982516 -264750 0 X X 0 1 X 1 0 X 60767 136138 82403 0 0 279308 60767 136138 82403 279308 0 0 0 279308 2502 940217 942719 63269 136138 1022620 1222027 0.22860 0.29350 0.00000 X 1534 128 1406 116417 11367 105050 72895 1282 71613 178069 DUE TO RELATED PARTY 64401 64401 0 0 0 0 0 264750 0 264750 0 264750 0 1 0 0 0 0 0 1 0 KEITH A MYERS PRESIDENT/CEO 0 1600000 0 1296685 0 246549 0 4876 0 22321 0 3170431 0 0 HONG CHAE SENIOR VICE PRESIDENT/CFO 0 1003347 0 1050 0 59834 0 19842 0 17830 0 1101903 0 0 ALAN SADOWSKY SR. VP OF COMMUNITY-BASED SERVICES 0 441691 0 1050 0 16862 0 27329 0 10098 0 497030 0 0 PART I, LINE 3 MORSELIFE THERAPY CORPORATION'S KEY PERSONNEL ARE EMPLOYED BY MORSELIFE HEALTH SYSTEM, INC., A RELATED 501(C)(3) ORGANIZATION. THE ORGANIZATION USES THE FOLLOWING TO ESTABLISH COMPENSATION FOR MORSELIFE THERAPY CORPORATION'S KEY PERSONNEL: COMPENSATION COMMITTEE; FORM 990 OF OTHER ORGANIZATIONS; WRITTEN EMPLOYMENT CONTRACT; COMPENSATION SURVEY OR STUDY; APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. KEY EXECUTIVE, KEITH MYERS, PARTICIPATES IN THE DEFERRED COMPENSATION PLAN UNDER IRC SEC. 457(F). JOSEPH L. MORSE HEALTH CENTER, INC. MADE CONTRIBUTIONS ON BEHALF OF KEITH MYERS TO THE PLAN IN THE AMOUNT OF $49,343 FOR THE YEAR ENDED DECEMBER 31, 2018. JOSEPH L. MORSE HEALTH CENTER, INC. MADE CONTRIBUTIONS ON BEHALF OF THE FOLLOWING LISTED EMPLOYEES THAT PARTICIPATED IN THE DEFERRED COMPENSATION PLAN UNDER IRC SEC. 457(B). CHAE, HONG - $10,842. MYERS, KEITH - $4,876. PART I, LINE 4B MORSELIFE HEALTH SYSTEM, INC. MAINTAINS TWO NONQUALIFIED EMPLOYEE DEFERRED COMPENSATION PLANS OPEN TO CERTAIN KEY EMPLOYEES UNDER INTERNAL REVENUE CODE 457(B) AND SECTION 457(F) (COLLECTIVELY, THE 457 PLANS). THE 457 PLANS PROVIDE, AMONG OTHER THINGS, FOR VOLUNTARY CONTRIBUTIONS TO BE MADE BY ELIGIBLE PARTICIPANTS. THESE FUNDS REMAIN THE PROPERTY OF MORSELIFE HEALTH SYSTEM, INC. AND SUBSIDIARIES. MORSELIFE HEALTH SYSTEM, INC. AND SUBSIDIARIES HAVE A FIDUCIARY DUTY OF ACCOUNTABILITY FOR THESE FUNDS. PART I, LINE 7 KEITH MYERS, PRESIDENT AND CEO, HAS AN INCENTIVE/BONUS CLAUSE IN HIS EMPLOYMENT AGREEMENT WITH MORSELIFE HEALTH SYSTEM, INC. (A RELATED ORGANIZATION). THE INCENTIVE/BONUS IS BASED ON INDIVIDUAL PERFORMANCE, AS APPROVED BY THE BOARD OF DIRECTORS. FORM 990, PART III, LINE 2 THE ORGANIZATION IS IN THE PROCESS OF OBTAINING CERTIFICATION TO BECOME A HOSPICE SERVICE PROVIDER. FORM 990, PART III, LINE 3 THE ORGANIZATION HAS CEASED CONDUCTING ITS ITS HOME SKILLED REHABILITATION AND NURSING SERVICES. FORM 990, PART VI, SECTION A, LINE 3 AS OF JANUARY 1, 2019, THE ORGANIZATION ENTERED INTO AN ADDITIONAL MANAGEMENT AND CONSULTANT AGREEMENT WITH A TERM OF 5 YEARS WITH, AMPLIFII MANAGEMENT, LLC ("AMPLIFII"), A MANAGEMENT AND CONSULTING GROUP THAT HAS ENTERED INTO A SIMILAR AGREEMENT WITH THE ORGANIZATION'S AFFILIATES. FORM 990, PART VI, SECTION A, LINE 6 MORSELIFE HOME CARE INC. IS THE SOLE SHAREHOLDER OF THE ORGANIZATION. MORSELIFE HEALTH SYSTEM, INC. IS THE SOLE MEMBER OF MORSELIFE HOME CARE INC. THEREFORE, MORSELIFE HEALTH SYSTEM, INC. IS THE INDIRECT SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE INDIRECT SOLE MEMBER, MORSELIFE HEALTH SYSTEM, INC., SHALL ELECT BOARD MEMBERS AND AT ANY TIME IN ITS SOLE DISCRETION, REMOVE AND NAME A REPLACEMENT FOR ANY BOARD MEMBER. FORM 990, PART VI, SECTION A, LINE 7B MORSELIFE HEALTH SYSTEM, INC. IS THE INDIRECT SOLE MEMBER OF MORSELIFE THERAPY CORPORATION AND, AS SUCH, ELECTS THE BOARD OF DIRECTORS AND HAS ULTIMATE VOTING AND VETO AUTHORITY OVER THE AGENCY'S BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE COMMITTEE, COMPOSED OF THE CHAIRPERSON OF THE BOARD OF DIRECTORS FROM EACH OF THE MORSELIFE RELATED ORGANIZATIONS AND THE SENIOR VICE PRESIDENT OF FINANCE, IS RESPONSIBLE FOR THE REVIEW OF THE FORM 990. THE CHAIRPERSON OF MORSELIFE HEALTH SYSTEM, INC. IS THE CHAIRPERSON OF THE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES ALL BOARD MEMBERS TO SUBMIT A CONFLICT OF INTEREST STATEMENT ON AN ANNUAL BASIS. THE STATEMENTS, WHEN COMPLETED AND RETURNED, ARE REVIEWED BY THE PRESIDENT TO ENSURE THAT THERE ARE NO INADVERTENT CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C OVERSIGHT OF AUDIT AND SELECTION OF INDEPENDENT ACCOUNTANT: THE ORGANIZATION'S AUDIT, COMPLIANCE AND ETHICS COMMITTEE IS RESPONSIBLE FOR THE SELECTION, MONITORING AND EVALUATION OF AN INDEPENDENT ACCOUNTING FIRM AND OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS. SCHEDULE A, PART III, SECTION D, LINE 20 AS OF MAY 31, 2019, THE ORGANIZATION IS IN THE PROCESS OF OBTAINING ITS CERTIFICATION AND LICENSE TO BE A HOSPICE SERVICE PROVIDER. AS PART OF THE CERTIFICATION PROCESS, MORSELIFE HOSPICE INSTITUTE, INC. MUST PROVIDE ITS SERVICES WITHOUT CHARGE DURING THE CERTIFICATION PROCESS. THE ORGANIZATION BELIEVES IT WILL OBTAIN ITS CERTIFICATION, ENTITLING IT TO FEDERAL AND STATE REIMBURSEMENTS, IN LATE 2019. MORSELIFE FOUNDATION INC 4847 DAVID S MACK DRIVE WEST PALM BEACH FL 33417 592774476 PROVIDES FUNDING TO AFFILIATED TAX-EXEMPT ENTITIES FL 501(C)(3) LINE 7 MORSELIFE HEALTH SYSTEM INC 0 LOLA & SAUL KRAMER SENIOR SERVICES AGENCY INC 4847 DAVID S MACK DRIVE WEST PALM BEACH FL 33417 900730105 PROVIDES COMMUNITY-BASED SERVICES TO SENIORS FL 501(C)(3) LINE 11 MORSELIFE HEALTH SYSTEM INC 0 NEARLY NEW THRIFT SHOP OF MORSE GERIATRIC INC 4847 DAVID S MACK DRIVE WEST PALM BEACH FL 33417 592533256 RAISES FUNDS TO SUPPORT AFFILIATED TAX-EXEMPT ENTITIES FL 501(C)(3) LINE 12C, III-FI MORSELIFE HEALTH SYSTEM INC 0 MORSELIFE HEALTH SYSTEM INC 4847 DAVID S MACK DRIVE WEST PALM BEACH FL 33417 650018299 PROVIDES HEALTH CARE, HOUSING AND SUPPORT SERVICES TO SENIORS FL 501(C)(3) LINE 12D, III-O N/A 0 FRIENDS OF MORSELIFE INC 4847 DAVID S MACK DRIVE WEST PALM BEACH FL 33417 650329966 RAISES FUNDS TO SUPPORT AFFILIATED TAX-EXEMPT ENTITIES FL 501(C)(3) LINE 7 MORSELIFE HEALTH SYSTEM INC 0 MORSELIFE HOUSING CORPORATION INC 4847 DAVID S MACK DRIVE WEST PALM BEACH FL 33417 650888855 OPERATES A SENIOR LIVING COMMUNITY WITH FULL HEALTH SERVICES FL 501(C)(3) LINE 11 MORSELIFE HEALTH SYSTEM INC 0 MORSELIFE HOME CARE INC 4847 DAVID S MACK DRIVE WEST PALM BEACH FL 33417 592753822 PROVIDES HOME HEALTH AND OTHER SERVICES TO SENIORS FL 501(C)(3) LINE 11 MORSELIFE HEALTH SYSTEM INC 0 JOSEPH L MORSE HEALTH CENTER INC 4847 DAVID S MACK DRIVE WEST PALM BEACH FL 33417 592120896 OWNS AND OPERATES A SKILLED NURSING FACILITY FL 501(C)(3) LINE 11 MORSELIFE HEALTH SYSTEM INC 0 0 0 0 0 1 0 0 0 0 0 1 0 1 1 1 1 0 0 0